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  • Writer's pictureHelene Paxton

The Case for Reduction of Hospital and Health Care Infections: A Consumer View Point

The Case for Reduction of Hospital and Health Care Infections: A Consumer View Point

If you had been a recent patient in your local hospital and came home only to find that you now had an infection, what would be your immediate reaction?

1. It happens all the time;

2. It cannot be helped?

3. They did not mean to do it?

4. It was an accident.

5. It was my fault

But if that infection

1. Caused you to lose work time;

2. Caused you to lose a limb;

3. Caused a family member or yourself to die;

4. Found out that the risk was known, but were not informed?

Or, if you found out that a hospital had a MRSA (resistant Staph bacteria) outbreak for eight months in your hospital and did not let the public know because they did not determine that those infants were at higher risk than children elsewhere, or that water contamination in a neonatal unit caused children to get Pseudomonas another bad bacteria, and it happened again a few months later, what would you do? Does the public have the right to know? Does it take someone risking their jobs to get a response from our State Officials?

There are many examples of hospital acquired infections as well as other infections caused by not washing hands, improper sterilization, not changing syringes, not using single use vials, improper pharmacy compounding disinfection, improper anti-microbial use, etc. How many people have to be at risk and die, before the proper inspections are performed as in the case of the mold contamination of a spinal infusion drug or patients contracting Hepatitis C (HCV) from re-use of disposable syringes?

Infections associated with healthcare are not only the realm of acute care hospitals but also include nursing homes, rehabilitation units, long term care hospitals, surgery and infusion centers, compounding pharmacies, the pharma industry, etc. The community and its establishments are also implicated in HAI transmission, but are known as community onset. Day-care centers, gyms, schools, our homes are all implicated in infection transmission.

Can the public ask for better accountability, explanations, and disclosures of risks before entering an establishment? Can HAI infections be controlled?

The answer for both must be yes:

1. Web sites and consumer report sites attempt to give the public data, but often these sites are woefully behind in their information. Is the public able to decipher the meaning of the data and how it might impact them? Generally the answer is no, as the metrics are complicated. Consumers need to ask for clear definable parameters to base their decisions. Contacts can be made through their State Health Departments, the Center for Disease Control and Prevention (CDC); their local elected representatives, Centers for Medicare and Medicaid Services (CMS) or consumers can ask their primary care physicians and their local hospitals for information.

2. Can HAI infections be controlled; the answer is a resounding yes.

This may actually surprise you as there are so many factors that impart risk for infection. Risk for infections includes patient’s age, patient’s underlying condition (predisposition), use of antimicrobials, recent hospital stays, living conditions, nutritional status, in-dwelling devices, recent surgeries, and exposure to infected persons, food, pets and the environment.

A recent study suggests that hospital rooms tested for toxigenic Clostridium difficile

(C. diff ) spores are 33% of the time positive for C. diff even though the previous patient did not have clinical C. diff. (Duberke, 2017) How can this be? Similarly another study found that in a sample of homes in the Houston area, that 30 % were positive for the presence of C. diff. (Alam,2014). Again, how can that be? The key is that whether in a hospital or in the community, we are at risk for infection. In a normal state of health, the microbes are unnoticed, causing little or no harm, but in other situations as stated above they cause harm and potential for disease

If you knew that the environments you find yourself in including hospitals could be disinfected, lowering the risk, would you insist that this be performed? Consumers can drive the changes to a cleaner environment. New technologies and new chemicals are available that lower the endemic load of pathogens for any environment. You as the consumer can drive the necessary changes to lower the infection rates in any situation but especially in the most critical environments where you go to be treated such as your local hospital. Be informed, do something!

Links:

Alam MJ, et al. anaerobe,2014;27:31-33

Duberke, 2017 Webinar; www.captodayonline.com

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The Ongoing Crisis of COV-19:  An Exhausting Proposition for All

 

              This has been an exhausting week both physically and mentally due to pressures from all sides and most of all from the media.  Those of us that teach are having to reinvent our courses and reinvent ourselves to meet the needs of our students.  The students are a very diversified group with many different capabilities and very different access to technology.  Although it sounds great to have a plan to put all our courses on-line…it’s not so simple.  I have the privilege of tutoring students from many different countries and states and the common denominator is confusion!  Most want to do what’s right but don’t know how to or are getting conflicting messages from their instructors.  Most are worried about their grades and completing their assignments.  Many are still working which adds to the burden. 

              I find it interesting that people want this to be over and yet are fearful that if they go back to work, they will be at risk.  The Ford Company wants to go back to work, but employees are afraid.  Has the media made us so fearful that rational thinking is not possible?  Does the whole country have to be on lock-down just because parts of the country have a high number of cases or are considered an epi-center?  We understand the fear associated with this unknown entity, yet are we applying our best resources to this issue?  Have we tapped into the experts that understand the ecology of the viruses? David Quammen in his recent book called “Spillover”:…..Discusses the possibilities of such a Pandemic and reviews  SARS-1 and HIV, Nipah and others.  Were we not already forewarned many times of this pandemic possibility?

  What modeling has been done to predict where the virus may go?  Are all States and counties there in, in the same predicament?  Can we not narrow down our recommendations to allow parts of the country to go back to work? For Once I agree with our President, we need to get this country back at work.  We need to maintain safe distancing, lower risks where possible, maintain cleanliness and good eating habits, but lets go back to work where the virus is not.

 

Dr. Helene Paxton

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