When pregnant women are tested for group B strep (GBS), some might wonder about how this particular bacteria can cause harm. July’s International Group B Strep Awareness Month aims to provide information and awareness around this potentially devastating pregnancy, birth, and early infant complication.
“Babies can become infected with GBS during passage through the birth canal if their mother is colonized,” says Marti Perhach, CEO and cofounder of Group B Strep International, whose daughter Rose was stillborn due to group B strep. “If exposed to GBS in this way, babies can then become colonized at the mucus membrane sites of their gastrointestinal or respiratory tracts.”
Pregnant women are routinely screened for group B strep in late pregnancy, but not always. Because the bacteria can be passed along to the baby during pregnancy and delivery, infants are especially susceptible to infection. “GBS can be dangerous to babies due to their underdeveloped immune systems and the virulence of group B strep,” says Perhach. “GBS most commonly causes sepsis, meningitis, and pneumonia. Some GBS survivors experience handicaps such as blindness, deafness, mental challenges, and/or cerebral palsy.”
The Centers for Disease Control and Prevention offers a clear explanation about GBS infection in this Prevention of Perinatal Group B Streptococcal Disease report (page 3) where the organization notes the following guidelines: “Early-onset infections (within the first 7 days of life) are acquired vertically through exposure to GBS from the vagina of a colonized woman. Neonatal infection occurs primarily when GBS ascends from the vagina to the amniotic fluid after onset of labor or rupture of membranes, although GBS also can invade through intact membranes. GBS can be aspirated into the fetal lungs, which in turn can lead to bacteremia. Infants also can become infected with GBS during passage through the birth canal; infants who are exposed to the organism through this route can become colonized at mucus membrane sites in the gastrointestinal or respiratory tracts.”
The bacterium is the leading cause of infection in newborns in the United States, Perhach says, and is particularly dangerous because it can morph into severe symptoms very quickly. And while many people think of strep throat when they hear about strep bacteria, the kind that often affects the throat is strep A.
Even women who test negative for GBS in the last weeks of pregnancy can still become colonized or they may receive a test with a false negative result. “More than 60 percent of GBS cases within the first seven days of life occur in babies whose mothers had tested negative for GBS,” Perhach says. GBS is a naturally occurring bacteria, often found in the gastrointestinal tract where it is the source for genitourinary colonization, she says.
What do nurses need to know about group B strep infection? According to Perhach, it’s essential to recognize that pregnancy and delivery can pose a risk for GBS infection, but GBS can still cause potential for harm before and after delivery. “GBS can cause babies to be miscarried or stillborn (known as prenatal-onset GBS disease) as well as born too soon,” she says. “GBS can cause preterm labor and preterm premature rupture of membranes. GBS can also infect babies from seven days after birth up to several months of age which is called late-onset. Late-onset disease is primarily acquired by horizontal transmission from the mother, but also can be acquired from hospital sources or from individuals in the community.”
And although treatment is generally intrapartum antibiotics given to women, they are only effective about 90 percent of the time, says Perhach. “Nurses should know the signs and symptoms of possible GBS infection in babies, before and after birth,” says Perhach. Group B Strep International has several brochures for nurses to find more information. Because GBS can still show up in the early months of an infant’s life, it’s especially important for neonatal nurses and others who might encounter parents and infants to be aware.
Group B Strep International is also offering a free online presentation “Signs of GBS Disease: Eyes and Ears” during the International Conference on Group B Strep (ICGBS) 2020 July 20-22 (the presentation can be accessed online after the conference as well).
Spreading the word about preventing GBS infections, prevention measures, and awareness of the signs and symptoms of infection can go a long way toward catching the problem early and preventing a problem.
Summer is here and the living is supposed to be easy. But for nurses, especially in 2020, the summertime looks like it’s going to be pretty busy. Are you looking for an energy boost?
Even as cases of the coronavirus taper off in some of the spring hotspots, it’s increasing at a rapid rate in other areas across the country. As a nurse, you know caring for yourself right now is essential, even as you find your time and energy depleted.
One way to boost your energy, your immunity, and your outlook is by eating food that offers both top nutrition and comfort food but is easy to prepare. As a bonus, any leftovers become an easy lunch to bring to work.
Here are a few tips for focusing on food to give you energy.
- Choose Seasonal Foods
Summer makes it easy to get a lot of nutrition because so many fruits and vegetables are in season. Whether it’s in a supermarket, a big box store, or a farmers’ market, ripe produce is often available when you are doing other errands. Choose peaches and melons that are sweet, packed with energy-boosting water, and offer plenty of vitamins. Dark green lettuces are tender, easy to wash, and full of folate.
- Get Your Protein
Protein prevents hunger pains between meals, fuels your long days, and keeps your body running. Lots of people choose to cut down on protein when they are trying to lose weight (or some weight-loss plans rely on protein overloads). Keeping a steady supply of protein from your food choices varies nutrition totals and keeps you from fading fast during a long shift. Choose from meats and seafood, beans, tofu, cheeses, and other dairy items like yogurt.
- Try Something New
You don’t have to be in the mood to whip up new recipes to try something new. Many supermarkets offer prepared foods that you can try with a small size or just commit to trying a new food. Or see if your family or a friend would want to go in on ingredients and try to come up with a dish that take less than five ingredients and three steps.
- Convenience Works
When you’re tired and facing down the dinner hour, a prebagged, washed salad and a cooked rotisserie chicken makes a great dinner with plenty of leftover possibilities. Premade soups, slices of veggie pizza, and frozen meatballs also add variety and ease to your meal selections. Thaw bagged, cooked frozen shrimp and cook a box of pasta—top both with a jarred cream sauce and some cherry tomatoes and you have a nutritious and filling meal. Watch out for extra salt and fat in some premade meals, but choosing something easy is what summer eating is all about.
Be mindful of what you’re eating and see if you notice any changes in your energy levels or even in the way you look at food. Summer is a good time to lighten up cooking effort, but you don’t want to skimp on getting healthy food. Make it enjoyable and easy to prepare and recoup a little peace during these stressful times.
Today is World Sickle Cell Day—a day designed to spread awareness and understanding of sickle cell disease–an often painful inherited blood disorder.
The Sickle Cell Disease Association of America (SCDAA) is marking the 10th year of this recognition. There is no cure for sickle cell disease right now, although some patients have had success with various treatments including hydroxyurea treatment and bone marrow treatment.
According to SCDAA, complications from sickle cell disease (SCD) happen when a normal blood flow is reduced or prevented from flowing normally throughout the body. With SCD, some normally round red blood cells become crescent shaped (sickle shaped) and because of that change, can no longer flow through small blood vessels. These misshapen cells can actually cause a blockage, thereby reducing a normal blood flow that tissues need to stay healthy and to keep the body functioning properly. A common result is that reduced blood flow damages tissues and can lead to debilitating pain.
Blood cells with sickle cells don’t live as long in the body (about 16 days vs. 120 days for normal cells according to the SCDAA), so that rapid turnover can lead to the myriad complications that come with a sickle cell diagnosis including anemia and jaundice. Because SCD affects nearly every organ in the body, systemic complications can involve major systems including the lungs and kidneys. And the damage can also leave the body less able to fight off and control infections.
Current treatments are often a reaction to the complications, although some, like a preventative antibiotic and vaccinations in children, can help prevent complications from beginning. Patients may find various combinations of blood transfusions, pain management, antibiotics, breathing treatments, proper vaccinations, and other medications.
As with other chronic conditions, people with SCD have to take extra care with their own health. Because people are born with sickle cell disease, the disorder is a lifelong condition and can be especially challenging for children to cope with. Generally, a hematologist will manage the condition and any treatments. According to the Centers for Disease Control and Prevention, staying well-hydrated is especially important as is good nutrition and rest. Anyone with sickle cell disease can stay active to help overall health, but just be especially aware of fatigue and fluctuations in body temperature—moderation is the best approach.
According to the CDC, sickle cell disease affects about 100,000 people in the United States with a greater diagnosis rate in minority populations. Sickle cell disease happens in approximately 1 out of every 365 Black or African-American births and 1 out of every 16,300 Hispanic-American births.
More common is being diagnosed as a carrier of the sickle cell trait (SCT) which is not sickle cell disease. A carrier of SCT has one copy of the defective gene that can cause sickle cell disease (you need two copies to have the disease).
For those with SCD, finding a provider who is familiar with the disease and with cutting-edge treatment is important. Research information, through organizations such as the Foundation for Sickle Cell Disease Research is essential. But the emotional struggle of coping with a complex, chronic, and invisible disease that can have such disruption in someone’s life is big. Getting the emotional and social support of a caring community is going to make a difference in developing coping skills and getting through rough times.
If you know someone who is impacted by sickle cell disease in any way, today makes it easier to spread the word, provide education, and let them know they aren’t alone.
Nursing assistants (NA) have been essential members on healthcare teams throughout the COVID-19 crisis. And while the pandemic continues to spread around the world, National Nursing Assistants Day on June 18 is timed to thank nursing assistants for the care they provide.
For 43 years, the National Network of Career Nursing Assistants has sponsored an entire week to celebrate those who choose this career. This year, that week runs from June 18 to 25 and is being marked as “Celebrate in Place” as many events have moved away from in-person formats.
According to Genevieve Gipson, RN, Med, RNC, and director of the National Network of Career Nursing Assistants, the theme for the week is kindness. NAs are encouraged to focus on a different aspect of kindness throughout the week and focus on events and projects that can continue to have an impact over the course of the year.
The National Association of Health Care Assistants seeks to elevate and promote the professional NA career . Working on teams and with other healthcare providers delivers more consistent and better patient care and nursing assistants are part of the team.
Nursing assistants and certified nursing assistants perform the routine patient care that often allows opportunities to talk with patients and learn more about them. Whether a patient is in a long-term care facility and sees a nursing assistant almost daily or in a short-term hospital stay and only has brief interactions, NAs and CNAs can make an enormous impact on the patient’s general care. By getting to know a patient and listening to them, nursing assistants can pick up on subtle physical or emotional changes or on preferences that could help fine tune such necessities as a preferred meal plan or understand family relationships.
NAs work under the supervision of registered professional nurses and perform duties that can range from basic patient care including bathing, feeding, toileting, grooming, dressing, and answering patient calls for help. They are generally responsible for things that help keep patients comfortable such as changing linens or checking bandages.
NAs can increase their training and competency with certification. Each state determines its own certification requirements, so plan to look into this additional step in whichever state you plan to practice. The extra certification can take a couple of months to complete, but offers additional skills that will be used every day.
The impact of NA-provided patient care can’t be understated. Because of their close interaction, they often help patients who are lonely and can comfort those who may need companionship. During the COVID-19 crisis, many facilities restricted visitors and so healthcare teams were the only people many patients could see for months. Having a friendly person to talk with calms nerves, staves off loneliness, and provides a much-needed human connection.
Celebrate National Nursing Assistants Day and National Nursing Assistants Week and be proud of the much appreciated care you provide.
June is recognized as Alzheimer’s and Brain Awareness month and during this month nurses act as excellent resources for their patients.
Whether your primary patient population is young or old, education about taking care of this essential organ is important. And while Alzheimer’s disease causes the biggest impact on those 65 and older, early onset Alzheimer’s devastates families as well.
Alzheimer’s and dementia, although not the same, are related. Both conditions affect the brain because they are related to damage of the brain’s cells, but neither is actually a normal result of growing older.
Although Alzheimer’s has no cure, many experts believe that protecting brain health can help delay it or possibly avoid it. There’s no magic, however, as so many varied factors can weigh into whether or not someone develops particular brain diseases.
Because there are still so many unanswered questions, anything that can help brain health is worthwhile for people who have concerns about these conditions. Many times, anything that protects health in general, especially heart health, is good for the brain. Talking to patients about the importance of taking care of themselves in general, from food choices to protecting against preventable head injury, can lead into conversations and education about how to do that in everyday activities.
According to the Alzheimer’s Association, 60 to 80 percent of dementia cases are caused by Alzheimer’s disease, a specific brain disease. Dementia, on the other hand, is characterized by general symptoms of decline in thinking, including the memory issues that many people begin to worry about as they age, but it doesn’t always mean someone has Alzheimer’s.
What can impact someone’s chances of developing Alzheimer’s? Advancing age is a risk factor as more cases of dementia, including Alzheimer’s, show up in older people. But a family history can indicate a genetic risk for developing the disease. People who are Black or Latinx also have greater risk of Alzheimer’s disease, so education about heart health and controlling high blood pressure, high cholesterol, and getting heart-pumping activity can go a long way to helping keep hearts and brains healthy.
Although no one can cure Alzheimer’s yet, research is ongoing into medications and treatments that offer much hope for a cure. In the meantime, if patients ask what they can do, there’s plenty you can tell them. They can get involved in advocacy on the local, state, and national level. That could mean advocating for residents of a long-term care facility in their hometown or getting involved on a national scale to pass legislation that impacts the research and the people affected by Alzheimer’s and brain health in general. There are many clinical trials run through the Alzheimer’s Association, the Mayo Clinic, and the National Institute on Aging, among others that need people who might offer clues into the disease, whether they have a brain disease or not.
Patients can also learn what they can do to help their own brain health. Small things like ensuring rugs are not trip hazards, clearing walkways of snow and ice, wearing a seatbelt always, and being aware of sports with high concussion risk such as football or soccer can help prevent the injury that can lead to cell damage.
During June, have conversations with your patients to help get them started on a path that boosts their brain health.