October 3, 2012 Meeting Minutes

Welcome

Introduction to Blood Management & Transfusion Safety

The Biology of Influenza Leading to Pneumonia and Current Diagnostic Options

Roundtables

The 2012 Fall meeting with Vendor fair was held at the Doubletree Hotel in Alsip, Illinois on Wednesday, October 3rd from 9:00 AM to 3:00 PM.  The meeting was attended by 34 registered healthcare professionals and sponsored by Alere, Hemocue and MAS.  Registered vendors included: Abaxis, Alere,  BD, Beckman Coulter, Enterix Inc, Fisher HealthCare,  HemoCue, Innovative Medical Systems, ITC, Laboratory Data Systems, MAS, Nova Bio-Medical, PTS Inc/CardioChek, Quidel, Radiometer, Roche CoaguChek, Roche Glucose, Siemens, and Telcor. 

Welcome: The meeting commenced with opening remarks by Joanne McEldowney, RN.  Members of the core group include:  Wendy Denk, Ingalls Hospital, Harvey, IL; Joanne McEldowney, RN, Univ of Illinois – Chicago, Chicago, IL; Gil Salas, Univ of Illinois – Chicago, Chicago, IL and Sandra Curran, Univ of Illinois.    

The first session, “The Biology of Influenza Leading to Pneumonia and Current Diagnostic Options”, was presented by Norman Moore, PhD, Director of Scientific Affairs, Infectious Diseases and was sponsored by Alere.  Dr. Moore gave a brief history of Streptococcus pneumoniae and Influenza, emphasizing the significance of both on the US population.  Pneumonia is the sixth leading cause of death in the US and the major cause of death from infectious diseases.  With an aging population, Pneumococcal pneumonia cases may increase 96% between 2004 and 2040.  As for the Influenza virus, there are different strains each year and 5-20% of the US population is affected annually.

The Infectious Disease Society of American/American Thoracic Society Consensus Guidelines include Diagnostic testing that requires a chest Xray or other imaging techniques for a diagnosis of pneumonia and recommends identifying the specific pathogens before administering drugs. 

Common Diagnostic tests for Pneumonia: Gram stain, Sputum culture, Blood culture, Latex agglutination assays, DFA/IFA, PCR, Serology, Urinary antigen  

Common Diagnostic tests for Influenza: Viral culture, DFA, PCR and rapid tests.

The Vendor Fair was held from 10am – Noon and once again we thank the vendors for their support and the time they spent with us.

There are pros and cons for all diagnostic tests, way too many to include in this synopsis.  There are, however, three ways to improve Influenza rapid test performance: test early infections (at the “I think I’m getting something” stage), ensure sample collection is appropriate (NP swab and nasal wash), and limit the dilution in transport media.

There is a connection between influenza and pneumonia based on an Emerging Infectious Disease study.  Concurrent infection significantly increases risk of complications and if only looking for influenza, pneumococcal pneumonia may be missed or if only looking for pneumonia, influenza may be missed.

Following the Vendor Fair and lunch, “Introduction to Blood Management & Transfusion Safety” was presented by Joseph Thomas, RN, BSN/ Vice-President, Program Services, Strategic Healthcare Group LLC and sponsored by Hemocue.  Although the opportunity for POC testing could play a role in a  blood management program, bedside hemoglobin/coagulation testing is not performed at all hospitals so the clinical laboratory provides hematology and coagulation capabilities for the high acuity patient. Joseph gave an informative talk about the need to address the triggers for blood transfusions, transfusion ordering practices and hospital anemia management and prevention.

Sandra Curran led the Roundtable Discussions

• How are you authenticating physician verbal POCT orders?

• Do the Tight Glycemic protocols using POC devices in critical care patients improve outcomes or not?

• Recent CAP or TJC outcomes (fire drills, Physician Performing Microscopy, min/max temperatures, verbal orders)

• Causes and frequencies of failed electronic transmissions of POC results. Upload failures-why?

• Anyone using gastric pH testing for correct NG placement? Any problems encountered because of erroneous test results? If patient’s on an inhibitor, don’t need to measure the pH?

 There will be no spring meeting; the next meeting with a Vendor Fair will be October 2, 2013 at the Doubletree Hotel in Alsip. 

Respectfully Submitted,

Wendy Denk, MT(ASCP)