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Herpetic whitlow
Material for the Review section, including books, monographs, articles, and audiovisuals, should be sent to Sego Matsumiya, R.N., Infection Control Nurse, Veterans Administration Medical Center, 500 Foothill Blvd., Salt Lake City, UT 84148. Individual reprints of articles reviewed must be obtained from the designated author.
nupMc whwow Lucey J, Baron M: Am J Nurs 84~60-81~1984. Reprint requests: Joyce Lucey, R.N., B.S.N., Rosewell Park Memorial Institute, Buffalo, NY 14263.
Two ICPs at Rosewell Park Memorial Institute report three cases of herpetic whitlow in intensive care unit nurses that occurred over an 1 &month period. They describe the protracted clinical course of infection for each nurse and relate the impact that it had on their work. The case histories clearly point out the need for precautions in caring for immunocompromised patients at high risk for herpetic infections in an acute care settingeven when the patients are asymptomatic. In addition to the case histories of each nurse, the article describes the signs and symptoms, diagnostic methods, treatment, and sequelae of herpetic whitlow. Colored photographs of the affected digits accompany the article and are extremely helpful for those of us not too familiar with this problem. The long-term implications for the person affected are serious; the lesion is potentially disabling. ICPs will find this paper timely and informative in view of the increase in use of life-support systems and critical care nursing. N8thmd runway of amq?t& toc~~kho~~lwrarmd no&
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Harris RB: Cancer Nurs (Feb.) 23-32, 1984. Reprint requests: Ms. R. 8. Harris, R.N., Adelphi University School of Nursing, Garden City, New York, NY 11530.
This article reports on the results of a national survey to categorize the techniques of caring for tracheotomy sites by departments of head and neck surgery. Specifically, the initial purpose of this survey was to determine the 344
prevalence of clean tracheotomy care (cleaning and suctioning) compared to sterile technique. Questionnaires were sent out to 386 physicians and nurses; 189 responses were obtained (49%). The investigator found that there was a great deal of confusion regarding the interpretation of “clean” and “sterile” technique. Respondents who reported using sterile technique often used tap water, disposable cups, and/or no gloves. Thus, actual practice was inconsistent with the reported technique of care. The investigator concluded that clean, nonsterile technique is a fairly common practice of postoperative tracheotomy care in head and neck surgical patients. Even though only 17% of the respondents admitted to the use of this technique, a total of 60% admitted to practices that were categorized as clean rather than sterile. This report raises some interesting questions for the ICP. Even though this study does not discuss infections with each type of care, one must wonder if clean technique might be as safe as sterile technique. The efficacy of sterile technique has never been demonstrated in a clinical study, yet it certainly is more involved and costly than clean technique. Furthermore, this study should stimulate ICPs to reanalyze the consistency between their hospitals’ written policies and actual practice regarding the care of tracheotomy sites.
Lipsky BA, lnui TS, Plorde JJ, and Berger RE: Am J Med 76~257262, 1884. Reprint requests: Dr. 8. A. Lipsky, Medical Comprehensive Care Unit (1363), Veterans Admihistratton Medical Center, 4435 Beacon Ave., South, Seatfle, WA 98108.
The investigators designed this study to determine whether the results of voided urine cul-
nupMc whwow Lucey J, Baron M: Am J Nurs 84~60-81~1984. Reprint requests: Joyce Lucey, R.N., B.S.N., Rosewell Park Memorial Institute, Buffalo, NY 14263.
Two ICPs at Rosewell Park Memorial Institute report three cases of herpetic whitlow in intensive care unit nurses that occurred over an 1 &month period. They describe the protracted clinical course of infection for each nurse and relate the impact that it had on their work. The case histories clearly point out the need for precautions in caring for immunocompromised patients at high risk for herpetic infections in an acute care settingeven when the patients are asymptomatic. In addition to the case histories of each nurse, the article describes the signs and symptoms, diagnostic methods, treatment, and sequelae of herpetic whitlow. Colored photographs of the affected digits accompany the article and are extremely helpful for those of us not too familiar with this problem. The long-term implications for the person affected are serious; the lesion is potentially disabling. ICPs will find this paper timely and informative in view of the increase in use of life-support systems and critical care nursing. N8thmd runway of amq?t& toc~~kho~~lwrarmd no&
tm#mWmy
care
ts
Harris RB: Cancer Nurs (Feb.) 23-32, 1984. Reprint requests: Ms. R. 8. Harris, R.N., Adelphi University School of Nursing, Garden City, New York, NY 11530.
This article reports on the results of a national survey to categorize the techniques of caring for tracheotomy sites by departments of head and neck surgery. Specifically, the initial purpose of this survey was to determine the 344
prevalence of clean tracheotomy care (cleaning and suctioning) compared to sterile technique. Questionnaires were sent out to 386 physicians and nurses; 189 responses were obtained (49%). The investigator found that there was a great deal of confusion regarding the interpretation of “clean” and “sterile” technique. Respondents who reported using sterile technique often used tap water, disposable cups, and/or no gloves. Thus, actual practice was inconsistent with the reported technique of care. The investigator concluded that clean, nonsterile technique is a fairly common practice of postoperative tracheotomy care in head and neck surgical patients. Even though only 17% of the respondents admitted to the use of this technique, a total of 60% admitted to practices that were categorized as clean rather than sterile. This report raises some interesting questions for the ICP. Even though this study does not discuss infections with each type of care, one must wonder if clean technique might be as safe as sterile technique. The efficacy of sterile technique has never been demonstrated in a clinical study, yet it certainly is more involved and costly than clean technique. Furthermore, this study should stimulate ICPs to reanalyze the consistency between their hospitals’ written policies and actual practice regarding the care of tracheotomy sites.
Lipsky BA, lnui TS, Plorde JJ, and Berger RE: Am J Med 76~257262, 1884. Reprint requests: Dr. 8. A. Lipsky, Medical Comprehensive Care Unit (1363), Veterans Admihistratton Medical Center, 4435 Beacon Ave., South, Seatfle, WA 98108.
The investigators designed this study to determine whether the results of voided urine cul-