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presented by Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN
Financial - Lisa Gorski receives compensation from MedBridge for the production of this course. She also receives compensation from BD Medical, Genentech, ivWatch, and Saxe Communications. Nonfinancial - Lisa Gorski is a Chairperson, Infusion Nurses Certification Corporation and Infusion Nurses Society Standards of Practice Committee.
Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.
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Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN
Lisa A. Gorski, MS, RN, HHCNS-BC, CRNI, FAAN, has worked for more than 30 years as a clinical nurse specialist (CNS) for Wheaton Franciscan Home Health & Hospice, now part of Ascension at Home in Milwaukee, Wisconsin. As a CNS, she has developed and oversees the home infusion therapy program, provides staff education, and is…
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1. The Big Picture: Understanding Antimicrobial Resistance and Antibiotic Stewardship
Improving the use of antibiotics is a critical patient safety issue, as exposure to antibiotics is associated with adverse reactions, alterations of the patient’s bacterial population, and antimicrobial resistance. Antimicrobial resistance leads to higher mortality rates, increased length of hospital stays, and higher cost of treatment. In the chapter, the problem of antimicrobial resistance is explored, including specific urgent, serious, and concerning antimicrobial resistance threats. Clostridium difficile infections, including risk factors, transmission, and patient education, are highlighted in this chapter.
2. Antimicrobial Stewardship and the Home Care Clinician
The Centers for Disease Control and Prevention (CDC) identify four core actions aimed at the prevention of antimicrobial resistance: infection prevention activities, the identification and tracking of infections, antimicrobial stewardship, and the development of new drugs and diagnostics. In the chapter, the focus is on the role of antimicrobial stewardship by the home care clinician. A case example is used to demonstrate the clinician’s role.
3. Additional Infection Prevention Strategies: Vaccination and Aseptic Technique
Both pediatric and adult vaccinations are critically important components of infection prevention. The role of the home care clinician is highlighted through the example of influenza vaccination. Because the provision of invasive procedures such as infusion administration, wound care, and urinary catheter management is common in home care, aseptic technique is essential to infection prevention. This concept is defined and explored through the internationally recognized framework of Aseptic Non Touch Technique. Setting up for common procedures is demonstrated in this chapter.
4. Infections and Sepsis: Recognition and Actions
While this series of presentations has focused on prevention of infections, the reality is that infections in home care patients do occur, and signs and symptoms must be recognized. Furthermore, home care patients may be at risk for the life-threatening complication of sepsis. Many home care patients are at increased risk for sepsis, and 85% of sepsis cases happen in the community. Sepsis is a medical emergency, and home care clinicians must recognize its presentation and act appropriately. This chapter includes a case example to demonstrate an at-risk patient.
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