Archive | October 2020

October Month Awareness on Bullying!

Unless you were homeschooled in the wild or have some type of supernatural luck, you’ve probably tangled with a mean girl or bully at some point in your life. Unfortunately, bullies grow up and get jobs, so you might just run into them again in the workplace, on social media or even in your close-knit neighborhood community. Bullying is not just succumbed to childhood but it is also very prevalent in adulthood as well. Unfortunately, adult bullying behavior identically reflects childhood bully behavior: it methodically targets a person with the intention to intimidate, undermine, or degrade. The same tactics get used, too: gossip, sabotage, exclusion, public shaming, and many other conscious behaviors. Many adult victims feel as though they cannot take any action against bullying out of fear they may cause trouble, lose their job or be viewed as weak; however, there are many steps adults can take to discourage bullying and stand up to their perpetrator.

Take the issue seriously and present it in an objective manner

Yes, bullying can be a huge hit to your ego and it can lead to feelings of depression and anxiety however you must report this behavior from an objective standpoint. Whether you are reporting this behavior to school officials, your managers at work or to legal authorities; make sure you have all the facts documented in detail and try not to bring your subjective feelings into the matter. If you feel as though your boss or teacher will not take these complaints seriously then go two or three level higher up the ladder; talk to the school principal or your manager’s boss. Keep it straightforward and low on emotion. Rehearsing your story beforehand with friends, family, or your therapist will help you stay calm and collected. Use words such as “harassment”, or “abuse” as these terms have higher connotations in the legal system and oftentimes the term “bullying” may be displayed to others as juvenile.

Take care of your mental health

Bullying can be damaging to your mental health. Bullying can lead many adults to drink excessively, self-medicate, overeat and disengage from friends and family. Other adults will choose to fight back in a negative manner, which can result in self-destruction. Avoid succumbing to bad behaviors and make sure you are leaning on support from family and friends during this time.

Don’t let your bully know you are affected by their behavior

Bullying is a well-thought out manipulative behavior to cause harm or damage to another individual. Bullies want to hurt you. Victims of bullying should not confront their bully and they should completely disengage from the individual. It is important to not fight the bully but instead fight the actions by reporting them to the proper authorities.

Don’t be a bystander

If you see another adult being bullied, stand up for that adult. Help them document what is occurring, offer positive affirmations and provide any help or advice they may need. By allowing bullying to take place around you, you are indirectly supporting this behavior.

Don’t blame yourself

Sometimes, bullying can be so camouflaged and insidious that we start to blame ourselves. You did not ask for this, you do not deserve this and you may never know why the bully decided to target you.

Be prepared to step away

If you have reported this abuse and nothing is getting done, it may be time to step away from your job or find a new school. Bullying can result in severe psychological effects that can carry over into your personal life and no job is worth that kind of abuse.


“Smoking leads to disease and disability and harms nearly every organ of the body in time.  More than 16 million Americans are living with a disease caused by smoking.”.

Center for disease control and prevention (CDC)

Lung Cancer Facts

You may be surprised to learn that the most deadly cancer among both men and women in the United States isn’t breast cancer: It’s lung cancer.

Although the rate of new lung cancer cases has dropped in recent years along with the smoking rate, lung cancer still accounts for more deaths than any other cancer in both men and women, according to the American Cancer Society.

So even though you’ll probably never see professional athletes sporting pearl-colored gloves and shoes (pearl is the color of the lung cancer ribbon) to raise awareness, it’s important to learn about the disease: who is at risk — not just people who smoke tobacco — how it’s treated and why early detection is the best defense.

Here, Mary Jo Fidler, MD, a medical oncologist at Rush University Medical Center, discusses five things everyone should know about lung cancer.

1. It’s often caused by a combination of factors.

“It’s natural to associate lung cancer with cigarette smoking,” Fidler says. “Although it’s true that smoking is responsible for 80 percent of all lung cancer cases, lung cancer among people who have never smoked is the sixth leading cause of cancer death worldwide.”

These are some of the leading causes of lung cancer among nonsmokers:

  • Exposure to radon gas released from soil and building materials
  • Exposure to asbestos, diesel exhaust and/or industrial chemicals
  • Exposure to secondhand smoke (the U.S. Department of Health and Human Services says secondhand smoke increases a nonsmoker’s lung cancer risk by as much as 20 to 30 percent)
  • Air pollution

And while any of these factors can cause lung cancer on its own, the disease is often the result of interacting factors.

For instance, according to the National Institutes of Health, there is a greater risk for lung cancer when smokers are also exposed to radon gas. And research studies have shown that the combination of smoking and asbestos exposure greatly increases a person’s risk of developing lung cancer vs. both nonsmoking asbestos workers and smokers who are not exposed to asbestos.

Occupational exposures — including asbestos, uranium and coke (a type of fuel used in smelters, blast furnaces and foundries) — can also increase a person’s risk of dying from their lung cancer, according to another study.

2. Genes may play a role in lung cancer risk.

Scientists have discovered that another culprit may be responsible for some nonsmokers getting lung cancer: genetics.

A study published in the journal Nature Genetics identified three genetic variations — two on chromosome 6 and one on chromosome 10 — that are associated with increased lung cancer risk in Asian women who have never smoked.

Findings have shown that the risk of lung cancer among people who never smoked, especially Asian women, may be associated with specific genetic characteristics that distinguish it from lung cancer in smokers.

Another study, published in Cancer, found that a variant in the NFKB1 gene was associated with a 21 to 44 percent reduced risk of lung cancer. Because a protein produced in part of the NFKB1 gene is known to play a significant role in inflammation and immunity by regulating gene expression, cell death and cell production, the study suggests that inflammation and immune response may be associated with lung cancer risk.

Further research is needed, however, to determine whether there’s a cause and effect relationship between this variant in the NFKB1 gene and lung cancer. Future studies may also shed more light on the exact role inflammation plays in lung cancer risk.

3. If you’re at high risk, CT scans are an effective screening tool.

As with other cancers, the key to surviving lung cancer is catching it in the earliest stages, when it’s most treatable.

The five-year survival rate for people whose cancers are diagnosed when they’re still localized — meaning they haven’t yet spread to the lymph node drainage system or other areas of the body — can be as high as 80 to 90 percent; the survival rate plummets to 2 percent if the diagnosis happens after the cancer has spread to other body parts.

Unfortunately, because symptoms (including persistent cough or coughing up blood, unexplained weight loss, persistent chest pain and shortness of breath) don’t usually appear until the later stages, lung cancer is tough to diagnose early.

Low-dose spiral computed tomography (CT) has proven to reduce lung cancer deaths in patients at high risk for lung cancer. In fact, the National Lung Screening Trial found a 20 percent reduction in deaths from lung cancer among current or former heavy smokers who were screened with low-dose spiral CT (versus those screened by chest X-ray).

However, because the scans can also yield false positive results — by mistaking scar tissue or benign lumps for cancer — they’re recommended only for people at high-risk, for whom the benefits of early detection outweigh the risks of potential false positives and repeated exposure from the scans.

Lung cancer screening is recommended for people who meet these criteria:

  • Are between the ages of 55 and 77 (for Medicare coverage) and 55 and 80 (for commercial insurance coverage)
  • Have at least a 30 pack-year smoking history (an average of one pack a day for 30 or more years)
  • Are in good health and have no signs of lung cancer (weight loss or coughing up blood)
  • Have not had a chest CT in the past year.

“Talk to your doctor if you’re in this high-risk group,” says Fidler. “The best evidence we have available tells us that while CT scanning isn’t right for everyone, for those at high risk it does prevent lung cancer deaths by enabling earlier diagnoses.”

We have had a historically huge amount of FDA approvals in a relatively short amount of time for lung cancer therapies, which is good reason for optimism.

4. Some tumors can be removed minimally invasively.

Tumors that are caught in the early stages can often be surgically removed, giving patients a good chance of being cancer-free.

The standard procedure to remove the lobe of the lung in which the tumor is located, known as a lobectomy, typically requires a six-inch incision in the chest through which the ribsare spread apart.

But at a handful of medical centers, including Rush, roughly 80 percent of lobectomies can be done using a minimally invasive approach.

Video-assisted thoracoscopic surgery (VATS) lobectomies are performed through small incisions (and without spreading the rib cage) using a tiny video camera and specialized surgical instruments. There are many benefits to a VATS lobectomy vs. open surgery — including less pain and fewer complications after surgery, less time in the hospital and a speedier recovery — and the results are comparable, making it a good option for many tumors.

5. Newer treatments pack a targeted punch.

Research has yielded a wealth of information about how lung cancer cells change and grow, enabling scientists to develop drugs to specifically address those changes.

These “targeted” drug therapies, used alone or in combination with chemotherapy, are typically less toxic and have fewer side effects than chemotherapy because they zero in on specific genes or proteins more often found in cancer cells then in healthy tissue.

These are some of the targeted therapies currently available for lung cancer

  • Monoclonal antibodies (bevacizumab, ramucirumab)
  • EGFR inhibitors (erlotinib, afatinib, gefitinib)
    • Osimertinib, an EGFR inhibitor that also targets cells with the T790M mutation
    • Necitumumab, an EGRF inhibitor for squamous cell non-small cell lung cancer
  • Drugs that target the ALK gene (crizotinib, ceritinib, alectinib)


“Every cell in your body needs oxygen in order to live. The air we breathe contains oxygen and other gases. Once in the lungs, oxygen is moved into the bloodstream and carried through your body. Lung capacity declines as you age. Keep your lungs healthy by taking good care of yourself every day. Eat a balanced diet, exercise and reduce stress to breathe easier.”
American Lung Association

Healthy Lung Month

October is a month set aside for lung awareness. It’s National Healthy Lung Month, and Lung Health Day is October 28. National Respiratory Care Week is October 25-30. It may seem arbitrary to set aside a particular month for health awareness, but it’s useful to remind ourselves of the things in our environment that can harm us and to act with compassion toward those who have already been harmed.

Lung disease affects a staggering number of Americans. About 10 million adults are diagnosed with chronic bronchitis each year, and about 4.7 million others have ever been diagnosed with emphysema. Chronic bronchitis and emphysema constitute the diseases that make up Chronic Obstructive Pulmonary Disease (COPD). About 25 million people live with asthma as well.

Occupational lung diseases, which include asbestosis and mesothelioma, also affect many Americans. Occupational illnesses are estimated to cost $150 billion annually. Chronic Obstructive Pulmonary Disease (COPD), typically caused by long-term exposure to lung irritants that damage the lungs and airways, is attributed to occupational exposure 19.2% of the time.

In support of Healthy Lung Month, let’s raise awareness about the rapid escalation of lung disease in the United States.

The notion that harmful air pollutants exist only outdoors is false. Some pollutants occurring in the home can be more harmful than those commonly encountered outdoors. Modern homes harbor many sources of respiratory irritation, but it’s not terribly difficult to lung-proof your home. Some common lung irritants found indoors are lead, formaldehyde, radon, cleaning agent vapors, and fire-retardants. Natural pollutants also make their way into the home, including pet dander, dust mites, and mold. Here are a few simple ways the people, especially those with lung disease, can avoid these lung damaging agents.

  • Clean the Air:Buy a vacuum with a HEPA filter to reduce lead, chemical build-up, and allergens such as pet dander in the home. Follow this step by mopping with a microfiber mop to soak up any leftover particles.
  • Avoid exposure to indoor pollutants that can damage your lungs.
  • Minimize exposure to outdoor air pollution.
  • Green Your Space:Fill your place with plants! Indoor plants help purify the air, removing toxins such as formaldehyde, benzene, toluene, and xylene. Spider plants and aloe vera plants are good choices for the home.
  • Go Natural: Fragrances in cleaning products, laundry detergents, and air fresheners can all damage the lungs opt for fragrance-free whenever possible.
  • Test for Radon: Make sure your home has a radon detector. This colorless, odorless gas is the second leading cause of lung cancer in the United States today.
  • Don’t Vape or Smoke

Your entire body depends on your lungs to keep breathing and distributing oxygen-rich blood throughout your body and to get rid of the body’s gaseous waste, carbon dioxide. Our bodies do have a natural defense system designed to protect the lungs, keeping dirt, germs and other irritants at bay. But there are some important things you can do on a regular basis to keep your lungs healthy and reduce the risk of disease.

Sometimes we take our health for granted. Lungs keep us alive and well and for the most part, we don’t need to think about them.  Remember without lungs we couldn’t survive.  Love your lungs this October and work to make any necessary changes to keep yours healthy!

*Prevention of Stroke or Transient Ischemic Attack (TIA)*

There are 2 types of strokes:

1-Hemmoragic-a blood vessel that bursts in the brain causing lack of oxygen to be supplied to the area of the brain (a lobe) where the vessel ruptured.  Lack of oxygen to any area of the body tissue=starvation to the tissue; where in this case is the brain=a stroke.

2-Blockages-These blockages caused by the following: blood clots, athero-sclerosis, a common disorder, it happens due to fat, cholesterol, with even tar from smoking, or other substances that build up in the walls of the arteries forming hard structures called plaque and in time creating a blockage in the vessel interfering with blood supply providing oxygen to tissue and if blocked in the brain=high probability of a stroke occurring if not taken care of.   “Recommended related to Heart Disease” by Web MD which states that atherosclerosis is the key cause of heart attacks & strokes including it’s the number one killer in the United States.  Risk Factors for atherosclerosis include high blood pressure (b/p)=arteriosclerosis, blood level of high bad cholesterol (LDL), blood level of low good cholesterol (HDL), smoking, diabetes, and history of heart attacks in your nuclear family.  Definitely a healthy diet, having exercise in your life, and your weight within the therapeutic body mass index level will help prevent, if not treat, atherosclerosis.

The Risk Factors of this disease, especially diet & sedentary lifestyle:

  1. High Blood Pressure (b/p)-This is also known as the diagnosis hypertension.  In understanding how hypertension works let’s use a metaphor:  Think of a blood vessel as a long thin balloon and if we stand on it the pressure will increase inside the balloon causing the diameter of the balloon to swell up.  If you continue to step on the balloon adding additional pressure this causes it to finally reach it’s total amount of pressure or when you exceed the total level of pressure this results in popping the balloon.  Similar concept with high b/p, that’s if the pressure keeps rising in our blood vessels due to blockage or vasoconstriction (which is making the vessels diameter more narrow=increased pressure in the vessels) sooner or later a vessel bursts somewhere in the body due to the b/p passing it’s total level in the amount of pressure that it can handle in the circulatory system which can result into a burst of an artery, like in the brain causing a stroke or in a vessel near the heart causing a myocardial infarction (but this is another topic some other day).  Think of food,  a human being not eating leads into starvation, well for blood cells lack of oxygen=starvation to the cells.  This causes in both situations or cases a lack of nutrition (the tissue is lacking oxygen).  With a stroke, not enough oxygen is getting to the brain resulting from either a hemorrhage (loosing too much blood=loosing to many cells=oxygen (food for tissue) or a blockage preventing 02 getting to the area.  Though many people have increased b/p due to only 2 things diet leading them to obesity, and lack of exercise due to a sedentary lifestyle, which could be changed and resolve the problem in most cases.  Increased b/p can also be due noncompliance- like continuing to smoke, or not following the healthy regimen the M.D. ordered for you as a patient.  The overall healthy regimen for a person with hypertension would be a low sodium diet (preventing further vasoconstriction), even low in cholesterol/fat/1800-2000 calories a day (preventing obesity or further weight gain), balancing rest with exercise and the b/p medications taken as prescribed, by their M.D.    So for many Americans hypertension can be controlled just by diet with balancing exercise with rest.  For others it might take a little more like doing which is what I just mentioned with following your medication regimen as ordered and going to your doctor having your b/p monitored, as your M.D. prescribes.


  1. Smoking-For starters, this unhealthy habit puts you at risk for high blood pressure since it causes vasoconstriction (narrowing) of the vessels in our body due to the nicotine.  The answer to this risk factor is simply quit this unhealthy habit. I have a dear friend doing great in quitting this habit now. Smoking adds to the plaque building up in the vessels.  Centers for Disease state that in 2010 the leading cause of death was heart disease followed by cancer than to chronic respiratory disease and lastly stroke.  Over time a healthy diet balanced with exercise daily or every 2 days for 30minutes would help decrease the cardiac disease and stroke.  The American Lung Association states that smoking is directly responsible for approximately 90 percent of lung cancer deaths and approximately 80-90 percent of COPD (emphysema and chronic bronchitis) deaths.
  • Among adults who have ever smoked, 70% started smoking regularly at age 18 or younger, and 86% at age 21 or younger.
  • Smoking harms nearly every organ in the body, and is a main cause of lung cancer and chronic obstructive pulmonary disease (COPD, including chronic bronchitis and emphysema). It is also a cause of coronary heart disease (CAD), stroke and a host of other cancers and diseases.       _______________________________________________                                                                                                                             3. Cholesterol is also found in some foods, such as seafood, eggs, meats and dairy products.LDL can cause plaque build-up. Plaque is a thick, hard substance that can clog arteries. Recent studies show that high levels of LDL and triglycerides (blood fats) raise the risk of ischemic stroke. Plaque can also increase risk of a transient ischemic attack (TIA) where stroke symptoms go away within 24 hours.
  • The second main type of cholesterol is high-density lipoprotein (HDL), often called the “goodcholesterol. High levels of HDL may reduce stroke risk.
  • Because cholesterol does not dissolve in the blood on its own, it must be carried to and from cells by particles called lipoproteins. There are two main types of lipoproteins: low-density lipoproteins (LDL)=the bad cholesterol and high-density lipoproteins=the good cholesterol (HDL).
  • The National Stroke Association states the following about cholesterol: Cholesterol is a soft, waxy fat (lipid) that is made by the body. It is found in the bloodstream and in all of your body’s cells. The body needs cholesterol to form cell membranes, some hormones and vitamin D.
  • So let’s take a car for instance, if the transmission is bad and not repaired by a mechanic the engine will be affected and soon fail completely.  Now let’s take the lungs, if they are bad and you don’t go to a doctor to help treat the problem the heart will be affected at some point to failure in function. This is the same with a heart (the engine of the body), that when it is bad with no repair or Rx it will soon affect the lungs (the transmission of the body). When one of these organs works at its fullest potential without the other organ properly functioning, in time, it will affect the other organ.  If a smoker doesn’t quit it causes COPD=Emphysema (this does take over years) and it will affect the heart in time to not function as effectively with someone who has healthy lungs.  Worse, if you don’t quit smoking you increase the risk of getting CAD (coronary artery disease) and add to the problem atherosclerosis, if you already have the diagnosis which is caused by fatty materials (lipids), fibrous tissue with tar (from the smoking) causing blockages in the vessels or even better cause arteriosclerosis (narrowing of the vessels). You also have a risk at lung cancer.
  • Stroke verses TIA=Nonreversible verses Reversible. Stroke is scarring to the brain where TIA doesn’t.  Like Heart Attack verses Angina, Heart Attack is scarring to the heart verses no scarring to the heart with Angina. Both Angina and TIA are just lack of oxygen to the heart and the brain, causing the symptoms due to lack of oxygen=ischemia.  Both heart attack and stroke are both a lot worse than just ischemia.  They both get to the point where there in no oxygen causing actual permanent damage to the organ since the problem never reversed=scarring to the heart and brain.High cholesterol levels or plaque build-up in the arteries can block normal blood flow to the brain and cause a stroke. High cholesterol may also increase the risk of heart disease and atherosclerosis, which are both risk factors for stroke.                                                               
  • I have a dear friend who I’ve known almost 35 years that survived coronary artery bypass surgery over 55 y/o, with 5 blockages (2 arteries 100% blocked and 3 arteries at least 80% blocked=5 vessels blocked).  That was a set up for a silent heart attack if he didn’t have the surgery but he was lucky in getting symptoms of chest pain and fatigue/lethargy due to these blockages.  This made him go the doctor.  He stopped smoking the day before the surgery.   His life had taken a 360 turn and stopped in his daily routine and life schedule.  It had begun all over again at almost 60.   Without controlling your blood pressure therapeutically or without ending your smoking or without eating healthy with living healthy habits the heart at first will be able to compensate with living unhealthy habits but over time the heart may find it so hard to function or work that the heart starts to fail in doing its job effectively (it decompensates causing to go into failure if no changes are made).  Again let’s take a car, you do maintenance to the vehicle for it will operate and last longer, well the exact principle with the human body.  Pretty simple isn’t it.
  • Good Diet, Good Exercise balanced with rest, and no smoking with B/P well controlled. _______________________________________________

If you don’t eat a healthy diet, keep your weight in a therapeutic range, properly exercise than expect to be at high odds you will be leaning more towards shortening your life span.  You can control your diet, weight and your exercise the right way with a little direction.  There is many places for just that direction in helping you maintain a good diet including weight and giving you guidance whether it be at a clinic, work out facility or a weight loss food place via the community or internet with or by yourself but recommended to use simply a book.

It is recommended to go to your M.D. first before making any changes for the doctor will know all your medical history and can give you the right direction in what’s the best route for you in reaching your goals.


“October marks National Liver Awareness month. Estimates for the global burden of chronic liver disease range from 50 million to over 100 million affected individuals. According to the Centers for Disease Control and Prevention (CDC), from 2000 — 2018 there was a 31% increase in deaths from chronic liver disease. Numerous diseases ranging from liver cancer to nonalcoholic fatty liver disease (NAFLD) to hepatitis pose an increasing concern. Almost 33,000 Americans die annually from liver cancer every year, according to the American Liver Foundation.”
Hunterdon Gastroenterology Associates

The Liver and NAFLD (Non-Alcoholic Fatty Liver Disease).


The liver is a large, meaty organ that sits on the right side of the belly. Weighing about 3 pounds, the liver is reddish-brown in color and feels rubbery to the touch. Normally you can’t feel the liver, because it’s protected by the rib cage.

The liver has two large sections, called the right and the left lobes. The gallbladder sits under the liver, along with parts of the pancreas and intestines. The liver and these organs work together to digest, absorb, and process food.

The liver’s main job is to filter the blood coming from the digestive tract, before passing it to the rest of the body. The liver also detoxifies chemicals and metabolizes drugs. As it does so, the liver secretes bile that ends up back in the intestines. The liver also makes proteins important for blood clotting and other functions.

The liver is a vital organ of vertebrates and in some other animals. In the human it is located in the upper right quadrant of the abdomen, below the diaphragm. The liver has a wide range of functions, including detoxification of various metabolites, protein synthesis, and the production of biochemicals necessary for digestion.

The liver is a gland and plays a major role in metabolism with numerous functions in the human body, including regulation of glycogen storage, decomposition of red blood cells, plasma protein synthesis, hormone production, and detoxification.[3] It is an accessory digestive gland and produces bile, an alkaline compound which aids in digestion via the emulsification of lipids. The gallbladder, a small pouch that sits just under the liver, stores bile produced by the liver. The liver’s highly specialized tissue consisting of mostly hepatocytes regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex molecules, many of which are necessary for normal vital functions Estimates regarding the organ’s total number of functions vary, but textbooks generally cite it being around 500.

Nonalcoholic fatty liver disease is a term used to describe the accumulation of fat in the liver of people who drink little or no alcohol.

Nonalcoholic fatty liver disease is common and, for most people, causes no signs and symptoms and no complications.

But in some people with nonalcoholic fatty liver disease, the fat that accumulates can cause inflammation and scarring in the liver. This more serious form of nonalcoholic fatty liver disease is sometimes called nonalcoholic steatohepatitis.

At its most severe, nonalcoholic fatty liver disease can progress to liver failure.

Much of the American Liver Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

Much of the Foundation’s emphasis during October continues to point to the cause and treatment for liver diseases like hepatitis A, B and C; cirrhosis, biliary atresia and liver cancer.

But the Foundation is also tapping into the heightened awareness during Liver Awareness Month to draw attention to the alarming increase in the incidence of Non-Alcoholic Fatty Liver Disease (NAFLD), which, staggeringly, affects up to 25 percent of people in the United States.

As its name suggests, NAFLD is the buildup of extra fat in the liver that isn’t caused by alcohol. It’s normal for the liver to contain some fat. But if more than 5 to 10 percent of the liver’s weight is fat, then it is called a “fatty liver.”

Most often, NAFLD tends to develop in people who are overweight or obese or have diabetes, high cholesterol or high triglycerides. Sedentary behavior is another major contributing factor to the onset of NAFLD.

For these reasons, concern continues to grow as one in 10 children—that’s seven million children in the United States—is estimated to have fatty livers.

NALFD can become even more serious. It can progress to Non-Alcoholic Steatohepatitis (NASH), which means that along with the fat, there is inflammation and damage to the liver. A swollen liver may cause scarring (cirrhosis) over time and may even lead to liver cancer or liver failure.



“One of the best ways to prevent the spread of germs is proper hand hygiene. Make sure those caring for you and your visitors have cleaned their hands. Don’t hesitate to ask any staff member if they’ve cleaned their hands.

Respiratory infections can be easily spread to others. Remember to cover your cough or sneeze and encourage your visitors to do the same.”


Infection Prevention Month

According to the Centers for Disease Control and Prevention, one out of every 20 hospitalized patients will contract a healthcare-associated infection. The spread of these infections, however, can be controlled. There are several simple and cost-effective strategies that can help prevent infections, from the basic tenet of hand hygiene to the team-oriented approach of Comprehensive Unit-based Safety Programs.

Four infection prevention and process improvement experts weigh-in on the 10 best strategies for prevention of infections.

1. Hand Hygiene. According to the CDC, this is the simplest approach to preventing the spread of infections and needs to be incorporated into the culture of the organization. Surgical team personnel should wash their arms and forearms before a procedure and put on sterile gloves, according to CDC guidelines for infection control. Steven J. Schweon, RN, MPH, infection prevention consultant and member of The Society for Healthcare Epidemiology of America, suggests the “clean in, clean out” approach, wherein hands and equipment are cleaned or disinfected on the way into the patient’s room and on the way out again.

2. Environmental hygiene. According to J. Hudson Garrett, PhD, MSN, MPH, FNP-BC, CSRN, VA-BC, senior director for clinical affairs at PDI, one of the most common sources of transmission of infection is environmental surfaces. Certain types of microbial bacteria are capable of surviving on environmental surfaces for months at a time, according to Mr. Garrett. When healthcare providers or patients touch these surfaces with their skin, the bacteria can be transmitted, causing infection. Thus, it is essential that the environment be kept clean and disinfected. Patients and their families are now the biggest advocates of medical safety, and Mr. Garrett suggests including them in infection prevention protocols, especially with respect to maintaining a clean and sanitary environment. It is also important to involve multidisciplinary environmental hygiene teams in meetings regarding adherence to infection prevention protocols. Irena L. Kenneley, PhD, APRN-BC, assistant professor at the Frances Payne Bolton School of Nursing at Case Western Reserve University in Cleveland and member of the Association for Professionals in Infection Control and Prevention, says that meeting with environmental services and sharing in-house surveillance data helps them relate housekeeping tasks with the spread of infection and helps ensure optimal environmental hygiene.

3. Screening and cohorting patients. Part of the preoperative health evaluation process should include consistent screening of patients, says Siew Lee Grand-Clément, a black belt in robust process improvement at the Joint Commission Center for Transforming Healthcare. These patients must then be treated prior to surgery or any other procedure. However, it is essential that patients who are suffering from the same disease or infection should be kept together in a designated area. “This is essential to ensure that cross infections do not happen,” says Dr. Kenneley. Infections can spread easily from one patient to another if they are being treated in the same area, with the same staff and shared patient care equipment. Some infectious agents are even airborne, says the CDC. Organizations must also evaluate whether the staff is adhering to specific protocols for specific infections, Dr. Kenneley says.

4. Vaccinations. The staff at a healthcare organization may sometimes be the cause of the spread of infections. They come into contact with patients with different types of diseases and may contract infections, according to the CDC. As a result, organizations must make sure that recommended vaccinations are being administered to their staff as recommended. “Keeping healthcare professionals healthy pays dividends,” says Mr. Schweon. It results in decreased transmission risk to co-workers and patients.

5. Surveillance. Through surveillance, organizations should gather data regarding infection patterns at their facility. They should also regularly assess current infection prevention protocols. Having a robust infection surveillance program helps organizations measure outcomes, assess processes of care and promote patient safety, says Mr. Schweon. Sharing the data that the infection surveillance program gathers is the next step. “Communicate, display and discuss all process and outcomes measures with all stakeholders,” says Dr. Kenneley.

6. Antibiotic stewardship. The misuse and overuse of antibiotics can put patients at a risk of contracting infections, according to the Association for Professionals in Infection Control and Epidemiology. Inappropriate antibiotic use may also result in patients becoming resistant to some drugs. If those patients contract an infection, it becomes harder to treat them and the risk of it spreading increases. Mr. Schweon suggests establishing a program to assist with appropriate antibiotic selection and dosing. This helps optimize patient outcomes and minimize adverse events like C. difficile infection and antibiotic toxicity, he says.

7. Care coordination. Breakdown of communication in the surgical preparation, planning and postoperative care management among various care providers during the care transition process can lead to surgical site infections that could otherwise be avoided, says Ms. Grand-Clément. Often, the concept of “stopping the line” is not practiced, which is when care providers are doubtful if certain necessary infection prevention or surgical preparation activities have been completed by the previous care providers, and they halt the care transition process until the matter is resolved. Organizations must avoid situations where a certain process is overlooked by a department that assumes another department has already completed that it. “Activities must be timed and accountability should be specifically assigned,” she says. There needs to be coordination of care and communication within the surgical team as well. There is a risk of breaking the sterile field in the surgery room particularly around the portion of the surgical procedure when multiple, critical activities are taking place at the same time that require staff to multitask, she says. Care coordination goes a long way in preventing surgical site infections.

8. Following the evidence. Keeping abreast of the latest findings regarding the spread of infections and strategies for prevention is essential for a successful infection prevention program. “Infection preventionists must continually monitor the professional literature and attend educational conferences for the latest information with preventing infections,” says Mr. Schweon. However, it is also important to first look at the reality of your organization’s processes and perform your own gap assessment before adopting new practices. What is new in the infection prevention field may not necessarily be the best fit for your organization, says Ms. Grand-Clément.

9. Appreciating all the departments that support the infection prevention program. An organization’s culture may need to shift from thinking that only infection preventionists are accountable for infection prevention, because every patient encounter throughout the care continuum presents all healthcare workers with an infection prevention opportunity, says Ms. Grand-Clément. All caregivers are accountable, and to encourage infection prevention protocols, healthcare professionals should show appreciation for all the people who help keep infections at bay, from the people who prepare surgical instruments for the operating room to those preparing the food safely for patients, staff and visitors, says Mr. Schweon.

10. Comprehensive Unit-based Safety Programs. The Comprehensive Unit-based Safety Program is a structured strategic framework for patient safety improvement that integrates communication, teamwork and leadership, according to the Agency for Healthcare Research and Quality. Each unit should have its own infection prevention champions, with these individuals becoming an extension of the infection prevention and control department, adds Mr. Garrett. “The CUSP program has demonstrated time and time again how effective unit-based champions can be in influencing positive change and improving outcomes,” says Mr. Garrett.

Each of these strategies helps organizations keep the spread of infections at bay. When implemented, supported and carried out together, these 10 strategies are instrumental in ensuring the success of an infection prevention program at an organization.