Posts Tagged ‘mrsa death’

Legislators off on vacation

July 24th, 2009 No comments

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

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

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

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

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

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

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.


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.

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.