Ask a nurse, and other news

Your article “Nurses in Charge” (Dec. 6, p. 28) shines a much-needed light on the contributions nurses can make to quality improvement at hospitals that recognize their insights and passion. Beyond the inspiring examples mentioned in your piece, nurses can also lead initiatives in highly scientific, critical areas such as infection control—as our experience at Broward Health Coral Springs (Fla.) Medical Center has shown. We were having trouble in further reducing our rate of central line-associated bloodstream infections (CLABSIs), despite prodigious efforts to do so. The leadership of our regional manager of epidemiology, Ava Dobin, a registered nurse, helped save the day. Under Dobin's guidance, we implemented a well-designed new protocol that has nearly eliminated CLABSIs at our institution. There has been only one in eight months, a rare occurrence at any U.S. hospital. Because Dobin understood nursing behavior, she believed that our protocol for manually disinfecting the tops and threads of intravenous needleless connectors was at the heart of the problem. She encouraged us to trial an engineered disinfection cap to replace the manual protocol between line accesses. This made compliance verification as simple as observing that the cap is in place. Except for one, CLABSIs have disappeared, and the new best practice has helped us achieve cost savings too. It was nursing knowledge and leadership that led to this success.

Drew Grossman

Concerning “Bishop says Ariz. hospital no longer a Catholic facility,” (ModernHealthcare.com, Dec. 21): While it appears that Bishop Olmsted made a questionable decision to strip a hospital of its “Catholic” label and denigrate the values of the medical staff on hand at the time treatment was rendered, I must hesitate from final judgment and ask: Are we missing something in this news report? The fetus was 11 weeks old and allegedly threatened the life of a mother of four. Are there reasonable clinicians out there who would suggest that there was time to treat the medical condition of the mother and thus save the life of mother and baby? Others would have to weigh in on that issue before we rush to judge Olmsted as an archaic and self-serving relic, or agree with Olmsted that the decision to abort the fetus and Catholic ethics might have been based on “materially burdensome” factors—something suggested by the equity group in Boston when questioned as to its intent to carry on Catholic ethical traditions.

Brian Shea

Regarding “EHR reimbursement registration opens Jan. 3,” ModernHealthcare.com, Dec. 23): Getting the correct information out to providers is critically important given some of the misinformation being distributed by electronic health-record vendors who are behind in delivering meaningful use. What is particularly important in this article are the links the author has provided to validate his information. For those providers who are serving the Medicaid community (bless them), although they know each state program is administered separately, when they hear that the CMS is receiving registrations from hospitals and individual providers, they jump to the conclusion that this automatically includes them, which is simply not the case. Succinct and clear information.

Michael Glass