Nursing care for patients infected or colonized with vancomycin-resistant enterococci (VRE)

Advances in medicine enable many patients to regain their health. But, at the same time, they become susceptible to hospital-acquired infections. The occurrence of vancomycin-resistant enterococci is a considerable problem in the modern health system. In order to limit the risk of VRE infection, proper patient care is vital, which is focused on compliance with relevant procedures (isolation, decontamination, education). Mutual cooperation between charge nurses and the ward sister and epidemiological nurse plays a major role in nursing surveillance of patients with VRE.

[Wound care management of ulceration in a palliative care patient]

The wound care management of a palliative care patient with sinusitis pinoidalis is documented. The treatment is validated by the expert's opinion. There is only little evidence-based treatment of such a lesion. In our experience, photo documentation is helpful in decision-making during the treatment process. In addition, healing of larger defects seems to improve upon frequent and extensive liquid cleansing.

Vancomycin peak serum concentration monitoring

Vancomycin is a glycopeptide antibiotic commonly used in the treatment of gram-positive bacterial infections. With the rising prevalence of resistant gram-positive bacterial infections in healthcare institutions and the advent of attempts to curb escalating medical cost, vancomycin is being used with increasing frequency in the homecare setting for infection management. In view of its variability in pharmacokinetics and the potential for toxicities, serum concentrations often are measured. This article reviews the pharmacology of vancomycin and suggests a practical approach to serum concentration monitoring in homecare.

Vancomycin-resistant enterococcus

Vancomycin-resistant enterococcus (VRE) rapidly is becoming a significant cause of nosocomial infections. VRE lives in the environment (e.g., bedside tables, side rails, door knobs) for five to seven days, making transmission difficult to eliminate. Patients who are immunosuppressed or are receiving multiple antibiotics are particularly susceptible to developing VRE infections. Nursing management is the cornerstone of prevention and treatment. Nurses need to identify patients at risk, maintain isolation, and educate patients, family members, and other healthcare team members.