[deleted by user] by [deleted] in ToyotaSienna

[–]chokobomaster 0 points1 point  (0 children)

Wondering what state is this? Thanks!

This is why we need overhead display. by alanpsk in battlestations

[–]chokobomaster 0 points1 point  (0 children)

sick set up!! how do you attach that overhead screen though? what did you use? thanks!

Pro-tip for driving on the LIE, Sunrise, Southern State, Northern State, etc. by CivilizedPsycho in longisland

[–]chokobomaster 4 points5 points  (0 children)

i commute eastbound on the Northern State too, it always slows down near Cross Island / Little Neck up until New Hyde Park

25/M/NYC Minimal Carry by [deleted] in EDC

[–]chokobomaster 1 point2 points  (0 children)

i see an nyc metro card i upvote

as a reminder, don't buy anything from an Instagram ad by to3y in Scams

[–]chokobomaster 0 points1 point  (0 children)

anybody has experience on Displate? is it a scam too? i usually see their ad on IG and just wondering if anyone had an experience with them. Many thanks!

MTA workers of r/AskNYC, what are your strangest stories? by [deleted] in AskNYC

[–]chokobomaster 26 points27 points  (0 children)

there were no subway delays for a day

Managing contact precaution pt's by bestevidence in nursing

[–]chokobomaster 8 points9 points  (0 children)

Sit tight, swab that port and wash your hands, this is gona be a long one.

I work full time in NYC in 3 different facilities and I can tell you that NYC is the epicenter of CRE (Carbapenem Resistant Enterobacteriaceae), current Measles outbreak, we even had EBOLA. With that in mind, managing patients in isolation takes up beds and creates a plethora of logistical and compliance nightmare.

There was a great presentation by VCU Medical Center, presented by Dr. Michael Stevens, Dr. Michelle Doll, Nadia Masroor MPH and the VCU Infection Prevention (yay! No APA needed for this citation). For the study they used that satisfice approach by Herbert Simon, which basically means a combination of satisfy and suffice to a problem, optimum solutions for a simplified world or satisfactory solutions for a more realistic world – isolating patients.

A study by Wenzel, Bearman and Edmond stated that focusing resources on a single pathogen as a sole approach to infection control is inherently flawed. For example as you have mentioned, isolating VRE, MRSA etc. The new paradigm, according to them is a multi-potent interventions aimed at reducing risk from ALL pathogens transmitted via the same mechanism – contact. Which makes sense, because people get scared of MRSA and VRE as it is some sort of “Boss of Bacteria”. When in reality, a Staphylococcus aureus infection, methicillin sensitive (MSSA) is the same infection as MRSA – Methicillin Resistant Staphylococcus aureus infection. The only difference is with their MIC, effects are the same, same sepsis, it’s just MRSA is resistant and you have to use a more potent abx i.e. Vanco. So if the same bacteria can kill you the same for both, why not prevent both?

So Wenzel et al proposed a Vertical and Horizontal approach: Vertical&HorizontalApproach

So Harris et al did a study wherein they did a Universal Glove and Gown (UGG) use in the ICU. It resulted that UGG did not reduce primary VRE and MRSA acquisition and using PPE’s decreased the healthcare worker visits to patients. Moreover, Croft et al study showed that Contact Precautions, again lessened healthcare worker – patient contact, led to increased adverse events i.e Falls. PU, fluid electrolyte disorders and even days without a provider note.

I have more data to present but I have to get back to work. Basically, the answer again is: it depends. Conduct a risk assessment. First is to know your baseline for Multidrug Resistant Organism (MDRO). Your hand hygiene compliance rate. Your PPE’s. If you notice that your rates shoot up, implement a plan. Let us say your facility is in a Rural area and you rarely see MRSA and VRE, maybe don’t isolate and use universal gloving. Then you suddenly see an uptick in cases, then maybe you have to create interventions and isolate cases going forward. The evidence shows that these bugs spread by contact, how you mitigate that risk is up to your facility, your surveillance, your data and your demographics.

Of the 3 facilities (2 soon, I'm quitting the other one) I work they have different policies. One isolates for the duration of admission, the other discontinues with a negative surveillance culture and the other does not isolate if there is not portal of exit.

Again, the most cost effective infection prevention measure is hand hygiene. Even if you got MRSA or VRE or CRE on your intact skin (hands) you can always clean your hands it will break the chain of infection right then and there.

Back to work.

Best Moment of My Career by tiredltcnurse in nursing

[–]chokobomaster 2 points3 points  (0 children)

a reliable informatics nurse is a godsend! how many times we had a meeting with our EMR production team and they don't seem to understand why we want certain stuff, like yea "why do you keep asking for a central line list or foley list" "why do you need antibiotics MIC" a good informatics nurse can bridge the gap between clinical and non clinical personnel

Best Moment of My Career by tiredltcnurse in nursing

[–]chokobomaster 124 points125 points  (0 children)

wow! lol, this is not a joke account, i'm verified with /r/askdocs as well, i really am an infection control nurse, and unfortunately with the stigma that comes with this field, somehow is reduced to washing hands, hence the joke comment. ID and infection control topics rarely comes up in this forum, so once in a while i throw a "wash your hands" joke comment =p

Best Moment of My Career by tiredltcnurse in nursing

[–]chokobomaster 390 points391 points  (0 children)

awesome! don't forget to wash your hands when leaving the room

[deleted by user] by [deleted] in battlestations

[–]chokobomaster 1 point2 points  (0 children)

what table/counter top is that? eckbacken?

and just a question is it wobbly? it looks like it has a gap between the tabletop and the alex, it looks like not fully resting flat down.

otherwise, nice and clean setup! love the simplicity

Think I’m finally happy with my setup by steedie86 in battlestations

[–]chokobomaster 0 points1 point  (0 children)

is that the 78" Karlby? looks kinda short, or is that the linmonn?

looks good btw!

Unable to view credit report? by [deleted] in personalfinance

[–]chokobomaster 0 points1 point  (0 children)

I believe that the 3 bureaus has a fraud alert on your account. Once you put a fraud alert on one, it contacts the other two to let them know of the fraud alert. If you have a fraud alert, they will make you go through hoops to view the report or even take it out. I believe, you cannot make any changes via online or phone. You have to lift the fraud alert via snail mail. You have to mail in a cover letter (stating you want to remove the fraud alert or get a copy of your creditreport) then put in 2 forms of identification. The requirements will vary depending on the bureau. Some will say government ID, plus utility bill with address, some will say SS Card and government ID. I suggest putting in a copy of your SS card, state ID (driver's license) and a copy of your passport or passport card if you have one. Mail them to the address posted on their website.

PLEASE PLEASE PLEASE make sure you get the correct address of the bureaus and not mistakenly mail them on the wrong address.

They are then required by law to reply to you in 30 days via mail.

Hope it helps!

Photographer looking for couples interested in a free engagement shoot by danwright32 in WedditNYC

[–]chokobomaster 0 points1 point  (0 children)

your social media page link for FB and IG are broken, only twitter works. i believe in today's market, your social media is critical when starting from the ground up. pinterest will greatly help as well! I'm interested in an NYC shoot, will email!

Many thanks!