Nurse bags: A hospital health threat

Getting sick or dying from something you catch while in the hospital happens more than you may think. 1.7 million people get infections in hospitals every year, and nearly 100,000 people will die from them.

While hospitals have safety measures in place, they can't protect you from what they don't know is a potential threat.

How one nurse's discovery could save lives for thousands of people.

They can be lifesavers, but these resuscitation bags, known as ambu bags, may also be a danger.

If contaminated, the ambu bag can collect bacteria, which could be transmitted to the patient and contribute to the potentially-deadly ventilator associated pneumonia. But safety guidelines for using the bags are vague. The CDC recommends only that they be replaced as needed or when they're visibly soiled.

"Well, what may be visibly soiled doesn't necessarily mean that it's not infectious because you can't see bacteria,” explains Lorene D. Cathey, MSN, RN, CIC, the director of infection prevention at UT Medical Center.

That prompted registered Nurse Niki Rasnake to lead a study at the University of Tennessee Medical Center to help establish new safety guidelines.

"I followed 147 patients and followed them through the first seven days of their hospital stay, if they were intubated, and I would actually take their actual bag,” explains Niki Rasnake BSN, RN, CEN, the trauma program manager at University of Tennessee Medical Center. “They would seem clean in appearance, but when we swabbed them, they did, grow out bacterial growth."

Rasnake says there was a seven to eight percent chance of contamination on the first two days of using the ambu bag, but that number jumped to nearly 30 percent by days five and six.

"And that's what alarmed us because a lot of people could be ventilated, on a ventilator, for, you know, anywhere from one to two weeks," says Niki.

Thanks to Rasnake's discovery, the hospital now changes the filters on its bags every four days.

Rasnake's study, along with other measures, contributed to a 44 percent drop in ventilator-associated pneumonia cases over the past two years at the UT Medical Center.

She recently presented her findings at a national conference and hopes they will enhance safety precautions across the country.

Nurse bags: A hospital health threat
REPORT #1997

BACKGROUND: Pneumonia is an infection in the lungs caused by breathing in bacteria or because of illness. It becomes much easier for infection to cause pneumonia after having a cold or flu. These illnesses can make it more difficult for the lung to fight off infections caused by bacteria. Pneumonia can range in seriousness from mild to life-threatening.

TYPES OF PNEUMONIA: There are three main types of pneumonia: community-associated pneumonia, healthcare-associated pneumonia, and "walking" pneumonia. Community-associated pneumonia occurs when one gets the infection from a place in everyday life; such as school, work, or one's home. Healthcare-associated pneumonia comes when the infection originates from a hospital or nursing home. What doctors sometimes call "walking" pneumonia is simply a term for more mild pneumonia symptoms. (SOURCE:

SYMPTOMS: There are a variety of symptoms associated with the bacteria which can cause pneumonia. The most common are:

* Coughing, especially coughing up mucus or blood
* Shortness of breath
* Chest pain that fluctuates with breathing

HEALTHCARE-ASSOCIATED PNEUMONIA: Perhaps the most serious type of pneumonia is healthcare-associated pneumonia. The infection is more harmful because, many times, the bacteria which cause the infection can be multidrug-resistant. Even with drug-resistant strains of the illness, the best way to treat the infection is with a course of antibiotics. However, even these may cause the infection to become more resistant. (SOURCE:

For More Information, Contact:

Niki Rasnake BSN, RN, CEN
Trauma Program Manager
University of Tennessee Medical Center

Lorene D. Cathey, MSN, RN, CIC
Director, Infection Prevention
UT Medical Center

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