My name is Korrina and I am the mother of two beautiful twin girls. Lena and Kassie are former 24 weekers. They were born in October 2006 at 24 weeks, 6 days gestation. Lena was 1lb 7oz (647g) and Kassie was 1lb 5oz (600g). Like most preemie moms I do not have joyous memories of the birth of my children and I often feel like I got ripped off (...)
http://bitsandpiecesofme.com/for-parents-of-premature-preemie-babies/
14/02/2009
New ruling in premature baby case
A high court judge gave doctors more discretion yesterday to decide on the treatment of Charlotte Wyatt, the tiny premature baby clinging to life in a hospital oxygen box, after a breakdown in the relationship between the doctors treating her and her parents, Darren and Debbie.
Portsmouth Hospitals NHS Trust won a court ruling last October that doctors need not put the terminally ill baby on a ventilator if her condition deteriorated.
But the trust took the case back to the high court yesterday after repeated disagreements broke out about drugs being given to 14-month-old Charlotte at St Mary's hospital, Portsmouth, to combat infections and ease her chronic lung disease.
Her parents accuse doctors of not doing all they might to keep her alive and have reported them to the police.
Doctors feel so threatened that the hospital has insisted that Mr Wyatt, 33, must be accompanied by a security guard when he visits his daughter.
Mr Justice Hedley, who two months ago ruled that Charlotte should not be subjected to aggressive treatment and should be allowed to die in her parents' arms, said yesterday after a private hearing that the inability of doctors and parents to reach agreement had posed risks for Charlotte.
If the difficulties were not resolved, there would be a further hearing on January 28.
But Mr Wyatt and his 23-year-old wife, of Buckland, Portsmouth, believe there is still a glimmer of hope for their baby, which doctors dispute.
Mr Justice Hedley said: "My immediate task is to make some provision in the meantime, in particular over the holiday period, so that the welfare of Charlotte is not imperilled and the work of the treating clinicians is not seriously impaired."
He said hospital staff had a duty to act in the best interests of the child if there was an emergency and they could not secure an agreement with the parents or contact them.
The judge ordered the hospital to use its "best endeavours" to obtain the parents' consent before embarking on any treatment or exercising any discretion permitted.
The clinicians were allowed to vary the use of drugs and nursing care which had already been agreed for Charlotte.
The judge had heard from paediatric experts at the first hearing that she was not expected to live beyond a further year and was likely to succumb to a respiratory infection this winter.
http://www.guardian.co.uk/society/2004/dec/18/health.medicineandhealth
Portsmouth Hospitals NHS Trust won a court ruling last October that doctors need not put the terminally ill baby on a ventilator if her condition deteriorated.
But the trust took the case back to the high court yesterday after repeated disagreements broke out about drugs being given to 14-month-old Charlotte at St Mary's hospital, Portsmouth, to combat infections and ease her chronic lung disease.
Her parents accuse doctors of not doing all they might to keep her alive and have reported them to the police.
Doctors feel so threatened that the hospital has insisted that Mr Wyatt, 33, must be accompanied by a security guard when he visits his daughter.
Mr Justice Hedley, who two months ago ruled that Charlotte should not be subjected to aggressive treatment and should be allowed to die in her parents' arms, said yesterday after a private hearing that the inability of doctors and parents to reach agreement had posed risks for Charlotte.
If the difficulties were not resolved, there would be a further hearing on January 28.
But Mr Wyatt and his 23-year-old wife, of Buckland, Portsmouth, believe there is still a glimmer of hope for their baby, which doctors dispute.
Mr Justice Hedley said: "My immediate task is to make some provision in the meantime, in particular over the holiday period, so that the welfare of Charlotte is not imperilled and the work of the treating clinicians is not seriously impaired."
He said hospital staff had a duty to act in the best interests of the child if there was an emergency and they could not secure an agreement with the parents or contact them.
The judge ordered the hospital to use its "best endeavours" to obtain the parents' consent before embarking on any treatment or exercising any discretion permitted.
The clinicians were allowed to vary the use of drugs and nursing care which had already been agreed for Charlotte.
The judge had heard from paediatric experts at the first hearing that she was not expected to live beyond a further year and was likely to succumb to a respiratory infection this winter.
http://www.guardian.co.uk/society/2004/dec/18/health.medicineandhealth
12/02/2009
Essentials of the standard precautions to be used in the care of all patients
[http://www.who.int/water_sanitation_health/medicalwaste/148to158.pdf]
A. Hand washing
· Wash hands after touching blood, secretions, excretions and contaminated items, whether or not gloves are worn. · Wash hands immediately after gloves are removed, between patient contacts.
· Use a plain soap for routine hand washing.
· Use an antimicrobial agent for specific circumstances.
B. Gloves
Wear gloves when touching blood, body fluids, secretions, excretions, and contaminated items.
Put on clean gloves just before touching mucous membranes and non-intact skin.
C. Mask, eye protection, face shield
Wear a mask and eye protection or a face shield during procedures and patientcare activities that are likely to generate splashes or sprays of blood, body fluids, secretions, and excretions.
D. Gown
Wear a gown during procedures and patient-care activities that are likely to generate splashes or sprays of blood, body fluids, secretions, or excretions.
E. Patient-care equipment
Ensure that reusable equipment is not used for the care of another patient until it has been cleaned and reprocessed appropriately.
F. Environmental control
Ensure that the hospital has adequate procedures for the routine care, cleaning, and disinfection of environmental surfaces.
G. Linen
Handle used linen, soiled with blood, body fluids, secretions, and excretions in a manner that prevents skin and mucous membrane exposures, and that avoids transfer of microorganisms to other patients and environments.
H. Occupational health and bloodborne pathogens
· Take care to prevent injuries when using needles, scalpels, and other sharp instruments or devices.
· Use ventilation devices as an alternative to mouth-to-mouth resuscitation methods.
I. Place of care of the patient
Place a patient who contaminates the environment or who does not assist in maintaining appropriate hygiene in an isolated (or separate) room.
Hospital infection rates in England out of control
Zosia Kmietowicz/ London [http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1117592]
The NHS in England could save an estimated £150m ($240m) and many hundreds of lives by tightening hygiene rules in hospitals and investing in infection control, according to the spending watchdog the National Audit Office. The money could then be ploughed back into patient care.
At least 100000 cases of hospital acquired infections occur each year in England, with an estimated 5000 deaths, all of which cost the NHS in the region of £1bn annually, states the report.
Better education of staff on the spread of infection, improved surveillance of patients who have had major surgery, and the involvement of senior clinicians and management in the control of infection could reduce this burden by 15%Sir John Bourn, head of the National Audit Office, told parliament.
At any one time 9%of patients in hospital are being treated for an infection they acquired there. Yet one in five trusts do not have an infection control programme, 40%are dissatisfied with their isolation facilities, and 60%have no defined budget.
Despite guidance from the Department of Health that chief executives should take overall responsibility for ensuring effective infection control, there is little evidence of their involvement. More than half were not aware of the resources spent on hospital acquired infection or the number of cases, says the report.
“Hospital infections are a huge problem for the NHS,” said Sir John. “They prolong patients' stay in hospital and, in worst cases, cause permanent disability and even death. By implementing the [National Audit Office's] recommendations, the NHS could make real improvements in the quality of care for patients and free up significant additional resources,” he added.
Among other recommendations, he said that hospitals should join the nosocomial infection national surveillance scheme, which collects statistics on infection rates to allow local comparisons to be made.
More research on appropriate staffing levels is also warranted. In some areas a single infection control nurse is expected to cover over 1000 beds—a number described by the report as “unacceptably high.”
Moreover, despite a recommendation by the Royal College of Pathologists that the ratio of infection control doctors to beds should be 1:1000, only 46 trusts out of the 219 studied by the report reached that standard.
David Davis MP, chairman of the Public Accounts Committee, commented: “There is clear evidence that in many cases investing more in infection control—for example, by funding more infection control nurses—would save both cash and lives. There would also be a dramatic improvement in the quality of care for many other patients.”
The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England is available through the National Audit Office's home page (www.nao.gov.uk).
The NHS in England could save an estimated £150m ($240m) and many hundreds of lives by tightening hygiene rules in hospitals and investing in infection control, according to the spending watchdog the National Audit Office. The money could then be ploughed back into patient care.
At least 100000 cases of hospital acquired infections occur each year in England, with an estimated 5000 deaths, all of which cost the NHS in the region of £1bn annually, states the report.
Better education of staff on the spread of infection, improved surveillance of patients who have had major surgery, and the involvement of senior clinicians and management in the control of infection could reduce this burden by 15%Sir John Bourn, head of the National Audit Office, told parliament.
At any one time 9%of patients in hospital are being treated for an infection they acquired there. Yet one in five trusts do not have an infection control programme, 40%are dissatisfied with their isolation facilities, and 60%have no defined budget.
Despite guidance from the Department of Health that chief executives should take overall responsibility for ensuring effective infection control, there is little evidence of their involvement. More than half were not aware of the resources spent on hospital acquired infection or the number of cases, says the report.
“Hospital infections are a huge problem for the NHS,” said Sir John. “They prolong patients' stay in hospital and, in worst cases, cause permanent disability and even death. By implementing the [National Audit Office's] recommendations, the NHS could make real improvements in the quality of care for patients and free up significant additional resources,” he added.
Among other recommendations, he said that hospitals should join the nosocomial infection national surveillance scheme, which collects statistics on infection rates to allow local comparisons to be made.
More research on appropriate staffing levels is also warranted. In some areas a single infection control nurse is expected to cover over 1000 beds—a number described by the report as “unacceptably high.”
Moreover, despite a recommendation by the Royal College of Pathologists that the ratio of infection control doctors to beds should be 1:1000, only 46 trusts out of the 219 studied by the report reached that standard.
David Davis MP, chairman of the Public Accounts Committee, commented: “There is clear evidence that in many cases investing more in infection control—for example, by funding more infection control nurses—would save both cash and lives. There would also be a dramatic improvement in the quality of care for many other patients.”
The Management and Control of Hospital Acquired Infection in Acute NHS Trusts in England is available through the National Audit Office's home page (www.nao.gov.uk).
BMJ. 2000 February 26; 320(7234): 534.
PMCID: PMC1117592
Copyright © 2000, British Medical Journal
Hospital acquired infections
[http://www.privatehealth.co.uk/private-hospitals/hospital-infections-guide/]
Healthcare-associated infections (HAIs) are one of the most pressing issues facing our health services today. According to the Department of Health 1 in 10 patients acquires a HAI, and those who do contract an infection stay in hospital nearly three times longer than ordinary patients, placing tremendous financial pressure on the already strapped-for-cash health services.
The two hospital acquired infections, known as 'superbugs', posing a particularly serious threat to our hospital wards are MRSA and C. difficile. MRSA stands for methicillin-resistant staphylococcus aureus and is a form of bacteria from the Staphylococcus aureus (SA) family. If SA bacteria get into the body via cuts or wounds they can cause a boil or abscess and more seriously blood poisoning or a heart-valve infection. Clostridium difficile (C. difficile) is a bacterium from the Clostridium family causing diarrhoea and in more serious cases damage to the colon and intestines.
Many experts believe that the misuse of antibiotics has caused the drug-resistant SA infections to occur (if a course of treatment is not finished some of the bacteria can multiply and survive a range of antibiotics) and the high turnover of patients and high bed occupancy rates in our health services compound the problem. Indeed, the Health Protection Agency believes that reducing bed occupancy in NHS hospitals to 85%, or lower, is a crucial move to reduce the incidence of HAIs, but it is a Catch-22 situation as it is difficult to eliminate the superbugs with such a high volume of patients.
Healthcare-associated infections (HAIs) are one of the most pressing issues facing our health services today. According to the Department of Health 1 in 10 patients acquires a HAI, and those who do contract an infection stay in hospital nearly three times longer than ordinary patients, placing tremendous financial pressure on the already strapped-for-cash health services.
The two hospital acquired infections, known as 'superbugs', posing a particularly serious threat to our hospital wards are MRSA and C. difficile. MRSA stands for methicillin-resistant staphylococcus aureus and is a form of bacteria from the Staphylococcus aureus (SA) family. If SA bacteria get into the body via cuts or wounds they can cause a boil or abscess and more seriously blood poisoning or a heart-valve infection. Clostridium difficile (C. difficile) is a bacterium from the Clostridium family causing diarrhoea and in more serious cases damage to the colon and intestines.
Many experts believe that the misuse of antibiotics has caused the drug-resistant SA infections to occur (if a course of treatment is not finished some of the bacteria can multiply and survive a range of antibiotics) and the high turnover of patients and high bed occupancy rates in our health services compound the problem. Indeed, the Health Protection Agency believes that reducing bed occupancy in NHS hospitals to 85%, or lower, is a crucial move to reduce the incidence of HAIs, but it is a Catch-22 situation as it is difficult to eliminate the superbugs with such a high volume of patients.
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