The Role of Physician and Nurse Attitudes in the Health Care of Injecting Drug Users

In 2005, 60 health care workers were recruited through services that attract injecting drug users (IDUs) and asked to complete attitude measures regarding IDU clients. Mediation analyses indicated that conservative health care workers displayed more negative attitudes toward their IDU clients because they believe that injecting drug use is within the control of the IDU. Negative attitudes toward IDU clients, in turn, were associated with worry about IDU clients’ behavior in the clinic and with beliefs that IDU clients should disclose their hepatitis C status to their health care worker. Perceptions of controllability of drug use were also associated with the belief that IDU clients’ ailments were caused by their IDU status. The study's limitations are noted.     

Clinician Confidence About Conversations at the End of Life Is Strengthened Using the Four Habits Approach

Communicating about cancer is not easy. At a time when patients are asked to make complicated choices about treatment and to be responsible for most of their own care, communication problems are consistently presented as a barrier to satisfactory medical treatment. This article identifies problems in communication and describes interventions the multidisciplinary team can use to improve the exchange of information and feelings among patients, families, and health care providers. The specific focuses are communication at the time of diagnosis and during progressive disease and the challenges and difficulties of communicating about pain, sexual functioning, and financial problems throughout the cancer experience.     

The coated antiseptic tip (CAT) syringe

Abstract

Catheter-related blood stream infections (CR-BSI) account for 30% of healthcare acquired infection (HAI). Colonization of connector hubs and contaminated syringes are thought to increase the risk of CR-BSI. The Coated Antiseptic Tip (CAT) syringe was developed to decontaminate connector hubs, thereby reducing the risk of CR-BSI. Needleless valves (n?=?20) and three-way connectors (n?=?20) were contaminated with common critical care pathogens. At hourly intervals, CAT syringes were inserted into the connector hubs and normal saline was injected through the connector. This was repeated with control (non-coated) syringes. The internal surface of the connector hubs were swabbed at t?=?0, t?=?1?h and t?=?4?h, inoculated onto blood agar plates and analysed by a blinded microbiologist. Growth was counted as the number of colony forming units. Baseline swabbing demonstrated 100% bacterial hub colonization in both connectors. The CAT syringe showed a significant reduction in CFU growth at 0 and 1?h compared with control syringes (p?<?0.05). At 4?h, the CAT syringe completely eliminated bacterial growth in both of the connector hubs. The CAT syringe can effectively disinfect both three-way and needleless connectors.