EH Adopts New Suicide Risk Assessment Tool

Suicide is the 10th leading cause of death in the United States. Patients with suicidal ideation vary widely in their risk for a suicide attempt depending upon whether they have a plan, intent, history of attempts, and other factors. It is important to conduct an in-depth assessment of patients who screen positive for suicide risk […]

Sustained Improvements in Hospital-Acquired C. Difficile Infections

For the past three quarters, we have seen a sustained improvement in the rate of hospital-acquired C. Difficile infections (CDI) at Englewood Hospital. For 2019, our year-to-date standardized infection ratio is 0.457, down from 1.141 from our 2018 rate. In early 2018, a multidisciplinary CDI Prevention Committee was initiated in response to an increase in […]

Coagulation Factor Xa (Andexxa) Now Available on EH’s Pharmacy Formulary

The United States Food and Drug Administration (FDA) recently approved coagulation factor Xa (Andexxa) for the reversal of rivaroxaban (Xarelto) or apixaban (Eliquis) when needed due to life-threatening or uncontrolled bleeding. The drug carries a boxed warning of thromboembolic risks, ischemic risks, cardiac arrest, and sudden deaths. The Englewood Health Pharmacy is making its limited […]

Nurse-driven Telemetry Removal Protocol Now in Effect

As of August 1, the nurse-driven protocol to discontinue telemetry monitoring when the order expires went into effect. Previously, when the order for telemetry monitoring expired, patients remained on telemetry usually until discharged from the hospital. This at times has resulted in a scarcity of telemetry beds (especially on Dean 6 and Dean 7), prolonging […]

Improving Documentation of Major Comorbid Conditions: Encephalopathy

As a follow up to Quality Update: Key Feature of Wave 3 Helps Providers Improve Documentation of Major Comorbid Conditions, let’s review encephalopathy. Encephalopathy is any diffuse disease of the brain that alters brain function or structure. It can be acute or chronic. Acute encephalopathy is reversible and resolves when the underlying cause is corrected. It […]

Antibiotic Resistance: What We All Can Do to Address This Global Health Threat

By Deirdre Minihan, PharmD, BCPS Clinical Coordinator for Infectious Diseases, Pharmacy Dept. Last month’s Infection Prevention Update provided an overview of antibiotic stewardship—a comprehensive antimicrobial management program to improve patient outcomes from infection, minimize adverse effects such as healthcare-associated infections, and limit bacterial resistance. Between 20 and 50% of all antibiotics prescribed in U.S. acute […]

Precautions and Personal Protective Equipment (PPE)

Fundamental infection prevention principles include the use of Standard and Transmission-Based Precautions. Standard Precautions represent the minimum infection prevention measures for all patient care, regardless of the patient’s infection status. These evidence-based practices—meant to prevent the spread of infections among patients and protect healthcare personnel—include: hand hygiene the use of personal protective equipment (e.g. gowns, […]

Midline Catheters Now Available at Englewood as Alternative to PICC

Midline catheters are a more secure peripheral alternative for patients who require venous access for up to 30 days. Midlines are longer peripheral IVs inserted by an interventional radiologist under ultrasound guidance and can be used for blood draws, medications, and intravenous fluids. TPN, vasopressors, and chemotherapeutics are generally not used with a midline. Benefits […]

Lab Updates: HIV, APTT, and Hepatitis A Tests

HIV 1/2 Antibody Screen Algorithm The laboratory has implemented a new algorithm for HIV 1/2 antibody screen. Any primary antibody reactive screen will undergo the secondary HIV antibody screen. If both screens are reactive, the likelihood of HIV infection is high and the specimen will be sent out for confirmatory testing. If the two screening […]

Correctly Coding Healthcare-Associated Pneumonia

As a follow up to Quality Update: Key Feature of Wave 3 Helps Providers Improve Documentation of Major Comorbid Conditions, let’s review healthcare-associated pneumonia (HCAP). HCAP requires specificity to be accurately coded. HCAP is considered to be one of the following types of pneumonia: Gram-Negative Pneumonia: E.Coli, Klebsiella, Proteus, Pseudomonas, Enterobacter and others Staphylococcal ( MRSA/MSSA) […]