Evaluation of an inpatient heart failure screening tool.

Heart failure is increasing in incidence, prevalence, and mortality. The purpose of this study was to test the predictive accuracy of a screening tool to identify inpatients with heart failure. The tool demonstrated statistical significance for predictability, with 68.3% sensitivity, 86% specificity, and overall accuracy of 77.5%. The tool facilitated heart failure screening and subsequent implementation of evidence-based therapies.

Cleaned, ready-to-use, reusable electrocardiographic lead wires as a source of pathogenic microorganisms.

BACKGROUND: Cleaned electrocardiographic lead wires are a potential source of microorganisms capable of causing nosocomial infection. OBJECTIVES: To examine fungal and bacterial growth on cleaned reusable lead wires, determine if microbial growth is associated with hospital site or work environment, determine the prevalence of antibiotic-resistant bacteria, and learn if antibiotic-resistant bacteria are associated with hospital site and work environment. METHODS: Cleaned lead wires (N = 320) from critical care and telemetry units, emergency departments, and operating rooms of 4 hospitals were swabbed and the specimens cultured for microbial growth. Bacterial species were grouped by their risk for human infection: at risk (n = 9), potential risk (n = 5), and no risk (n = 10). Work environments were compared by using pairwise contrasts from a generalized estimating equation model. RESULTS: Fungi were rare (0.6%). Of 226 cultures from 201 wires (62.8%) with bacterial growth, 121 were of at- or potential-risk bacteria (37.8%). Urban hospitals had less growth (P ≤ .001) and fewer bacterial species per wire (P ≤ .001) than did community hospitals. Presence of any bacteria (P = .02) and number of bacterial species per wire (P = .002) were lowest in operating rooms; emergency departments and telemetry units had more growth than did critical care units. Among specimens of staphylococci and enterococci, 6 each were sensitive to antibiotics; of 4 resistant staphylococcal species, 1 was not a human opportunistic pathogen and 3 were potential-risk species. CONCLUSIONS: Bacteria are common on reusable, cleaned lead wires and differ by hospital and clinical area.