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Swine Flu and Hospital Acquired Infections

Frank Bailey — Sun, 26 Apr 2009 12:42:45 GMT

Swine flu confirmed in a Queens school…what next? Although these cases are mild, is it possible this virus could mutate much like the viruses have in antibiotic resistant strains? Remember MRSA, C. diff, and VRE.

President Obama has been getting regular updates on this virus and apparently the World Health Organization has warned countries around the world to be on the alert for any unusual flu outbreaks. According to Yahoo News, a deadly swine flu strain in Mexico has killed up to 81 people and likely sickened 1,324 since April 13. The CDC has confirmed 11 cases of swine flu in California, Texas and Kansas in addition to the cases in New York.

What concerns me, is that this outbreak is minor compared to the incidences of MRSA infections contracted every day in our hospitals and nursing homes for failure to follow guidelines as simple as washing hands between patients. What has to be done to get the attention of health care workers and stop the spread of these hospital acquired infections?

Are lawsuits the answer? Surely there has to be some other way to get the attention of the administration in our hospitals and nursing homes…

Originally posted at InjuryBoard by Frank Bailey

MRSA Attacks Skin

Frank Bailey — Thu, 23 Apr 2009 15:42:48 GMT

I have been blogging about MRSA for the last few weeks: MRSA: Can It Come From Food Animals . Today I thought my readers might want to see what MRSA can do when it attacks a person’s skin. This is just one of many pictures:

Photo credit: Gregory Moran, M.D.

I invite you to go to a webpage that will literally make your skin crawl when you see what these microbes can do. Why then aren’t our hospitals and nursing homes doing more to fight this terrible infection?

Originally posted at InjuryBoard by Frank Bailey

Medication Errors

Frank Bailey — Thu, 09 Jul 2009 09:37:56 GMT

Medication errors injure over a million patients a year. Medication errors are by far the most common medical error. A report by the Institute of Medicine of the National Academies, found than in any given week, 80% of U.S. adults take at least one medication. Almost one third take at least five different medications. The committee found at least one medication error per day occurred with each hospital patient.

The committee also found at least 25% of medication related injuries are preventable. The cost of these errors occurring in hospitals alone is estimated to amount to $3.5 billion a year. This does not take into account the human loss of life or the pain associated with these errors.

If President Obama wants to overhaul the medical system, he should start with preventing medication errors, in hospitals, nursing homes and clinics.

Originally posted at InjuryBoard by Frank Bailey

The Negligent Doctor Protection Act

Frank Bailey — Sat, 10 Oct 2009 14:57:11 GMT

New efforts by the insurance industry to transfer the cost of caring for catastrophically injured Americans to taxpayers have surfaced. If the insurance industry is successful in its efforts to limit jury verdicts, it will no longer have to worry about insuring negligent doctors. Why? Because the taxpayers will pick up the tab for the doctor’s negligence. How will this work? Suppose a child suffers a brain injury due to the negligence of a physician. Who is going to pay for the cost of caring for that child for life with caps on damages…the taxpayers. Why? Because with a cap on the amount of money that child can receive for the human damages, there will not be enough money to provide for the care and assistance that child will need over a lifetime…The cap will only hurt catastrophically injured children and adults, but it will be devastating for them. I always though America took care of its sick and injured, but the insurance industry is trying to change that so it can make even higher profits…

Let’s look at what the Congressional Budget Office said Friday. A cap on pain and suffering damages would result in $4.1 billion a year saved out of a $2.5 trillion a year expenditure. I may be wrong in my division, but I believe that is less than one tenth of one percent savings. Is that worth transferring the care of the sick and injured away from the wrongdoer to the taxpayers. I think not.

We have to put a stop to this charade before someone in our community or family is caught up in the greed of the insurance industry. Contact your Senators and Congressmen and tell them to vote no to caps on jury verdicts.

Originally posted at InjuryBoard by Frank Bailey

Prevention of Hospital Acquired Infections in Central Line Catheters

Frank Bailey — Wed, 21 Jan 2009 10:22:26 GMT

A central line catheter is a catheter placed into a large vein in the neck, chest, or groin. It is used to administer medication or fluids. Certain medications, such as inotropes and amiodarone are usualloy given through a central line.

According to the CDC, each year, an estimated 250,000 cases of central line bloodstream infections occur in hospitals in the United States, with an estimated mortality of 12%--25% for each infection The marginal cost to the health-care system is approximately $25,000 per episode .

In 2001, the CDC was invited by the Pittsburgh Regional Healthcare Initiative to provide technical assistance for a hospital-based intervention to prevent central line infections among intensive care unit (ICU) patients in southwestern Pennsylvania. During a 4-year period, central line infection rates among ICU patients declined 68%, from 4.31 to 1.36 per 1,000 central line days. The results suggest that a coordinated, multi-institutional infection-control initiative is an effective approach to reducing hospital acquired infections.

The best prevention for hospital acquired infection is a patient who is not afraid to ask or question their health care provider. If you need a "central line" catheter, ask your doctor about the benefits of one that is antibiotic-impregnated or silver-chlorhexidine coated to reduce infections.

The Agency for Healthcare Research and Quality recommends use of antibiotic catheters as one of its eleven patient safety practices. The Annals of Internal Medicine contains an excellent article on the prevention of hospital acquired infections; "Central venous catheters coated with Minocycline and Rifampin for the prevention of catheter-related colonization and bloodstream infections," Annals of Internal Medicine 127.4 (1997): 267-274.

Remember, patient safety starts with you.

Originally posted at InjuryBoard by Frank Bailey

Eye Lacerations: ER treatment of a cut on an eye

Sach Oliver — Fri, 12 Dec 2008 17:34:41 GMT

Eye injuries can be serious, involving several parts of the eye and are usually quite painful. Most minor eye injuries can be treated at your home. However, if you have a major eye injury, it should be taken seriously and quickly.

What to do if you suffer a minor eye injury:

Cut on your eyelid: apply a sterile bandage or cloth to protect the area. If you don’t have a sterile bandage, use a clean cloth. DO NOT use fluffy cotton bandages around the eye that could tear apart and get stuck in the eye. This could lead to infection or irritation of the eye. Keep bandages clean and dry.

Reduce swelling: apply ice or cold packs for 15 minutes 3 or 4 times a day during the first two days. The quicker you apply a cold pack, the less swelling you are likely to have. After the swelling subsides, a warm cloth may help relieve the pain.

What to do if you suffer a major eye injury:

If you are suffering from complete or partial loss of vision, severe itching, redness, or any other severe injury to your eyes, you need to get immediate attention from an ophthalmologist.

Corneal Abrasions:

A corneal abrasion is a scratch or injury to the cornea, the clear, dome shaped surface that covers the front of the eye. This is a very common occurrence. There are many things that can cause an abrasion to the cornea. The most common causes include foreign bodies in the eye (dirt, pebbles, insects), a scratch from a toy or fingernail, or contact lenses.

How do Emergency Rooms treat Corneal Abrasions?

A scratched cornea usually heals without complications. Pain relievers and surface antibiotics may be prescribed. The treatment of cuts vary according to the extent of the injury. A small cut usually does not need stitches, but a sever cut to the eyeball requires immediate treatment and usually surgery.

Overall, the seriousness of lacerations to the eye depends on the individual’s cut. This can range from small annoyance to serious. The potential risks of not seeing a doctor may be as serious as infection or blindness. If at all in doubt, see your nearest emergency room.

I would like to thank John Shaw, our law clerk, for helping me research this important topic.

Originally posted at InjuryBoard by Sach Oliver

MRSA And Your Life Update

Frank Bailey — Sun, 05 Apr 2009 09:16:01 GMT

MRSA. How would you like to die from a preventable infection you contracted while hospitalized for minor surgery? That is what is happening to thousands of people every year. Is it possible the CDC, a government agency that is supposed to protect people, is underreporting these infections?

According to the latest figures published by the CDC, 1,700,000 patients contract hospital acquired infections each year. But when you look at the numbers, the fastest growing, and one of the most difficult to cure, MRSA (methicillinn resistant Staphylococcus aureus), is growing by leaps and bounds. In 1993, there were only an estmated 2000 MRSA infections reported in American hospitals. Then in 2005 there were 368,000 reported cases. In 2007, according to the American Journal of Infection Control, 2.4 percent of all patients had MRSA infections. That would result in an amazing 880,000 victims a year.

But, let's look futher. MRSA only accounts for eight percent of hospital acquired infections according to Julie Gerberding, M.D., the director of the CDC. What about other superbugs such as VRE, (vancomycin resistant Enterococcus) and C. diff , (Clostridium difficile)?

These new facts discredit the CDC's official 1,700,000 estimate.

There are many applications of life saving changes that need to be implemented in our hospitals. MRSA screening is one. The test is a noninvasive simple skin test. At Evanston Northwestern Healthcare System, a group of three hospitals near Chicago, the screening reduced MRSA infections seventy percent! Dr. Lance Peterson, the study's lead author, stated, "If it works in these three hospitals, it will work anywhere."

NEW...More about the work at Evanston Northwestern Healthcare. Evanston received the John M. Eisenberg Patient Safety and Quality Award for its work.

MRSA infection rates were cut by 60% within the first year of the program. Universal MRSA surveillance has also decreased the risk of other patients and staff becoming infected. Peterson indicated that "The biggest risk for getting a MRSA infection is becoming colonized in the nose with it. Our program has successfully prevented nasal colonization of patients coming to ENH for their care. We want people to come here for their healthcare and not go home with something unexpected that will later cause an infection – and the program is successful in doing just that."

If your hospital doesn't do MRSA screening, ask why they aren't utilizing this safe proceedure to protect their patients. I would be interested in their answer.

What about screening healthcare workers? Can they be the main carriers?

Originally posted at InjuryBoard by Frank Bailey

Hospitals May Not Be Doing Enough To Fight MRSA

Drew Dixon — Wed, 18 Jun 2008 10:07:38 GMT

A recent survey of the infection control practitioners found that 54 percent of them believe hospitals aren't doing everything they can to prevent the spread of methicillin- resistant staph aureus (MRSA). According to the Mayo Clinic, MRSA infection is caused by Staphylococcus aureus bacteria — often called "staph." It's a strain of staph that's resistant to the broad spectrum of antibiotics commonly used to treat staph, sometimes leading to death. In fact, MRSA is believed MRSA to lead to more than 19,000 deaths of patients each year.

Staph skin infections, including MRSA, generally start as small red bumps that resemble pimples, boils or spider bites and can quickly turn to painful, deep abscesses that require surgical draining. MRSA may also penetrate the body causing infections in the bones, joints, surgical wounds, bloodstream, heart valves, and the lungs.

Because the bacterium is spreading broadly beyond hospitals, some state law makers are trying to create new state laws to prevent the spread of MRSA. In Illinois law makers now require hospitals to test all "at risk" patients and patients in intensive care for MRSA and isolate them if they carry the drug resistant bacterium.

For more information on healthcare associated MRSA check out ww.cdc.gov/ncidod/dhqp/ar_MRSA.html.

Image source: Wikimedia commons

Originally posted at InjuryBoard by Drew Dixon

To Err is Human: Building a Safer Health System: Medical Negligence Occurs but Why?

Sach Oliver — Fri, 27 Feb 2009 10:46:35 GMT

To Err is Human: Building a Safer Health System: Medical Negligence Occurs but Why?

The Institute of Medicine found a decade ago that as many as 98,000 people die every year from preventable medical errors, costing the nation an estimated $29 billion. The literature where this data is found is titled, To Err Is Human: Building a Safer Health System. The authors note medical errors kill more people than motor vehicle accidents, breast cancer, guns, AIDS, and many other harms. Matter of fact, they say medical errors are the nations 6^th leading cause of death.

The literature’s goal is to educate and set out plans to reduce medical errors and improve patient safety through the design of safer health systems. To Err is Human asserts that the problem is not bad people in health care – it is that good people are working in bad systems that need to be safer.

I agree with this literature in that most of the time it is not bad people causing harm, it is usually bad systems. Patient safety in America’s health care system should be a priority and “bad systems” should be held accountable for their actions that cause harm. Medical Negligence lawsuits are sometimes the only avenue harmed patients have to hold the “bad systems” accountable.

Originally posted at InjuryBoard by Sach Oliver

Hospital Negligence: Yes, Hospitals are Dangerous Places

Paul Ford — Tue, 03 Feb 2009 16:32:20 GMT

A trip to your local emergency room can be a very dangerous experience. Hospital negligence is of epidemic proportions. And this in not the opinion of lawyers. It is the opinion of the medical community.

Current research done by the medical community suggests that nearly 200,000 patients die each year in hospitals as victims of medical mistakes.

Furthermore, there is little evidence that this stagering statistic has improved.

The 2008 study referenced above was conducted by a review of Medicare patient records, usually the poorest members of our society. Can one conclude that economics plays a role in the level and quality of healthcare one receives? Perhaps. But what is certain is that hospitals are dangerous places and medical errors do occur.

Imagine the uproar that would occur if 390 jumbo jets loaded with passengers were to crash and kill all of the passengers over the rest of the year 2009. The level of scrutiny would be unprecedented. The news coverage would be nonstop. People would be demanding that the system be fixed. Yet, as the 2004 study pointed out, that is the number of deaths occurring in American hospitals as a result of preventable errors.

It is not uncommon to pick up a newspaper or turn on the news and hear someone talking about the problems created by the filing of medical malpractice actions. Yet, when reviewing the studies referenced above, it is clear that the real epidemic is in the number of preventable medical errors occuring in hospitals. And the numbers cited above are for DEATHS, not injuries that the patient recovers from. When those numbers are added, the number of preventable errors in American hospitals each year is mind-numbing.

Perhaps you or a loved one has had a similar experience. If so, I would love to learn more about your experience. It is important to share this information. Further, I invite you to check back to this site as we post additional articles, written by a doctor and a nurse, about things you can do to help prevent such medical injuries and protect yourself and your loved ones.

GOLDEN, Colo. (April 8, 2008)

– Patient safety incidents cost the federal Medicare program $8.8 billion and resulted in 238,337 potentially preventable deaths during 2004 through 2006, according to HealthGrades' fifth annual Patient Safety in American Hospitals Study.

HealthGrades' analysis of 41 million Medicare patient records found that patients treated at topperforming hospitals had, on average, a 43 percent lower chance of experiencing one or moremedical errors compared to the poorest-performing hospitals

– An average of 195,000 people in the U.S. died due to potentially preventable, in-hospital medical errors in each of the years 2000, 2001 and 2002, according to a new study of 37 million patient records that was released today by HealthGrades, the healthcare quality company

Lakewood, Colo. (July 27, 2004)

Originally posted at InjuryBoard by Paul Ford