ABSTRACT
The care of patients with multidrug-resistant organisms (MDROs) varies in rehabilitation settings. Implementation of strict contact isolation in some facilities may limit patients from reaching their rehabilitation goals. This article describes our rehabilitation and long-term acute care facility's efforts to develop a policy that would enable patients with MDROs to meet their rehabilitation goals within a safe environment. A multidisciplinary team developed a two-track care process allowing staff to quickly identify appropriate activities for these patients. The team also developed educational materials for staff and families, addressed cleaning practices, and standardized the criteria for follow-up cultures and discontinuation of isolation. The MDRO policy was instituted throughout the hospital in August 1999. The incidence of nosocomially acquired MDROs has decreased slightly from the baseline rate of .076 per 100 patient days to .039 per 100 patient days during the 4-month period following the implementation of the policy.
Subject(s)
Cross Infection/drug therapy , Cross Infection/nursing , Drug Resistance, Multiple , Rehabilitation Nursing/standards , Guidelines as Topic , Humans , Quality Assurance, Health Care , Rehabilitation Nursing/organization & administrationABSTRACT
A review of malignant tumors of the thyroid encountered in a noninstitutional, private surgical practice has been presented. Clinical judgment, coupled with radioactive iodine scanning, has given effective diagnostic direction. Subtotal thyroidectomy, as used by our group, has achieved satisfactory results in this relatively small number of malignant tumors of the thyroid gland. Hopefully, this experience has held up satisfactorily under scrutiny and will be meaningful to other surgeons in similar settings.