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Posts Tagged ‘hospital acquired mrsa’

Maine Quality Forum Decision, LETS DO A STUDY

September 18th, 2009 2 comments

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.

Kathleen Sebelius press release

September 10th, 2009 No comments

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

Congresswoman Jackie Speier, on healthcare reform and MRSA

July 29th, 2009 No comments

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.

Now, I’m going to talk about a specific bacteria infection that people get typically in the hospital. It’s called Methicillin-resistant Staphylococcus aureus. Now we say MRSA for short. Now, the MRSA infection rate is growing by leaps and bounds. In fact, there’s 100,000 cases of MRSA a year. Two-thirds of those people that get that infection get it in the hospital setting.

Now, of the 100,000 people that will get a MRSA infection, 19,000 of them will die because of that infection. Now, that’s a stunning figure.

If there was a 747 that crashed in the United States every week, that’s the equivalent of 19,000 deaths. And if there was a 747 that crashed every week in America, we wouldn’t tolerate it. We’d call on the FAA. We’d call on the airlines. We would stop it. But we’ve done very little to stop the spread of MRSA in hospital settings.

Now, this health care reform bill takes an important step, not a full step. It doesn’t go all the way, but it does now require that hospitals will have to report their hospital-acquired infections.

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

Representative Jackie Speier, MRSA bill

June 20th, 2009 1 comment

I was invited to Washington DC to help Rep Jackie Speier introduce a new federal bill to mandate steps to stop MRSA in our hospitals.  Jeanine Thomas of the MRSA Survivors network told Rep. Speier’s assistant about my father.  I told them both that I was willing to make the trip to DC to breifly tell about Dad because it is important to do this.  It is important to me, and to anyone who has had MRSA or has lost a loved one because of MRSA.  It is important to every patient who enters the hospital in the future.  It is important to everybody.

I admire Rep Speier for bringing this timely and necessary bill forward.  Each State is getting stimulus money for programs to help stop Hospital Acquired Infections.  The word is out about our hospitals and most hospitals are not doing the best they can.  Active Detection and Isolation is what they need to do.   If Rep Speier’s bill passes, all hospitals will be doing just that.

So, I am camped outside of the city at Lake Fairfax County Campground preparing to be at the Capitol on June 24 to help bring this bill out.  I have to say……..this is a lovely area with so many things to see and do…..but it’s a little  humid and drippy for my taste.  Maine weather suits me best.

Hospital visitors and MRSA

June 12th, 2009 1 comment

The question I am asked repeatedly is why aren’t families told to use the same precautions as the hospital staff do when the patient has MRSA.

I’m not 100%  sure I can answer that question because I wondered the same thing.  When I helped to care for my father while he was infected with respiratory MRSA, for the first 6 days after he was admitted, there were NO precautions.  That was because he was not diagnosed for that entire time.  Fortunately, both my mother and I, who visited most often, wore clean clothes every day and we didn’t go throughout the hospital to the cafeteria or other rooms.  We only went back and forth to the hospital.  We did not carry MRSA into the hospital and we did not carry it around to other parts of the hospital, although it was a possibility before we were aware and alerted to Dad’s infection.

I believe an accurate answer for visitors of MRSA patients, would be if you are going to be giving care and your clothes are going to be touching the patient or their environment, you should be following hand washing, gloving and gowning exactly the same as the staff.  The nursing staff should instruct you on correct procedure for this and you should do this to protect yourself.  My family all learned meticulous hand washing before gloving and then washing before we left the room.  WE also wore masks while visiting, after Dad was diagnosed with respiratory MRSA.

Then there is the question of small children visiting.  I think that we need to revisit the days of not allowing small children to visit in hospitals.  Many of them, in fact most of them are either in pre schools or day care situations.  MRSA is common in those places.  If a child is not old enough to learn precautions with MRSA patients, they should not be allowed to visit.  It amazes me the number of patients who feel that the hospital room is an appropriate place for a social gathering.  Small children are allowed to crawl on the floors and climb on furniture, and get itno things.  This is unacceptable in hospitals. These activities are a risk to the child and also to the patient because of what the child may be carrying.

There is no standard approach to these precautions for visitors.  Maybe it is time for one.  Anyone who is going to participate in caring for the MRSA patient needs to use the same precautions as the staff, assuming the staff  is using the appropriate precautions.  Visitors who are just stopping by to say hello should at least wash their hands and use gloves and avoid physical contact with the patient and their surroundings.  And they should always check with the nurse before entering the room in case additional instructions are necessary.

MRSA reporting in Maine

June 11th, 2009 No comments

My proposal, LD1038, addressed MRSA reporting. My intent with this reporting was to make MRSA a reportable infectious disease in the State of Maine, and also to make hospitals accountable for the number of vulnerable patients who become infected after being hospitalized. So, my hope was to have two categories of MRSA positive cultures for reporting purposes, “Positive on Admission” or Positive while hospitalized”. There is a big difference here. It is believed that over 80% of MRSA infections are healthcare related. It is time to hold healthcare providers accountable for the infections people acquire while in their care.
During the Health and Human Services committee hearings, after I made huge concessions on my bill, Maine State Nurses Association and I were given seats in the Maine Quality Forum Infection control collaborative to help make the decisions regarding MRSA and other Health Care Infections prevention. As far as I know, I am a full fledged member of this Infection control Collaborative and so I will readdress the issue of MRSA reporting in future meetings.
Essentially at my first (non productive) meeting with the MQF, I was told that there would only be reporting of the number of patients who were determined to be high risk and the number who were screened. This tells the health care consumers nothing. We already know that about 15 to 20% of the general public are MRSA colonized. What consumers want to know is how many  full fledged lethal and disabling MRSA infecitons are coming out of our hospitals. What I want to know is exactly that!
My father was infected because of lax and inadequate infection control in his hospital. He had no screening on admission and the two other vicitms who died in the month prior to his admission did not have any screening either. So, until they were diagnosed with full fledged lethal and terminal MRSA infections with a clinical culture after they were likely housed with unsuspecting and uninfected patients. I wish I had a way to find out who was roomed with those two other patients, just to see if any of them became infected. My guess is that they did. And so it goes. An undetected infection goes on until it can’t be ignored anymore. In the mean time, unsuspecting and vulnerable patients are roomed with those infected patients, until doctors figure out that the roommate is infected. They become either colonized or infected and then they infect others…on and on it goes.
If the MQF has a true desire to stop these infections, they must know first how many there are. It is my opinion that they already do know and that unless MANDATED, they will never reveal or report the true numbers of these infections. I was told that by reporting the infections the way I suggested, “it would not reflect an accurate picture of the problem”. And I suppose their way of reporting WILL paint an accurate picture? I think the problem is huge and they would have to be brutally honest and report all acquired infections for there to be a true depiction of the problem.
If the MQF does not bend on this reporting, or on the high risk screening, I will work to get a mandate. There is always January to begin again with proposals and bills and new laws. I am way past the feeling that hospitals are untouchable. My family and I have been personally harmed and my father has been killed by hospital error. He was infected by MRSA and it was preventable. It is time for these publicly funded and operated facilities to answer to consumers, and the public about their inadequacies and then begin the work of effective prevention and reporting in their practices.
No longer will consumers sign away their lives on consents that allow hospitals to give them infections and not hold them responsible. No longer will patients tolerate being housed with infected or colonized patients and be put at risk by their hospital for serious life threatening infections. No longer will hospitals be allowed to keep all of this infection mess secret. No longer will they stay at status quo, act liket hey are doing a bang up job and be allowed to continue to kill people in their care.
Maine hospitals have a long way to go before they will regain my trust and respect. I hope to help them along with that.

Why we need screening for MRSA

June 8th, 2009 No comments

I my previous post, I mentioned that humans carry MRSA two ways, colonization and actual infection with the accompanying symptoms, according to what part of the body it affects.

So, why is it important to screen hospital  incoming patients for MRSA?

When we are admitted to the hospital, we have no control over who we are roomed with, how well the housekeepers clean, if the staff washes their hands, or many other safety factors.  We can stay alert or ask a friend to and keep on top of those things, but if somebody is roomed with us who has MRSA in their nose or somewhere else on their body, we can’t control that.  We are forced into living with and sharing facilities with a stranger, not knowing what they are in the hospital for unless we ask them ourselves.  I know of two people who found out their roommates had MRSA and it was only a short time later that they had it too.  This is just plain unacceptable.

I live with the suspicion that my father was roomed with a patient with MRSA.  3 of his roommates had respiratory infections, all of them with chronic lung problems and at least one of them came from a nursing home. They all predeceased Dad.   ALL of them were at high risk for MRSA, but NO SCREENING was done at his hospital and so they do not detect MRSA except when they do what is called “CLINICAL” cultures.  Patients are often 4 or  6 or 10 days into their infections before the difinitive diagnosis of MRSA is made and that diagnosis is made with a CLINICAL culture.   Then it may be several days (or never) before anybody discloses to the patient that they have it.  During that time, no special precautions are taken and the germ is spread with wild abandon.  It gets onto the doctors clothing and hands, onto the nurses scrubs, ….it gets carried to the nurses station and onto the computers, off it goes to the Physical Therapy room and into Xray, to the MRI machine and onto the lab techs box she carries, and around and around it goes.  No wonder there is inadequate control over MRSA in Maine hospitals.

Screening on admission, of high risk patients, will alert the hospital, the caregivers and the patient that they are carrying MRSA.  This may be just colonization, but that is significant in and of itself.  It means they have no signs of infection, but the germ is growing in thier nose, or a body crease, or open sore or on their skin.   And they can spread it around.

Large numbers of colonized patients are admitted to hospitals every day that are not detected.  This is both a risk to those patients and to the other patients they are  roomed with. We can’t continue to keep our heads in the sad about colonized patients.  Both CDC and SHEA, the so called experts of disease control, state that colonized patients as well as infected patients need to be isolated and contact precautions used.  That means a separate room and handwashing, gloves, gowns and masks (as needed)  on or between every patient contact.  Yet, it is impossible to abide by that recommendation.  Why?  Because without screening, we will not know if they are colonized. 

Patients who are colonized with MRSA are at a significant increased risk of getting a full fledged infection.  They are also reservoirs of MRSA for spread to other patients, Healthcare workers and the environment.  Without knowing who is colonized and enacting the proper contact precautions, MRSA gets spread all over the place and there is no way to control it.

We screen, we isolate and we protect…both the colonized patient and the other patients.  No MRSA prevention program will work without high risk screening /Active Detection and Isolation.

ACTIVE DETECTION AND ISOLATION FOR MRSA IN MAINE

June 4th, 2009 No comments

Humans can have MRSA germs two ways. Some of us with healthy immune systems can carry MRSA in our noses or other parts of our bodies and have absolutely no symptoms. The first time we are aware of it is if a MRSA screening culture is done, perhaps before a hospital admission. This carriage of MRSA is called colonization. This form of MRSA is usually found when screening cultures are done and before there are any signs or symptoms of actual infection. Although this form of MRSA is benign, it increases a person’s risk of actual infection about 7 times over.
The second way we can have MRSA is during actual MRSA infection with the accompanying symptoms. MRSA can affect skin, bones, hearts, lungs, joints or any other part of the body. Infection usually occurs when the patients is vulnerable because of certain risk factors and/or because of inadequate infection prevention in hospital settings. Certain lifestyles can make one more vulnerable to Community Acquired MRSA, but it is Hospital acquired MRSA that I am addressing here.
The signs of infection are according to what part of the body it affects. If it is Respiratory MRSA, like my own father contracted in his hospital, the symptoms can be fever, profound weakness, loss of appetite, somnolence, and coughing with sputum. If the infection is in a wound, the symptoms can be fever, swelling or redness of the wound, drainage from the wound, pain, profound weakness, and loss of appetite. Sometimes if the infection is inside the body because it has been sewn up inside there during surgery, the symptoms are extreme pain, malaise, and fever. This is called MRSA infection. These infections are found by “clinical cultures”. This means the culture is done as a diagnostic measure, AFTER he patient already has an infection.
My proposal for Maine LD 1038 was written with the goal of getting Active Detection and Isolation in all hospitals in the State of Maine. This means each and every hospital would have a standard approach to MRSA prevention that starts with MRSA screening of high risk patients.
First step is having a list of high risk patients. There is a pretty standard list of patients who are considered to be at high risk for MRSA. All of those high risk patients will be screened on or just before admission for MRSA carriage or infection. The purpose of screening is to find all colonized and /or infected patients on admission. Both colonized and infected MRSA patients can be a reservoir of MRSA germs and can spread disease. These patients can also spread MRSA from their colonized body part into a surgical site, a central IV line, up a urinary catheter, or into their own lungs,
Second step is to isolate those patients who test positive for MRSA. This step is to keep infected or colonized patients separate from patients who do not carry the MRSA germ.
Third step is to initiate precautions to include hand washing, gloves, gowns and masks as necessary before and between patient contacts.
Forth step is to attempt decolonization for patients who will undergo certain procedures that are known to be risky for acquisition of MRSA infections, such as joint replacements, cardiac surgery, or central line placement. Also, an admission to certain departments in hospital puts patients and higher risk.
In addition to the above steps, decontamination of the patient’s immediate area is necessary.
And to strengthen and enforce these steps, we need concise, standard and easy to understand education for every single level of staff who are involved in direct patient care and contact. Compliance with and standardization of these steps is not possible without proper education and an attempt to change the culture in hospitals
My meaning of culture change is one of having the goal be PREVENTION of MRSA rather than REACTION to MRSA. Also, when this approach is proven successful, the staff will develop an “ownership” of the process. Just think how wonderful it will be to be able to tell Maine Consumers that we have dropped the numbers of infections by 30% or 50% or even more in just one year or two.
It can happen. It MUST happen. We know the current approach is not working. About 5% of infections…central line infections…. has decreased. That was old news from 2007 that was just recently brought out for bragging rights by the CDC. It is really just a small number of MRSA infections. All reductions of MRSA infections are desirable, but our goal is to have zero infections, in as short a time as possible.

Maine MRSA screening, fiscal note

May 10th, 2009 4 comments

A a very supportive Senator informed me that there has been a fiscal note attached to my bill, Maine LD 1038.
We got one tiny part of the LD 1038 passed, and that is mandatory high risk screening. It may be small, but high risk screening is the first step in MRSA prevention in the State of Maine.
A Screening test costs between $0 and $100 in the State of Maine. There is no set price, but a fair average is around $20. I guess the actual charge to the patient is according to whether or not your hospital is going to put it to you on the price. If a person is found to be MRSA positive, and decolonization is started, a it can save a patient’s life or limb. It can also save other patients from being exposed to an unknown MRSA colonization or infection. So far that $20 screening culture is a good deal all around.

Now I will talk about my father’s expenses. If he had not been infected in his hospital while he worked to rehabilitate from a minor fracture he would be here today. Instead we buried him May 8th. So, the ultimate cost to Dad was his life. I cannot put a dollar sign on that.

However, his expenses for the hospital and doctors for 20 days for the infection and the complications he suffered because of the infection was about $30,000. Then when they deemed him “well enough” to be discharged, he went to a nursing home for almost 10 weeks to the tune of around $17,000. That amount was paid out of his life savings. No offer ever came from the hospital to help cover that expense, even though the hospital was responsible for his infection. My parents are not rich but they had a little too much money to qualify for Mainecare. And, because Dad was no longer at home or in hospital, they had to pay for his oxygen equipment out of pocket too. Dad’s prescription meds were also covered by his insurance except for his $2 copay for each one. The expense to the insurance company for his meds is unknown. But, I do know it was substantial. So, the total cost to my parents and their insurances for his MRSA Pneumonia was between $47,000 and $50,000.

If mandatory screening prevented, let’s say 4 invasive MRSA infections a year, in his small hospital alone, (and I KNOW it will prevent many more than that), the savings would be $200,000 in expenses to those 4 patient and their insurances. My father’s MRSA infection would be considered a “simple” and inexpensive case of MRSA because it didn’t involve numerous repeated surgeries to clean out pus and dead or infected tissue from a joint or belly or chest caused by MRSA. Many joint, chest or belly MRSA infections involve repeated surgeries. My guess is that those infections would cost up to $100,000 or much more. One of my new friends who lost his wife because of MRSA after having an ovarian cyst removed, stated that his wife’s bills added up to a half million dollars before she died. She had repeated surgeries and lost part of her intestines because of MRSA. For the purpose of “fiscal” notes, we will say that an average invasive Hospital Acquired MRSA infection costs $50,000. My father’s hospital has 25 beds. Of course we do not know their rate of MRSA, but I do know that 2 people died of MRSA after Joint replacements in the month prior to Dad’s first hospital admission. My educated guess is that their infections cost their families much more than $50,000. If their infections and Dad’s infections had been prevented, and they had lived and been discharge home to their loving families, there would have been a minimum of $150,000(more likely over $200,000) in savings to them, their families and insurance companies. That savings would have been for preventing those 3 infections in one month alone.
For the sake of making a solid guess on savings to famlies and hospitals by prevention of just 3 infections in a month’s time, I believe $150,000 is more than fair. Now if that number of infections is the average number for every month, it would be over a million dollars savings in a year. I hope to God I am wrong in stating there would be 3 invasive MRSA infectons that caused death in my father’s hospital every month, but I do know as fact that happened the month my father was first admitted. It may be nicer for me to just say that screening and contact isolation may prevent 3 simple HA MRSA Infections per month in my fathers hospital.c
To give my father’s hospital a huge benifit of the doubt and it is difficult for me to do that….we will guess that there is $500,000 spent out by patients and their insurances on invasive hospital acquired MRSA infections from my fathers 25 bed hospital every year. This amount would be a very conservative amount to say the least. Of course at this time MRSA infections are not reported, so we have no way of knowing for sure how many infections there really are in Maine Hospitals. But, again, giving Dad’s hospital a huge benifit of the doubt, we will guess that there would be a savings of $500,000 on MRSA infections a year in his 25 bed hospital.

Now we can look at the hospitals side of this. It is good “fiscal” business for hosptials to care for MRSA infected patients. It makes the hospital money. Just how much money it makes for the hospital? We can’t say for sure. Patients who are infected in hospitals spend a lot more inpatient days, spend tens of thousands more dollars for their care, and often times become reinfected so they are readmitted and it costs even more. Then of course they can only stay for just so long in an acute care setting, so they must find either long term care, or at home care after discharge. But, I am only covering the in hospital expense in this post. It’s sad to say, but these infections are huge money maker for hospitals, doctors, pharmceutical companies, protective gear companies etc. The antibiotics alone (around $200 a dose for IV Vancomycin) make a huge profit for the hospital. I really want to give the hospitals credit here and say they want to STOP HOSPITAL INFECTIONS, but the reality is that hospitals make a fortune on these infections. Even more money is made on studies and research.

And there is more benefit to hospitals regarding these infections. They are not held legally or morally liable in any way for these infections. If a surgeon cuts off the wrong leg, patients can sue a hospital and the doctor and be compensated for their pain, suffering and loss. I challenge anyone reading this post to tell me of ONE SINGLE SETTLEMENT in Maine over a MRSA infection that was contracted inside hospital walls. It is nearly unheard of. There is not one iota of doubt that my father contracted his infection in his hospital. In fact we were told more than once by his physicians that he contracted it in his hospital. But my research revealed that very few legal settlements have been made because of hospital acquired MRSA. There was however a huge settlement in a prison when many prisoners contracted MRSA…I know…this is off subject. My point here is that hospitals make a lot of money on MRSA infections and they are not held accountible (financially, legally or otherwise) in any way for those infections.

We learned in our work with MRSA that screening tests are already covered by insurance when they are done in the more progressive hospitals in Maine that are already doing some MRSA screenings. And we learned that federal stimulus money is available for programs to prevent Hospital Acquired Infections. So, a Maine fiscal note attached to high risk MRSA Screening for all of Maine is bogus.

The cost of mandatory screening is about $20 a pop. I don’t know the number of hospital admissions per year at my father’s 25 bed hospital, nor do I know how many of those patients would be considered at high risk for MRSA,, but the fact is they would NOT be doing over 20,000 high risk MRSA screenings per year. The savings that I guessed above…$500,00…. would cover more than 20,000 high risk screenings. Whatever is left over would undoubtedly be a huge savings for hospitals, patients and their insurance providers.

The savings to patients in terms of pain, suffering, death and devastating disabliity….PRICELESS.

The talk of cost for these infections is very difficult for me to discuss. My father, my family and I are personally hurt and harmed by MRSA that was caused by lax infection control in a hospital. Dad is gone. It hits me often how final that is. This is grief and sadness I have never before experienced. So, to hear that my State Governement wants to put a dollar sign on a solid proven MRSA preventative step makes me very angry.

Bangor Daily News article

May 7th, 2009 No comments

In today’s Bangor Daily News, Meg Haskell has written a well thought out article about my proposal, and the need for prevention. Please read this article and comment.

http://www.bangordailynews.com/detail/105443.html