CHICAGO, July 2 (Xinhua) -- Indwelling devices like catheters cause roughly 25 percent of hospital infections, and most problems with catheter use stem from poor physician-nurse communication, a study posted on the website of the University of Michigan (UM) on Monday states.
Source: Xinhua| 2019-07-03 02:59:16|Editor: yan
UM researchers interviewed a small group of nurses, physician assistants, nurse practitioners and physicians about problems monitoring and communicating among their teams about patients' indwelling catheters.
All respondents said poor communication delayed removal of unnecessary catheters. Communication broke down for various reasons and on many levels: poor relationships between doctors and nurses, hierarchical differences or misalignment of workflows that prevented nurses from being present for daily rounds.
Catheters are hidden beneath blankets, so physicians don't automatically know who's using one, especially if a nurse isn't there to point it out.
Catheters often remain in too long, which can cause infection, or they aren't necessary at all. It's estimated that 60 percent to 90 percent of intensive care patients, and 10 percent to 30 percent outside the ICU have urinary catheters, according to the study.
"Any foreign object in the body carries an infection risk, and a catheter can serve as a superhighway for bacteria to enter the bloodstream or body," said Milisa Manojlovich, a professor at the UM School of Nursing.
Electronic health records also cause confusion, sometimes nurses and doctors have different information, or there's a lag updating charts, or a reliance on both paper and computer records causes problems, Manojlovich says.
Research shows that some patients and caregivers request catheters, believing they're preferable to getting up to use the toilet. However, they should understand that catheters bring risk of infection, and non-infection risks such as pain, trauma or bleeding, and should talk to their nurse or physician about complications.
The study is slated for the July issue of the American Journal of Critical Care.
Cancer Research UK says it is not about blaming people for being overweight.
Nor is it suggesting that smoking and obesity are directly comparable in terms of cancer risk. Both increase a person's risk.
But it says being overweight or obese causes around 22,800 cases of cancer each year, compared to smoking which causes 54,300. For the four highlighted cancers:-
Bowel - Of around 42,000 new cases, being overweight or obese causes 4,800, smoking 2,900
Kidney - 12,900 in total; being overweight or obese causes 2,900, smoking 1,600
Liver - 5,900 in total; being overweight or obese causes 1,300 cases, smoking 1,200
Ovarian - 7,500 in total; being overweight or obese causes 490 cases per year, smoking 25
Smoking remains the UK's leading preventable cause of cancer overall. Obesity ranks second, says CRUK.
But while smoking rates are decreasing, obesity is increasing, which health experts agree is concerning.
When asked about plans to extend the tax on soft drinks to milkshakes, Mr Johnson mocked his own weight and said he was "very, very reluctant" to imposes taxes that "clobber those who can least afford it".
He suggested we "encourage people to walk, cycle and generally do more exercise".
Media captionIn 2018, Cancer Research UK said around 38% of all cancers diagnoses could have been prevented
Just over one in four UK adults are obese.
In the UK, there are about:
13.4 million obese adults who do not smoke
6.3 million adult smokers who are not obese
1.5 million obese adult smokers
While the link between obesity and cancer is well established, the biological mechanisms behind it are not yet fully understood.
Fat cells make extra hormones and growth factors that tell cells in the body to divide more often. This increases the chance of cancerous cells being made.
Physical activity probably plays a role too, experts say.
Being overweight or obese does not mean a person will definitely develop cancer but it does raise their risk.
And this risk is higher the more weight a person gains and the longer they are overweight for.
According to Cancer Research UK, 13 different cancers are linked to obesity: • breast (in women after the menopause) • bowel • pancreatic • oesophageal (food pipe) • liver • kidney • upper stomach • gallbladder • womb • ovarian • thyroid • multiple myeloma (blood cancer) • meningioma (brain cancer)
The link between obesity and cancer is in adults only, although a healthy weight is important for children too.
Each year in the UK, the charity says, excess weight causes about:
1,900 more cases of bowel cancer than smoking
1,400 more cases of kidney cancer
460 more cases of ovarian cancer
180 more cases of liver cancer
Prof Linda Bauld, Cancer Research UK's prevention expert, said the government should do more to tackle the UK's obesity problem.
The government had been slow to restrict unhealthy food and drink ads, the British Medical Association said.
"While we are very much aware of the health risks associated with smoking, less effort has been thrown behind tackling obesity, which is now a major cause of cancer," it said,
NHS England chief executive Simon Stevens said: "The NHS can't win the 'battle against the bulge' on its own.
"Families, food businesses and government all need to play their part if we're to avoid copying America's damaging and costly example."
Obesity is rivalling smoking as a cause of cancer, responsible for more cases of bowel, kidney, ovarian and liver cancer than cigarettes, according to the UK’s leading cancer charity.
Smoking is still the biggest cause of cancer, but Cancer Research UK (CRUK) has warned that government action to tackle obesity is vital, because it is a significant factor in 13 different types of cancer. Obese people now outnumber smokers by two to one.
Michelle Mitchell, the charity’s chief executive, said: “As smoking rates fall and obesity rates rise, we can clearly see the impact on a national health crisis when the government puts policies in place – and when it puts its head in the sand.
“Our children could be a smoke-free generation, but we’ve hit a devastating record high for childhood obesity, and now we need urgent government intervention to end the epidemic. They still have a chance to save lives.”
Excess weight causes about 1,900 more cases of bowel cancer than smoking in the UK each year, said CRUK. There are also 1,400 more cases of kidney cancer caused by excess weight than by smoking each year, 460 more ovarian cancers and 180 more cases of liver cancer.
The charity issued its warning as figures were released by Public Health England and the Office for National Statistics showing the decline in smoking in the UK. There has been a big reduction in the overall smoking rate to 14.7% last year, down five percentage points from 2011. Across the UK, 26% of the adult population were classified as obese in 2016, while 40% of men and 30% of women were overweight.
Simon Stevens, the chief executive of NHS England, said: “Although cancer survival is at a record high, this significant progress is in danger of being undone by the fast-growing epidemic of obesity, given excess weight is linked to 13 types of cancer.
“This study is further proof that obesity is the new smoking, and the NHS can’t win the ‘battle against the bulge’ on its own; families, food businesses and government all need to play their part if we’re to avoid copying America’s damaging and costly example.”
Caroline Cerny of the Obesity Health Alliance, a coalition of more than 40 health organisations, said: “The causes of obesity are complex, but we know that the environment we live in plays a huge role, and currently this is heavily skewed towards unhealthy options. This is why we need the government to push on with plans to bring in a 9pm watershed on junk food adverts on TV and online, reduce the amount of unhealthy food promoted in supermarkets, and take sugar out of everyday food and drinks.”
Eating too much sugar contributes to people having too many calories during the day, which can lead to weight gain. Being overweight increases the risk of health problems such as heart diseases, type 2 diabetes, and some forms of cancer. Sugar is also one of the main causes of tooth decay.
The NHS advises that most adults and children in the UK eat too much of a type of sugar called 'free sugars'. These are the sugars added to food and drinks, found in biscuits, chocolate, breakfast cereals and fizzy drinks. But they are also found naturally in honey and unsweetened fruit juices.
The UK government’s recommendation is that these 'free sugars' should not make up more than 5% of the calories you have every day. That is still quite a lot of sugar - it equates to seven sugar cubes worth for an adult. But bear in mind that one can of a fizzy drink can include the equivalent of 9 cubes of sugar. Children under 4 should avoid all sugar-sweetened drinks and food with added 'free sugars' in it.
Sugar found naturally in milk, fruit and vegetables does not count as 'free sugars', so people do not need to cut down on them.
Martin Belam
CRUK agrees with that agenda. “There isn’t a silver bullet to reduce obesity, but the huge fall in smoking over the years – partly thanks to advertising and environmental bans – shows that government-led change works. It was needed to tackle sky-high smoking rates, and now the same is true for obesity,” said Prof Linda Bauld, the charity’s prevention expert.
The British Medical Association said the government was dragging its heels over bringing in measures to curb obesity. “The severity of this problem must not be underestimated. As well as the pressing need to raise public awareness of the worrying link between obesity and multiple types of cancer, we need to see a reversal of the cuts to public health funding so we can prevent children and adults reaching this critical stage. Failure to do so will continue to cost lives,” said the association’s board of science chair, Prof Parveen Kumar.
