Is it Time to Move Beyond CLABSI?

When it comes to infection control in vascular access, central line-associated bloodstream infections (CLABSIs) certainly get the most attention. Yet the medical community is increasingly recognizing how infections associated with other types of vascular access devices are putting patients at risk.

Take peripheral IV (PIV) catheters, the most commonly used type of vascular access device. Nearly 90 percent of hospitalized patients require a PIV at some point during their stay, and PIV usage far outnumbers that of central vascular access devices (CVAD). PIVs, therefore, account for an infection rate that approaches the CVAD infection rate in absolute terms.

Yet there is currently no mandatory reporting system for bloodstream infections associated with PIVs in the U.S., making it one of the most underreported types of infections in vascular access. Epidemiologist Robert Garcia, an infection preventionist with 40 years of hospital experience, shares these concerns — and he has a plan to address this significant patient safety issue.

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2021 INS Standards Highlight Anti-Reflux Technology for Needleless Connectors

Guest post by Nancy Moureau, RN, PhD, CEO of PICC Excellence

In vascular access, needleless connectors (NC) are now recommended worldwide to maintain closed IV systems and promote safety by preventing needlestick injuries. Over the past 25 years, many different NCs have come onto the market, with wide variations in design and function among the various types. As a result, there is a lot of confusion among clinicians regarding the proper use and management of these small yet complex devices, which can have serious patient safety implications.

Fortunately, the Infusion Nurses Society provides some clarity on this issue by significantly expanding its guidance on NCs in the 2021 Infusion Therapy Standards of Practice. This includes clearer definitions of the various types of NC technology and emphasizes the importance of understanding how to use each type properly to minimize blood reflux.

Many clinicians are not aware of the impact blood reflux can have, or view it as a minor issue that can be easily addressed with proper flushing. However, evidence is mounting that reflux is largely avoidable and leads to many complications that seriously impact patient safety.

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UGPIV Practices: Are they jeopardizing patient safety?

A new continuing education program details how a lack of standardized policies related to ultrasound-guided peripheral IV (UGPIV) catheter insertions can negatively impact patient safety. The webinar also suggests UGPIV performance improvement initiatives that “can help to create a culture of safety across the healthcare continuum,” according to presenter Nancy Moureau, RN, PhD, an internationally recognized expert and consultant in vascular access and CEO of PICC Excellence.

The on-demand webcast, Patient Safety and Ultrasound-Guided Peripheral IV Placement: The Need for Standardized Practices, offers 1 contact hour of continuing education for nurses. It is sponsored by Parker Laboratories.

“While the use of ultrasound guidance to improve success during PIV catheter placements is becoming more common, suboptimal aseptic technique and variations in supply usage poses a very serious risk to patients,” said Dr. Moureau. “To increase safety during UGPIV insertions, healthcare organizations should adopt a multidisciplinary approach to standardize policies and procedures based on current evidence and recommendations, while at the same identifying opportunities for pragmatic, incremental improvements.”

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The Future of Breast Cancer Treatment: Destroying Tumors with a Laser

Breast cancer patients have long been in need of reliable therapeutic options that reduce pain and the risk of disfigurement. At the forthcoming MedTech conference of the Advanced Medical Technology Association (AdvaMed, Washington, DC), laser therapy specialist Novian Health Inc (Chicago) will showcase a novel technology for the ablation of early-stage breast tumors. The company’s CE-marked system is seeking to displace existing surgical procedures as the treatment of choice for early-stage breast tumors.

Every year, more than 275,000 women in the United States and 2 million around the world receive the dreaded diagnosis of breast cancer. The news can be overwhelming, triggering sudden and intense emotions. One participant in a study of patient responses to a breast cancer diagnosis said she felt “paralyzed and frozen with fear.”

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D&D remembers Regis Philbin

While this post is a departure from our usual medicine-focused content, we at D&D wanted to acknowledge the recent passing of Regis Philbin. A few members of our staff were fortunate enough to meet Regis during his 88 years on earth — their reminiscences are below.

From Greg Dennis, retired co-founder of Dowling & Dennis:

Regis Philbin had a son who was confined to a wheelchair and relied upon a small piece of technology made by a large medical company. As it happened, Dowling & Dennis did some PR consulting work for that company.

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COVID-19 and the Importance of Virtual Learning: The Future of Medical Education

When the novel coronavirus began sweeping around the world earlier this year, it left doctors, hospitals and public health experts scrambling for answers. How should diagnoses of COVID-19 cases be made? What are the symptoms that need the most careful monitoring? What are the right treatment options for each stage of the disease? And what happens if patients have other conditions, such as being pregnant? The answers were—and continue to be—evolving so rapidly that it has been hard for overworked physicians, nurses and other healthcare providers to keep up.

But there is one place they can turn quickly for the latest information—a free online training module from a medical education company called CaseNetwork. First released on March 17, this program also illustrates the growing potential of virtual, case-based medical education even long after the pandemic has subsided.

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Using Liquid Biopsy to Capture Circulating Multiple Myeloma Cells: The Key to Personalized Treatment?

What if you could isolate a single cancer cell from a patient and use its genetic makeup to create a personalized treatment plan optimized for that individual?

That’s exactly what Menarini Silicon Biosystems Inc. (MSB) hopes its technology could one day do for people with multiple myeloma.

Multiple myeloma is the most common hematological malignancy.  It forms in plasma cells, white blood cells found mainly in the bone marrow that protect the body from infection by producing antibodies. When these cells become malignant, abnormal plasma cells accumulate in the bone marrow, producing abnormal antibodies and crowding out normal blood-forming cells. Some of these abnormal cells, known as circulating multiple myeloma cells (CMMC), escape from the primary tumor space and travel through the bloodstream.

Current approaches for diagnosing patients with multiple myeloma require bone marrow aspiration and biopsy. These are invasive procedures that use a hollow needle inserted into the hipbone or breastbone to remove bone marrow, blood, and a small piece of bone. While generally safe, bone marrow exams can result in excessive bleeding, infection, and long-lasting discomfort.

Liquid biopsies, on the other hand, examine cancer-related material from a peripheral blood sample obtained from a simple, common blood draw. MSB has developed a method for enumerating CMMC from liquid biopsies using CELLSEARCH® and DEPArray™ technologies.

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Transforming IV Therapy: Using the Right Approach to Get the Right Result

 

The IV Therapy Services team at Hartford Hospital was recognized as the 2019 Clinical Team of the Year for their remarkable work in improving IV care for patients.

Patients hate needles.

This basic fact makes IV therapy a pressing healthcare issue affecting nearly every specialty, according to Lee Steere, RN, CRNI, VA-BC, Manager of IV Therapy Services at Hartford Hospital – especially when you consider that nearly 90 percent of hospitalized patients will require a peripheral IV (PIV) catheter at some point during their stay.

In the United States, PIV failure rates average around 53%, meaning one out of every two catheters fail to last until the end of treatment. This could be the reason that needle sticks are among the top ten patient fears, according to a national survey of hospitalized patients.

“Patients seeking care at healthcare facilities receive too many needle sticks,” Steere said. “My passion is to achieve the goal of one PIV per patient which entails getting an IV inserted on the first attempt and lasting until the prescribed treatment is complete.” Continue reading “Transforming IV Therapy: Using the Right Approach to Get the Right Result”

From Reconstruction to Going Flat – Helping Women Look & Feel Better After Breast Cancer with Oncoplastic Surgery

Barry Rosen, MD, Guest Contributor

Barry-Rosen-OR-photo-1.jpgRecovery from breast cancer can be a difficult journey, both physically and emotionally. An important part of recovery from the trauma of cancer diagnosis is to be able to put the entire experience in the rear view mirror, so to speak. But it’s hard to do that if you have a daily reminder in the form of a disfiguring scar.

It was once common for surgeons to focus solely on removing a breast cancer tumor with little regard for the appearance of the breast. But we now know we can deliver excellent cosmetic outcomes without compromising oncologic safety. There have been tremendous advances in the past 20 years in the diagnosis and treatment of breast cancer that enable us to help our patients look and feel better after breast cancer.

One of these important advances is oncoplastic surgery (OPS). Though popular in Europe for several decades, it’s only begun to gain traction in the United States within the last 10 years. OPS combines breast surgery with plastic and reconstructive techniques to achieve the best possible cosmetic outcomes without compromising cancer care. It can be as simple as closing the cavity and hiding the scar, or performing a more complex procedure like a breast lift or reduction in conjunction with removing the tumor. Continue reading “From Reconstruction to Going Flat – Helping Women Look & Feel Better After Breast Cancer with Oncoplastic Surgery”

Following the (Investment) Money in Medical Devices

It will come as no surprise to medical device startups that the funding climate in medical devices is still challenging. We talked recently with two experts who come to this question with two different perspectives.

– Alice McKeon is VP Healthcare Investment Banking at Network 1 Financial, which is based in Red Bank, N.J.

– Dan Clark is a Cofounder and the Chief Marketing Officer at Linear Health Sciences, makers of the Orchid Safety Release Valve.

The power and policies emanating from Washington DC are on the minds of many people these days. How will the Trump Administration affect the investment climate in medical devices?Wall Street Bull image

“The short answer is, no one really knows,” McKeon said. It’s unclear what will happen to the Affordable Care Act (Obamacare). That in turn raises questions in potential investors’ minds. Continue reading “Following the (Investment) Money in Medical Devices”