Are there systematic reviews of the evidence about the effect of chlorhexidine on rate of catheter associated urinary tract infections?

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Joanna Briggs Institute’s JBI+COnNECT, an evidence summary source, has published this evidence summary:  Urethral Catheter (Indwelling Short-Term):  Urinary Tract Infection Prevention

The Clinical Bottom Line section summarizes evidence on various care regimens, including daily cleaning.  Two relevant statements:
“Daily cleansing of the urethral meatus using soap and water or perineal cleanser has been shown to be effective to reduce CAUTI.3 (Level II)”
“The following interventions are not deemed effective for reducing CAUTI incidence: sterile technique for catheter insertion, use of antiseptic solutions or ointment during routine meatal care, 2-chambered urinary drainage bags, antiseptic filters incorporated into the drainage bag, bladder or catheter irrigation, frequent urinary drainage bag changes and placing an antiseptic solution into the urinary drainage bag.3 (Level I)”

References to other systematic reviews are available through this PubMed search: chlorhexidine AND urinary tract infection AND catheter AND (systematic review OR meta-analysis)

What is the standard of care for a patient with cryptogenic organizing pneumonia, i.e., “BOOP”, and how is it related to acute respiratory distress syndrome?

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Cryptogenic organizing pneumonia (COP)  is a form of idiopathic interstitial pneumonia, and the DynaMed Plus entry for Interstitial Lung Disease will provide details about clinical presentation and treatment.  Look in the Treatment section for details.  The Treatment Overview includes links to Corticosteroid therapy and a section for Cause-Specific Therapy (on menu on the left side of the screen) for Other Idiopathic Interstitial Pneumonias.

Acute Respiratory Failure.  In:  Conn’s Current Therapy, 2017.
Includes a discussion of clinical presentation and causes of ARDS, as well as conditions that can mimic ARDS, including COP.

Updated 10/12/2017 ldt

What is the evidence on actively engaging nurses at bedside shift report?

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Joanna Briggs Institute’s JBI+COnNECT, an evidence summary source, has published this evidence summary on clinical handover.
Good overview of evidence, but nothing specifically on nurses’ attitudes or how to actively engage nurses in bedside shift report specifically.

PubMed
bedside shift AND (report OR round* OR handover) AND (attitudes OR (nurses AND psychology))
The articles below are from the PubMed search and describe implementation of or changes to shift reports and may be most helpful.

1: Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: a case study. Int
J Nurs Pract. 2010 Feb;16(1):27-34. PubMed PMID: 20158545.

2: Staggers N, Jennings BM. The content and context of change of shift report on
medical and surgical units. J Nurs Adm. 2009 Sep;39(9):393-8. PubMed PMID:
19745636.

3: Athwal P, Fields W, Wagnell E. Standardization of change-of-shift report. J
Nurs Care Qual. 2009 Apr-Jun;24(2):143-7. PubMed PMID: 19287253.

4: Caruso EM. The evolution of nurse-to-nurse bedside report on a
medical-surgical cardiology unit. Medsurg Nurs. 2007 Feb;16(1):17-22. PubMed
PMID: 17441625.

5: Anderson CD, Mangino RR. Nurse shift report: who says you can’t talk in front
of the patient? Nurs Adm Q. 2006 Apr-Jun;30(2):112-22. PubMed PMID: 16648723.

6: Philpin S. ‘Handing over’: transmission of information between nurses in an
intensive therapy unit. Nurs Crit Care. 2006 Mar-Apr;11(2):86-93. PubMed PMID:
16555756.

7: Manias E, Street A. The handover: uncovering the hidden practices of nurses.
Intensive Crit Care Nurs. 2000 Dec;16(6):373-83. PubMed PMID: 11091469.

CINAHL search:  bedside AND shift AND (report OR round* OR handover) AND (attitudes OR (nurses AND psychology))
Limited to English and Peer-reviewed,   Excluded records that are also in Medline (PubMed)
Retrieved one additional record that includes a survey of nurses’ attitudes.
Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover.Detail Only Available (includes abstract); Street, Maryann; Eustace, Paula; Livingston, Patricia M; Craike, Melinda J; Kent, Bridie; Patterson, Denise; International Journal of Nursing Practice, 2011 Apr; 17 (2): 133-40.

The fulltext for this article is available through the JBI+  journals page.

What are the signs and symptoms of lupus and mononucleosis?

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DynaMed provides this type of information for disease states. Each link below will take you to a summary of information on that disease. Use the menu on the left side of the screen to navigate to the History and Physical Sections for signs and symptoms.

Systemic lupus erythematosus (SLE)

Infectious mononucleosis

DynaMed and other point-of-care information resources are available on the Nursing Community of the Health Sciences Center Library’s website.

Does perineal cleaning with chlorhexidine prior to inserting a urinary catheter reduce the rate of catheter-acquired urinary tract infections (CAUTI)?

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Bottom line:  There is no evidence that cleaning the perineal area with chlorhexidine prior to catheter insertion reduces the rate of CAUTI.

Summary:  Identified documents using JBI+COnNECT (Joanna Briggs Institute)

Review of results led to CDC CAUTI guidelines, 2009.
Page 43 references two studies that found no difference between cleaning with chlorhexidine v. water prior to catheter insertion.  There are also studies referenced in that section that address intermittent care.

A systematic review of the management of short-term indwelling urethral catheters to prevent urinary tract infections
Page 702 – describes 1 RCT of 436 patients admitted to obstetrical unit who were randomized to periurethral cleaning with water v. chlorhexidine prior to insertion of catheter.  No significant difference in rates of CAUTI between the groups.

The RCT of 436 patients is also referenced in this best practice summary: Management of short-term indwelling urethral catheters to prevent urinary tract infections

What are the recidivism rates for hospitalized medical psychiatry or geriatric psychiatry patients?

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Readmission to psychiatric units of acute care hospitals
Healthc Q. 2007;10(2):30-2.
Madi N, Zhao H, Li JF.  Hospital readmissions for patients with mental illness in Canada.
In Canada, during the years 2002-2004, 37% of patients discharged with a mental illness diagnosis were readmitted at acute care hospitals within a one year period.

Readmission to psychiatric hospitals
Psychol Rep. 2003 Dec;93(3 Pt 1):816-8.
Feigon S, Hays JR.  Prediction of readmission of psychiatric inpatients.
Prospective study of 943 patients admitted to an urban psychiatric hospital.  Over 5 years of follow up, 33% of the patients (all ages) had at least one readmission.

Aust N Z J Psychiatry. 2011 Jul;45(7):578-85.
Zhang J, et al.  Factors associated with length of stay and the risk of readmission in an acute psychiatric inpatient facility: a retrospective study.
Retrospective study of 286 randomly selected admissions over 12 month period.  Of the 178 patients involved in these admissions, 46% were readmitted during this 12 month period.

Readmission to geriatric psychiatry inpatient unit
J Geriatr Psychiatry Neurol. 2006 Dec;19(4):226-30.
Woo BK, et al.  Factors associated with frequent admissions to an acute geriatric psychiatric inpatient unit.
Study included 424 consecutive admissions to a university-based geriatric psychiatry inpatient unit over a 20-month period. Mean age of patients was 79.4 years.  35.6% were readmissions.