House of Cards
We build them up meticulously, with tender loving care, only to watch them come tumbling down just when we are convinced of their firm foundation and stable armament, and least expect it. We want to believe in our medical institutions. We want to believe in their quality of care. Wishful thinking may abound here, however, as horror stories continue to mount and testimony comes out of the closet. The predominant question remains unanswered. Are our hospitals safe?
The cards have been dealt. Read them and weep. Hospital-acquired infections amount to 2 million each year, with one in 20 hospitalized patients falling victim. With more and more bacteria becoming resistant to our dwindling arsenal of antibiotics, it comes as no surprise that hospital infections are the eighth-leading cause of death in the U.S. The numbers are staggering. Every year 90,000 Americans die of infections contracted during hospital stays for other causes. Those who manage to dodge the infectious bullet are plain fortunate. Those who take a “flesh wound” curse the hospital, their caregivers, and they day they were born, as weeks of intravenous antibiotics and major surgery to remove necrotic tissue are their compensation for attempting to keep their organism in tiptop shape in the first place.
We as a society must ask ourselves the questions, do we feel lucky? Are hospital-acquired infections inevitable? Does pro-action really work? While the answers to our queries may be sobering, they will nonetheless reap rewards in the future. Currently, it has been estimated that more than 60 percent of staphylococcal germs are resistant to antibiotics. With those cards stacked against us, we must seek to prevent rather than treat infections. To do that, patient education and caregiver attention to detail must become first and foremost, as is usually the case. Hands must be washed on a regular and repetitive basis (as bacteria are largely spread through touch), blood pressure cuffs and other instruments must be cleaned for every patient, antibiotics must be administered before surgery, and overuse of catheters and intravenous lines must become a “no-no.” What good are latex gloves, if the hands they house are dirty! And let’s not forget our doctors’ neckties. In a recent study conducted on those silk status symbols, 20 of 43 neckties tested harbored bacteria and other creepy crawlers in them. While demanding that your physician remove his necktie and wash his hands might be an exaggeration, it might not be such a bad idea, after all, before physical examination or instrumentation.
Hospital infections, when care trumps lip service, should be no more common in the old and immunocompromised than in average patients on the hospital ward. Common sense should reign. Doorknobs, curtains, cabinets, blood pressure cuffs, writing implements, charts, and other extraneous paraphernalia should not be touched once our fearless men and women in white have scrubbed or gloved. Now, that might sound redundant and go without saying, but our modern-day reliance on antibiotics has clouded good old conventional wisdom.
Currently, hospital infection rates in the U.S. hover around a wound infection for one of every 24 surgical patients, and a urinary tract infection for up to 25 percent of patients requiring a catheter for a week or longer. While those are national averages, we can certainly do better. Focused infection prevention will not only save lives, but will pay dividends of $1.2 million or more to an average hospital over a two-year period. With the average charge for an infection case reaching $185,260, compared with $31,389 for a non-infection case, the time has come to “debug” the health care system before the roof comes down and costs become unsustainable.
Now that you know the problem, what can you can you, the health care consumer, do? Or are you just a small fish in an underworld of card sharks? Some simple rules to follow will call their bluffs. Wash your hands frequently, and ask your caregivers to wash theirs. Sometimes easier said than done! Lose weight and stop smoking before surgery to cut down on the chances of infection. Make sure your physician prescribes an antibiotic before surgery, and don’t allow the doctor to shave the surgical site. Hair clippers are less infection-provoking than razors. If your friends are ill, tell them to stay away from the hospital. Finally, when IVs and catheters become loose, call for help.
If all else fails, there is always Russian roulette……
© 2007, Albert M. Balesh, M.D. All rights reserved.
The cards have been dealt. Read them and weep. Hospital-acquired infections amount to 2 million each year, with one in 20 hospitalized patients falling victim. With more and more bacteria becoming resistant to our dwindling arsenal of antibiotics, it comes as no surprise that hospital infections are the eighth-leading cause of death in the U.S. The numbers are staggering. Every year 90,000 Americans die of infections contracted during hospital stays for other causes. Those who manage to dodge the infectious bullet are plain fortunate. Those who take a “flesh wound” curse the hospital, their caregivers, and they day they were born, as weeks of intravenous antibiotics and major surgery to remove necrotic tissue are their compensation for attempting to keep their organism in tiptop shape in the first place.
We as a society must ask ourselves the questions, do we feel lucky? Are hospital-acquired infections inevitable? Does pro-action really work? While the answers to our queries may be sobering, they will nonetheless reap rewards in the future. Currently, it has been estimated that more than 60 percent of staphylococcal germs are resistant to antibiotics. With those cards stacked against us, we must seek to prevent rather than treat infections. To do that, patient education and caregiver attention to detail must become first and foremost, as is usually the case. Hands must be washed on a regular and repetitive basis (as bacteria are largely spread through touch), blood pressure cuffs and other instruments must be cleaned for every patient, antibiotics must be administered before surgery, and overuse of catheters and intravenous lines must become a “no-no.” What good are latex gloves, if the hands they house are dirty! And let’s not forget our doctors’ neckties. In a recent study conducted on those silk status symbols, 20 of 43 neckties tested harbored bacteria and other creepy crawlers in them. While demanding that your physician remove his necktie and wash his hands might be an exaggeration, it might not be such a bad idea, after all, before physical examination or instrumentation.
Hospital infections, when care trumps lip service, should be no more common in the old and immunocompromised than in average patients on the hospital ward. Common sense should reign. Doorknobs, curtains, cabinets, blood pressure cuffs, writing implements, charts, and other extraneous paraphernalia should not be touched once our fearless men and women in white have scrubbed or gloved. Now, that might sound redundant and go without saying, but our modern-day reliance on antibiotics has clouded good old conventional wisdom.
Currently, hospital infection rates in the U.S. hover around a wound infection for one of every 24 surgical patients, and a urinary tract infection for up to 25 percent of patients requiring a catheter for a week or longer. While those are national averages, we can certainly do better. Focused infection prevention will not only save lives, but will pay dividends of $1.2 million or more to an average hospital over a two-year period. With the average charge for an infection case reaching $185,260, compared with $31,389 for a non-infection case, the time has come to “debug” the health care system before the roof comes down and costs become unsustainable.
Now that you know the problem, what can you can you, the health care consumer, do? Or are you just a small fish in an underworld of card sharks? Some simple rules to follow will call their bluffs. Wash your hands frequently, and ask your caregivers to wash theirs. Sometimes easier said than done! Lose weight and stop smoking before surgery to cut down on the chances of infection. Make sure your physician prescribes an antibiotic before surgery, and don’t allow the doctor to shave the surgical site. Hair clippers are less infection-provoking than razors. If your friends are ill, tell them to stay away from the hospital. Finally, when IVs and catheters become loose, call for help.
If all else fails, there is always Russian roulette……
© 2007, Albert M. Balesh, M.D. All rights reserved.
posted by Dr. Al at
5/27/2007 04:23:00 PM
2 Comments:
Eeyew! Makes me not want to become a hospital patient for sure. Good article, Dr. Al. I hadn't heard that about neckties, but I'm always glad to hear reasons against those silly things.
By
Peg Spencer, at Monday, June 04, 2007 12:59:00 PM
I was wondering where you were, Peg. I thought you might have abandoned ship, or accepted that lucrative writing position somewhere. Thank you, as always, for taking the time to read my material. I know that you have much better and more important things to do, and I certainly appreciate your gesture. Sincerely, Dr. Al
By
Dr. Al, at Monday, June 04, 2007 8:23:00 PM
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