Wednesday, December 21, 2011

Hospitals are Hazardous to Your Health! (Part 2)

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Hospitals install spying cameras to track hand washing rates among medical workers
Jonathan Benson, staff writer
Wednesday, December 21, 2011
(NaturalNews) Roughly 100,000 people die every year from hospital-acquired infections, and many of these could be prevented if more medical workers simply remembered to wash and sanitize their hands throughout the day, say experts. One way some hospitals are drastically increasing hand washing rates is by installing video monitoring systems that constantly film sinks and alcohol sanitizing stations, and report footage back to nurses throughout the day.
North Shore University Hospital (NSUH) in Manhasset, NY, is one of only a few hospitals that has decided to take this more drastic measure to increase hygiene levels among medical workers -- but it is one that has had incredible success. According to a controlled, peer-reviewed study on the hospital's video monitoring system recently published in the journal Clinical Infectious Diseases, watching employees through the Big Brother-esque video monitoring system has increased the overall hand washing rate by nearly 1400 percent, taking it from 6.5 percent to nearly 88 percent.
The way it works is that medical workers, and primarily those that work in intensive care units (ICU), are given ten seconds to wash or sanitize their hands every time they enter or exit a patient's room. If medical workers successfully clean their hands within that ten-second window, the action is logged into the system as a success -- but if they fail, the action is logged as a failure. The results are then compiled and displayed on LED panels located across from the nurse stations throughout the day.
"They look at the rates," said Isabel Law, nurse manager of the surgical ICU at NSUH, to The New York Times concerning the display of the hospital's hygiene rates for all to see. "It becomes a positive competition. Seeing 'Great Shift!!' is important. It's human nature that we all want to do well. Now we have a picture to see how we're doing."
Similar programs have been experimented with at various other hospitals, but most of them have generally had less overall success. One such program utilizes a system that "sniffs" workers hands to detect the presence of alcohol from alcohol-based sanitizers whenever they enter or leave a room. Another involves simply measuring the levels of soap and alcohol in dispensers at the end of each day compared with at the beginning.
Sources for this article include:
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Some doctors are lousy handwashers: B.C. audit
CBC News
Thursday, June 17, 2010
Doctors, nurses and other health-care professionals at several Vancouver Island hospitals aren't practising proper hygiene, according to an audit conducted into handwashing techniques.
Health professionals were openly observed for the entire month last February at Victoria General, Royal Jubilee, Saanich Peninsula and Nanaimo General hospitals. The audit showed that less than one third of all handwashing is done properly and that physicians are the worst offenders.
On average, they were in compliance 12 per cent of the time.
The head of infection prevention and control for the heath authority, Bev Dobbin, called the results "surprising" and "disappointing."
Dobbin said she was not sure why health professionals have such a low compliance rate but suspects that it's usually because they haven't removed watches or rings before washing.
"You might have done the technique appropriately, but if you had one of those other barriers to hand hygiene, it was a fail," she said.
Prompted by the high failure rate, the health authority has prepared new handwashing guidelines with a goal of 100 per cent compliance.
"We have drafted [a policy] and I anticipate it will be in place by the fall," Dobbin said.
Dobbin said the policy would be voluntary and stipulates no penalties if it is violated.
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14 Worst Hospital Mistakes to Avoid
How Hospitals Can Make You Sick
Going in for surgery? Get the facts you need to be your own health advocate
By Joanne Chen
Published November 2011
Apart from interfering with your beach vacation, there's another, more serious reason to steer clear of summer surgery if you can: a 10% spike in fatalities at teaching hospitals in July, confirmed by a new Journal of General Internal Medicine study. David Phillips, PhD, the study's lead author and professor of sociology at the University of California, San Diego, speculates that the "July effect" may occur because that's the month when new doctors-in-training begin their residencies.
The fatalities aren't the fault of poor knife skills botching operations, though--rather, they're due to mistakes made prescribing and administering patient medications, both surgery-related and not.
All told, as many as 98,000 deaths occur each year due to all kinds of medical mistakes--the equivalent of a fully packed 747 crashing every other day. According to a congressionally mandated study on Medicare recipients, during 2008, 1 in 7 hospital patients experienced at least one unintended harm that prolonged his or her stay, caused permanent injury, required life-sustaining treatment, or resulted in death.
So what can you do to make sure this doesn't happen to you or someone you love? Plenty, say doctors, nurses, and researchers. Read on to find out where to start.
1. Choose your hospital carefully
Infections that are acquired after checking into the hospital kill 31,000 patients a year, which nearly rivals the number of breast cancer deaths annually, says Peter Pronovost, MD, PhD, the author of Safe Patients, Smart Hospitals. What's more, most of these could easily have been prevented.
If you have a choice of hospitals, ask if your doctor knows your options' infection rates, which are measured using "catheter days," meaning every 24 hours that a tube is inserted in a patient's blood vessels. "The best hospitals' rates have been zero in one thousand catheter days for a year or more," says Dr. Pronovost. "If it's risen above three, I'd be worried."
2. Check your doctor's experience
The more often a doctor has performed a procedure, the more familiar she is with its variations and complications and the higher her success rate is likely to be. Confirm that your physician is board certified in her specialty (check the American Board of Medical Specialties at abms.org), but also ask her how many times she's treated your condition.
Related: Find out why not getting a second opinion is one of the biggest health mistakes you can make.
3. Say no to Fridays and weekends
Weekends, nights, and holidays are not the optimal times for operations. Even the lead-up to the weekend can be problematic: "For elective surgery, avoid a Friday afternoon operation slot if possible," advises a surgeon in a busy Midwestern hospital who asked not to be named. "The operating room staff may be fatigued and less able to concentrate then."
It gets worse on the weekend. Stroke patients treated in hospitals on Saturday and Sunday were 16% more likely to die than those treated on weekdays, found a recent study from the University of Toronto. Staffing tends to be lighter then; getting lab results takes longer; and on-call docs have to drive in from home.
When you're scheduling surgery, time of day matters: Ask for the second or third slot of the morning. "Any kinks in the team's coordination or machinery are worked out, and the staff's still well-rested," explains Matthew Buchanan, MD, an orthopedic surgeon in Falls Church, VA.
4. Ask about your electronic records
Often, in a busy hospital, complicated medication orders are dictated quickly to harried staffs, so they can frequently be a source of error. If possible, use a hospital with electronic records, which can reduce prescription slipups sevenfold, according to a recent Weill Cornell Medical College study. When information is entered, the computer alerts staff to potential problems by beeping, freezing, and/or flashing a warning message to prevent improper dosages, incorrectly filled prescriptions, and dangerous drug interactions. Only 17% of hospitals have such a system for medications, but it's worth checking for: After the Lucile Packard Children's Hospital at Stanford in Palo Alto, CA, adopted one, its death rates dropped by 20%.
5. Bring your own bottles
The bottles we mean are strictly Rx. Doctors suggest you bring your actual prescriptions to the hospital--don't just write down the names. "You cut chances of blunders such as missed doses and interactions when the staff sees what you're taking," says Tanya Froelich, MD, an assistant professor of pediatrics at Cincinnati Children's Hospital Medical Center.
6. Request a blood-clot screening
One in 100 patients admitted to a hospital dies of venous thromboembolism--a potentially deadly blood clot that forms in a vein--but half of those lives could have been saved with simple preventive measures available everywhere. When you're admitted to the hospital, you should be screened--particularly if you'll be recovering from cancer, heart disease, or any other major illness, says Frederick Anderson Jr., PhD, who wrote about the topic in the American Journal of Medicine. But half of at-risk patients don't get basic clot-prevention help, such as compression stockings or heparin therapy--so double-check with your doctor that your risk has been adequately assessed and the appropriate measures taken.
7. Don't go it alone
When you're a patient in the hospital, you're likely to be worried, stressed out, and under sedation at times, so it's helpful to have your relatives and friends with you to act as your advocates. "I love it when someone close to the patient is there," comments Ralph Brindis, MD, clinical professor of medicine at the University of California, San Francisco. "They can ask questions the patient hasn't thought of, and--because they know their loved one--they understand what she'd be anxious or unclear about." By acting as extra eyes and ears for you, this team can keep track of your treatment and may prevent errors that would otherwise go unnoticed.
8. Get the surgery plan (before you go under)
Your surgeon should call a time-out before your procedure so the operating team can make sure everyone knows who you are, why you're there, and the correct site of the procedure. Things can still go wrong, however, when a surgery requires multiple incision sites or if the team skips procedural steps during an emergency. To be safe, ask your surgeon to draw the proposed incisions right on the body part that will be operated on so you can see them while you're still awake, recommends Dr. Buchanan.
9. Don't get shortchanged by shift changes
The chance of medical mishaps shoots up during shift changes, says Arthur Aaron Levin, MPH, director of the Center for Medical Consumers. Before your current nurse leaves, request time to review your chart and what treatment you're supposed to get next. And meet with your new nurse, too, to ask any questions you have, advises Caitlin Brennan, RN, PhD, a postdoctoral fellow at Case Western Reserve University Frances Payne Bolton School of Nursing.
10. Demand a hand-wash
Potential for infection lurks everywhere in a hospital, so ask everyone to wash their hands before touching you. Sanitary gel dispensers should be available just outside or inside your room, but if you're not sure they've been used, keep your own gel by your bedside, rub some on before shaking hands, and offer it to visitors, says Lawrence C. Chao, MD, an ophthalmologist in Irvine, CA.
11. … and a regular room-cleaning
Typically, a room is completely washed down between patients, but if you're there for a few days, ask that frequently touched areas be disinfected. It's not always done but should be, says Lisa McGiffert, director of Consumer Union's Safe Patient Project. "Everything in the room could potentially spread infection," she says.
12. Avoid these two surprising germ magnets
The elevator: It's a favorite shot on Grey's Anatomy--but ever notice how no one washes her hands before pressing the buttons? When you're up again, use a tissue when handling publicly pawed buttons and knobs.
Your doctor's tie or necklace: Doctors may come into contact with all kinds of deadly germs and can spread them to you. In a 2004 study, 20 out of 40 doctors' ties were found to be contaminated with dangerous bacteria. And a separate Emory University study found harmful staph bacteria on 17 out of 84 stethoscopes. Ask physicians to tuck dangling ties or necklaces into their coats, and have alcohol wipes at the ready to disinfect anything (like pens or medical instruments) that's touched by many hands and may be contaminated with health hazards.
13. Prevent dangerous falls
Up to 30% of falls result in serious injury--and in hospitals, they often occur when you're en route to the bathroom. Call for help if you're unsteady on your feet. And even if you're not, skidproof socks help on slippery hospital floors. Bring your own or ask an aide for a pair.
14. Smile when you ask for something
No study proves that bringing treats to the nurses wins special privileges, but being pleasant does seem to make staff particularly attentive. Try to be friendly even when there's a problem: "I understand that it's busy, but my IV is beeping, and I'm worried." Manipulative? Insecure? Maybe--but it's your life that's at stake.
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Also See:
Hospitals are Hazardous to Your Health! (Part 1)
10 September 2010
http://arcticcompass.blogspot.com/2010/09/are-hospitals-hazardous-to-your-health.html
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