Safe Patient Care Blog

Hospitals Provide Limited Infection Data

Tue, 10 Apr 2012 20:58:00 GMT

On paper, 21 states currently have laws that require hospitals to monitor surgical site infections and publish the data. However, of these 21 states, only 8 actually make the data available to the public.

Even among the hospitals that actually manage to put up the data, the reports only involve 10 procedures. You don't have to be an Arizona medical malpractice attorney to know that that there is a huge gap between the laws requiring states to monitor and report infection data, and the manner in which hospitals actually implement the laws.

According to the study that has just been published in the Journal for Healthcare Quality, there are wide variations in the number of surgical procedures that are tracked. For instance, some states include infection data for 7 different types of procedures, and others include infection data for just 3 types of procedures. That means that there are large areas of patient safety data that are currently not being revealed to the public.

Hospitals may choose to conceal the poorly performing department in their facility. In most hospitals, there's one department that performs below par, and has high readmission rates. Hospitals would rather not reveal all data, because it would shock patients to find out how bad the readmission rates in these departments are. That is why you find such under reporting of infection data.

The federal administration is to blame in part for the blatant under reporting of data. The federal administration has not established any reporting standards for hospitals that would lay down the kind of data that has to be revealed. In fact, the healthcare industry has lobbied heavily against any federal standards for reporting data.

Incomplete information may not be sufficient to inform patients, and make them aware of a hospital’s infection prevention and safety record. For the data to be user-friendly, it must include more numbers of procedures.

New Efforts to Reduce Ventilator Alarm Fatigue

Thu, 29 Mar 2012 16:48:00 GMT

The federal administration is taking new steps to reduce the desensitization of nurses, who become used to frequent ventilator alarms. Ventilator alarm fatigue has been recognized by several health organizations as a serious health problem that needs attention. According to the Food and Drug Administration, in 2010, there were 800 patient deaths that were linked in some manner to alarms.

The Food and Drug Administration has now announced that is taking steps to reduce the incidence of ventilator alarm fatigue in hospitals, by tightening the review of new devices that include alarm settings. The agency will increase the kind of alarm standards training that it provides to its reviewers, who are in charge of reviewing new devices.

The Food and Drug Administration is bombarded with applications for approval of a number of devices every year, and many of these devices include alarm facilities. The agency wants to cut down the number of unnecessary alarm-related devices that are used in hospital settings.

Arizona medical malpractice attorneys have found that one of the reasons for fatigue related to ventilator alarms and other types of alarms is that there are far too many unnecessary alarms in hospitals. Alarms are connected to cardiac monitors, medication pumps and beds. Many of these alarms are important, and alter nurses to changes in the person's condition. However, there are equally as many alarms used in hospital settings that alert nurses to even insignificant changes in the patient's condition. It is these kinds of alarms that the Food and Drug Administration wants to eliminate

Nurses become attuned to these alarms, and begin to ignore them or neglect them. This can result in serious patient injuries, and even deaths. Ventilator alarm fatigue contributes to thousands of deaths every year.

Doctors Often Sugarcoat Patient Prognosis

Thu, 16 Feb 2012 17:51:00 GMT

Doctors often find it hard to give patients the cold hard truth when it comes to their prognosis. Therefore, it's not so surprising to Arizona medical malpractice attorneys that so many of them to choose to sugarcoat the truth. According to a new survey, approximately 55% of doctors admitted that they sometimes put a spin on a patient's prognosis.

The results of the survey have been published in the February issue of Health Affairs. The results indicate to Arizona medical malpractice attorneys that transparency which has been a goal for hospitals and health advocates, is still a long way off.

The survey of doctors also found that 66% believed that they should disclose serious medical errors to patients. However, approximately one-third did not believe that it was necessary to inform patients about medical errors. That fact should confirm to Arizona medical malpractice lawyers that that we need to make more progress towards complete transparency in the healthcare industry.

Additionally, 35% of doctors also did not believe that it was important to tell patients about any financial relationship that they had with pharmaceutical drug and medical device companies. A new law that will go into effect next year will require pharmaceutical drug and medical device companies to report on payments that they make to doctors.

When it comes to patient prognosis, many doctors do not find anything wrong with putting a positive spin on the prognosis, even though they are aware that as doctors, they are held to high standards of openness and honesty. Additionally, patients need to have accurate information about their prognosis in order to make decisions about treatment. Doctors, who believe that they're saving their patients anxiety and grief by sugarcoating facts, may actually be delaying their complete recovery.

Leapfrog Announces Annual Top 10 Hospitals List

Sun, 11 Dec 2011 20:26:00 GMT

The Leapfrog Hospital Survey, which Arizona medical malpractice lawyers, health care personnel and patients rely on for information about the best healthcare in the country, has released its annual Top 10 Hospitals list.

A total of 65 hospitals around the country feature on the list, a record that matches the one set in 2010. According to Leapfrog, the ‘Top Hospital’ designation is meant to recognize those hospitals that have delivered the highest quality of healthcare measurable by certain yardsticks, like the prevention of medical errors, reduction of mortality for high-risk procedures and reduction of hospital readmissions.

Several organizations release hospital ratings every year, but the Leapfrog Hospital Survey has been widely recognized as one of the most reliable and accurate indicators of top quality healthcare. According to Leapfrog, its surveyors base their ratings on several parameters -how patients fare in the hospital, the kind of resources that are used to care for patients and the kind of management practices that are utilized in order to promote patient safety. Approximately 55% of America's hospitals report to Leapfrog on standardized measures, so that patients can rate hospitals based on how they fare in the rankings. Some names, like Cleveland Clinic, are missing from the list, because they have stopped reporting to Leapfrog.

The 2011.hospital rankings include university teaching hospitals, children's hospitals and community hospitals in rural and urban environments. The 65 hospitals in the list this year included several Kaiser Permanente facilities in California. The number one position was taken by the Kaiser Permanente Medical Center in Antioch, followed by several other Kaiser Permanente hospitals. Hospitals from Florida, Illinois, Massachusetts, Maryland, Michigan, Minnesota, New Jersey, North Carolina, New Mexico, New York, Ohio, Tennessee, South Carolina and Pennsylvania also made it to the list.

Latex Gloves Can Increase the Risk of Hospital-Acquired Infections

Mon, 21 Nov 2011 23:37:00 GMT

Healthcare personnel who wear latex gloves may be exposing themselves and patients to the risk of infection. According to a study reported in the New York Times, medical personnel who wear latex gloves are less likely to wash their hands after removing the gloves. This is a dangerous practice because germs can be transmitted through the latex gloves.

The results of the study have been published in the Infection Control and Hospital Epidemiology Journal. Researchers looked at 7,000 doctor-patient interactions in hospitals in England and Wales. The researchers found that the overall handwashing rate was 47.7%, regardless of whether gloves were worn or not. However, when the medical personnel were wearing gloves, the hand washing rate dropped to about 41%.

Doctors and nurses wear gloves when they're working with people with infectious diseases, and the bodily fluids from such patients can contain deadly disease-causing germs. These germs can seep through the gloves, and when these people fail to wash their hands after removing the gloves, they place themselves and patients at risk of infections. Additionally, medical personnel may be at risk of having the germs transmitted to their hands when they remove the gloves. That's why it's necessary that these people wash their hands thoroughly after removing the gloves.

Arizona medical malpractice lawyers find that proper handwashing procedures are some of the simplest steps that doctors and nurses can take to reduce the risk of hospital -acquired infections. Unfortunately, these basic steps are often ignored. In fact, many infection control strategies in hospitals around the country are now focusing on compliance with handwashing and hand hygiene procedures. Hospitals are also experimenting with cameras installed at wash areas to encourage staff to wash hands before and after handling patients.

Study Notes Differences in Hand Hygiene in Hospital Emergency Rooms

Wed, 12 Oct 2011 19:52:00 GMT

A new study finds that several factors, including the location and type of health care worker, determined hand hygiene compliance rates among healthcare personnel in an emergency room. The results of the study have been published in the November issue of Infection Control and Hospital Epidemiology.

The study confirms to Arizona medical malpractice attorneys the role of several factors in crowded hospital emergency rooms that increase the risk of infections. For instance, the study found many healthcare personnel in hospital emergency rooms preferred to wear gloves instead of washing hands after seeing each patient. This practice does NOT minimize infection risks, and may actually enhance them.

Additionally, the study found that hand hygiene education leaves out several types of workers, increasing infection risks. For instance, workers responsible for transporting patients from an emergency department to a room or another department, were much less likely to receive training in hand hygiene compliance. These people were therefore, much less likely to wash their hands after taking care of a patient, compared to other types of workers. The researchers also found that providers taking care of a patient in a hallway bed had lower hand hygiene compliance rates.

This is believed to be the largest such study into hospital emergency departments, and involved data from 5,800 patient encounters in an emergency room. Researchers found that overall, appropriate hand washing practices were in place about 90% of the time.

Considering that one out of every five American residents can expect to visit an emergency department this year, Arizona medical malpractice lawyers believe that it's important to focus on infection prevention and control in these departments. The risks in emergency rooms are especially high because of overcrowding, which is common in many Arizona hospitals.

Hospital Workers’ Clothes Can Be Source of Infections

Tue, 20 Sep 2011 22:24:00 GMT

Many healthcare professionals, including doctors and nurses, may be carrying more than just their stethoscopes and trays around the hospital. The study shows that their clothing may contain deadly infection-causing organisms, like MRSA.

A group of Israeli scientists swabbed the white coats and uniforms worn by doctors and nurses. What they found on the clothing was staggering. They found that more than 60% of items of clothing contained clusters of potentially dangerous bacteria. Doctors uniforms tended to be slightly cleaner than nurses, but only just. Approximately 60% of doctors clothing contained bacteria, while 65% of nurses clothing were contaminated.

What Arizona medical malpractice lawyers find even more alarming is the presence of potentially deadly, antibiotic-resistant bugs like MRSA on the clothing. Antibiotic resistant strains were found on 14% of the nurses’ uniforms, and about 6% of the doctors clothing.

However, the Association for Professionals in Infection Control and Epidemiology believes that there is no reason for concern, because there is minimal risk of infections spreading through doctors’ clothing. Most hospital-acquired infections spread through poor hand washing practices by healthcare professionals. Even the researchers note that patients may not be at risk of infections through the germs on the nurses or doctors clothing. However, any infection risks still exist when you consider that the people coming in contact with these doctors and nurses with contaminated clothing are in a fragile state, with weakened immune systems.

Changing clothing everyday seems to dramatically reduce the risks of contamination. Only 8% of doctors and nurses who changed their clothing daily were found to have germs on their uniforms, while 29% of professionals who did not change clothes every day, were found to have germs on their clothing.

Surgical Errors More Frequent Than Believed

Fri, 26 Aug 2011 16:06:00 GMT

Surgical errors, including wrong site surgeries and wrong patient surgeries, occur even more frequently in American hospitals than Arizona medical malpractice lawyers have feared. According to the results of a new analysis, these kinds of errors occur as many as 40 times a week in the country.

That makes it about 40 incidents a week involving surgeries on the wrong body part, on the wrong patient, or even the wrong surgery. The results from a Joint Commission Center for Transferring Healthcare analysis found that there were at least 29 areas which are prone to errors that can lead to wrong site surgery. The data focused on eight hospitals. The mistakes that were made ranged from incomplete documentation and lack of timeout to surgical room errors.

This indicates to Arizona medical malpractice attorneys that wrong site surgeries continue to remain a major patient safety issue in the United States years after the Joint Commission Center for Transferring Healthcare released protocols to deal with these safety issues. The Joint Commission protocols involve the use of a simple checklist to prevent wrong site surgical errors. The checklist encourages doctors to mark the site to be operated on before beginning the surgery. It also calls for doctors and nurses in the operating room to take a timeout before the surgery, and to carefully determine whether the patient to be operated on is scheduled for that surgery.

However, in spite of widespread promotion of these protocols, and the fact that many hospitals use them, there still far too many wrong site surgeries occurring in the country. Also, while it may seem like wrong site surgeries are widespread, the fact is that these are rare, and many doctors and surgeons don't have experience with these. These doctors, therefore, may not be equipped to avoid wrong site hazards. Wrong site surgeries may be rare, but that doesn't change the fact that these can be devastating.

John Hopkins Will Establish $10 Million Patient Safety Institute

Wed, 01 Jun 2011 21:15:00 GMT

It is probably the first patient safety institute of its kind in the country. John Hopkins has announced that it will use a $10 million gift to set up a patient safety institute. The goal of the institute would be to study the prevention of hospital- acquired infections, improper treatment, misdiagnosis and other kinds of medical errors that contribute to thousands of deaths every year. Arizona patient safety lawyers believe that it's high time we had a center like this.

The institute will be known as the Armstrong Institute for Patient Safety and Quality. The institute will conduct research into infection prevention and control, misdiagnosis, mistreatment and other common patient safety problems in the United States. The $10 million gift has been given by C. Michael Armstrong, who is the chairman of John Hopkins Medicine's Board of Trustees as well as a former chairman of Comcast, AT&T and IBM World Trade Corporation.

According to Armstrong, in spite of the fact that there is an intense focus on patient care at John Hopkins, every year he would come across several cases of patients injured due to medical errors. He felt the need to establish a center that would focus exclusively on the prevention of such errors, thereby enhancing patient safety.

A recent study published in the journal Health Affairs found that as many as 1/3^rd of patients suffer a medical error. The rates of such errors have remained more or less constant over the years, in spite of increasing concerns over the injuries and deaths from such errors every year. Hospitals have been under pressure to share data about infections and mistakes in their facilities, and to raise the focus on quality reporting and analysis.

John Hopkins has a special place in patient safety - one of the doctors, Peter Pronovost, a professor of anesthesiology at the center, developed a checklist aimed at the prevention of medical errors. The checklist is currently being used by thousands of hospitals and facilities across the country. In some states, there has been a substantial reduction of hospital errors by as much as 10% from the use of the checklist.

Lack of Research Contributes to Poor Care of Pediatric Patients with Hospital-Acquired Infections

Tue, 19 Apr 2011 02:09:00 GMT

A study indicates that a number of factors, including lack of research into pediatric health, and the lack of quality measures to gauge pediatric safety, may expose these young patients to a higher risk of hospital-acquired infections. There are many differences between pediatric and adult patients, but unfortunately, Arizona medical malpractice lawyers see that many hospitals choose to overlook these differences.

The study was conducted by two Cleveland Clinic Children's Hospital physicians, and the results have been published in the Journal of the American Medical Association. According to the study, the rates of central line-associated bloodstream infections and surgical site infections and other hospital-acquired infections rates differ for both children and adult patients. For instance, pediatric patients have a higher susceptibility to central line-associated bloodstream infections and viral respiratory tract infections than adult patients. However, adult patients are more susceptible to catheter-associated urinary tract infections, surgical site infections and ventilator-associated pneumonia. In spite of these differences, the surveillance of infections continues to be the same for both groups.

The higher incidence of central line-associated bloodstream questions and pediatric patients poses a special challenge to hospitals and facilities caring for these patients. For instance, preventing central line-associated bloodstream infections in pediatric patients is very important, because in these patients, there may often be the need to draw blood. Besides, there is poorer vascular access to pediatric patients. Catheters are often maintained for a longer period of time in child patients, and this often increases the risks of central line-associated bloodstream infections.

Unfortunately, there is little solid research that can help us to understand how hospital-inquiry questions can be prevented in children. We need more rigorous research into the prevention of hospital-acquired infections in child patients, and verification of the best practices for preventing these infections.

Aviation Safety Concepts Could Enhance Patient Safety

Tue, 29 Mar 2011 22:49:00 GMT

The Milbank Quarterly has published a report that defines aviation safety initiatives that can also be used in the healthcare field, to enhance patient safety and reduce costs. The report is titled Counterheroism, Common Knowledge and Ergonomics: Concepts from Aviation That Could Improve Patient Safety.

The report discusses 15 examples of measures to reduce the possibility of aviation safety errors, which are not currently being used in the healthcare sector. The safety initiatives that are currently being used in the field of aviation safety to reduce the possibility of crashes include the use of checklists. Airline pilots have been using electronic checklists to tick off items that have to be completed before takeoff and while the flight is in operation. Pilots use different types of checklists including read and do checklists, challenge and response checklists and aide memoire checklists like pre-departure briefings. Similarly, surgical safety checklists developed by the World Health Organization can be used to enhance patient safety.

Airline pilots also routinely use a training program called Cockpit Resource Management or Crew Resource Management. The program emphasizes the importance of using people, information and equipment in order to ensure a safe flight. The researchers believe that a program called Threat and Error Management that is currently used in the aviation sector can be used in the healthcare sector too.

Before every flight, commercial aircraft crews gather together for a joint safety briefing. Arizona medical malpractice lawyers believe that these practices can be carried over into the healthcare sector, by having joint briefings before the start of clinics, ward rounds and handoffs as well as at the beginning of every day.

Besides, commercial aircraft pilots also follow sterile cockpit rules, requiring pilots and cabin crew to abstain from all non-essential talk. Aviation safety rules also place all authority for important flight decisions with the captain. An airline cockpit has a standardized layout, which allows pilots easy and quick access to the instrumentation controls. Similar concepts can be used in the healthcare sector to streamline safety procedures and enhance patient safety.

Avoid Emergency Room Wait Times

Wed, 26 Jan 2011 18:54:00 GMT

According to a report by the Government Accountability Office in 2009, the average wait time in an emergency room in the US in some cases was almost double the recommended time. That same year, Press Ganey Associates found that patients who were admitted to a hospital had to wait an average of six hours in the emergency room. Approximately 400,000 patients had to wait 24 hours or more.

Arizona medical malpractice attorneys are familiar with the serious risk to patient lives and safety when they have unreasonable wait times in a hospital emergency room. However, there are some things that you can do to avoid long wait times.

Don't wait for an emergency to find out that your hospital ER is always cramped. Find out the average wait times of hospital emergency rooms closest to you. Many hospital emergency rooms now post their average wait times on their websites to inform patients about wait times.

Visit an ER on these days only if it’s a real emergency. If possible, avoid visiting a hospital emergency room on high-traffic days like Mondays. Mondays can typically be very busy for emergency rooms, because many people who fall sick over the weekend walk into ERs on a Monday.

Be proactive, and coordinate your own medical care. It's always a good idea to call your physician on the way to the ER, and recount your symptoms. The physician can then contact the ER, and explain your symptoms, so you can expect better care.

When faced with a long line at the hospital emergency room, it doesn't pay to be rude or angry. Be cooperative, but persistent.

Even as you're waiting, inform others or someone else about any changes in the patient's symptoms. Even a slight change in temperature or persistent weakness should be brought to the attention of nursing staff.

If you still have not been attended to after a certain period of time, ask for the charge nurse or the shift supervisor. Use words like “emergency” and “needs to be evaluated right away” to have your concerns taken more seriously.

Private ICU Rooms in Hospitals Reduce Risk of Infections

Tue, 18 Jan 2011 21:40:00 GMT

This is not a study that will contain surprises for Arizona medical malpractice attorneys. A study in Canada shows that patients who are in private ICU rooms, have a vastly reduced risk of contracting hospital infections than those who are put up in shared rooms.

The study conducted by researchers in Montréal analyzed more than 19,300 hospital admissions over a period of five years at the McGill University. They analyzed admissions at the ICUs before the general intensive care facility was transformed into private rooms, after renovations. They found that the infection rate for patients in the private rooms was 54% lower than before the renovation. According to the authors of the study, private intensive care rooms may enhance infection control practices, and reduce the risk of transmission of infections from patient to patient. The researchers in fact are recommending conversion of general intensive care facilities into private rooms, to reduce the risk of contracting hospital-acquired infections.

As mentioned, none of this is exactly rocket science. When patients are in isolation, the chances of contracting dangerous infections decrease substantially. In fact, other researchers have called for changes in the hospital design that allows for private rooms in intensive care. However, there are far too many health facilities that still haven't implemented this enhanced hospital design, with the result that patients are still crammed into general intensive care rooms with a higher risk of infections.

No one is suggesting that having private rooms is a one-step solution for soaring hospital infection rates. Besides, there will be space and other constraints that prevent hospitals from moving to a private room design. In such cases, hospitals can use other methods like using separate and private washrooms, targeted screening of patients and enhanced infection control methodologies and training to prevent infections.

Study Finds Delayed Surgeries Increases Infection Risks

Wed, 29 Dec 2010 19:59:00 GMT

Patients have a much higher risk of developing infections and complications after an elective surgery if their surgery has been delayed after being admitted into the hospital. A new study analyzed data from patients who developed postsurgical infections. These patients had undergone three common types of surgeries. A total of 87,318 persons had undergone coronary artery bypass grafts, while 46,728 persons had undergone colon resections, and 28,960 persons had undergone lung resections. These patients then developed a range of infections, including pneumonia, postoperative sepsis, urinary tract infections and surgical site infections.

The researchers found that in each type of surgery, postoperative infection rates were much lower if the patient had the surgery on the day of admission into the hospital. For instance, in the case of a coronary artery bypass grafts, infection rates were approximately 5.7% when the surgery was performed on the day of hospital admission. However, the infection rate soared to 18.2% when the surgery was performed between six and 10 days after hospital admission.

The rate of infection for colon resection was 8.4% for surgery on the day of the admission, and 21.6% if performed several days later. For lung resection, the rate of infection was 10.2% if the surgery was performed on the same day, and 20.6% if the surgery was performed a few days later.

As any Arizona medical malpractice lawyer knows, multiple factors contributed to these results. For instance, there is a combination of factors that contributes to postsurgical complications, including the age of the patient, as well as other health issues, that could affect post surgery recovery rates. However, this analysis seems to confirm that there is a relationship between delaying the patient’s surgery after admission, and the development of such complications.

Despite Efforts, Little Progress in Patient Safety

Mon, 29 Nov 2010 19:15:00 GMT

A new study out of North Carolina confirms every Arizona medical malpractice attorney’s worst fear - we are nowhere closer to making hospitals safer for patients. The study was conducted in 10 hospitals in North Carolina between 2002 and 2007, and is believed to be the first study in nearly a decade analyzing the harm that patients can be exposed to from medical care in hospitals. It is also believed to be one of the most rigorous studies into medical errors, which contribute as many as 90,000 deaths annually in the United States, since the publication of a path breaking report by the Institute of Medicine in 1999.

Broadly, the study found that harm to patients from hospitals continues to be common, and the number of incidents involving patients harmed from medical errors has not declined significantly. The researchers found that 18% of the patients in the study were harmed because of medical care, and out of these, more than 60% of the injuries were preventable. While many of the problems were treatable and did not result in lasting damage, some were serious, and almost 2.5% of these errors contributed to the patient's death.

The most specific problem areas continue to be complications from surgical procedures and drugs, as well as hospital-acquired infections. These are still the most common and most hazardous threats to patients in US hospitals.

Even though the study was conducted in North Carolina, the researchers believe that the results are likely to be more or less the same elsewhere across the country. The research program specifically targeted North Carolina, because that state has more developed and established programs to enhance patient safety. However, what the researchers found was a dismal pattern of medical errors contributing to preventable deaths in a state that has actually invested heavily in patient safety.