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Posts Tagged ‘mrsa disability’

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

CDC reaction to swine flu

May 3rd, 2009 1 comment

It’s wonderful to know that the CDC, homeland security and state health services can pull together and react to the very real possiblility of a pandemic of swine flu. Antiviral medicines are being shipped to the State of Maine as we speak. It’s only been a week or so since …was it 7 or 8 students in NY and a few others in California had contracted mild cases of Swine flu. All hell broke loose. We have seen doctors, nurses, the director of homeland security, the PRESIDENT, CDC representative etc all on TV talking about the flu. And of course EVERYBODY is talking about HANDWASHING!
So, I have to wonder why nobody from CDC, homeland security, state health services, Customs and Border protection, the President, Governors, doctors, nurses and other health officials NEVER address the 18,000 deaths caused by MRSA in 2006 and the many more thousands since then. NEVER, I have never heard it addressed in the news. I only learned of it while doing research. 18,000 is more deaths than AIDs/HIV, more than breast cancer and more than motor vehicle accidents. Yet, no big wigs have addressed it. And there hasn’t been one organized approach mandated to stop these horrible infections that attack us while we or our family members lie vulnerable in hospitals. I even saw Dr Salvatore the infectious disease doctor from Maine Medical Center on TV this morning speaking about Swine flu. He is the very same doctor who spoke out in strong opposition to my MRSA prevention bill,Maine LD 1038 and spoke of an upcoming vaccination for MRSA. Well a vaccine is a long way down the pike and we have to do something NOW about MRSA.

I think I know why there isn’t a huge alert out there about MRSA or C Diff or VRE or any other Hospital acquired infections. The answer is the last three words of the last sentence. They are acquired in the hospital. Citizens are not afraid to address Community Acquired MRSA. Schools and nursery schools have closed because of MRSA infections in their places. I have never heard of a hospital or even a hospital floor being closed because of MRSA infections, and believe me, there are plenty of outbreaks and deaths and disabilities because of these infections. But hospitals are not closed, and floors of hospitals aren’t closed, nor are they held responsible for the infections, nor do they report the infections to anybody, nor do they develop new strategies to stop the infections. They just bury their heads in the sand, fail to disclose the infections (in many cases) to the victims and families, and pretend it isn’t there…….well, until the NEXT infection. Until the next poor soul who’s knee joint fills up with MRSA pus, or the next person who can’t control their diarrhea from C Diff, or the next old person who develops MRSA pneumonia and dies, like my father did. Hospitals have remained untouchable when it comes to these infections. Believe it or not, hospitals are sometimes wrong. In Maine, they have been wrong about hospital acquired infections.
No, these hospital acquired infections don’t make the news, not much anyway. Then if they do, doctors, hospital officials and others who don’t want to face the music, downplay the stories and say there is way too much media hoopla over these infections. Hospitals and hospital officials,associations and doctors do NOT want exposure (no pun intended) of these infections.
Well, it seems that there is a lot of hoopla over several dozen mild cases of Swine Flu. It’s like a national disaster has struck. Unfortunately, there have been deaths in Mexico, but none here in the US.
Well, let me announce that there have been thousands upon thousands of deaths because of infections that patients are catching IN HOSPITALS. It is time the word was out there and the CDC, Federal government, State governments, doctors, nurses, Governors and THE PRESIDENT dealt with the reality of big numbers of deaths and disability because of infections people are catching in their modern hospitals. It is a disgrace and it is unnecessary. It is time to fight these infections. Investments in prevention need to be made and new precautions and practices need to be developed.
Wake up America. There is already a lot of deadly infection in this country and it comes out of hospitals. The threat isn’t your neighbor or your friend with Swine flu….it is your health care facility and the danger of infections spreading there.
I’d love to be able to make a living by going on TV and telling people they can avoid an illness by washing their hands and coughing into their elbow. My mother never made money teaching me that when I was a child but those experts are banking on it. It’s important, I know, to prevent the spread of flu. But, the experts aren’t really dealing with the tough horrible illnesses, like MRSA, C DIFF and VRE, now are they?

Handwashing and MRSA

April 21st, 2009 5 comments

Handwashing is very important in the prevention of hospital acquired infections, to include MRSA. But, it is not the silver bullet for prevention. Even if it was, only about 40% of health care givers are compliant. I see two problems with this. The first one is noncompliance should not ever be a problem or an issue. It is time, with the current rising numbers of HA infections to mandate compliance or dish out some sort of punishment. It is one of the simplest, most basic methods of infection control there is. My parents taught me the basics of handwashing when I was just a toddler. It simply should not be tolerated if nurses, doctors, techs, and other Health care workers do not wash their hands between patient contacts. It is just plain ignorant. Fine them, reprimand them and if that doesn’t work FIRE THEM! Remember, I am a nurse and I am saying this. Dirty hands are now like a loaded gun. The germs dirty hands can carry are lethal and deadly and we cannot tolerate dirty hands.
Next, although handwashing is paramount in infection control, it is not enough. CDC and most hospitals have been hanging their infection control hats on handwashing alone for too many years. MRSA spreads to patients on contaminated hands (number one method of transfer), on contaminated clothing, on environmental objects, in the air if a patient who has respiratory MRSA coughs within 4 feet of you, and on medical instruments. An unclean stethescope can bring MRSA to you. As can a nurses hair dangling over you while he/she changes your “sterile” dressing, or puts in an IV or catheter.
I saw a sneezing ,coughing nurse (with no mask) caring for Dad while he suffered from MRSA pneumonia. If he hadn’t already been sick with MRSA, maybe she could have given it to him. I saw a nurse pick somthing sticky off the bottom of her shoe and then without washing her hands, attend to my mother after her recent surgery. I saw a nurse drop a blanket to the floor and then pick it up and turn it over for my mother to sit on. I saw a bed moved from the ICU in Dad’s hospital and put in the place of Dad’s after he was moved into ICU. They did this without first cleaning the space Dad had been in. No wonder they have a problem with MRSA in that hospital.
So, handwashing is good and necessary. But, Isolating infected patients, using handwashing AND the appropriate precations with gloves, gowns and masks, and decontamination of the patients surroundings and equipment is what is necessary each and every time to prevent spreading germs such as MRSA.
Other important things are…HCWs should not be wearing hair that hangs over her shoulders and around her face when she is caring for patients. The old nuns at my nursing school were very strict about that and they were right. “Hair off the collar girls”……I can hear the nuns now. We caught the wrath of those nuns if we had dirty shoe laces!
Sterile fields for dressing changes, IV insertions, and urinary catheters are a must. Caregivers should not be allowed to have fake or long painted nails, numerous clunky rings, dangling jewelry , or exposed bellies and upper derrieres with exposed ‘crackage’(belly shirts and hip huggers anyone?). Sick nurses with coughing and sneezing should not be caring for vulnerable patients. If it is absolutly necessary, they should wear a mask during each patient contact along with the other necessary barriers and strict hand washing.
So, yes, wash your hands before touching me or my vulnerable family members. And encourage and remind me to wash my hands too. If I am a patient and I wash my hands regularly, there is less contamination of my immediate environment and any contamination that might be brought to me can be washed away.
I am a tolerant and pretty understanding person. But I will never understand why so many educated nurses, doctors, and othe HCWs find it so difficult to grasp the importance of precautions, asepsis and cleanliness. Please if any of you ever take care of me, at least wash your hands and wear clean clothes every day. Skip the ties and fake nails and keep me safe.

Abbreviated LD 1038 passes through Maine Health and Human services Committee

April 10th, 2009 No comments

On Tuesday, April 7, my family, friends, nurses, senators and representatives, Union officials, and others testified before the Maine Health and Human SErvices committee. My testimony was allowed in full even though it was very long. Generally there is a 3 minute limit. I took 20 minutes. I needed to be heard. My 13 year old nephew made us all incredibly proud when he stood before the daunting group of committee members at a podium with a microphone and read his testimony. It was against the rules of decorum (no reactions to testimony) but everybody applauded and/or cried when he spoke of his Grampy.
But of course there was opposition. Some of it was reasonable and some of it was just plain stupid, but everybody gets their say. So, we left feeling very confident that our bill would pass.
On April 9, we went back for work sessions. Vanessa Sylvester of Maine State Nurses Association handled the communications between the Maine Hospital association, and the Maine Health Quality forum and me. The communication was fast and quick and we lost out on most of the bill, but we did get Mandated High Risk screening in the State of Maine passed with a unanimous vote from the committee. This is not criticism of Vanessa. She was in a tough spot and worked very hard. Other very valuable pieces of my legislation got lost or transferred over to the other bill that originally was just for reporting of MRSA and C Diff.
My bill was comprehensive and all inclusive. It addressed the most effective approach to MRSA prevention which is Active detection and Isolation. The componants of a good plan are Mandatory screening, Isolation or cohorting, Precautions and decolonization. I got the screening. MSNA and a “consumer” (that’s me) got seats on the MQF committee. We were given until Oct 1 to come up with a solid effective plan for MRSA prevention. This is fine. I will collaborate. I will go to the meetings with an open mind and a lot of knowlege and ideas. But, if we hit a rock wall with ADI, active detection and Isolation and decolonization, I will be back in the Maine legislature next January before the confetti falls to the ground New Years Eve. This is a promise to my father, my family and everybody who advised me and supported my bill. I will not settle for an inadequate plan for MRSA prevention in the State of Maine. In fact I told the director of the MQF, who coincidentally graduated high school with my husband, that together we can come up with the absolute best MRSA prevention program in the country. Then when the Federal CDC wakes up to ever increasing numbers of MRSA victims in our country, they can use our policy as an example for a national policy. That is a lofty goal but a good one.
So the work has just begun. Stay tuned.

Testimony of family regarding Dad’s MRSA

April 5th, 2009 1 comment

My family, Maine State Nurses Association, representaves and friends have all prepared testimony for the Health and Human Services Committee hearing on April 7. I have written the entire story of Dad’s unnecessary hospital acquired MRSA pneumonia. I have had this story in my head for 3 months. When I knew we had to present testimony to the HHS about Dad I asked my family members to write something. My mother, who is very humble and unassuming, didn’t really feel that she could say much about it. Then she read what both of my brothers, my nephew, my son and I had written. She laid awake all night thinking about what she might say. She then asked me if I thought it would help if she said something. I told her of course it would. She said “if it kept me awake, it must mean I should write something”. So she did. It is short and to the point and very poigniant. The testimonies of my other family members revealed to me the pain and hurt they went through during Dad’s illness. His death has effected each of us profoundly but differently, but it was just as hurtful to all of us.
I respect my family and especially my mother for writing from their hearts to help LD 1038 pass. All of them will help, with their testimony to save lives. We couldn’t do that for Dad. We tried for all we were worth to help him, but the disease won.
My testimony is brutally honest and a bit long. But, his story needs to be told in detail to have the intended impact. He suffered terribly and he was confused and frustrated with his terminal infection. About 2 weeks before he died, I had finally convinced the nursing home doctor to do some diagnostics to see where we stood with Dad’s health. When I explained the tests to Dad, he said “What I have is really serious isn’t it?”. He had no idea. And, neither did I at first. The preventable scourge that Dad was given in his hospital blindsided me and my family. By the time we had the results from Dad’s diagnostic tests, he had died.
Dad would be so proud of his family now. He always was anyway. But if he could see all of us standing up and giving our testimony to pass a bill that will save lives, he would absolutely burst with pride. He would cry if he could see his 13 year old nephew Cyle read his testimony about his Grampy. I know I will.

Please, call or write your senators and representatives to support LD 1038. We need to stop MRSA and other Hospital acquired infections. If you have a story and would like it presented to the Health and Human Services committee, please contact me at kathydayrn@aol.com and I will help you with that. The hearing is in Augusta on April 7 after 2pm.

LD 1038 Maine Labor Lobby Day

March 27th, 2009 No comments

I was introduced to the world of political lobbying yesterday.
I have had very little experience with such things. I learned a great deal. MSNA is incredibly supportive our bill, and for that I am grateful. The MSNA staff is very skilled at lobbying and they helped promote LD 1038 yesterday. Their members and other staff nurses around the State will be the stewards of MRSA Prevention with this new law.
It occurred to me yesterday that I have never commented on the nurses who cared for my father in his community hospital. His care was a tremendous challenge. He was completely helpless, on isolation and at times a little cantankerous. I couldn’t blame him. His clear mind was trapped inside his newly helpless body. It was totally unfair to him, my family and to the healthcare workers who cared for him. We all worked hard to take care of him after all.
I have stated that the precautions taken during my father’s stay were inconsistent. They were. But I cannot place blame on the direct care staff. They worked tirelessly caring for my father. I want to thank them for what they do every day and for the tender and compassionate care they gave my father and my family.
I place blame on an ineffective preventative policy regarding MRSA. Administrators write policy. Administrators monitor infection control compliance and infection clusters. Administrators appropriate funds for preventative programs.

The main goal of my proposal and all the work involved is that lives will be saved and fewer people will suffer the results of hospital acquired MRSA infections. Another goal is to empower direct caregivers with the tools and the policies necessary to actively prevent these infections. Unfortunately now, caregivers are given the assignment to care for too many people who are already infected. This approach by hospitals is reactive rather than proactive.

One of my many positions as an RN was doing triage at the front desk of a busy ER. I loved doing triage and if I do say so myself….I was darned good at it.
I recognized a Level I triage patient within a very few minutes or seconds of a patients arrival. As a triage nurse I did a quick efficient assessment of a patients symptoms, appearance, vital signs, and history to decide what level of triage they fell into. Simply put, Level 1 triage meant that a patient’s life or limb was in jeopardy. Wow, what better way to describe MRSA. MRSA infection prevention should be a Level I triage priority in Maine hospitals every single day….. Life and limb, literally are put at risk when hospital patients contract MRSA.
I reiterate…the nurses who cared for my father were phenomenal, and I thank them. I hold them in high regard and respect them for their hard work.

John McCleary’s MRSA Nightmare

February 9th, 2009 7 comments

My name is Kathy Day RN. I am a nurse and I am the daughter of a MRSA victim. John P McCleary, my father, died on Janaury 9, 2009 because of Hospital Acquired MRSA pneumonia. He was 83 years old. He fell on Septemeber 26, 2008 and fractured his fibula, the small outside bone of the lower leg. It was a minor fracture that didn’t even require a cast or splint. He also had a urinary tract infection and was treated for that. He had chronic lung problems, but he had never been hospitalized specifically because of that. He was kept in the hospital for 12 days for physical rehabilitation. He worked through his pain from the fracture and he managed to get back on his feet. On October 7, he was discharged home and walked into his home on his own with a walker. On October 9, he couldn’t get up from bed. He had fever and profound weakness. My 82 year old mother had to call the ambulance to return my Dad to the hospital.
In the ER, he was worked up with lab, xray, and urine tests. His admitting diagnosis was Left upper Lobe pneumonia and possible heart problems.
On October 10, the illness stressed Dad so much that he did indeed have a heart attack. His blood pressure dropped dangerously low. He was transferred from his regular bed to an ICU bed for blood transfusions, monitoring, urinary catheterization, and O2 Saturation level monitoring. He was so weak he could barely sip water from a straw. He spent several days in the ICU. When the nurse put his urinary catheter in she told me “he will get an infection”. It was a statement, not a guess. I was so worried that Dad would get bedsores from being wet with  urine that I kind of dismissed that comment. Within 2 days, he had a urinary infection. He had clear urine on this second admission. He not only had an infection, he had a MRSA infection. In the meantime, he had been coughing up large amounts of sputum. I asked if they intended to culture his sputum. The nurse went to check with the doctor and came back to hand me a specimen cup to obtain the sample myself. I did. Two more days passed before the culture came back positive for MRSA pneumonia. Dad had that infection in his lungs on admission. He had passed his infection to his hands from handling his sputum, onto his catheter and up into his bladder.
My family,Dads vistors, all of the staff, and everybody else who came in contact with my father before the MRSA pneumonia diagnosis, were exposed to MRSA. Had the doctor ordered a nasal culture for MRSA screening purposes on admission, my father would have been on the correct precautions from the beginning. Also, because he had fever, and had just been in the hospital, had high risk factors, and showed pneumonia in his lungs, the doctors should have been able to piece together the fact that Dad had MRSA in his lungs, or at least suspected it.  To go back even further than Dad’s infection, if the hopsital had observed the CDC recommendations for follow up of MRSA outbreaks, Dad might not have gotten an infection in the first place. There had been 2 MRSA deaths just one month prior to Dad’s admission and yet the hospital still did not MRSA screening of patients.
My father spent another 20 days in the hospital. He was very weak and debilitated. He got thrush from the Vancomycin. He also had an allergic reaction to it and got an itchy rash all over. His skin began to break down. He was unable to eat. This was the most disturbing part of his disease. His inability to eat was frustrating to him and to his family. He rapidly became malnourished frighteningly thin. He lost most of his hearing, again from the Vancomycin. Ototoxicity is what that is called. He expressed the will and desire to live and get better, but it was just not possible.
Toward the end of his hospital stay, he was given the unfortunate news that he would be transferred to a nursing home. He needed total bed care and my mother and I weren’t able to give that at home. He was never able to stand  or walk again. Attempts were made at the nursing home by a physical therapist to get him back on his feet, but he had syncopal (severe dizziness) episodes…he nearly passed out. He didn’t have a foot under him. So, he spent his last 2 months of life in an isolation room, unable to hear, eat or enjoy anything. He was on constant oxygen and he needed assistance with simple movements. The skin on his sacrum broke down and it began to break down on his heels, toe tips and shoulder blades. All of my family and his other visitors had to wear masks and gloves, so he couldn’t read our lips or see us smile. We couldn’t kiss him. He was frustrated and confused by this sudden decline in his health. He absolutely HATED being in the nursing home.
He had no idea about the fight it took to get him in there instead of 30 to 70 miles away. The day he was to be transferred to the nursing home, which is about 5 minutes away from my parent’s home….we were told there was no bed available. A bed had been promised to us for a full 2 weeks. My mother was self pay, which made it easier to get a bed in the nursing home. When I was told that the bed was no longer available, I called the nursing director of the home. I was told all sorts of nonsense about how they had an “emergency” admission and now there were no male beds left, etc etc. I told them that was totally unfair and I would speak to the director, the medical director, the infection control nurse, the owners and the Governor of the State of Maine if that is what it took to get my father into his hometown nursing home. It took an entire afternoon of staff meetings at that nursing home, but he got a bed. We had to meet 3 demands. One was Dad had to pass the usual Gould assessment test. The second was that Dad would have to wear a mask if he ever left the room there. And third and most unusual, he had to accept Hospice care. He never did accept Hospice. Neither he nor my mother were interested in Hospice and that is a very personal decision. After the fact, I have since learned that it is against the American with Disabilities Act to descriminate against a patient with MRSA, the same as it is for a patient with HIV/AIDS when it comes to nursing home admission.
My father spent 2 very lonely sad months in his isolation room at the nursing home. My mother visited him faithfully two or three times a day. We decorated his room to make it more comfortable, but it wasn’t home and that is what Dad wanted…to go home. It would never happen. Ironically, his mother, my grandmother, died in that same nursing home room 33 years ago.
My mother received a call on January 9 around midnight. Dad had taken a turn for the worse. The doctor also called me. Mike, my husband and I drove 70 miles to the nursing home. My mother and I comforted Dad all night until his respirations slowed and then stopped at 450 am. This was the saddest experience I have ever had in my life. Dad was coherent and alert until almost the very end. The end was peaceful and he knew we were with him and we were ready to let him go. He had wasted away to around 125lbs by the time he passed. He had lost well over 50 lbs.  He barely resembled the big handsome Irishman we had loved all our lives.

 MRSA had killed my father.  The MRSA came from his trusted community hospital.  The treatment for his minor ankle fracture shoule have been simple and short term.

My anger and frustration over this preventable illness has motivated me to do something about it. Doctors told me “it happens and there just isn’t much we can do about it” “Precautions are a nursing thing” (as if it is impossible for a doctor to become contaminated and spread the disease). There was a lot of expressed helplessness and “I don’t know” answers to my questions. I just couldn’t accpept that.
I am from the old school of nursing. Strict sterile technique and precautions were taught and there was NO LEEWAY. Nurses could not pick and choose which parts of precautions they would use. There was a set of rules for certain diseases and that is what we did. Precautions in my fathers hospital were very inconsistant. They ranged from some caregivers not even washing their hands , to others using  full fledged precautions…according to who his nurse was any given day.
Also, the hospital did absolutely NO admission MRSA screening. So, it is likely that he was roomed with somebody else who had MRSA. Three of my father’s 5 roommates during his first hospitalization have died, and all three had respiratory issues. I strongly suspect that he contracted MRSA from an infected roommate. If not, then he contracted it from unwashed contaminated hands or dirty equipment. In any case, his hospital is responsible for is infection and therefore his death.

I contacted the CDC in the State of Maine. To my surprise, MRSA infections are not a reportable disease in Maine. Chicken pox, measles, TB, venereal diseases and avian flu (no cases of this have been contracted within the US) are all reportable diseases. MRSA is not. This allows hospitals to have big or even huge numbers of these infections that complicate patients recoveries or even cause their deaths, and they are not in any way accountable. It is allowed to remain secret. Hospitals even get paid for the extended stays that are caused by these infections.  They cost on an average of $25,000 to $50,000 for each patient who becomes infected.
MRSA infects skin, blood, organs, body cavities, surgical wounds, bone, lungs, central line sites, and joints after replacement. Infections can be superficial to very invasive. Invasive infections cause disability, amputations, long recovery periods, reoccurance of infection and worst of all death, like my father.
For years people have died of ’staph’ infections. MRSA is a staph infection but it is resistant to Methicillin which is a synthetic Pennicillin.  CDC says there were about 100,000 invasive MRSA infections in 2005 and over 18,000 of them died. Some say, because of the lack of accurate reporting that the number is 8 times that high. In any case, there are more deaths from MRSA than from HIV/AIDS. The numbers creep up every year and the numbers are alarmingly high.

I have researched MRSA until my eyes hurt. I decided that Maine needs a MRSA legislation. Illinois and several other States have such legislation and it has helped to decrease their infection numbers. Jeanine Thomas, of the MRSA Survivors Network, has been very helpful to me in my endeavor to write and submit a MRSA prevention proposal to the State legislature in Maine. Adam Goode D-Representative, Bangor, ME, is my chief sponsor. He has worked diligently gaining support for this proposal. I have called and written to numerous Senators and Representatives in the State to rally them and their support. I have met absoluetly NO resistance to my proposal. Maine State Nurses Association is endorsing me and will lobby on my behalf in the Legislature. AARP of Penobscot County has also supported me.
This legislation is past due. Every health care consumer should be concerned about the safety of our hospitals. My proposal includes the major steps to MRSA prevention. Screening, Precautions, Isolation, Reporting, Education, and non descrimination are all the important factors in this proposal.
The citizens of Maine and their representatives will make this bill a law. Please contact your local representatives and Senators to support the McCleary MRSA Prevention bill.

Getting the word out

February 8th, 2009 1 comment

In order to get my MRSA proposal for the State of Maine out there, I have taken several steps.

My first step was to contact State Representatives and Senators.  Adam Goode D-Representative of Bangor, ME has expressed the most interest and decided to sponsor my proposal. He also works in advocacy at his regular job with Maine People’s alliance.   He in turn promoted my proposal in the House and the Senate. I have also written and phoned many members of the House and Senate to make them aware of my work and why I am doing it.  The majority of those I have managed to speak with are fully supportive.    The steps for making a proposal a bill and then a law are all new to me. This is not the usual “nursing” type of thing that I have done in the past.  I am learning a great deal in this process.

I also emailed and phoned  organizations for their support.  AARP of Penobscot County and Maine State Nurses Association are supporting  my work.  I will meet with the Maine State Employees Association soon.  They are the biggest union in Maine.  I will speak to any and all organizations who are interested in making Maine hospitals cleaner and safer.  I hope to target the elderly, since they are the most vulnerable.

This work is what I am doing instead of just staying mad. I am not funded by any organization or individual.  I started the work alone, but I hope to gain support for what I believe is very important to Maine health care consumers. I want patients in Maine Hospitals to be confident that they won’t have to suffer like my father did.   I was frustrated and angry about what happened to my father.  My anger led me to this passion to make a difference.  I do not believe that hospitals are helpless in this.  All of the research, recommendations and information is out there about MRSA control.  Unfortunately, it is NOT ORGANIZED or MANDATED.  There is too much gossip and not enough fact circulating in hospitals amongst care givers and patients.  Simple inexpensive, standardized and organized steps can help hospitals to avoid spreading MRSA inside their walls.  Every hospital large or small  in Maine needs to be on the same page with MRSA prevention.  The days of “evidence based” steps for MRSA control are over. The only evidence needed is the alarming increase of MRSA infections and deaths in our hospitals.   My father is now on the data……..Data does NOT prevent MRSA.  Dad is not a number. He was my affectionate, loving and generous father.  Simple steps at his hospital could have prevented my father from contracting MRSA pneumonia while he was rehabilitating from a minor injury.

Anybody reading this page can help me to get the word out.  Send my webpage to everybody on your email list. Call or email your Senators and Representatives.  Help me to help others to avoid needless suffering from MRSA infections.  Email me at Mammy1111@aol.com if you would like me to speak to your group about MRSA prevention and my proposal.