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Archive for Sunday, August 26, 2007

Hospital infections blamed in thousands of deaths

Consumer group working to make data available to public

August 26, 2007

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Each year in the United States, more people die from infections they picked up at hospitals than from car accidents or homicides.

It's a statistic the Consumers Union has used to try to pass legislation state by state that would make the rate of hospital-acquired infections public.

According to the Centers for Disease Control and Prevention, hospital-acquired infections account for 1.7 million infections each year and result in 99,000 deaths.

In contrast, the U.S. Department of Justice and FBI estimated 16,692 homicides in 2005, and the National Highway Traffic Safety Administration reported that 42,642 people died in motor vehicle accidents in 2006.

The issue resurfaced last week when news broke that Medicare was no longer going to cover the costs of treating hospital-acquired infections or surgical errors. Hospitals would have to find a way to pay for them on their own.

"I think it's one of these things people are looking at right now because you can get your arms around it," said Judy Bellome, chief executive officer of the Douglas County Visiting Nurses Association and Hospice. "It's easy to understand."

The Consumers Union, publisher of Consumer Reports, has been campaigning to make the infection rates public for years. Missouri and 19 other states have passed laws that require hospitals to release some of their infection rate data.

In Kansas, no such law exists. In the last legislative session, a bill was proposed by the Committee on Health and Human Services, but it made little progress.

Michael McCauley, with Consumers Union's Stop Hospital Infection campaign, said high infection rates point to deeper problems at the hospital, such as a lack of staffing.

"We felt by focusing our attention on infections, we'd get at other issues that would ultimately improve care," he said.

Regional data

Three area hospitals - Kansas University Hospital, Lawrence Memorial Hospital and Stormont-Vail Regional Health Center in Topeka - agreed to release the rate of bloodstream infections that are associated with IV use. The same information can be obtained for St. Luke's Hospital at the Missouri Department of Health and Senior Services' Web site at www.dhss.mo.gov.

The infection rates for different units throughout the hospitals were all below the national benchmarks set by the National Nosocomial Infections Surveillance System (see accompanying graphic).

KU Hospital and LMH also released data on the pneumonia infection rates for those using ventilators. Those, too, were below the national benchmark. KU Hospital also has a rate below the national average for urinary tract infections associated with catheters.

However, that was all the information the four hospitals would give out on infection rates. For the rest - such as infections around surgical sites - hospital officials said they didn't track the data or were concerned that it would be easy for readers to misinterpret.

St. Francis Health Center would not release the data. Overland Park Regional Medical Center did not respond to repeated requests for the data.

Hospital officials shy away from releasing the data - saying it can be hard to track where the infection originated, especially in cases where a patient transfers hospitals. Also, they say, some patients, such as those with severe burns or AIDS, are more at risk for developing infections. The hospitals who are the most vigilant could have the higher numbers, while other hospitals could under-report them, they say.

Dennis McCulloch, KU Hospital spokesman, said hospital infection rates should be just one factor patients use when comparing hospitals. The data should be weighed along with a hospital's mortality rates or the number of return visits, he said.

Prevention

Hospital officials agree about what can be done to reduce the spread of infections: handwashing and lots of it.

Standard practice is for health care workers - doctors, nurses, physical therapists - to wash hands in-between seeing patients. But Consumer Union's McCauley said national studies show that health care workers are washing their hands only 50 percent of the time.

"We've got hospitals where simple things like handwashing are not consistently followed," McCauley said. "There's a lot of room for improvement."

Nina Shik, KU Hospital infection control manager, said dispensers with alcohol-based soaps are outside all hospital rooms. Health care workers use them before entering. Hospital officials monitor employees to make sure they are complying.

"We tried everything: posters, lapel buttons, talking to people, sharing hand hygiene data," Shik said. "But we're teaching people to do something they already know. It's not an educational issue. Most of the time, we're reminding them."

Bellome said if patients or family members question whether health care workers have washed their hands, they should ask.

Other steps - such as clipping, but not shaving the hair around surgical sites - also reduce infections. Also, hospitals give patients antibiotics an hour before surgical incisions are made to ward off infections.

At Stormont-Vail Regional Health Center, the staff developed a specialized IV therapy team that was vigilant about patients' dressings and IV maintenance. The team helped get bloodstream infection rates down, hospital spokeswoman Nancy Burkhardt said.

KU Hospital has installed a new data system that will use patients' hospital records to alert staff of outbreaks.

Shik and others predict that hospital infection rates will re-emerge soon in the Legislature. Her only concern is if the state does start collecting rates, it should use data the public can easily understand with numbers that are comparable.

McCauley hopes more states pass public reporting laws.

"It's an opportunity to make more informed choices when you seek out care," McCauley said. "It'll shine a spotlight on the hospitals doing a good job and those that aren't."

Comments

i_tching 6 years, 7 months ago

How do you tell if an infection that occurs in a hospital came from the care given there, or whether it was brought in by the patient on admission, or by a visitor?

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stbaker 6 years, 7 months ago

formerlawres: 1. Do you have a spleen, or do you know that it was removed as planned? 2. Do you know if you were born with two kidneys, or if you had two kidneys prior to your surgery? There are cases where people have genetic anomalies...Like maybe they are born with only one kidney, or they are missing a portion of their brain, or their heart is on the right side rather than the left...People often do not know this unless they had imaging or surgery that would reveal the anomaly. Or...maybe somebody botched your surgery, as you would suggest...Typical of any surgery would be to send the removed tissue/organ to pathology (lab). Seems odd that they would remove the incorrect organ, and then nobody notice for....say 8 years. ODD, though not necessary impossible. If you were truly concerned, you could request your medical records.

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formerlawres 6 years, 7 months ago

went to LMH to have a Spleenectomy found out 8 yrs later that i did not have a kidney .I would like to know how that happen?

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just_thinking 6 years, 7 months ago

staff 04, how in the +ell is right thinker wrong?it's morons like you who love g.w.b.....

ill betcha you'd vote for that sorry s.+. b. in a new york minute , ha ha ha hah.....................

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Shmoo 6 years, 7 months ago

well that just makes me feel a whole lot better.....yeah I'll go to the hospital one day and remeber this....yeah I think we're all goinna skip happily into the hospital singing " oh what a beautiful morning" then look at another patiant waiting to go into the ER and say "hey great day to die huh?" NO I don't think so.....this goes along with my point that most doctors can't be trusted I mean really they could be injecting drugs into you for all you know the last thing we need is lil high 6-year-olds going all kinds of crazy and poking people's eyes with pen and forcing eachother to eat....GLUUUUUUUUUUUUUUUUUUUUUUUUUE O.O okay my random rant is over.......

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staff04 6 years, 7 months ago

No, right_thinker, it is YOUR fault. When will you idiots start to realize the consequences of your votes?

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smitty 6 years, 7 months ago

Bush cuts medicacid/medicare by 36 billion by '09

Feds will no longer pay for hospital borne infections.. http://www.medicalnewstoday.com/articles/80074.php

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camper 6 years, 7 months ago

These infections are becoming scary. Especially staph. My father developed an infection after bypass surgery several years ago. The result was a trip to ER and a collapsed lung. My uncle also developed a rare blood disorder after surgery. I suspect an infection of some kind was responsible for this. On a positive note, it appears LMH is doing a better job than most hospitals.

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notnowdear 6 years, 7 months ago

AI system predicts medicine's hidden powers http://technology.newscientist.com/article/dn12535-ai-system-predicts-medicines-hidden-powers-.html * 15:03 24 August 2007 * NewScientist.com news service

Treatments for new or drug-resistant infectious diseases may already be in our medicine cabinets, say the molecular biologists responsible for developing an artificial-intelligence system that can predict unknown antibiotic properties of existing drugs.

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notnowdear 6 years, 7 months ago

Let's also address environmental toxins, including that of our drinking water, in the role of decreased immunities in people.

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notnowdear 6 years, 7 months ago

The public needs to demand from it's public-sponsored hospital lower client to nurse ratios. We can do this, as consumers.

Need more help at the bottom-end employees and far less high-paid VPs at the top end of LMH. And you need to pay the base services, client-contact people more money so that retention is maintained.

More client assistance insures that good handwashing is practiced, and that infection is spotted and treated at an earlier time.

Let's get back to basics with our medical practices.

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Cait McKnelly 6 years, 7 months ago

  1. The fines would simply be passed on to the "consumer".
  2. The greatest danger isn't from the ER staff, it's from the day to day operations of the hospital staff with inpatients, especially in ICU and post surgical. These people already have weakened immune systems from being ill. My father died from a hospital aquired infection. He had major surgery and was in ICU for about a week afterward. While he was in ICU he contracted MRSA (antibiotic resistant staph) in the surgical wound. It literally ate him alive. He was dead in 3 weeks. We probably would have had a case to sue the hospital but my father had an advance directive. They would have had to go against the directive to aggressively treat the infection and he chose not to let them do it. My mom just let him go as he wished and didn't pursue it.
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staff04 6 years, 7 months ago

If only we could keep people who are truly sick IN the hospital and keep those who need other types of care out...hmmmm...

Kind of hard, as Medicare and Medicaid keep making it harder and harder for beneficiaries to seek care in outpatient facilities...it is even less expensive to M/M to have those services done outside of the hospital, but we don't think like that when we are slashing so we can afford ridiculous tax cuts for the wealthiest few...

Maybe when gramma dies from her disease while she is waiting 6 months for the mammogram she had to drive 200 miles to get, we'll start to come around and prioritize who REALLY needs the help...

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just_thinking 6 years, 7 months ago

WHAT IS UP WITH THIS? NOW WHAT DO THEY THINK WE SHOULD DO WHEN WE NEED MEDICAL CARE? DO WE DIE OFF LIKE HERDS OF CATTLE AND LET THE STUPID EMERGENCY ROOMS RAKE IN THE CASH OUT OF OUR POCKETS? COME ON HERE, LET'S GET WITH REALITY HERE, THEY SAY WE HAVE 21st century STATE OF THE ART MEDICAL CARE AND FACILITIES , BUT OBVIOUSLY THIS IS NOT TRUE AT ALL.IF THEY CAN'T HAVE A CLEAN AND BACTERIAL FREE FACILITY, THEN DON'T YOU THINK THAT WE SHOULD GET FREE MEDICAL CARE ON THE HOUSE? IN 1930 ELIZABETH WATKINS BUILT OUR HOSPITAL AT A COST OF 175,000.00. SHE WOULD GREATLY BE ASHAMED OF THIS OUTCRY OF DIESEASES AT YOUR'E OWN EMERGENCY ROOM, SO FOR CRY SAKES PEOPLE I SAY DO TWO THINGS. 1.HAVE THE STATE HEALTH DEPARTMENT GO TO ALL HOSPITALS AND HAVE THE HOSPITALS PASS A INSPECTION AND IF THEY DON'T PASS THEN OUTREGOUSLY FINE THEM TILL THEY CORRECT IT. & # 2. THE PUBLICS SHOULD BOYCOTT THE E.R. STAFF PEOPLE AND THE C.E.O.'S OF THE E.R.S.HOW MUCH LONGER CAN THIS CONTINUE UNTIL SOMETHING IS DONE ABOUT IT ?.......

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