**Veteran's Health Matters**

**VA Medical Facilities Take Lead in Fight Against MRSA**

Its formal name is methicillin resistant staphylococcus aureus. Better
known as MRSA, it's a type of bacteria which is resistant to certain
antibiotics, including methicillin and other more common antibiotics,
such as oxacillin, penicillin and amoxicillin.

MRSA is an often deadly type of so-called "staph infections," occurring
most frequently among individuals in hospitals, nursing homes and other
health-care facilities. The most likely candidates for staph infections
are those with weakened immune systems.

Because MRSA transmission and infection rates in VA health-care
facilities were comparable to the national average, the Veterans Health
Administration launched a pilot program in 2006 aimed at significantly
reducing infection rates among veterans.

Building on the success of that pilot program, which reduced that staph
infection rate by 50 percent, the VA now has tough new screening
requirements in place in all of its 153 hospitals. In addition to
emphasizing its commitment to hospital hygiene and flagging affected
patients for special precautions, VA facilities monitor all incoming
patients on key units with nasal swabs and cultures for MRSA.

"VA demonstrated that dramatic reductions in MRSA-related infections are
possible," said Acting Secretary of Veterans Affairs Gordon H.
Mansfield. "VA's completion of our national deployment of these serious
prevention measures reinforces VA's stature as one of the safest
health-care environments nationally.

" Recently published data from the Centers for Disease Control and
Prevention in collaboration with other researchers estimated there may
be more than 94,000 MRSA cases a year in the United States, associated
with 18,650 deaths annually.

"MRSA is a dangerous infection, difficult to eradicate, that can cause
pneumonia, wound or bloodstream infections," said Dr. Michael J.
Kussman, VA's Under Secretary for Health. "Our ability to reduce the
number of cases of MRSA infection enhances our ability to provide
quality health care for veterans."

***"Our ability to reduce the number of cases of MRSA infection enhances
our ability to provide quality health care for veterans."***

MRSA reflects the broader problem of multi-drug resistant organisms,
which are difficult to treat with conventional antibiotics. In addition
to handwashing, isolation of infected patients and the use of gowns to
prevent spread, the VA initiative focuses on "culture change" among its
health-care workers in an effort to improve awareness of the threat and
make infection prevention a routine component of care during each
patient encounter every day.

After the successful pilot program in VA's Pittsburgh Health Care
System, the Department began screening incoming patients to its
intensive care units in March 2007. The program has been expanded to
other high-risk hospital units, including transplant and spinal cord
injury as well as general surgical and medical patient wards.

The national initiative focuses on implementing the VHA MRSA Bundle,
which consists of four essential elements:

• Active Surveillance (Admission/Transfer/Discharge Swabbing)

• Aggressive Hand Hygiene

• Contact Precautions

• Cultural Transformation (Leadership and Staff Engagement)

Consistent use of the VHA MRSA Bundle has been shown to markedly reduce
MRSA- related infections in the pilot facilities. VHA's efforts will
hopefully serve as a model of effective strategies for other health-care
systems in the reduction of MRSA transmission.

**VA National News**

**VA Announces Grants for Homeless Programs**

As the Department of Veterans Affairs (VA) marks the 20^th^ anniversary
of its homeless program, VA has awarded 46 grants worth more than \$16
million to public and private nonprofit groups to assist homeless
veterans.

"For the last 20 years, VA has worked with its community partners to
lift veterans out of homelessness," said Gordon H. Mansfield, Acting
Secretary of Veterans Affairs. "We are making progress by expanding
treatment, rehabilitation and safe transitional housing for our homeless
veterans, though more remains to be done."

Based on VA's national estimates, the number of homeless veterans on any
night has decreased 20 percent during the last six years, and veterans
as a percent of the adult homeless population has decreased 10 percent.

This latest round of grants creates 950 beds for homeless veterans,
bringing to more than 12,000 the number of VA-funded community-based
beds provided by public and community nonprofit and faith-based
organizations in 34 states and the District of Columbia.

VA has the largest integrated network of homeless assistance programs in
the country. It is the only federal agency providing substantial
one-on-one contact with the homeless.

**Restaurant Founder Honored for Business Support of Veterans**

Shortly before leaving office, Secretary of Veterans Affairs Jim
Nicholson presented a Secretary's Award to Little Caesars' founder
Michael Ilitch in recognition of his advancement of veterans in business
through pizza franchise discounts.

To assist service-disabled veterans who want to open a Little Caesars
restaurant, the program waives a \$20,000 franchise fee on the first
store, provides \$10,000 credit on the initial equipment order, and
provides a variety of marketing support and financing options and other
benefits, which can total \$68,000. For other veterans, the fee is
reduced by \$5,000 and the credit extended for equipment is \$5,000.

In conjunction with the award ceremony, Ilitch, a Marine Corps veteran,
served pizza to homeless veterans at VA headquarters in Washington from
Little Caesars' "Love Kitchen," a pizza kitchen on wheels that travels
across the U.S. and Canada to feed the homeless and disaster survivors.

Veterans are offered business opportunities by a variety of franchisers
through the International Franchise Association\'s VetFran program. More
information is available at www.franchise.org, and the VA Center for
Veterans Enterprise's resource site to assist veteran entrepreneurs at
www.vetbiz.gov.

**VA to Establish Nursing Academy**

To address a shortage of nurses across the nation and ensure that
veterans continue to receive personalized, world-class care in its
facilities, VA has announced creation of a new multi-campus Nursing
Academy. The new academy is a virtual organization, with central
administration in Washington and teaching at competitively selected
nursing schools across the country which partner with VA.

Despite this shortage, the American Association of Colleges of Nursing
has reported that more than 42,000 qualified applicants were turned away
from nursing schools in 2006 because of insufficient numbers of faculty,
clinical sites, classroom space and clinical mentors.

VA currently provides clinical education to nearly 100,000 health
professional trainees annually, including students from more than 600
schools of nursing. Its new five-year, \$40 million pilot program
establishes partnerships with 12 nursing schools across the country
during the next three years.

VA has one of the largest nursing staffs of any health-care system in
the world, with about 61,000 registered nurses, licensed practical
nurses, vocational nurses and nursing assistants at the department\'s
153 medical centers and nearly 900 clinics. Further information about
the pilot program can be obtained from VA's Office of Academic
Affiliations web site at [www.va.gov/oaa](http://www.va.gov/oaa).

**VA Plans PTSD Conference**

Acting Secretary of Veterans Affairs Gordon H. Mansfield has announced
that the VA will convene a "consensus conference" with the Department of
Defense (DoD) and the National Institutes of Health (NIH) to improve the
designs and methodologies all three agencies will use in future research
studies regarding Post- Traumatic Stress Disorder (PTSD). The conference
date and location will be announced separately.

VA staff will work closely with DoD to study how early interventions,
such as the Army's "Battlemind" training and the "Marine Operational
Stress Surveillance and Training Program," both designed to help service
members transition from combat back to home, can improve outcomes for
veterans with PTSD.

**MRSA Questions and Answers**

**Q: What is MRSA?**

**A:** MRSA stands for Methicillin Resistant Staphylococcus Aureus.
Staphylococcus (STAFF-ih-low-KOCK-us) aureus (ARE-ee-us) is a type of
"super" germ that lives in the nose, on the skin, and on other surfaces
that come in contact with the bacteria. In most cases, this "super" germ
causes no infection. But in some people, it can cause serious wound and
blood infections. MRSA is considered "methicillin resistant" because it
does not react to methicillin or other standard medicines. Hospitals and
other healthcare facilities have been found to be sources of MRSA.
However, there have also been cases of MRSA in the community.

**Q: Who gets MRSA infections?**

**A:** People who are at the greatest risk for developing an infection
or become colonized are those who:

• are elderly or children;

• are very ill;

• are unable to fight off infection because of a serious disease, such
as HIV or diabetes;

• have been recently hospitalized or undergone a surgical procedure.

**Q: How is MRSA primarily spread?**

**A:** MRSA is primarily spread by direct physical contact with a person
or object carrying the bacteria. Objects can include medical equipment,
sheets or even a tabletop. In the hospital setting, the most common way
MRSA is spread is by health- are workers' hands.

**Q: Can MRSA be spread in non-health-care facilities, such as community
gyms?**

A: MRSA is everywhere, so it could very well be living on communal
equipment at a gym. The best protection is to always practice good hand
hygiene.

**Q: How is MRSA diagnosed?**

A: Your health-care practitioner can have a simple test performed. The
VHA MRSA Prevention Initiative requires VA facilities to test patients
upon admission and discharge with a simple and painless nasal swab test.

**Q: Why is MRSA prevention important?**

A: MRSA is responsible for 100,000 U.S. hospitalizations each year. It
tremendously increases the total burden of infection for the patient,
and increases the risk of death four-fold. These patients also have
hospital stays more than two-and-a-half times longer than they otherwise
would.

**VA Facility Highlights**

**San Francisco**

**Bike Riding Vets Support Injured Comrades**

The San Francisco VA Medical Center recently hosted actor Jack Scalia
and injured veteran bike riders who were taking part in "Operation
American Spirit." This was a 1,500-mile bike ride to raise awareness and
funding for injured troops who served in Iraq and Afghanistan. The
16-day journey began in Portland and ended in San Diego. The riders made
stops at VA medical centers along the way, including both the San
Francisco and Palo Alto VA Medical Centers. While at SFVAMC, Scalia and
injured veteran J.R. Martinez met with patients on an inpatient unit,
thanking them for their service to our country. SFVAMC leadership and
staff were on hand during the early Sunday morning visit to welcome the
riders and thank them for their efforts on behalf of the VA and
veterans.

**Northern California**

**New Facilities Opening at VANCHCS**

You may have noticed that the Sacramento VA Medical Center at VA
Northern California Health Care System has been undergoing major
construction projects during the past few years. Now some of the
projects are completed or are nearing completion, which will greatly
enhance our veterans' experience the next time they visit.

A new Outpatient Specialty Care Building, located by our Canteen, has
opened. The two-story building will offer specialty care in the areas of
Neurology, Nephrology, Pulmonary, EMG, GI Liver/Hepatology, Physical
Medicine and Rehabilitation, ENT and Cardiology. In addition, an
Outpatient Mental Health Building located right next door is scheduled
to open in January 2008. At that time, Mental Health Services will move
from their current location onto hospital property, providing easier
access for patients who have multiple, same day appointments.

Furthermore, the lobby renovation of Building 650, the original Mather
Air Force Base Hospital, is complete. There are now two large lobbies at
the entrance to the Medical Center, providing easy access for patients
entering either the main hospital or Building 650. All these projects,
and the addition of more than 40 new parking spaces close to the
hospital, will provide improved access to our campus and allow us to
keep pace with our state of

**Pacific Islands**

**Senate Veterans' Affairs Committee Convenes in Hawaii**

U.S. Senator Daniel K. Akaka (D., Hawaii), Chairman of the Senate
Veterans' Affairs Committee, recently held three formal committee
hearings and four town hall meetings to discuss and learn more about VA
health care in Hawaii and the Pacific region. The formal hearings were
held in Oahu, Maui, and Kona, and the town hall meetings on Lanai,
Molokai, Hilo and Kauai.

Among those testifying at the hearings were: Dr. Michael Kussman, VA
Under Secretary for Health; William Tuerk, VA Under Secretary for
Memorial Affairs; Ronald R. Aument, Deputy Under Secretary for Benefits;
Dr. Robert L. Wiebe, Director, VA Sierra Pacific Network; Dr. James
Hastings, Director, VA Pacific Islands Health Care System, other
officials, and veterans.

Also testifying were Gregg Reed, VA Regional Director; Mark Moses,
Director for the State Office of Veterans Services; MG Robert Lee, State
Adjutant General; BG Gary M. Ishikawa, Hawaii Deputy Adjutant General;
Colonel Gerald Gibbons, Chief of Staff, 9^th^ Regional Readiness
Command; and Colonel Arthur Wallace, Acting Commanding General, Tripler
Army Medical Center.

All the sessions were very well received and provided an excellent venue
for veterans to express their needs and concerns to the Senate Committee
and VA officials.

**Palo Alto**

**New Teleradiology Center Coming to Palo Alto**

The VA Palo Alto Health Care System will soon be the first site and home
base for a national system of VA teleradiology that will provide remote
interpretation of radiology studies for VA hospitals throughout the
country. Another teleradiology center will be located in Puerto Rico.
The time zone difference and hours of operation between the two centers
will provide service on a 24/7 basis. Based on projected workload, the
center will employ a minimum of 10 radiologists. Teleradiology is the
electronic transmission of radiology images for interpretation or
consultation at another location. Teleradiology is particularly well
suited to the VA and may include the following benefits:

• Allow smaller VA facilities to send images to be read at a central
location.

• Assist VA facilities that cannot recruit radiologists.

• Reduce inefficient radiology staffing at low volume facilities.

• Allow interpretation of studies in off-hours and night coverage.

• Improve turnaround time for reports.

• Permit cross coverage with other federal agencies.

• Allow images to be sent to another facility for expert specialist
consultation.

• Promote use of a common information structure encompassing all VA
facilities.

Most important, the new center will increase productivity, and address
one of the most pressing problems in radiology, namely, a national
shortage of radiologists.

**Central California**

**Seasonal Flu Shots Offered in Unique Setting Palo Alto**

VA Central California Health Care System expects to administer flu shots
to 10,000 veterans during the 2007-2008 influenza seasons. This number
continues to increase and for this year's flu campaign, VA staff needed
to find a larger space than was available indoors.

The unique solution to this challenge was to erect a new outdoor shelter
on the front lawn of the Medical Center. From there, nurses and
volunteers are able to efficiently administer vaccine to thousands of
veterans, without the high traffic into the outpatient clinic spaces.

In 2006, all VA facilities in Network 21 were provided with a "Western
Shelter," to assist with Disaster Surge Preparedness -- specifically
Pandemic Flu. Each 19' x 35' shelter is constructed of waterproof
fabric, hard rollout flooring, and includes lighting, heating and air
conditioning, plus a toilet and sink vestibule.

Sean Hinds, Emergency Management Specialist, said, "It was a great
opportunity to practice raising the Shelter to prepare for a true
emergency and to add a new dimension for veterans in the 2007 Flu
Clinic."

**Sierra Nevada**

**VASNHCS's Bowling Team: Battle Born Blind Veterans**

Patty Beck-Weaver, a visual impairment coordinator, has come on board
here at VASNHCS to help visually impaired veterans. But her mission goes
beyond that. She noticed a common thread among visually impaired
veterans: "... sadness, despair and isolation -- even from their
families," she said.

Patty's main duties are to obtain low-vision aids, and to train veterans
how to use the devices, but she felt she needed to come up with
something else that would better help her clients. She discovered a tool
that worked: a bowling team.

The team first played in May 2006 at the Veterans Affairs' National
Golden Age Games in Hampton, Virginia. Thereafter, the group, consisting
of 20 members who are considered legally blind, took the name Battle
Born Blind Veterans. Also known as the High Rollers, they began to meet
Tuesday mornings on a regular basis.

Patty's goal of providing an outlet for visually impaired veterans is
helped immeasurably by the support of the VA Medical Center and its
staff. "They really help these veterans be as successful as they want to
be," she said. "I'm blessed, because I have an opportunity to help them
overcome obstacles they think are hopeless."

**A Laughing Matter: The Diesel Fitter**

Marty had recently retired after 26 years of military service and had
taken a job in what seemed an unlikely place for a battle-scarred
veteran -- a women's lingerie factory. Amazed at his choice of jobs, one
of his old buddies asked him, "What in the world are you doing in a
lingerie factory?" Marty's replied: "I'm a diesel fitter." Puzzled by
what seemed to be an unlikely connection between diesel engines and
lingerie, his buddy asked Marty to describe in more detail exactly what
his job entailed. "That's easy," said Marty. "All day long, I stand at
the end of the line where the women's panties are made. As they get to
me, I hold up each pair and if they're made properly, I just announce,
"Yeh, dees'l fit 'er."

**Protect Yourself with a Yearly Flu Shot**

The influenza (or flu) season, which begins in autumn, and continues
through early spring, has arrived again. The good news is that the flu
is highly preventable with a yearly flu vaccine. Vaccinations are
available daily for enrolled veterans at our walk- in clinics.

The flu is a contagious respiratory illness caused by the influenza
virus, and can have serious and life threatening complications. Last
year, more than 200,000 people were hospitalized in the United States,
and more than 36,000 people died, making it the sixth leading cause of
death in adults. It should not be confused with the "stomach flu," which
is a catchall name for stomach upset caused by other microorganisms.

Unfortunately, too many people ignore the threat, their favorite excuses
being either, "I got a shot last year," or, "If I get the shot, I'm
afraid I'll get the flu."

Neither excuse is valid. Flu viruses change from year to year, so prior
years' flu shots afford no protection whatever. And, because the flu
vaccine is an inactivated (or "killed") virus, it's impossible to get
the flu from that vaccine.

The risk is simply too great to ignore. A bout of influenza will
generally mean, at best, a two- to-six-week period of high fever,
extreme tiredness, and various aches and pains. For older persons, and
for those with heart, lungs, asthma, diabetes, muscle or nerve
disorders, or kidney diseases, the danger is even greater. Also, people
who have blood problems or a weakened immune system need to be
vaccinated every year.

A recent article in the prestigious *New England Journal of Medicine*
cites an extensive study, which found that an increased use of flu shots
by elderly people at high risk of complications would prevent thousands
of deaths and hospital visits annually.

Study author Kristin L. Nichol, M.D., chief of medicine at the Veterans
Administration Medical Center in Minneapolis, said flu shots are more
cost-effective and could save more lives among people 65 and older than
screenings for cancer, heart disease and blood disorders.

This year, the VA recommends that anyone 50 years of age or older should
get a flu shot. Not only is the flu vaccine recommended for patients,
but VA has set a goal of vaccinating at least 60 percent of all
health-care providers.

**The Flu Q & A**

**How does the flu spread?**

It spreads when infected people cough or sneeze, or by touching
something with the virus on it, and then touching your mouth, nose or
eyes.

**What are the symptoms?**

They include: fever, headache, cough, sore throat, body aches, runny
nose, nausea, tiredness, vomiting and diarrhea.

**How does the vaccine work?**

The virus changes from year to year, so the vaccine is annually updated
to include the current strain. It takes about two to four weeks to
develop immunity. The vaccine can prevent illness by 70 to 90 percent.

**Who should be vaccinated?**

• Adults aged 50 years and older;

• Anyone with chronic medical conditions or an immune deficiency;

• Residents of nursing homes or long-term care facilities;

• People who can transmit flu to others at high risk for complications;

• Pregnant women;

• Children aged 6-59 months.

If you have an allergy to eggs, or have previously had a severe reaction
to the vaccine, don't get the flu shot. If you have questions, ask your
doctor or nurse.

**How can I help prevent the flu?**

• Place a tissue over your mouth and nose when you cough or sneeze (or
use your sleeve if you don't have a tissue);

• Frequently wash your hands with soap and water, or use a gel hand
sanitizer;

• Avoid close contact with others when sick;

• Avoid touching your mouth, nose or eyes, because germs can enter your
system this way.

**To locate your nearest Vet Center, visit www.vetcenter.va.gov**

**VA MEDICAL CENTERSAN FRANCISCO**

4150 Clement Street

San Francisco, CA 94121-1598

\(415\) 221-4810

**DOWNTOWN S.F.VA OPC**

401 3rd Street

San Francisco, Calif., 94107

\(415\) 551-7300

**VA EUREKA OPC**

714 F Street

Eureka, CA 95501

\(707\) 442-5335

**VA SAN BRUNO OPC**

1001 Sneath Lane

San Bruno, Calif., 94066

\(650\) 553-8000

**VA SANTA ROSA OPC**

3315 Chanate Road

Santa Rosa, CA 95404

\(707\) 570-3855

**VA UKIAH OPC**

630 Kings Court

Ukiah, CA 95482

\(707\) 468-7700

**VA NORTHERN CALIFORNIA HEALTH CARE SYSTEM VA MARTINEZ OPC**

150 Muir Road

Martinez, CA 94553

\(925\) 372-2000

**VA MEDICAL CENTER SACRAMENTO**

10535 Hospital Way

Sacramento, CA 95655

\(916\) 843-7000

**VA REDDING OPC**

351 Hartnell Avenue

Redding, CA 96002

\(530\) 226-7555

**VA CHICO OPC**

280 Cohasset Road

Chico, CA 95926

\(530\) 879-5000

**VA MCCLELLAN OPC**

5342 Dudley Boulevard

McClellan Park, CA 95652-1074

\(916\) 561-7400

**VA MARE ISLAND OPC**

201 Walnut Avenue

Mare Island, CA 94592

\(707\) 562-8200

**OAKLAND MENTAL HEALTH AND SUBSTANCE ABUSE PROGRAM**

Oakland Army Base

2505 West 14th Street

Oakland, CA 94607

\(510\) 587-3400

**VA OAKLAND OPC**

2221 Martin Luther King Jr. Way

Oakland, CA 94612

\(510\) 267-7800

**VA FAIRFIELD OPC**

103 Bodin Circle, Bldg. 778

Travis AFB, CA 94535

\(707\) 437-1800

**VA PALO ALTO HEALTH CARE SYSTEM**

3801 Miranda Avenue

Palo Alto, CA 94304-1290

\(650\) 493-5000

**VA MENLO PARK DIVISION**

795 Willow Road

Menlo Park, CA 94025

\(650\) 493-5000

**VA LIVERMORE DIVISION**

4951 Arroyo Road

Livermore, CA 94550

\(925\) 373-4700

**VA CAPITOLA OPC**

1350 N. 41st Street, Suite 102

Capitola, CA 95010

\(831\) 464-5519

**VA STOCKTON OPC**

500 W. Hospital Road

Stockton, CA 95231

\(209\) 946-3400

**VA MODESTO OPC**

1524 McHenry Ave., Suite 315

Modesto, CA 95350

\(209\) 557-6200

**VA MONTEREY OPC**

3401 Engineer Lane

Seaside, CA 93955

\(831\) 883-3800

**VA SAN JOSE OPC**

80 Great Oaks Boulevard

San Jose, CA 95119

\(408\) 363-3011

**VA SONORA OPC**

19747 Greenley Road

Sonora, CA 95370

\(209\) 588-2600

**VA CENTRAL CALIFORNIA HEALTH CARE SYSTEM**

2615 E. Clinton Avenue

Fresno, CA 93703-2286

\(559\) 225-6100

**VA SOUTH VALLEY OPC**

1050 North Cherry Street

Tulare, CA 93274

\(559\) 684-8703

**VA CASTLE OPC**

3605 Hospital Road, Suite D

Atwater, CA 95301-5140

\(209\) 381-0105

**VA SIERRA NEVADA HEALTH CARE SYSTEM**

1000 Locust Street

Reno, NV 89502-2597

\(775\) 786-7200

**VA LA HONTAN VALLEY OPC**

365 West A Street

Fallon, NV 89406

**VA SIERRA FOOTHILLS OPC**

11985 Heritage Oak Place

Suite #1

Auburn, California 95603

\(530\) 889-0872

**VA CARSON VALLEY OPC**

925 Ironwood Drive, Suite 2102

Minden, NV 89423

\(888\) 838-6256

**VA PACIFIC ISLANDS HEALTH CARE SYSTEM**

459 Patterson Road

Honolulu, HI 96819

\(808\) 433-1000

**VA PTSD RESIDENTIAL REHABILITATION PROGRAM**

459 Patterson Road

Honolulu, HI 96819

\(808\) 433-0004

**VA MAUI OPC**

203 Ho'ohana Street, Suite 303

Kahului, HI 96732

\(808\) 871-2454

**VA HILO OPC**

1285 Waianuenue Ave., Suite 211

Hilo, HI 96720

\(808\) 935-3781

**VA KONA CBOC**

75-377 Hualalai Road

Kailua-Kona, HI 96740

\(808\) 329-0774

**VA KAUAI OPC**

3-3367 Kuhio Hwy, Suite 200

Lihue, HI 96766

\(808\) 246-0497

**VA GUAM CLINIC**

US Naval Hospital

Wing E-200, Box 7608

Agana Heights, GU 96919

\(671\) 472-7250

**VA AMERICAN SAMOA CBOC**

Old Army Reserve Building

Pago Pago, American Samoa 96799

\(684\) 699-3730

**VA REGIONAL OFFICE & OUTPATIENT CENTER MANILA**

United States Department of Veterans Affairs

PSC 501

FPO, AP 96515-1100

\(011\) 632-523-6300

Kerri Childress, Editor

VISN 21

3801 Miranda Avenue

Palo Alto, CA 94304-1290

www.visn21.med.va.gov