Purpose
Buttonhole cannulation technique has gained acceptance in hemodialysis, as it was thought to reduce aneurysms in the arteriovenous fistula and decrease pain to the patient. These supposed benefits would, however, be invalid if this technique were to cause more infections than the typical rope-ladder cannulation technique. Infections related to cannulations sites can quickly become systemic and cause sepsis in the immunocompromised dialysis patient population. Our goal was to determine which method of cannulation causes more infections (Labriola, et al., 2011).
Review of Evidence
The buttonhole cannulation technique in chronic hemodialysis, when related to the rope ladder technique shows evidence to be associated with a significant increased
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
Bob Probert was a 45 year old man with 4 kids and a wife when he passed away from CTE. He drank, did drugs, and was a womanizer but he didn’t want his kids to find out. He knew they eventually would though and he said that when they did find out, he wanted it to be “straight from the source” (1.). He used to snort cocaine. Once when he was caught while smuggling drugs over the Detroit-Windsor border, he dumped it in the toilet. The first time he tried cocaine was in 1983. It was post-game and before long he was buying an ounce a week which was $800 so it was about $42,000 a year. His work permit was revoked by the US government. He met his wife in Relax Plaza in Windsor and even after he was caught on the border she still stayed with him. To pass drug tests, he would microwave his urine so it would come up clean.
Hemodialysis is the process of blood that is transported outside the body to a dialysis machine where it is cleaned of waste products and returned to the circulatory system. It is a lifetime requirement. As a result, of the repeated and life-long needle puncture of the involved blood vessels, thick scar tissue eventually develops which makes the procedure difficult and painful. To avoid this complication, a surgical procedure known as an arteriovenous fistula is performed. It produces a large vein that can be entered safely and easily with large needles for the three times a week procedure. New techniques are intended to improve the efficiency of dialysis and thereby increases life expectancy, as 20% of people with end-stage renal disease die annually. Peritoneal Dialysis. Peritoneum is the lining of the abdominal cavity. The tissue has the properties of a semi-permeable membrane, allowing the process of diffusion to take place in abdominal cavity. An incision is made through the anterior abdominal muscle wall; through this opening, a tube (catheter) is inserted into the abdominal space. Sterile dialysate (a solution to clear waste products) is introduced and allowed to remain in the cavity four to six hours or overnight. During this time, through the process of diffusion, impurities pass through the peritoneum into the dialysate. The dialysate and its collected impurities are then eliminated from the body. Kidney transplantation when possible, is the best alternative for end stage renal disease. Often, the body rejects the kidney and when this occurs the recipient must undergo a medication regimen to suppress the immune system. Relatives are recommended to donate their liver so that the body has a smaller chance to reject the kidney. I comparison with dialysis kidney transplantation has advantages that positively affect the person’s medical and vocational rehabilitation potential. The person with the
2013). Inappropriate use of urinary catheter in patients as stated by the CDC includes patients with incontinence, obtaining urine for culture, or other diagnostic tests when the patient can voluntarily void, and prolonged use after surgery without proper indications. Strategies used focused on initiating restrictions on catheter placement. Development of protocols that restrict catheter placement can serve as a constant reminder for providers about the correct use of catheters and provide alternatives to indwelling catheter use (Meddings et al. 2013). Alternatives to indwelling catheter includes condom catheter, or intermittent straight catheterization. One of the protocols used in this study are urinary retention protocols. This protocol integrates the use of a portable bladder ultrasound to verify urinary retention prior to catheterization. In addition, it recommends using intermittent catheterization to solve temporary issues rather than using indwelling catheters. Indwelling catheters are usually in for a longer period. As a result of that, patients are more at risk of developing infections. Use of portable bladder ultrasound will help to prevent unnecessary use of indwelling catheters; therefore, preventing
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
Ms. Bardsley functions as a hemodialysis liaison and leader in clinical practice with the following roles: charge nurse, preceptor, and mentor for her colleagues. She is the resource person for the Hct-Line monitoring tool. The tool is used to monitor patient’s fluid removal during treatment to avoid hypotensive episodes associated with decreased perfusion to the heart. She routinely monitors the patient outcomes which to date has resulted in 0 admissions. She recently updated the policy to make it more user friendly for the staff and to maintain staff competency.
After further multidisciplinary team meetings with the involvement of John the treatment option of automated peritoneal dialysis was implemented (NSF 2004). Once the Tenchkoff catheter had been inserted, education and training completed John was ready for discharge home.
(2)Saudan,P.,Niederberger,M.,De Seigneux,S.,Romand,J.,Pugin,J.,Pernrger,T.,& Martin,P.Y(2006).Adding a dialysis dose to continuous hemofiltration increases survival in patients with acute renal failure .Kidney international,70(7),1312-1317.
Quinan, P. (2007). Control and coping for individuals with end stage renal disease on hemodialysis: A position paper. CANNT Journal, 17(3), 77-84.
For this experiment, it is important to be familiar with the diving reflex. The diving reflex is found in all mammals and is mainly focused with the preservation of oxygen. The diving reflex refers to an animal surviving underwater without oxygen. They survive longer underwater than on dry land. In order for animals to remain under water for a longer period of time, they use their stored oxygen, decrease oxygen consumption, use anaerobic metabolism, as well as aquatic respiration (Usenko 2017). As stated by Michael Panneton, the size of oxygen stores in animals will also limit aerobic dive capacity (Panneton 2013). The temperature of the water also plays a role. The colder the water is, the larger the diving reflex of oxygen.
Hemodialysis is a procedure that cleans and filters your blood. It rids your body of harmful wastes and extra salt and fluids. It also controls blood pressure and helps your body keep the proper balance of chemicals such as potassium, sodium, and chloride.
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
As Burns and Grove (2001) & Polit and Hungler (1997) as cited in Ingham-Broomfield (2008 p.104) mentioned that the primary purpose of the literature review is to discuss what is known, gain broad background and understanding of the available information related to the study. As Coughlan, Cronin, and Ryan (2007) stated that literature review should also help to identify any gaps in the literature relating to the problem and suggest how those gaps might be filled. The authors of this article has not provided any review of literature and this could misinform the reader what the main focus of the study; however, several appropriate references were used in the background. The terms used in the key concepts are adequately defined and consistent with the topic. The background of the study introduces the previous knowledge or what is already known which is to investigate the effectiveness of an ATP designed to help ESRD patients to cope with stressors while receiving haemodialysis treatment.
In the beginning, Maytag was extremely competitive and popular. The company made its mark as the high quality, high price home laundry appliance maker. They were successful with making themselves leader in washing machines. As time passed, Maytag began to lose their competitive advantage. Maytag was slow to develop new innovations and models which cost the company to lose its leadership of the industry. This loss was very hard to recover from due to new competitors beginning to arise in this industry.
Chronic Kidney Disease. Mayo Foundation for Medical Education and Research, 2014. Web. 20 May 2014.