Sunday, July 10, 2022

Combating Clostridium difficile at Home

 


One Hospital's Success and How It Can Help Caregivers

When a 410-bed hospital in Atlanta, Georgia, faced a high rate of hospital-acquired C difficile infections (HO CDI), it decided to tackle the problem head on. Emory Saint Joseph’s Hospital leadership assembled a diverse team of professionals to develop strategies to combat HO CDI in its facility.

Clostridium difficile is a bacteria spread by the oral-fecal route. Antibiotic use raises the risk, particularly in vulnerable and older patients. It strikes approximately half a million people each year. Though usually considered an infection acquired in hospital settings, the team discovered that many patients already had C diff upon admission, underscoring its risk in the community setting.

After investigating the causes of the hospital’s cases between 2014-2016, the team developed the following infection prevention interventions:

*Better diagnostic stewardship. Nurses were allowed to test any loose, unformed stools within the first three days of admission.

*Enhanced environmental cleaning. A more effective sporicidal disinfectant was incorporated in the daily cleaning routine for ALL rooms, not just isolation rooms.

*More judicious use of antimicrobials for infection. Medications called fluoroquinolones were removed from standalone orders and only given when approved through certain channels. Medicines in this category raise the risk of contracting Clostridium difficile.

*Education of staff. The team incorporated training with enhanced communication to bring the best practices for infection control to the forefront.

*Accountability. Staff meetings were held to increase compliance with the new measures.

One year after incorporating these changes, infection rates had dropped 63%. After three years, infection rates had dropped 77%.

The team found the single most effective infection control intervention was handwashing. Simple, thorough washing with water and soap. Alcohol hand gels are not effective.

How can this help patients and their caregivers at home?

Besides the obvious benefit of clinical infection control for its inpatients, caregivers can learn from and incorporate some of this hospital's interventions at home.

This study clearly showed that C diff is a community problem, as well as an institutional one. As obvious as it might seem, the most important things we can do for our loved ones are often the simple ones.

*Wash our hands often and well. Use soap and warm water. Rinse thoroughly. Keep a roll of paper towels at each sink and use them instead of one household towel to dry. Sure, this costs money, but it’s a small price to stop the spread of disease.

*Keep the home clean. This boosts both our emotional and physical well-being. Not all cleaning products kill C diff but can help with general infection control. If you have C diff infection, do your research to find a home-approved product that kills their spores.

*Discuss the administration of fluoroquinolones with the medical provider and resist their over-prescription if C diff has been a problem. Have a respectful conversation and get the necessary answers to your questions. 

You, as a caregiver, are the most important member of the healthcare team caring for your loved one. You are the first-line of defense against infection. Your efforts to give your loved one quality care are not just necessary. They’re vital. Never feel you are “just” the caregiver. Your concerns, questions, and observations are critical to providing the best care possible for your family.

This article is for general information only and not meant to take the place of regular medical care or a physician's advice.

Study information gleaned from an original article in the American Journal of Infection Control, as presented on Medscape.org.

Friday, January 14, 2022

Finding Joy in the Journey

 



The caregiver's life often offers precious little opportunity for respite and interaction with others. The pandemic has made this especially challenging, since infection control involves social distancing when your loved one is vulnerable to illness. This isolates us from the usual activities and support systems we employ to help us survive and thrive in our circumstances. 

Caregivers are resourceful, though. 

We're adept at adapting to change.

At our house, we learned to make home our vacation destination. Before our son Kevin's spinal cord injury in 1997, we loved our frequent family trips, and we especially enjoyed the National Parks. One of my husband's favorite places to visit was Yellowstone National Park. 

When we became full-time caregivers, our traveling stopped. We adapted by opening our home to friends and family. Over the years, we hosted many barbecues, dinners, holiday celebrations, and themed birthday parties. If we couldn't go have fun, we brought the fun to us.

Then a pandemic hit town and my back gave out. Life drastically changed for us in the last few years. Our outside activities now mostly consist of grocery and take-out runs. Trips are not an option. I can't even throw myself into my gardening like I used to. 

But life has to be more than survival. 

Last year, feeling nostalgic for our old haunts, I invited my husband along on a "roadtrip" through the National Parks as we work together on puzzles of our favorite haunts. He liked the idea, so we set up a cozy corner of our living room with a rustic table, stools, and warm Edison lights. 


Kevin loved the idea and surprised us with a beautiful hardcover coffee table book of the National Parks to enrich our journey. Since then, this corner has become our ticket to relive some of our happiest family memories as we travel from park to park and city to city. Whether it's hiking around Glacier Park, admiring the Redwoods, or watching Old Faithful spew, we can enjoy the beauty of our world without leaving the comfort of our living room. 

When we're not on a trip, the corner serves as a place to "eat out" or play a game of checkers. What we do isn't as important as the moments we spend together. 

A bonus is the small effort we have to expend in the process. We're always tired. With an inviting corner waiting for us, we're more likely to take advantage of the chance to take a small break together. We also have a couple of tables and chairs in our favorite spots outside to share coffee and "break time," if the weather permits. We discovered that a table under the large trellis on the back deck served as a pleasant outdoor "cafe" where we shared dessert or a plate of cheese and crackers. Often we only had time for a cup of coffee. 

The important thing, we learned, is to make the world stop for a moment, so we can just be...alive. Together.

When things are going well, it's easy to take the small joys for granted. When life is hard, it's crucial to find the joy where we live.

Maybe puzzles and board games aren't your thing. What could you do to bring more joy into your caregiving experience? What could you change to make your world a more welcome place to live?

If you've already been doing this for some time, we'd love to hear your ideas. What has worked for you? 



 








Saturday, November 20, 2021

Keep Yourself and Your Family Safe from Salmonella

 


The Centers for Disease Control and Prevention (CDC) recently completed an investigation into the spread of salmonella from backyard poultry. This year, salmonella sickened 1,135 people in forty-eight states, the District of Columbia, and Puerto Rico. Nearly three hundred people were hospitalized, and two lost their lives. 

In recent years, having a backyard barnyard has become increasingly popular. Chickens, especially, are pets for many families. As fun as it can be to have chickens, ducks, turkeys, and even songbirds in your yard, it's important to remember that they harbor germs like salmonella. 

Salmonella causes fever, cramps, diarrhea (including bloody diarrhea), vomiting and dehydration. Although most people recover after five to seven days, some require hospitalization.  The elderly and those with a lowered immune system may be especially vulnerable. 

People get it by handling or snuggling with the poultry and then ingesting the germs. Below are a few pointers to staying healthy as you enjoy your backyard barnyard:

Do not let poultry into the home.

Resist the urge to kiss your pet hen.

Supervise children around the poultry and teach them safe handling of their pets.

Have a special pair of shoes to wear into the coop or pen. 

Wash you hands after holding poultry. 

Sanitize pet areas and feeders regularly.

Handle eggs safely. 


You can find more information on safe handling of poultry here:

https://www.cdc.gov/salmonella/backyardpoultry-05-21/index.html

Saturday, July 31, 2021

Leaked Internal CDC Document Uncovers New Worries



On July 30, 2021, The Washington Post reported a leaked internal CDC presentation that described troubling news about vaccination and the new Delta coronavirus variant. The document included information gleaned from sources and outbreak studies, including one from a recent outbreak in Barnstable County, Massachusetts. 

It was discovered about 75% of the Delta cases in that cluster occurred in previously vaccinated individuals. Those who had been vaccinated were found to carry a similar amount of viral load as the unvaccinated and capable of spreading the disease as easily. This prompted the recent CDC reversal of previous guidance releasing vaccinated people from wearing a mask indoors. 

Currently, an estimated 35,000 vaccinated people develop symptomatic infections of COVID-19 in America each week.

The study concluded the Delta variant is very contagious and possibly more deadly than the previous strains. Cases among the vaccinated are considered as contagious as those in unvaccinated individuals. It is still believed the risk of infection and death to be lower in those who are vaccinated.

The presentation offered the consideration of such strategies such as vaccine mandates for health care providers and universal masking to mitigate the resurgence of the disease.

Source: https://www.washingtonpost.com/context/cdc-breakthrough-infections/94390e3a-5e45-44a5-ac40-2744e4e25f2e

Wednesday, July 21, 2021

Incomparable

"But we have this treasure in earthen vessels, so that the surpassing greatness of the power will be of God and not from ourselves." 2 Corinthians 4:7
               God can use broken instruments to make incomparable music.

                                                      - Joni Eareckson Tada 

In A Place of Healing, quadriplegic artist and disability advocate Joni Eareckson Tada tells a story about famed violinist Yitzhak Perlman.
Disabled at a young age by polio, Perlman made a point of coming onstage by himself with the use of crutches and braces. 

At a concert in 1995, he made his usual painful entrance onto the stage. During his performance, a string broke on his violin. 

An awkward silence fell over the hall. Perlman could not simply walk off the stage for a few moments and replace the string. He stopped, closed his eyes, and thought for a moment. Then he motioned for the conductor to begin again. 

The virtuoso played the entire piece minus one string. He masterfully rewrote the score as he went, innovating with the strings to coax new sounds from his disabled violin. 

The performance was incredible. When it ended, the awestruck audience erupted into thunderous applause. 

Perlman answered their appreciation with these words: "You know, sometimes it is the artist's task to find out how much music you can still make with what you have left." 

My son Kevin dreamed of being a musician from an early age. At age thirteen, he had his own electric guitar. By nineteen, he played on the church worship team and was saving money to attend a discipleship training school that specialized in music ministry. He was playing guitar for a youth ministry outreach in Canada when he broke his neck. 

His fight for life was hard and long. As he recuperated from his injury, we began to realize the depth of the loss he had suffered. Initially paralyzed from the neck down, he eventually regained some feeling and movement in all parts of his body. 

But it wasn't enough for a normal life. Today he can do some things for himself but remains mostly disabled. The tracheostomy tube in his throat makes it hard for him to speak loud enough to be heard. 

Gone forever is his ability to sing and to play an instrument for God. I grieved especially hard over that loss. Many times I questioned God's decision to let that happen. 

I understand better now. 

Each day Kevin awakens to serve his God in trust and surrender. He has created a popular website featuring Christian music that probably reaches more people with the gospel than he would have ever reached with his guitar. 

It's a new score - a powerful performance. Sweet music, indeed. 

Do you ever feel you are broken beyond repair? Has life beaten you up, thrown you down, and threatened to steal the song God put in your heart? 

It's no problem for God. He's a creative genius. He knows exactly how to take what's left of our lives and use them to display His incomparable song of grace. 

In fact, the greatness of His power is magnified when played out on broken instruments. There's no danger someone will think we made the music ourselves, no doubt the Master is in the hall. 

All He asks is that we offer ourselves and prepare to be awestruck. The song of praise we hear will be incomparable. 


Master, I hear the music you play through our broken lives. 
There is no doubt who is in the hall. 
The grace, beauty, and power You display are incomparable. 
Once again, I offer my life to you. Amen.

Excerpted from Out from the Shadows: 31 Devotions for the Weary Caregiver by Pam Thorson.