McCleary MRSA Prevention

On December 23, just 4 days ago, I had Robotic surgery to remove my Uterus, Fallopian tubes, Ovaries and lymph nodes because of endometrial cancer.  After surgery, I got encouraging news that  most likely I will not need further treatment for cancer. I will get further information on this at my recheck appointment on January 11.  I am forever grateful to my surgeon, and my entire Maine Medical Center healthcare team for exemplary care and a good healthcare outcome.  My great outcome didn’t come  by accident.  It was becasue of  my Healthcare Team’s  attention to detail and careful, safe care.

Just a few weeks before my surgery I sent the following Holiday greeting to my Healthcare team, through an assistant Chief Medical Officer at Maine Medical Center.  My hope was that this letter would be widely distributed. With a few changes, this letter could have come from any empowered patient.  Empowerment is essential in patient safety, but it does not remove the fears that all patients face.  Being frightned is human nature and is experienced by everyone when facing surgery or other medical endeavors.  My intention in writing this letter was not just to get “special treatment” for myself.  I expect special treatment for every patient.  I also wanted to point out the vulnerability that all patients experience and how we put our complete trust in our Healthcare team. 

This letter was distributed and widely read at MMC.  I had visits from nursing and department leadership and staff members and they thanked me for this letter and asked for me to come back to address some of their groups.   Iwill do this gladly and proudly.  I am forever grateful for the safe and excellent care that I recieved at MMC. I believe this was accomplished by hard work, experience,  dedication and partnership with me throughout my healthcare experience.   

Here is my Holday Greeting to my Healthcare team……

Happy Holidays to my Hospital Healthcare Team                             December 23, 2011

I haven’t met any of you except my GYN/oncologist before I came here today to have surgery, and yet, I trust you, as my healthcare team, with my life.  I am one of you and I am one of “them”.  Today I am a patient (them), but I worked at MMC in 1970 for a few months as a freshly minted RN.  Your ER and your Hospital have grown so much that they are no longer recognizable to me.

Today my dedicated husband Mike is with me and will stay by my side and be my advocate.  I am his wife, and I am also a mother, grandmother, daughter, sister, aunt, niece, cousin and friend to many.  Before becoming a trusting but vulnerable patient today, I have been the “strong” one for my family, friends and many thousands of patients during my 41 years as an RN. 

Your work is more important to me than you know.  I have had a tragic personal experience with Hospital care. In 2009, my own father died of Hospital Acquired MRSA Pneumonia that he contracted in a small Maine Hospital.  It was an earth shattering experience for me and my family.  So, since then, it has become my quest to make healthcare safer for everyone by working as a patient safety activist.  My work has taken me to the State and Federal DHHS, and the Federal CDC. I affiliate with the Consumers Union Safe Patient Project.  I volunteer my time to make healthcare, and particularly Hospital care, safer for everybody.

The work that you do is challenging even on your best days. I know that it seems downright chaotic and impossible some days.   Keeping me safe isn’t easy; it will take a lot of work, skill, coordination, collaboration, communication and care.  Care is the key word.  In current political discussions on Healthcare…the true meaning of care seems to get lost.

So, here I am, meeting you all, for the first time today.  This visit wasn’t an option.   I came to MMC to get rid of cancer. Admittedly, I am frightened.  Certainly in that respect, I am exactly like all of your patients.  I chose your hospital and doctors after a great deal of research and comparison to others.  I trust you to keep me safe.  I need your expert care. So, please………  Take the important “time out” before surgery and complete that check list. Give me the appropriate pre op antibiotic and give it at the right time. Keep me warm and clip, don’t shave my hair.  Tell me your name and I will tell you mine, on every contact.  Do it even if I scowl after a half dozen times.  Be patient with my questions, because I don’t know the answers if I ask. Listen to my concerns and my husband’s.  Remember that although he is not medically trained, after 40 years of marriage, he knows me a whole lot better than any of you do. Once I am in my room, please don’t ask him, my lifeline, to leave my side.   He will take a load off your nursing staff and help keep me safe.    Wash your hands every single time you touch me, my stuff or my immediate environment.  Please, help to keep me and my room clean thereby protecting me from infection.  Pain Control is very important to me. Use the 5 Rights for every medicine you give me. Remove my urinary catheter as soon as possible. Involve me in all discussions about my healthcare plan and even if something has gone wrong.  Secrecy erodes trust.  This is a short list of steps that can keep me safe and sustain my trust. .   Push me hard to walk, cough, deep breath, and take fluids. I plan to cooperate with this plan, but I may whine a little.   I want to be out of here as soon as possible, hopefully in just one day.   It’s not that I don’t appreciate the hospitality and your tremendous efforts, it’s because I know it is the best thing for me and my health.

I am giving you my trust, gratitude and sincere admiration for the incredible work that you all do.

In return, you are giving me the best possible Christmas gift today.  You are giving me the safe, clean and expert healthcare that I need, so I can get back to my family for Christmas and begin my recovery from cancer and surgery.  I plan to be the “strong” one again in no time.

Thank you and Happy Holidays to all of you and your wonderful families. 

Sincerely, Your Patient, Kathy Day RN, Patient Safety activist and advocate

The study results released today by the Office of the Inspector General of the DHHS about Medicare patients is very disturbing.  ONE IN SEVEN medicare hospital inpatients suffered harm because of medical error/or infection.  This is huge. It is unacceptable and it is a big secret from most unsuspecting patients being admitted to the hospital.  Although half of our States have mandated reporting for medical error, not even all of those accurately report medical errors/hospital acquired infections.

How do we change this?  First of all we make them report it.  Mandatory public reporting of medical error and hospital acquired infections is a must.  Without transparency and accountability, there will be no change.   Mistakes and deadly infections will continue to be swept under that dirty rug and paltry investments in prevention will continue.  Second, we support improved staffing at our local facilities.  Safe staffing equals safer patients.  Third, we pressure our legislators to support any and all Safe Patient legislation, including prevention legislation,reporting legislation, patients rights legislation and informed consent legislation.

At the  recent Consumers Union Safe Project summit,  ad campaigns to educate people who are entering the hospital were discussed.  Having blind trust in our hospitals and doctors and other caregivers is a very naive way to conduct one’s self when hospitalized.  Educate yourself about your condition and help others who cannot do that for themselves. Ask if the surgery/treatment/medications are necessary and if there are alternatives.  Get second opinions.  Check out your Doctor’s history and experience.  Ask for your hospitals record on medical error and infections.  Finally take a patient advocate with you.  If you will be impaired physically and/or mentally because of your surgery or medical condition, ask a trusted loved one or friend to be your advocate. Don’t sign your consent for treatment or surgical procedure until you are perfectly clear on all the risks, including infections. Carry a journal for yourself or your advocate to use to document who visited you in the hospital and for what reason, list your medications, etc.  And make sure all of your caregivers, and visitors are washing their hands before touching you.

Don’t count on your hospital to do it all for you….as much as you would like that.  Take a stand for yourself or your loved one. Be prepared and educated.  You will be safer because of it.

http://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf