McCleary MRSA Prevention

What drives our hospitals?    I am not talking about the hands on caregivers like nurses.  NURSES ARE AWESOME!!  I am one myself! In general nurses are motivated by their love for and dedication to ill and injured patients.    I am talking about CEOs, hospitals associations and professional medical associations.  They will tell you if you ask them that their priorities are their patients and excellent medical outcomes.  “Care and compassion” are two more words you will hear in their responses.   The reality is that filling beds, money, money money and growing their organizations are their priorities.  This isn’t to say they intentionally do damage to patients , but they feel a certainty that they are above scrutiny if they do.   The other reality is that they lobby to avoid, and limit  medical  liablity…again money oriented motivation. 

So, wouldn’t it be something if lawyers took the challenge to turn the tables on MRSA?  I know, lawyers aren’t medical people, but……. a class action suit for MRSA infections acquired while under the care of  “caring and compassionate” hospitals may be the greatest  motivator for improved MRSA prevention.  It makes me sad  to have these thoughts.  But, I have witnessed the mechanisms of medical politics and power  first hand.  I never thought our medical care would come down to this.  It is mind boggling.  Our medical care is the fodder of politics from the level of your local doctor and  hospital all the way up to the president of the US.  Who would have thunk it.

In an ideal world, our doctors and hospitals would do whatever is necessary to give everyone the safest and highest quality of care that they can,  withholding nothing.   When we are sick or injured, we would all expect that, would we not?  Well, don’t hold your breath for that!   Everyone needs to assert themselves and bring an  advocate when they go into the hospital for anything.  Your nurses will advocate for you, but they also collect their paychecks from the hospital.  This limits their advocacy.  Complainers and whistle blowers are not tolerated well in hospitals, even when they are right!   Unionized nurses do hold more clout because of their numbers and professional representation. So if you are in a unionized hospital, consider yourself lucky.   You still must speak out for your own safety and that of your loved ones and friends.

I heard repeatedly  from hospitals representatives in Maine Quality Forum meetings that their goal for MRSA infections is ZERO.  If  the offending hospitals  continue with the inadequate screening, failing to isolate infected or colonized pateints, inadequate precautions, poor to moderate compliance with handwashing and rationing decolonization, this goal is unattainable.

When these inadequate policies prevail and as a  result the  goal of ZERO is rendered unattainable, MRSA infections will continue, with a vengeance.  MRSA thrives on poor technique and inadequate prevention. When you or your loved one gets infected with MRSA and are disabled or die because of it, get a lawyer.  Better yet, network with other victims and pull together a class actions suit!!   Someday, lawyers will take up this cause, unless hospitals smarten up first.

The method is available to bring MRSA rates to ZERO.  It is called Active Detection and Isolation.  Maine Hospitals have chosen to ignore that scientifically proven method at this time.

Litigation rather than legislation may be what motivates hospitals to STOP MRSA NOW!!!

I must note here, that money is not my motivation.  I am spending my husband’s pension and some of our savings on my advocacy work.  I collect no salary, take no donations and I ask for nothing.  All I want is safer hositals and ZERO MRSA infections.  I believe that is a noble and honest goal.

When my bill passed into law last spring,  there was a stipulation that the Maine Quality Forum would “define” what populations were at high risk for MRSA in Maine, for the purposes of screening.  This task was assigned to us by the Maine Health and Human Services Committee.   I attended meetings for 5 months and I worked diligently between meetings researching this subject.  I presented a solid list of known populations at risk for MRSA.  I gathered  this information from the CDC information and hundreds of other sources.  I never attended a meeting uninformed or unprepared.

I withstood stonewalling, dishonesty, reluctance and downright hostility in these meetings.  I took verbal beating repeatedly and with grace.   Without the refereeing of our leader and my  dedicated Maine State Nurses Association collegue, my pursuit of safer hospitals in Maine would have been much more difficult.  There is no doubt in my mind that they were trying their best to wear me down.  They thought “she will go away afer a while”.  Wow, they do not know me. 

The Maine Hospital Association and their associates, APIC (infection control professionals), and the MQF DO NOT WANT TO DO HIGH RISK SCREENING FOR THEIR PATIENTS.  They will tell you they are already doing it, or it is too expensive, or it is too cumbersome, or there is no need because they are improving handwashing,….my goodness, I can’t begin to complete the list of excuses I have heard.  The fact is that the MHA and APIC have lobbyists and money and they are fighting this effective approach to MRSA prevention tooth and nail. These associations and the MQF are the very people who should be making our hospitals safer.

What this all really boils down to is that Hospitals and doctors  do not want to be told what to do.  Another thing they don’t want is to be liable for an excellent MRSA Prevention program.  If patients have an increased expectation of hospitals and Active Detection and Isolation becomes standard practice in Maine, they will be held to it!  This means increased litigation for MRSA victims if the hospital fails to meet the standards.  Well, hells bells, why not?  Maine Hospitals are responsible if patients become infected on their watch.  They either improve safety or they are liable and there will be lawsuits!

 Maine hospitals  think they are doing a bang up job with MRSA prevention.  While I do recognize that some efforts are being made to stop MRSA, it is not nearly enough.  Why just last week I talked with a woman who had over 100,000 dollars in medical bills after her hospital discharge . She got MRSA, C Diff, and pseudomonas during an over 100 day stay at the local hospital.  She is still paying her bills off and she still suffers ill effects from those infections, but fortunately, she survived.   Another person  asked my son for my contact information because her father died 2 weeks ago with MRSA, same hospital.  So, although they are doing SOME things to improve prevention, they are not stopping the infections.

One  reason for this is that their screening protocol is not wide enough, and that is likely the same problem in all the hospitals in Maine who are still seeing new infections regularly.

Another reason is that they continue to room infected or colonized patients with uninfected pateints. I brought this up at the last MQF meeting and I got jumped on by 3 or 4 nurses all with similar excuses, including one that basically said that CDC says it is ok.   This  a recipe for disaster.  Your local infection control nurse will tell you that “patients do not spread MRSA, hands do”.  Yes, I agree, this is so.  But contaminated  instruments, uniforms, bathroom facilities  and other environmental contamination also spreads disease, with the help of hands.  And do not ever feel safe about the air you breath.  MRSA can be coughed 3 to 4 feet when a patient has MRSA pneumonia.  I have also read articles that air ventilation systems have tested positive for MRSA.  So, without effective air filtration, MRSA can spread that way too.

Another reason MRSA spreads is because doctors are rationing out treatment to interrupt colonization.  They get to pick and choose the patients who will get this simple treatment before invasive procedures.  The arguments for rationing is that there is some  antibiotic resistance, or that MRSA can come back or any number of other excuses.  The reality is that they are playing God in deciding who will have the advantage of simple decolonization ….if it will be you, or your neighbor or someone esle…. according to what procedure you are having.  This seems unethical to me.  If I am having a gut surgery and I have MRSA colonization, I want the treatment.  I will take my chances at resistance or that it might come back after I heal.  LET ME DECIDE my own fate.  This witholding of effective treatment to prevent active infection smacks of the “Sarah Palin” death panel referrence.  Not that I ever believed anything that Sarah Palin said.  My guess is that if any of the doctors who participated in our MQF work group had MRSA colonization and needed surgery, they would be pushing the antibiotic ointment up their noses and scrubbing their bodies with Phisohex frantically and frequently before anybody touched them!

There are many reasons that Maine hospitals are not stopping MRSA.  These are just a few and they are the ones I have addressed in my legislative proposal. 

I would love to see an ambitious investigative writer start calling all of our hospitals.  Their first question could be “how many patients in your hospital have MRSA now?”  Second question, “how many of those patients came into the hospital with those infections?”  Third question, “what is the prognosis for those patients?”   How long will those patients suffer from these infections?   “Is every MRSA colonized and infected patients isolated from other patients?”  “How high is your handwashing compliance?”  “Have your MRSA infections rate dropped or gone up in the past 10 years?”   “Are you aware of the Veterans Administration MRSA screening program and it’s success in dropping MRSA Infections?”   I want to do this investigation myself, but I have observed how close to the chest ANY MRSA information is guarded within these facilities.   I sat in meetings with representatives from hospitals all over the State and I don’t know any of the answers to any of these questions.  THIS IS THE BIGGEST DIRTIEST SECRET OF ALL IN MAINE HOSPITALS.  And the secret is closely guarded.  Each hospital’s representative in those meetings should have very proud CEOs.  They didn’t spill the beans on any useful numbers for the MQF group.

Two days ago, a unilateral and sudden decision was made by our MQF leader to do a “study”.  This decision was made with no plan, no deadline, no consultant, and no requirements.  After 5 months of pounding out a good solid list of high risk populations for screening, our work group’s direction changed.  It was announced, not suggested.  So, all of a sudden the MQF became a dictatorship, not a work group.  While all of the logistics and details of this “study” are being worked out and the study done and the analysis made and resulting recommendations are decided, Maine patients at high risk for MRSA will continue to be admitted to our hospitals without screening.  The expense of this test could be spent on a new effective screening program for all of our hospitals It is bogus and it is nothing but a stall tactic.  The hospitals believe they have won a battle of some sort.  If I thought for one minute that battle was against MRSA, I would not be writing this blog entry.  It is a power battle they think they have won.  MRSA prevention has little to do with it.

MRSA screening saves lives and stops suffering.  It is the first step in preventing MRSA infections.  Patients with undetected MRSA will continue to be admitted to Maine hospitals, and be roomed with uninfected patients.  Infections that can be prevented with simple decolonization treatment will continue to happen.    Rates will not drop.  And after a hospital allows this to happen to you, you will get the bill for the damages.  You will be billed for care rendered as a result of a preventable infection.

This study is a delay tactic.  This allows Maine hospitals to stall the inevitability of effective high risk MRSA screening.  This allows hospitals to continue doing exactly what they are doing now and that is not enough.  I hold the MQF , the Maine Hospital association and Maine hospitals responsible for every single new MRSA infection that occurs in Maine hospitals  while they are messing about with a study.    This is not what was expected of us in our work group…….we need to start screening now…and without further delay.

I will never give up this fight.  It is much to important to everybody.  My motivation comes from my grief and I will continue to grieve a long time for my special father who was infected by his trusted hospital and died as a result.

The following press release was issued from Kathleen Sebelius, Secretary of DHHS,  today.  I wrote to Secretary Sebelius about 6 weeks ago to tell her about my father and his nightmare with MRSA.  I took great care to include truthful and painful detail .She addressed my letter to her in this press release today.  In this release, the Woman from Maine is me and the 83 year old man who died in January from Hospital Acquired MRSA was my Dad.  Secretary Sebelius is listening.  Anyone who has a similar horrible medical experience in their lives needs to let Secretary Sebelius know.  She does read these stories from everyday citizens and responds to them. The part about my father is in the last third of this press release.

http://www.hhs.gov/news/press/2009pres/09/20090910c.html

Secretary Kathleen Sebelius, HHS, addresses audience at Orono Maine meeting

Kathy Day discussing John McCleary's MRSA death with Kathleen Sebelius

I was invited by Maine AARP to attend a meeting with Kathleen Sebelius with only about 50 other attendees.  I represented the local AARP at this meeting.  I was not called on to ask my carefully prepared question, but the discussion(in above photo) one on one was better.  Secretary Sebelius is very well versed on healthcare reform.  She told me about the stimulus money sent to all the States for enhanced infection control programs in hospitals.  She said that MRSA and other medical errors are “definitely on the radar”.  While she gave no specifics about MRSA, her sincerity and accessability  makes me confident that MRSA and other hospital errors and infections will be addressed.

Let’s just hope they will be addressed aggressively.  For way too many years, infections have grown in types and numbers year after year.  Without a reverse trend, what will happen?  More death, suffering, disability.  More anger and distrust in our Healthcare facilities.  A wave of litigation from fed up victims and/ or their families.  All of this is preventable with an aggressive mandatory approach to MRSA elimination.

The stories I heard at today’s forum moved me tremendously.  One of the panel members with a lengthy horribly terrifying story was a neighbor who lives about 6 houses away from me.  I had no idea of her troubles.  Mostly we heard about insurance, lack of or inadequate coverage, high deductibles or loss of benefits, and resulting financial ruin because of medical expenses.  Every citizen in this country has a right to healthcare.  Nobody should be sent home because they lack coverage if they have an illness or injury that requires hospitalization.

But, Healthcare reform proposals must also address quality and patient safety.  I hope I got that point across today.

MRSA can affect anyone.  It does not discriminate.  It affects newborns and preemies, young people, middle aged and elderly, men and women, black, white, yellow, brown.   It doesn’t matter.  It effects anyone.  I recently read an article about how MRSA killed the retired CEO of  a Hartford CT hospital, in his own hospital!  Then I found this excerpt from a non fiction book written by Julia Nora Pilas.  I cried when I read these two chapters of her book.  I can relate.  So can all the other MRSA victims’ survivors.

All of us who have lost someone we loved because of MRSA experienced the same shock, frustration, anger, hope then devastation, over the unexpected and unnecessary infection.  We watched as our loved ones trusted their hospitals to make them better.  They entered their hospitals frightened but also knowing they would get the best of care and the best results of that care.  The optimism we had is necessary for healing.  We must hope for the best and we expect the best.  Then when the doctor or nurse tells us that our loved on has an infection that may or may not respond to antibiotics it’s like getting hit over the head with a sledgehammer.  Then on top of that,  we learn that our loved one caught this infection while under the hospitals care. We become angry.  It is human nature.  When anybody is let down about something as important as our loved ones LIFE, it is enraging.

My anger fired my activism with MRSA.  It still does.  Something drives me when I write on this blog, or speak in front of cameras and reporters, or go to Maine Quality Forum meetings or write and call my Senators and Representatives, both State and Federal.  I know they are listening now.    We will make a difference for future patients. We have to.

Please look at this excert from Ms Pilas.  I plan to buy the book, maybe you will too.

http://www.juliapilasauthor.com/excerpt.htm

Addendum

I read Ms Pilas’ book.  I felt exactly the same fears, confusion, anger, distrust, and horror when my father went through his MRSA crisis.  It is an unnecessary shame on our hospitals and doctors that this eidemic in  modern healthcare facilities has not been controlled long before this.  Ms Pilas’ mother and all of her sisters watched as her beloved father suffered with festering infection with drainage so profuse that it ran onto the floor.  His kidneys shut down, he couldn’t breath on his own when the endotrachial tube was removed.  And all he asked for was “help” and “to go home”.  I listened to those same pleas from my father, for 3 months.   My mother and I wanted to take him home from the nursing home but there was no round the clock help available for us to care for him at home.  His MRSA rendered him helpless and weak.  He never walked after his infection, nor could he turn in bed or get up to the toilet. 

These are the real life horrors of hospital acquired MRSA infections.  The suffering is horrible and it needs to be stopped.  Anyone who reads this book will fully understand our anger, and the resulting determination to stop MRSA infections.

If this was MRSA

A question looms around in my head all the time.  Why are we, or our insurers paying for Healthcare acquired MRSA?  I don’t get it.

If I went to a fast food restaurant and had a ‘bad’ burger, then became voilently sick or died because of it, I could sue them or my family could.  Or I may even be able to convince the restaurant owner, without the benefit of a lawyer but with documents to prove the illness, that they owe me compensation for my illness.

Mind you, MRSA isn’t neatly wrapped like a burger, so it isn’t as blatant or obvious when the infection arrives.  MRSA comes on the dirty hands of a caregiver, or on contaminated equipment, or in a dirty environment. But, if a hospitals dishes out MRSA and a patient becomes infected or dies, they still get a bill, and the hospital fully intends to collect that money.  If the patient doesn’t get the bill, their insurer does and they pay!   I know of a man who was sued by his hospital (who gave him MRSA) because he refused to pay his bill!  Something is gravely wrong with this picture.  He has still refused to pay his bill and they had not dropped their suit the last I knew.  I know a woman who has recently lost her home becasue of a MRSA disability.  Yet another has her son in a program that should be 8 to 10 weeks long, but she can only afford 4 weeks.  He was infected with MRSA after a sponge was left in his face during facial surgery following an auto accident. She just had to leave him in California because there was not similar program in Hawaii, where he contracted his MRSA.   Another lost her business, again MRSA disability.  Another spent all of her life savings after her catatrophic health insurance ran out.  And on and on it goes.  Oh, and lets not forget that my own mother lost the love or her life and her husband of 61 years because of MRSA.  Nobody can put $$$$ signs on that.   All of these people were billed or their insurance companies were billed for preventable MRSA.  None of them are able to get any kind of compensation for the error that their  hospitals made that caused their infections. 

There is no doubt that my father’s MRSA was hospital acquired. He went in with a minor injury and became ill with a major deadly illness, MRSA Pneumonia.  It is indisputable that he got that illness while hospitalized.  Fortunately for him and my mother, he worked very hard during his life and he had excellent insurance benefits.  His private insurance and medicare paid for all of his hospital bills.  My opinion is that the insurance company should NOT have paid his bills and neither should my mother have paid.   If the hospital dishes out infections, they should absorb the cost, every single penny of it. They should also have paid his costs for the nursing home, which he did not have coverage for.  My parents paid that from their life savings.  Neither patients nor insurers should be paying for preventable infections.

Medicare has started refusing to reimburse for some infections, but HA MRSA is not on the list yet, unless it is a urinary tract infection becasue of a catheter.  I believe this is the case.  Medicare should not pay for any hospital acquired infections, including MRSA.  If this were the case, we would see a fast and huge drop in infection rates immediately.  Hospitals would make the necessary changes, regardless of cost, to stop the infections.  Anything they would pay would be less than what the cost of these infections is.

My Maine Quality forum meetings have been contentious and arduous to go through.  But, we are making progress.  The one thing that makes me want to pull my hair out is when they bring up cost.  I realize that cost is an issue, but it is also an issue to patients, their families and insurers. How long do they think people will put up with paying for infections , serious horrible infections, that hospitals dish out.  Preventable life threatening infections such as HA MRSA should not happen, and patients should definitely not be billed for their care if a hospital is responsible for the infection.  It is adding insult to injury…literally. Or should I say it is adding infection to injury?

Representatives from hospitals all over Maine come to the Maine Quality Forum meetings.  I know that some of the smaller  hospitals struggle with finances.  But, money spent on infection prevention is money well spent.  Any money spent on MRSA screening will come back to them  in reduced infections in their facilities and reduced expenses that they  sometimes absorb.

I attended a meeting of the Northern Infection control collaborative.  It was held in one of Eastern Maine Healthcare’s new buildings in Brewer Maine.  I went through heavy huge glass doors and elaborate hallways to attend this meeting.  My guess is that the cost of the glass alone (on the two floors of that EMH building that I was on)  would, if redirected to MRSA prevention, would pay for an entire MRSA prevention program for one (or more)  of our smaller hospitals.

I never want to hear about MRSA prevention  cost  in these meetings again.   I have read and heard enough from hospital representatives,  about the cost of MRSA prevention,  and how MRSA is the patients  own fault and that MRSA is “just part of doing business” and there “is nothing they can do about it”  etc.  I want to hear about how our hospitals will stop these infections and if they are unable to do that, how they will compensate the suffering victims (or their survivors) of Hospital Acquired MRSA and other HA infections.

A friend of mine called a few weeks ago and invited me to a celebration.  It occured to her and some others in my class of ’67  that we were all turning 60 this year.  So, she thought we  ought to gather and have a birthday party for ourselves.  Leave it to Anne. We all trapsed up to her old family farm in very very remote Maine.

My husband and I attended this collective birthday party yesterday.  It was in all possible ways a blast from the past.  I haven’t attended many reunions, so it had been way too long since I had seen my old classmates.

OLD is the key word here.  Of course, none of us are old, in our hearts or minds.  Most of my classmates appear to be in good physical shape, certainly in better shape than me!  But, we all talked, first about old times, then kids and grandkids, other classmates,   and eventually about health scares  and or experiences we or family members have endured.

One sweet old friend of mine  had breast cancer this year.  Another has neuropathy and diabetes.    A few die hards still SMOKED!!  GAH, this was a shock.  All of my 60 something old friends had one thing or another going on in thier lives.  Some spoke of  of aging or deceased parents.  Still another recently was widowed.  I heard all of the ups and downs of life in the few short hours that we were all together.  My old friends from high school, who 40 some years ago all believed they were invincible, now realize that they are not and neither are their families.  To me, this is the number one reason that I really need to attend every single Class of ’67 party that might come up in the future.  None of us will live forever and the partying together and staying in contact  must remain a priority!!

I was humbled by my classmates’ comments on my MRSA work.  I am not used to this kind of  attention,  and at times it is a little uncomfortable for me.    I have been a obscure retired “old” nurse for a while now.   Truthfully, I feel that my MRSA work is simply put, nursing. I don’t work as an RN anymore.  But, I think that once you become a nurse, you are always a nurse.  So, in my own way, I am caring for my family, my classmates and my friends and a ton of strangers.   I am trying my best to make hospitals safer for everbody, and that is really just form of nursing.  So, I guess I am not retired…yet! 

Anne our party hostess said, “Kick ass Kathy!” 

If that is what it takes to make all our hospitals safer and cleaner, you can count on it Anne!

Thank you to my classmates for this great party and for recognizing my work.

The web page I am directing you to here is how CW Speier addressed Congress regarding health care reform.

I liked the way she describes the fact that hospitals spew out these MRSa infections that kill people or drastically alter their lives and there is no one making them change. See the following quote from Jackie Speiers address on Health care reform and MRSA.

I want to tell you a dirty little secret. It’s a dirty little secret about health care that no one wants to talk about, and it’s about medical errors, and we have known about it for decades. The Institute of Medicine put out a report that said there are 100,000 deaths in America every year because of medical errors; 100,000 deaths.

What we need to do, furthermore, is put the protocols in place so that we can stop these infections from occurring and we can stop the deaths as well.

She says it well doesn’t she?  I often make the same comparison with hospitals and restaurants…if restaurants served up food that killed people they would be shut down.  Hospitals literally get away with murder…..at least the ones who will not change their approach to MRSA and other Hospital Acquired infections.  Please watch CW Jackie Speier and get your representatives to support or co sponsor this bill, HR 2739, regarding MRSA prevention.

http://www.c-spanarchives.org/congress/?q=node/77531&id=9013445

In the midst of heated debate about health care reform, our noble legislators are going on a month long vacation.  While many thousands of people are losing their healthcare insurance every day, the debate will stop until our entitled legislators are well rested and tanned. Oh, and lest we forget, if they get a sunburn or a sprain on vacation, they are covered by a very generous insurance package.

Healthcare reform is so needed and so overdue, and yet our leaders just take off and enjoy themselves. Those who oppose HC reform think this delay will hurt the reform act.   Part of reform is to improve the quality of our healthcare by reducing medical errors and hospital acquired infections.  Congresswoman Jackie Speier’s HR 2739 will be part of the reform if we are successful.  So until HC reform happens, not only are US citizens losing healthcare insurance every day, the healthcare consumer will continue to receive treatment in our nations hospitals, most of them having  inadequate infection control and rising numbers of preventable infections. 

Millions of American citizens fight every day with insurers who deny claims because of a pre existing ailment, or any other reason they can come up with.  Millions of others have no insurance at all and hundreds of thousands contract preventable infections because there is no solid mandate to prevent them.  Many thousands of those exposed to MRSA and other hospital acquired infections will die or become disabled.  Our healthcare system is in a mess and healthcare consumers suffer because of that every day.

President Obama continues to work every day, campaigning and fighting for Health Care reform, but our lawmakers need a vacation.  I admire our new president for knowing his priorities.

If just one senator or one representative had to be hospitalized and then contracted MRSA while there, that would be it.  We would have measures to stop MRSA infections.   I wouldn’t wish a MRSA infection on my worst enemy, but it is fact.  Unless someone is personally effected by the horrible infections that can be contracted in our hospitals, they are unaware and uninterested.  It is our job as families, vicitims, healthcare consumers, and others to MAKE THEM AWARE!   The staff of both of Maine’s representatives are aware because a staff member in the House caught MRSA in the gym in their office building, and because other activists and I informed them.  MRSA came close to them, and to their place of work .  They know they are not immune, and that nobody is.

Make your representatives work, the long hard hours it takes, to make a difference through healthcare reform, and to make our hospitals safer.   

Congresswoman Jackie Speier, California, introducing HR 2937

Jeanine Thomas, MRSA Survivors Network

The above link is coverage of the event in Washington DC with Congresswoman Jackie Speier, who introduced a MRSA prevention bill on June 24, 2009.

I participated in this event by telling my fathers unfortunate story.  Others present had suffered with MRSA and survived or they had lost someone to MRSA.

This event was very important to me and to MRSA prevention.  I networked with others who have done advocacy for MRSA victims and with those who had lost loved ones because of MRSA.  This bill will stop the scourge of MRSA in our hospitals with screening, isolation and precautions. 

Please contact your State representatives to support this bill.