Vital Signs

March 2006

Strong ICUs Recognized for Safety Improvements

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Team Approach Nets "Zero Outcome" 
Faculty and staff working on all of Strong ICUs are responsible for virtually eradicating ventilator-associated pneumonia, a common and sometimes fatal infection.  Team members responsible for creating and implementing the successful program in the Medical Intensive Care Unit include (From L. to R., seated):  Robert Panzer, M.D., Michelle Bonyak, R.N., Barry A. Evans, R.N., M.S.N., C.N.S., Lucille Nelson, R.N., Timothy J. Kehl, R.N., M.S.N.  Top Row: Kathy Doolin, R.N., Cherri Witscheber, R.N., Meg Gage, R.N., Michael J. Apostolakos, M.D., Emily Kate Ireland, R.N., Ann Peters, R.N., Mary Wicks, R.N., M.P.A.

Strong Memorial Hospital is one of only 14 hospitals in the country cited by the Institute of Healthcare Improvement (IHI) for effectively eliminating ventilator-associated pneumonia, a common and sometimes fatal infection. IHI, a non-profit organization advocating reform in health care institutions worldwide, recognized hospitals that had not reported a case of ventilator-associated pneumonia for at least one year in a specific intensive care unit or throughout the hospital.  

"These results are truly remarkable – a testament to the hospital's deep commitment to dramatically improve the quality of the health care it provides. Strong Memorial, along with the other hospitals, have shown that ventilator-associated pneumonia, which now occurs all too frequently in U.S. hospitals, can become a thing of the past,"said IHI President Donald M. Berwick, M.D., M.P.P. "The challenge now is to make these improvements permanent and to make this the new standard of care across the country."

Ventilator-associated pneumonia, or VAP, is a lung infection that can develop in patients dependent on mechanical ventilators to help them breathe. IHI estimates that 15 percent of patients on ventilators develop this serious complication, and an estimated half of those who develop VAP die from it, making it the leading killer among all of the hospital-acquired infections with an estimated 26,000 annual deaths.

In August 2002, Strong formed an ICU Patient Safety Taskforce, which worked with the IHI to develop a new and comprehensive approach to patient care, using the Medical Intensive Care Unit (MICU) as a pilot test area.  Using evidenced-based best practices as a foundation, the group created a bundle of care procedures for VAP that includes items such as raising the head of the bed to an angle of 30 to 45 degrees, maintaining meticulous oral care and gradually weaning a patient off the ventilator. 

The results have been stunning. After the full implementation of the VAP bundle, the MICU went more than a year without one case of ventilator-associated pneumonia, and in 850+ days since its introduction to the unit, only two patients have contracted VAP.

Michael Apostolakos, M.D., director of Adult Critical Care, said the dedicated work of the staff, nurses, residents and attending physicians brought about the remarkable reduction in infections.

"Assuring that these known standards and best practices are adhered to has reduced and virtually eliminated a complication that at one time, we thought was inevitable, "Apostolakos said. "Ventilator-associated pneumonia now is rare here."

"What we have done has not really cost any money and it has produced huge results,"said Barry Evans, R.N., project manager. In fact, the American Association of Critical Care Nurses has honored the program with its Baxter Excellence in Patient Safety Award (see below).

The VAP bundle was extended to the Surgical Intensive Care Unit and the Cardio-Vascular Intensive Care Unit about a year ago and it has produced similar reductions in infections.  Training is currently underway to introduce it to the Kessler Family Burn/Trauma Unit as well.

Program Wins Baxter Award

The American Association of Critical Care Nurses has named Strong Memorial Hospital's Medical Intensive Care Unit team a winner of the Baxter Excellence in Patient Safety Award for implementing a program to reduce the cases of ventilator-associated pneumonia. The unit has had only two cases in more than 850 days.

"To be cited by the organization that sets the standards is quite a feather in our cap," said Barry Evans, R.N., M.S. N., C.N.S., project manager.

The American Association of Critical Care Nurses is the world's largest specialty nursing organization, representing the interests of more than 400,000 nurses who are charged with the responsibility of caring for the most critically ill patients.

The Baxter award is one of the association's Circle of Excellence awards. It officially will be given in May at the association's National Teaching Institute and Critical Care Exposition in Anaheim, Calif.

Strong's MICU team is one of three recipients of the Baxter safety award. The others are: the MICU Nursing Research Team of the University of Virginia Health System of Charlottesville, Virginia, and the Hackley Hospital Keystone ICU Team from Muskegon, Mich.

 

 

Wilmot Cancer Center Receives $2.5M to Support Researchcancer center

The Medical Center and James P. Wilmot Cancer Center recently received $2.5 million in research funding from Reps. Thomas Reynolds and James Walsh to help build its research capability. The funding was included in the 2006 defense spending bill.

The Wilmot Cancer Center will use the funding to conduct innovative, interdisciplinary research aimed at improving the prevention, diagnosis and treatment of cancer. Various departments throughout the Medical Center are expected to tap into the funds as they conduct research to better understand the cellular and molecular basis of the most common cancers, including breast, prostate, lung and colon cancer, as well as leukemia and lymphoma.

Construction Update
As preparations commence for the construction of the new James P. Wilmot Cancer Center facility near the corner of East Drive and Crittenden Boulevard, there will be some changes in parking and pedestrian traffic flow patterns around this area.

In late February, Lot 5 became the staging ground for all construction equipment, and will be closed during the two-year project. In addition, the South Drive entrance and exit to the Ramp Garage also has been closed, and will remain so during the majority of this construction. Medical Center and Parking Department leaders are working to help improve traffic flow by expanding lanes and opening more parking booths during peak times, and are also looking at the possibility of creating alternate roads to access the South Drive entrance/exit Ramp Garage area. Pedestrians can also expect to see changes in sidewalk routes as the project proceeds.

This project also includes improvements to the storm water drainage system, which has been a problem in the Ambulatory Care Facility. Completion should prevent the occasional flooding that occurs on the ground floor during heavy rains. As the construction progresses, patience and caution will be required. Any questions should be directed to Daniel McGraw in Facilities at 273-1959.

"I'm pleased to see the support from Representatives Reynolds and Walsh for expanding cancer research here at the University of Rochester,"said University of Rochester President Joel Seligman. "Research is the key to improving cancer survival. For example, the development of a vaccine to prevent cervical cancer began right here at the University of Rochester. Our scientists found the critical component of the vaccine that could save hundreds of thousands of lives every year."

Cancer is one of the most prevalent and pervasive diseases that people face. The Wilmot Cancer Center and University of Rochester Medical Center are committed to providing the best possible care for people in Rochester and the Finger Lakes region, said C. McCollister Evarts, M.D., CEO of the Medical Center. 

"We are dedicated to conducting cutting-edge research to bring new discoveries that will lead to cures,"Evarts said.

The Wilmot Cancer Center is in the midst of a comprehensive campaign to raise $42.5 million to construct a 163,000-square-foot, four-story building and recruit 25 additional clinicians and scientists to expand research. To date, $20 million has been raised in the community

The new building and programs will let more Rochester area residents with cancer stay close to home for the very best care and accommodate a growing number of people from outside the region coming to Rochester for Wilmot's expertise.  It's expected the new building and programs will lead to Wilmot Cancer Center doubling its workforce, bringing the number to 1,200 employees, and create an additional 700 jobs to support the operation.

"We appreciate the efforts by our delegation to support the Wilmot Cancer Center as we expand our state-of-the-art cancer care for the people of upstate New York," said Richard I. Fisher, M.D., director of the Wilmot Cancer Center at the University of Rochester Medical Center.

 

 

University Community Benefits from United Way

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Kathy Adamski with son, Jared

As the University of Rochester kicks off its 2006 Greater Rochester United Way/Red Cross campaign this month, the focus may seem to be on numbers:  more faculty and staff participation and surpassing the $1 million mark reached last year. However, what is behind these number are the agencies funded by donations and the important services they provide to over 600,000 people annually.

For Kathy Adamski, a curriculum coordinator for the Ambulatory Clerkship (ACE) at the School of Medicine & Dentistry, United Way services were the last thing on her mind as she and her family adopted a beautiful little boy a few years back.  Physically healthy, highly intelligent and "pretty darned cute" according to his mother, Jared was welcomed with open arms by Adamski, her husband and four grown children.  But the happiness soon gave way to concern, as she and her family slowly discovered that Jared had an extremely rough start as a baby and toddler.

"In addition to being born addicted to cocaine, we learned his first few years of life included abuse, trauma, severe neglect, at times malnourishment, and even abandonment," Adamski said. "He's a beautiful child who just happened to be on the receiving end of a really rotten deal."

As time passed, the family saw escalating degrees of dangerous behaviors develop. After consulting numerous professionals, Jared was diagnosed as being seriously emotionally disturbed with multiple disorders. 

"In spite of now having a family who deeply loves him, the nature of his illness lends to an overall worsening of his condition throughout his childhood," Adamski said. "With the right support from family and community, he may be helped, but in all likelihood, he will never be cured.  Our goals for Jared are very simple: all we hope for is to keep him safe, and enable the best quality of life he is capable of enjoying." 

Several United Way agencies have played an integral role in helping the Adamskis find the help that Jared so desperately needs. Through Hillside Children's Center and the Hillside Family of Agencies, Jared has had access to inpatient and outpatient emergency care services, as well as intensive home-based counseling services for Jared and the entire Adamski family.

In addition, Jared is now able to attend the Hillside/Halpern Education Center in Webster, where he benefits from all manner of services; on-site psychiatric care, social worker interaction, and excellent teaching in an environment friendly to the emotionally disabled. 

"Amazingly, most of the services were and continue to be provided at absolutely no cost to us – or to other families who need them," Adamski said. "As a result of the assistance we've received over the past several months, and help we're slated to receive in time to come, Jared has the potential to be stable more of the time, be in a safe school setting he can enjoy, and has the opportunity for a much better quality of life than we could possibly have provided for him on our own."

You will soon be receiving your 2006 United Way pledge packet by way of the many volunteers here at the University. Last year, thousands of University faculty, staff, and retirees pledged over $1 million to the Greater Rochester United Way/Red Cross Campaign – the first time we achieved this benchmark.

Remember, giving to the United Way directly helps us here at the University in many ways.  More than 830 University workers and members of their families received assistance through United Way funded services last year, and many of our patients cared for in our hospitals often need the support of services funded by the United Way. The University also receives close to $1.3 million in funding raised by the United Way for programs in our Mt. Hope Family Center, the Children's Institute, Strong Memorial Hospital, and Visiting Nurse Service.

For more information, call our United Way office at 273-4722 or visit www.rochester.edu/unitedway.  The campaign runs through March 31.

 

School of Nursing Builds for the Future

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The School of Nursing will dedicate the new, $6.3 million Loretta C. Ford Education Wing April 28. The celebration will include talks on the history and future of the Nurse Practitioner movement, a time capsule ceremony and a gala at Casa Larga Vineyards. Ford, who was dean of the School from 1972 to 1985, created the profession of Nurse Practitioner.

The 19,500-square foot wing, the largest expansion in the School's history, houses four hi-tech classrooms, seminar rooms and an auditorium. It will enable a substantial increase in student enrollment. Patricia Chiverton, Ed.D., R.N., the School's dean, has called the expansion "a truly historic moment in the long history of the School."

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Faculty Spotlight

Media Clips

Accomplishments

Donald Greenblatt’s advice and helpful tactics on getting to sleep appear in the Wall Street Journal (Mar. 1).

Karl Kieburtz discussed the search for substances, such as nutritional supplements, that slow the progression of Parkinson's disease with the Associated Press (Feb. 23), whose article was carried by dozens of outlets worldwide.

Donna Palumbo continues to be a consistent source of information for a 10-part series on ADHD. Recently she discussed the diagnosis of ADHD in pre-schoolers, and the different symptoms of boys and girls with United Press International (Feb. 22).  Earlier, she also spoke with UPI (Feb. 16) about distinguishing children with ADHD from other children.

Phil Davidson's presentation on Seychelles, discussing mercury exposure and the safety of seafood, was covered by Newsday (Feb. 20), CNN.com, the Financial Times of London, and other outlets.

ScienceNow.com (Feb. 18), a Web site run by the American Associated for the Advancement of Science, discussed with Jim Melvin the search for disease biomarkers in saliva.

Jill Halterman's work linking asthma to behavior problems in children was covered by Reuters (Feb. 16), whose story ran in media outlets nationwide.

Two professors were interviewed by major networks regarding a new study about calcium, vitamin D, and bone density. Susan Bukata appeared on NBC Nightly News (Feb. 15), while Ed Puzas was quoted on ABCNews.com (Feb. 15).

John Treanor's comments on the use of an adjuvant to stretch the supply of bird-flu vaccine were carried in the Washington Post (Feb. 12), whose story also appeared on MSNBC and in newspapers nationwide.

Research by Yi-Fen Lee on vitamin D and prostate cancer was covered by WebMD (Feb. 10).

Newsday (Feb. 10) spoke with Ronnie Guillet about the problems that some children face as a result of a drug given to some children born prematurely.

William Barker discussed with HealthCentral.com (Feb. 6) and Reuters the increasing incidence of heart failure among older adults.

Handy Gelbard's work on the brain damage from chronic neurodegenerative diseases was covered by Newsday (Feb. 3).

Donna Palumbo was interviewed by United Press International  (Feb. 1) about the mental health of children.

UPI (Feb. 1) covered a study by Fred Ling and colleagues to test whether rimonabant can slow heart disease.

John Treanor spoke about a new approach toward a bird flu vaccine with Reuters (Jan. 31) and with WebMD (Jan. 30).

Associate Professor of Ophthalmology and Neurology Deborah I. Friedman, M.D., was recently elected president of the North American Neuro-Ophthalmology Society (NANOS), a professional organization of more than 500 members which aims to provide neuro-ophthalmology education at all levels: practicing physician, physicians in training, medical students, and patients. Friedman will serve a two-year term, becoming the organization’s chief spokesperson for the media, public and government agencies. Friedman also was recently elected a fellow of the American Headache Society, a professional society of health care providers dedicated to the study and treatment of headache.

Nationally renowned breastfeeding expert Ruth A. Lawrence, M.D., who directs the Breastfeeding and Human Lactation Study Center at Golisano Children’s Hospital, will serve as editor-in-chief of Breastfeeding Medicine, a new peer-reviewed journal being launched by the Academy of Breastfeeding Medicine. The inaugural issue of the quarterly publication is slated to publish April 1.


 

 

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Last updated: 06/23/2009 10:08 PM