In a new study  published online in Infection Control & Hospital Epidemiology, nearly half of American hospitals aren’t taking key steps to prevent Clostridium difficile, an  infection that kills nearly 30,000 people annually and sickens hundreds of thousands more –…

Recently we worked with a “TPR” hospital in Maryland. TPR stands for Total Patient Revenue System, a revenue constraint system developed by the Maryland Health Services Cost Review Commission to provide hospitals with a financial incentive to manage their resources…

Urinary tract infections (UTI’s) account for 20-30% of infections in Long Term Care and the most common cause of  hospitalization for bacterial infection. It has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This…

Diarrhea in the tube fed patient has many causes. Typically, it is not the tube-feeding formula itself, as most are lactose-free and have lower osmolality. Diarrhea may be related to the infusion rate of the feeding (given too quickly for…

As clinicians you know the direct cost of a C. diff outbreak is expensive in terms of nursing time, environmental services, medications, and testing as well as patient discomfort and embarrassment.  But the example reported below shows that the indirect…

In 1990 we started a revolution when we created the first ever pre-formed pureed meats for the dysphagia diet. We’ve come a long way since the industry turned away from  ‘mystery bowels’ of pureed foods. But one thing has remained…

It is often ignored but optimal wound healing requires adequate nutrition.  Time and again it has been shown that nutritional intervention maintains gut integrity, decreases risk of poor healing of pressure ulcers and surgical wounds, modulates inflammation and prevents negative…