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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

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

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

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

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

Swine Flu Shots...Are The Shots Dangerous?

Frank Bailey — Sun, 11 Oct 2009 17:25:41 GMT

Rush Limbaugh says he is not taking a swine flu shot. He is a smart man. In today’s Arkansas Democrat Gazette Mike Masterson wrote an excellent article about the dangers of the shot. Should we trust our government about this? I’m not sure…

Apparently there are concerns about the mercury, aluminum and squalene contained in the shots. Are these compatible with good health? We should ask, who is making money from the shots? Are they willing to put our health at risk?

As Mr. Masterson writes, “[I]t’s hard to know what is best for us and ours. Do we risk a three day bout in bed with influenza or take this vaccine that may or may not have dire health implications now or in the future?”

If our government is willing to put caps on damages for medical malpractice to appease the insurance industry, and grant immunity to corporations if the swine flu shots cause injury, why should we trust our government about the safety of this vaccine?

I urge everyone to research this issue and not just follow the herd.

Originally posted at InjuryBoard by Frank Bailey

Hospital Acquired Infections and C. diff.

Frank Bailey — Sat, 11 Apr 2009 16:29:00 GMT

Hospital acquired infections are on the rise in the United States. I have recently been blogging about MRSA, but today I want to address another killer, Clostridium difficile or “C. diff.”

C. diff. killed more patients in England in 2006 than MRSA, and the same virulent strain,ribotype 027 has begun to show up in some of our hospitals. So what are we to do?

Outside hospitals, C. diff. is found in about 5% of the population. It normally does not cause any problems because the other good bacteria in our gut keep it in check. The problem starts when a patient is given antibiotics. The antibiotics kill the good bacteria and C. diff. takes over causing severe diarrhea and inflammation.

The bacteria are spread in the hospital through oral-fecal contamination. A 2006 study in the Journal of Hospital Infection found that as many as one-third of blood pressure cuffs rolled from patient to patient carried C. diff. spores on the inside of the cuff. It is easy for a patient to touch their arm and then their food spreading the spores to their mouth and eventually their gut. This is especially true with patients who are fed in bed…those patients really don’t have an opportunity to wash their hands before they eat and are at risk to contract C. diff.

Cleaning is the key to stopping the spread of these deadly bacteria, but it has to be more than just routine cleaning to be effective against the C. diff. spores. Rigorous cleaning with bleach is required to disinfect rooms. Everything, bed rails, telephones, call buttons, toilet seats, and tables must be cleaned. Washing hands with soap and water is required to prevent the spread by healthcare workers. (Alcohol-based sanitizers are not as effective against C. diff. as soap and water)

Many physicians are not well versed about C. diff. A study in one hospital showed that 39% did not know the spores could be transferred from one patient to another on equipment such as stethoscopes and blood pressure cuffs.

Education of personnel about the dangers of spreading C. diff. and controlling antibiotic use are the best weapons to fight this hospital acquired infection. Treating C. diff. has been estimated to add $3.2 billion to the cost of medical care a year. What will it take to wake up hospital administrators to ensure rudimentary preventive measures are put in place and enforced?

Originally posted at InjuryBoard by Frank Bailey

Never Events

Frank Bailey — Thu, 20 Aug 2009 10:39:50 GMT

Did you know that Medicare and Medicaid are no longer reimbursing for “never events” that happen in hospitals?

What are never events?

1. Vascular catheter-associated bloodstream infections
2. Catheter-associated urinary tract infections
3. Mediastintis after coronary artery bypass surgery
4. Surgical site infections after bariatric surgery
5. Surgical site infections following spine, neck, shoulder, or elbow surgery
6. Deep venous thrombosis or pulmonary embolism following hip or knee replacement
7. Foreign body retained after surgery
8. Air embolism
9. Blood incompatibility
10. Stage III and IV pressure ulcers
11. Manifestations of poor glycemic control

What does this mean to a consumer of medical services? We at the Bailey and Oliver law firm are watching this as it develops.

Originally posted at InjuryBoard by Frank Bailey