MRSA: Victimization and Shooting the Messenger

Yesterday’s post, where I told the stories of three (+2) victims of MRSA infections, raised ire, blame and excuses from commentators and emailers alike.

Never mind that they were stories of five people who are infected with MRSA, one of whom has basically been left to die. Never mind that the frustration levels of these patients while trying to get treatment are over the top. Never mind that these people are victims of dirty medicine — the kind where guidelines and controls exist, but are ignored in too many places. The negative comments were aimed at me — it’s easier, after all, to shoot the messenger.

This post has been moved.  Find it by linking to its new location. 

MRSA: Patients Ignored, Left to Die

(Find an update to this post: MRSA, Victimization and Shooting the Messenger)

In the past two days, I have heard three stories, all related to MRSA and other hospital acquired staph infections, and all relating to heinous — even (in my not-so-humble-opinion) criminal acts on the parts of healthcare providers or politicos.

One story came from a colleague who visited a woman in the hospital. The woman contracted an infection after surgery almost a year ago. She is still in the hospital, on life support, not because of the surgery, but because the infection has just consumed her.

This post has been moved. Link here to find it in its new location.

MRSA: Those With Power Aren’t Paying Attention

Two reminders during the past week about MRSA and the real problems facing those who are infected by it — and those who aren’t.

The first was an email from Genevieve who told me about her husband’s experience after knee replacement surgery. Two days after being removed to a rehab center, he began running a fever, and his incision starting turning red — obviously the sign of an infection.

He was transported by ambulance to the hospital where he had the surgery, and the resident on call proceeded to examine his knee — with no gloves on! Genevieve objected — loudly she says — “wait! what if it’s MRSA?”

The doctor turned to her and in a loud voice, exclaimed that MRSA wasn’t the problem everyone thinks it is, and she shouldn’t get so upset! Genevieve, however, insisted he wash his hands and put on gloves before touching her husband again. (you, go, Genevieve!) Fortunately, while there was in infection at the site of the surgery, it was not MRSA.

The second reminder came in the form of an editorial included in Health Leader’s Media by Molly Rowe called MRSA, MRSA Me. She tells about her difficulties this past summer in getting her “spider bites” diagnosed as the MRSA they were, and the ensuing disinterest on the part of her family care doctor when she was later scheduled for knee surgery and they didn’t care about double checking that her infection had, in fact, been healed. You can just imagine what might have happened had the MRSA spread to her surgical site.

Clearly, despite the media attention, despite the 100,000 deaths each year, despite the cost to hospitals of taking care of those who get sick from it — the very people who can make a difference don’t seem to be paying attention! It’s as if they take the concept of transparency (recognizing the problem so they can do something about it) to mean invisibility (if we ignore it, it will go away.)

It’s time those leaders in hospitals, and their staff, became “infected” with whatever impetus is needed to take note and take these infections seriously. Sadly, it will likely require some horrible tragedy — like the loss of a hospital’s CEO or the CEO’s loved one to MRSA — before the people in a position to make a difference will do so.

For now, we patients need to do just what Genevieve did. She proclaimed her dissatisfaction loudly to take care of the present danger. THEN, she got in touch with the hospital’s administration afterwards to complain. She is truly an empowered advocate.

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MRSA in the Community (Interview)

While my heart breaks for the family of the young high school boy who lost his life to a MRSA infection, I can’t help but think his death will have saved the lives of millions in the future.

MRSA has been around for so many years, and tens of thousands of people have been dying, but no one has been paying attention! Now, they are. Sadly, MRSA has moved from the hospital where people have been acquiring it, and dying from it, for years, to the community. It’s a different strain, but no less deadly.

When we were kids, we were taught to wash our hands so the germs wouldn’t make us sick.

Now we need to teach our kids to wash and sanitize so the germs won’t cause someone to die.

Do a news search on google or yahoo using “MRSA” and “community” and you’ll come up with more than 1,000 citations this morning.

A few weeks ago, I interviewed infectious disease expert Dr. Shelly Gilroy for my radio show. This morning I’ve uploaded that interview, plus my previously (newspaper) published information about MRSA for your review.

I’ve also added some links to further information, including the most recent updates from the Centers for Disease Control.

There is a long way to go before this superbug, or any of the others, can be eradicated. Until then, we just have to stay smart, keep our hands washed, teach our kids how to avoid infections at school, use precautions when we are in places with equipment that will house the germs….

Read up, and be smart. Please!

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MRSA, other Staph Infections: Nothing New Here!

It’s all over the news this morning, from CNN to NBC to CBS, ABC and Fox – a report of widespread MRSA and other staph infections. They are superbugs that can’t be eradicated by the antibiotics that exist because the very nature of them is that they have overcome those killing agents.

So instead they are killing people worldwide.

There is nothing new here!

Patient safety experts have been calling attention to these superbugs for years, and predicting exactly what is now being reported: that people are dying who otherwise would not have died had they not acquired this infection. In this case, it took the death of a high school boy to call attention. My heart goes out to his family, along with some appreciation to this young man who has now become the catalyst for making these infections come to the top of the news heap.

This is Hospital Infection Prevention Week. Learn everything you can about these infections to stay clear and keep yourself and your loved ones safe. Take the steps necessary, especially if you must be in the hospital, to keep yourself clean of these infections.

Now, go wash and sanitize your hands.

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Find an update to this post, and a podcast interview here.

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MRSA Almost Destroyed in Pittsburgh

Some very positive steps are being taken in one Pittsburgh hospital, notable because they were taken on the intiative of the hospital and not because a gun was being held to the head of the decision-makers.

This article from the NY Times makes me stand up to cheer.  It tells about the efforts of the Veterans Affairs Hospital to eradicate MRSA and other superbug infections.  They do so by swabbing the noses of patients before they are admitted to the hospital to determine whether those patients are already infected before they arrive.  Those who are infected are then isolated in the hospital, and their providers and caretakers must wear gloves and gowns, plus clean themselves with foamy sanitizers, before they can visit the patient.  Everything from blood pressure cuffs to stethoscopes are either disposed of or sanitized after use with these patients. 

Infections at the hospital have dropped 78 percent since they started two years ago.

The Centers for Disease Control states that up to 99,000 Americans die from infections they’ve picked up while staying in a hospital — not whatever was wrong with them when they were admitted.  This one hospital’s experience shows us that 78,000 of those lives might have been saved.

You see?  It can be done!   Big cheers for the Veteran’s Hospital in Pittsburgh.  And — realization that in many countries of Europe, MRSA and other superbug hospital acquired infections have all but been eradicated already by taking similar measures.

All this reminds me of a conversation I had earlier this week with Bob, a friend who has the ability to stop me in my tracks by observations he makes.  He is a voracious reader and often sees the world from angles you and I don’t stop to consider.  In a conversation about my work in general, I stated to him, “I don’t think any doctor or any provider ever intends to harm a patient.  Mistakes happen for a lot of reasons and care is substandard for a lot of reasons, but no provider wants to hurt a patient.”

Bob’s reply?  “Of course they do.  If infections can be stopped just by washing hands, then why do studies show that doctors and other providers don’t wash their hands?  If they thought it through for a minute, then they would realize that each time they don’t wash their hands, they are making the choice to hurt or kill a patient.”

Ouch.  But — it can’t be argued.  And far be it from me to suggest otherwise.

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If you are a patient who will be admitted to a hospital, or the loved one of a soon-to-be-hospitalized patient, then find the 15 steps you can take to keep from acquiring MRSA or any other superbug at www.hospitalinfection.org

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MRSA Report Cites Irresponsibility Everywhere

My colleague Betsy McCaughey, chair of the Committee to Reduce Infection Deaths, publishes in July’s Best Hospitals 2007 of US News and World Report that hospitals must begin to take responsibility for their infection rates, and begin to take the necessary steps to clean themselves up.

She cites a study that shows that “65 percent of physicians and other medical professionals admitted they hadn’t washed their lab coat in at least a week, even though they knew it was dirty. Nearly 16 percent said they hadn’t put on a clean lab coat in at least a month. Lab coats become covered in bacteria when doctors lean over the bedsides of patients who carry the organisms. Days later the bacteria are still alive, repeatedly contaminating doctors’ hands and being carried to other patients.”

MRSA and other infectious agents are everywhere in hospitals.  McCaughey talks about measurements infectious agents on stethoscopes, blood pressure cuffs, EKG wires, plus the patient’s bedside TV remotes, telephones and the like.

And why is all this important?  Because HAIs, hospital acquired infections, (those are infections that patients pick up while they are in the hospital, in addition to whatever problems they had when they were admitted) account for tens of thousands of deaths each year in the US alone. 

Imagine going into the hospital for a routine surgery, only to die from an infection you got while you were there?

The problem is — all the important players are playing ostrich.  The CDC does not require testing.  JCAHO, the organization that accredits hospitals doesn’t even check into infection rates.  According to the article, Joint Commission standards don’t specify how rooms should be cleaned or what bacterial levels are unacceptable. Asked whether bacterial levels should be measured, Robert Wise, JCAHO’s vice president for standards and survey methods answers: “You can only ask hospitals to do so much.”

I guess it’s too much to ask the CDC, the Centers for Disease Control, to take responsibility for rules on measuring the infection rates.

I guess it’s too much to ask JCAHO to create a standard for hospitals and expect them to rise to it.

I guess it’s too much to ask Congress members to begin looking into this mess.

I guess it’s too much to ask hospitals to keep their patients safe — and alive.

I will ask you to read the article – and then to link to Dr. McCaughey’s website to learn how to protect yourself.  Clearly no one else cares — so you need to do it for yourself.

……………..  Read more about MRSA and steps to take yourself here…………

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MRSA: Killing More Americans everyday

APIC (Association for Professionals in Infection Control and Epidemiology) is holding its annual meeting this week, and today published the results of its latest findings on the number of people who die from MRSA (methicillin-resistant staphylococcus aureus) and other HAIs (hospital acquired infections).  These are superbug staph infections, usually acquired by hospital patients, but sometimes transmitted in the community as well.  Superbugs are called such because they have developed a resistance to drugs — nothing can kill them. 

That means — once a patient contracts a MRSA infection, s/he usually can’t get rid of it.  S/he will be infected for the rest of his/her life.

Bottom line?  Between 48,000 and 119,000 patients per year may be acquiring these infections.  That represents 46 per 1,000 patients.  These numbers are much higher than previously believed, and higher than reported in previous studies.  In particular, the Centers for Disease Control (CDC) had previously reported only 3.9 deaths per thousand.

If I’m doing my own math correctly, that means that the REAL rate is 120 times WORSE than what we thought?

And the thing that ticks me off about this the most?  These infections are PREVENTABLE!  If the proper precautions are taken in hospitals, then there is no reason why patients should acquire staph infections in the hospital.  None.

And do you know what the proper precautions consist of?  In most cases… simply washing one’s hands.  The bugs are most often transferred from a healthy person to a sick person.  Most of us have MRSA bugs living in our noses and we have no symptoms or illness from them. But people who have compromised immune systems (either they have an open wound, just had surgery, an auto-immune disease, a catheter inserted for a long time, or are elderly and probably frail) — they pick up the bugs from us healthy people and the bug has a field day.  Tens of thousands of them die.

VERY interesting way they did this research…  10,000 infection-control practitioners, including doctors and nurses in hospitals, nursing homes and rehab centers, were asked to document ONE day (last fall, between October and November).  A snapshot in time.  They counted the known cases of MRSA in their institutions.  1,200 hospitals and 100 nursing homes and rehab centers, representing all 50 states, submitted results.

(Hmmm…. I wonder why the others didn’t participate?  Is it possible they were afraid their rates were too high and someone would find out about it?  does that make it possible that even these numbers are too low?)

I know of two family friends who acquired infections in hospitals — then died.  In both cases, their causes of death were listed as what they were admitted with.  In both cases, my sense and intuition tell me that they would have survived had they not acquired those HAIs.

Knowing what you know about how infection spread can be avoided, think of it this way:  if one nurse or one doctor had bothered washing his or her hands, then my friends might not have died.

By my own observation, I have seen how lax health care providers are about hygiene.  Other studies have been undertaken to document how little regard practioners have for concientiously keeping their hands sanitized and clean.  I’m sure it’s a pain in the catoochie to have to wash and sanitize before touching every patient… but… when it can mean the difference between life and death?  Seriously.

Sharp patients know to watch out for violations when they must be in the hospital.  Ask providers to wash their hands, and use sanitizer, at every turn.  Don’t be embarrassed to ask!  Even if you are a visitor, you need to know you can transmit the bugs.  Be sure to clean bed rails, TV remotes, telephones — anything you touch that the patient also touches. Be diligent, because it can mean the difference between life and death.

More guidelines can be found here:  hospitalinfection.org 

APIC does a good job of suggesting their own steps and precautions for hospitals and other facilities to begin cutting the spread of HAIs.  What we know, from past experience, is that too many of these facilities don’t care to stop those infections.

Why?  Because their perception is that it will be too expensive to stop the infection madness.  They think they are saving money by not setting themselves up to stop the infection to begin with.  And they think they are making more money because patients have to stay in the hospital longer.  And their perception is THEIR reality. 

Neither of those statements is true, according to previous APIC studies.

How sad, that the REAL cost of HAIs is the loss of lives AND affects their wallets.  Why can’t they hear that message?

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MRSA and HAI update (Hospital Acquired Infections)

A few days ago I wrote about the cost to hospitals of letting their patients acquire an infection.  Prior to finding that report, I had always kind of assumed (yeah, I know) that patients who got sicker from getting an infection while in the hospital wouldn’t financially affect a hospital one way or the other — afterall, someone has to pay for the patient’s care.  The insurance company or medicare or the patient would have to pay for the extended stay and additional costs.

I was wrong, though — and the report from APIC (Association for Professionals in Infection Control) spelled out very clearly that hospitals in reality take a major financial hit when a patient acquires an infection.

Why is this important?  Why do I care if there is a negative hit to the hospital balance book?

Because I believe in the forces of capitalism, and the power of the almighty dollar, as having the ability to turn around infection rates when their source has to pay for it.  As hospital administrators (and shareholders when they factor in) realize that costs will go down, and profits will go up, once infections are controlled (REALLY controlled), then they will do what is necessary to stop their spread. 

Put another way, when hospital administrators realize that costs go up, and therefore profits go down when they ignore the infection problem, then realize the major negative impact on their bottom line, THEN they will pay attention. Otherwise?  They honestly don’t care. 

This ties in to the concept of infection rate reporting.  Across the country, states are passing laws to require hospitals to publicize their HAI rates.  Once that information becomes public, then we patients are able to choose which hospitals we want to do business with, either for our own care, or our loved ones’ care.  Hospitals with higher infection rates will find patients choosing to go to the hospitals with lower infection rates — and yes — they will take a financial hit.  Once they understand what the cost is in loss of patients X amount per patient X a year of lost patients?  Yup — they’ll do what they can to clean up the spread of these infections.

I sent the blog link mentioned above to my colleague Betsy McCaughey of RID (Reduce Infection Deaths).  While she found the report interesting, she reported to me that the basics of the report are quite good — but in fact — the costs and statistics are quite old.  So — get this (sit down!) — the actual cost of HAIs to hospitals in this country is:

$30.5 billion per year!!

I can’t fathom that figure.  Hospitals must grapple with it.  But as is always true, the wheels of change will turn slowly, and in the meantime, patients are getting sicker and dying in hospitals every day. 

I’ve sent you to the RID suggestions for staying safe in the hospital — so here’s that link again.

I’ve sent you to the Consumer’s Union Stop Infection campaign, too.  This is where you can learn if your state has the right legislation in place, and if not, you can help that campaign.

And my final recommendation for today is to be vigilant.  If you know you’re going to need a hospital stay — do your due diligence, learn which hospitals will keep you safer, and make your smart choice based on that info. 

Your best defense is a good offense.  Be prepared.

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MRSA Costs Hospitals Big Money!

I’ll admit it.  I was very skeptical when a link for a research report about the cost of hospital infections to hospitals – was sent to me.  I’ve never typed these words out loud before, but I’ve always thought that one reasons hospitals ignored (didn’t try to alleviate) MRSA and other hospital-acquired-infections (HAIs) is because they could make more money from patients who got sicker and had to stay in their facilities longer.  Made sense to me.  I just had no way of demonstrating it.

So I read the report, and re-read it.  And you know what?  It makes sense. And the bottom line is — HAIs are a major hit to the pocket book of hospitals.

The report was issued by APIC, the Association for Professionals in Infection Control and Epidemiology in February 2007.  The stated goals of the report are to dispel the following myths (paraphrasing here):

Find the rest of the post at its new location:

http://www.trishatorrey.com/2007/04/30/mrsa-costs-hospitals-big-money/

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