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Volume 11, Issue 10 | October 2011
Diagnosing and Preventing Clinical Dehydration in Geriatric Patients
Dehydration refers to intracellular volume depletion and correlates well with an increased serum osmolality. Intravascular volume depletion correlates well with an increased BUN-to-creatinine ratio (in patient’s without renal disease) or an increased serum sodium. Clinical dehydration is difficult to diagnose because there has been confusion over what is actually meant by dehydration. “Physicians may use the term dehydration incorrectly to signify water loss in either the intracellular or extracellular [which includes the intravascular space] compartments.”
Anti-Coagulation Therapy: Preventing Drug-Food/Interactions
National Patient Safety Goal NPSG.03.05.01, EP 4, requires organizations to use authoritative resources to manage potential food and drug interactions for residents/patients receiving the anticoagulant warfarin. EP 7 of that requirement states that organizations should provide education to staff, prescribers, residents/patients, and families. Such education should address known drug-food interactions as well as potential interactions between anticoagulants and other drugs, potential adverse drug reactions, and the importance of follow-up monitoring. Health care organizations that dispense or administer anticoagulant medications can help prevent medication errors caused by food-drug interactions by managing the diets of patients who take anticoagulants. Such organizations can help those patients self-manage their medications by educating them on what foods to avoid.
Educating Staff about MDROs
The Centers for Disease Control and Prevention (CDC) defines MDROs as “microorganisms, predominantly bacteria, that are resistant to one or more classes of antimicrobial agents.” MDROs include, but are not limited to, MRSA, Clostridium difficile, vancomycin-resistant enterococci, and multidrug-resistant gram negative bacteria. Due to their resistance to treatment, MDROs are associated with increased morbidity, length of stay, costs, and mortality.
National Patient Safety Goal NPSG.07.03.01, element of performance (EP) 2, requires hospitals and critical access hospitals to educate staff and licensed independent practitioners (LIPs) about health care associated–infections (HAIs), MDROs, and prevention strategies upon hire and annually thereafter.This education should be based on the results