Ten years later
Ten years ago right now, my father and my family were in the throes of a tragedy. Dad had fallen and he broke his fibula. The fibula is the small bone on the outside of the lower leg/ankle. That injury was simple and uncomplicated, but because of his condition and age, he needed rehabilitation. In Millinocket, Maine, in home health services are scant and the local nursing home does not offer rehab, so he was kept in the tiny community hospital for 12 days of rehab. And that is where his real troubles began.
He did well with rehab. He was discharged home and walked in without help. He was using a walker. He was home for 2 nights and woke the second morning unable to sit up. His weakness was so profound he was anchored to his bed. This was his first symptom of the MRSA infection in his lungs that eventually killed him. My mother called me (70 miles away) and we decided that he needed to go back to the hospital by ambulance. He never walked again, and he never came home. He suffered through sepsis, profound weight loss, skin ulcers, thrush, rashes, hearing loss, a urinary infection, and he had become a bed bound, profoundly ill man overnight.
He was #3. Two other beloved community seniors had become infected in that tiny 25 bed hospital with MRSA, and they died earlier in the same month. This was an outbreak, and nothing was ever disclosed. My family was not given information that could have helped us to avoid my father’s infection. Dad’s deadly debacle started in October 2008, and he suffered through weeks of debilitation in a nursing home until he died on January 9, 2009. He was just a shadow of himself by then. He had lost over 50lbs and was a skeletal version of his usual self. He was 6 feet tall and weighed around 125lbs when he died.
I am positive that my father’s infection was preventable. I blamed my father’s hospital for their carelessness with my Dad’s life and for not taking the steps necessary to keep him safe.
What has changed since then, in regards to infection prevention and CDC policy.
Not much.
The CDC still fails to define an outbreak. Is an outbreak a single deadly infection? Is it 2 or 3? WE NEED A DEFINITION. My opinion is that if a single hospital patient catches an infection that another patient had or has, that is an outbreak and it should be treated as an outbreak, not as routine. Also, any outbreak information must be made available to any incoming patient, and the community.. Public transparency is a must.
Next, the Federal and State CDCs do not have regulatory powers. This means that they have no authority to go into facilities that have an outbreak. They have to wait for an “invitation”. Honestly, this is not a birthday party, this is serious life threatening infection business and the CDC must have regulatory powers. Writing recommendations is lovely, but hospitals and other facilities get to choose whether or not they follow them and whether or not the CDC can pay a visit to their facility. The CDC must have enforcement and investigatory powers.
The actual number of deaths caused by Healthcare/Hospital acquired infections is a moving target, by design. Hospitals are very reluctant to own and report the infections that they cause. The love to blame patients for their own infections. One step that would give us more solid numbers of HAI deaths is to mandate that they be listed on death certificates. Any state can tell us how many people died of food poisoning, or if a car accident death was because seat belts were not used, but they can’t tell us how many people die of hospital acquired infections. That is because Hospitals have far too much control over what is reported and what is not. We need to take that choice away and make it mandatory that if any patient dies after becoming infected in a hospital, that the infection is listed as a cause of death. This gives us statistical information and a more accurate death count.
I am still an advocate for active detection and isolation. Rapid screening for MRSA, along with a detailed and rigid approach to MRSA prevention has helped the VA hospitals in our country to reduce their MRSA infections by 70%. Why then do private and other public hospitals reject this method of prevention. It is much cheaper to prevent infections this way than it is to treat them and our lives depend on effective prevention.
There are a million ways to help stop this scourge of hospital/healthcare infections. Suffice to say, that in the 10 years since my father was infected by his hospital, I am involved in the exact same conversations with the State and Federal CDC as I was then. There has been a small measure of progress. There is a lot of push back, by the powerful Hospital lobby. Frighteningly, there are more and different drug resistant infections being reported every day. It must stop. We have firm up regulation, and we have to permeate the protective and secretive shell that hospitals have around themselves….we need to put that shell around patients, our loved ones.
