BACKGROUND: This is the first study to determine whether nonskid slipper socks in contact with the hospital floor and worn into bed contaminate bed linen. PURPOSE: The main purpose of the study was to determine whether contamination of hospital linen occurred with bacteria transferred from the soles of nonskid slipper socks that have touched the floor. METHODS: This study mimicked real patients walking on a hospital floor wearing slipper socks and getting back into bed with the slipper socks on. Swab samples were collected from the surfaces of the hospital floor, nonskid slipper sock bottoms, and bed linen in 2 Midwestern hospitals. From the samples, bacterial isolates were identified and tested for antibiotic resistance. RESULTS: Isolates obtained from the samples were identified on all 3 surfaces at both hospitals, indicating spread of the bacteria from floor to the bed linen via the nonskid slipper socks. Antibiotic sensitivity test revealed that a significant number of isolates collected were resistant to at least 2 antibiotics tested. CONCLUSION: This study demonstrates cross-contamination of bed linen with potentially pathogenic bacteria present on the hospital floor via contact with patient-worn nonskid slipper socks. A simple practice change regarding the wearing of slipper socks could play an important role in preventing pathogen transfer to the bed linen. Awareness of the likelihood of hand contamination after touching the sock bottoms that have come in contact with the hospital floor should also be considered.

Patients who have major orthopaedic surgery are at high risk for developing venous thromboembolism (VTE). Assessment of risk and treatment to prevent VTE are considered standard of care due to its significant morbidity, potential mortality, and clinical burden and cost. Guidelines are available aiding orthopaedic surgeons to choose the best methods of VTE prophylaxis. Optimal VTE prevention has not been achieved. Recent advances in the understanding of the coagulation cascade have evolved because of a novel understanding of the molecular influences on the coagulation pathway. Subsequently, new anticoagulants have been developed that target specific factors within the coagulation cascade that are contrasted to the currently used agents that have a broad effect on the coagulation pathway. Multiple clinical trials have tested the new anticoagulants within the orthopaedic total knee and total hip arthroplasty arena. In addition, research to find new ways to prevent VTE was driven by limitations of the currently available agents. The new oral anticoagulants extensively trialed in orthopaedics are dabigatran, rivaroxaban, and apixaban. Clinical trials indicate that the new oral agents have the potential to impact VTE prophylaxis in regard to efficacy, predictability and consistency, clinical monitoring, adherence as to use and duration, and convenience. Concerns persist regarding issues of bleeding complications, liver enzyme elevation, patients with renal disease, and drug-to-drug interactions. The new oral agents do not have an antidote to reverse bleeding effect and have no reliable assay to measure effect. Nurses need to be aware of these new VTE prophylactic choices and their implications in order to provide the best outcomes for their patients.

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in trauma. What is known regarding VTE prophylaxis has been extrapolated from nontrauma data. Optimal methods of VTE prevention for trauma remain controversial and unknown. Trauma patients are unique and heterogeneous rendering many forms of treatment inappropriate. The most fatal complication of VTE is a pulmonary embolism (PE). There is a long history of protection against PE as vena caval interruption. Inferior vena cava (IVC) filters were designed to protect against PE. Since the approval by the Food and Drug Administration for the use of retrievable filters, trauma care specialists are increasingly choosing this form of prophylaxis. Indications for use, efficacy, and safety of IVC filters remain debated. There is lack of rigor in studies concerning IVC filters. Filters are not without complications. Removal rates for retrievable filters are poor. Nursing is instrumental in IVC filter prophylaxis, efficacy, and safety success.

Discussion of polysaccharide storage myopathy (PSSM) on four casesPolysaccharide storage myopathy (PSSM) is characterized by abnormal polysaccharides and increased glycogen storage in the musculature of affected horses, which are predisposed for recurrent exercise-induced myopathies. A familial predisposition for PSSM has been reported in American Quarter Horses (AQH) and related breeds. Two AQH and a Swiss Warmblood were presented to us for recurrent rhabdomyolysis and one Haflinger for severe exercise intolerance. The signalment, clinical examination, and serumactivity values of CK, ASAT and LDH before and after an exercise test lead to the tentive diagnosis of PSSM, which was confirmed by the histopathological evaluation of muscle biopsies. Increased muscle glycogen and pathognomonic, PAS-positive amylase-resistent polysaccharides were present in all the cases. Our report illustrates that PSSM must be included in the differential diagnosis of exercise induced recurrent myopathies in AQH as well as in horses of other breeds in Europe.