McCleary MRSA Prevention

The high road to MRSA prevention

An old friend and infection control nurse that I respect a great deal for her efforts told me she did not believe in legislating Infection Control.  Others on the Maine Health and Human Services Committee have made similar statements. 

I just wonder how far I would have gotten if I had continued to contact the CDC, the Maine State attorney general, the CEO of my poor deceased father’s hospital…..how far would I have gotten with improved infection control without the legislation from last year.  Considering the opposition that I have encountered to simply get Maine patients screened for MRSA, my belief is that I would not have gotten anywhere and that Maine Hospitals would not be paying as much attention to MRSA prevention as they are now …..because of legislation.

Since the early 1990s, MRSA has been a growing problem…growing out of control.  It was recognized years ago as an emerging problem but in the late 80s and early 9os, declarations of epidemics came up.  In 2003, the SHEA or Society of Healthcare Epidemiologists, presented recommendations for the control and prevention of MRSA and VRE, another deadly drug resistant infection.  Those who adapted those recommendations have succeeded in dropping MRSA rates and keeping them low.  CDC ignored this success and continued recommending hand washing campaigns and other various and inconsistent methods of control that did not work.  As a result, MRSA rates continued to climb to all time highs over the past few years.

The death of 19,000 people and infection of hundreds of thousands more did not motivate hospitals to add the SHEA recommendations to their plan to stop infections.  Those deaths, loss of limbs, loss of livelihoods, disabilities and other sad and real results of MRSA infections did nothing to move US hospitals to widely accept the success of ADI. Rather than be herded like sheep into the CDC guidelines, it seems that more would have been impressed with huge MRSA reductions after the use of ADI and broken from the CDC  “pack”.

Unfortunately, it is taking legislation to make the needed difference..  We  now have a law  in Maine and still, Hospitals, Epidemiologists, nurse leaders and others are fighting it and hoping it will just go away.  None of them have embraced screening and/or committed to isolation precautions for all patients with positive results……as a good and proven measure of prevention.  Instead they have declared it “well intentioned but ineffective”.  This declaration was made just 3 days after screening started by a leading epidemiologist in Maine.  The descriptor “Well intentioned but ineffective” could also be used for my fathers hospital care, and now he is gone.

I took the high road by seeking legislation. It is my right as a citizen of the US and the State of Maine to seek solutions through the law making process.  I know ADI will work to bring down MRSA rates in our State and I will not stop until I see every hospital in the State using it and reporting out the excellent results they are getting because of it.

There are some lower roads to consider to accomplish this goal.  One is to work on more legislation to mandate that NO HOSPITAL ACQUIRED INFECTIONS be covered by any insurance in the State of Maine.  We may have to do this through more than one agency committee, but my bet is that Medicaid, and the insurance monopolies would welcome a list of things that they would not have to reimburse hospitals for. This would mean increased savings and profits for insurance companies and hopefully less burden put upon already hurting Mainers, who can barely pay their premiums now.   Medicare has already begun this trend of payment for performance quality only and not for preventable hospital failures. I can work on that more with the Consumers Union. 

Why should anybody pay huge costs for a deadly infection that the hospital gave them.  If I could accomplish this legislation, there would be protections for insurance policy holders/ healthcare consumers/ those who drive the medical care business  too, that it would be illegal to bill them for their HAI related expenses.

The second and lowest road is litigation.  If there is a young, progressive and ambitious attorney who would take the time, I could educate him/her on how these infections are preventable and how our hospitals are not doing all they can to prevent them.  That seems like negligence on a very large scale.  It is so hard to get hurt and frightened victims to speak out against their doctors and hospitals (there is that God like aura around them you know), but if an advertisement went into all the newspapers in Maine and there was even a whiff of money to be won in a class action suit, victims would come out of the wood work.  It could be worded like this.  “If you or a loved one has been harmed by a hospital acquired infection please contact …….all cases will be considered for a possible class action suit.  There is a law in the State of Maine that mandates that all high risk populations must be screened for MRSA.  If you were not screened and got a MRSA infection while hospitalized, please contact us.”

These three options are all there are, at the present time anyway.  Consumers Union plans to work with the CDC to get MRSA recommendations rearranged in the correct effective order, but on the State level, the preceding are the options.  I prefer the high road, but I just do not know if I can trust the hospitals to do the right thing.

It is hard to trust when your precious father has been killed by inadequate MRSA prevention in his hospital.

My work with my MRSA bill , activism and advocacy has taken me all over Maine, to Chicago and to Washington DC twice with another trip coming up soon.  I meet with other advocates, our senators and representatives, the Consumers union, and victims regularly to help stop this scourge.   I have met many of the families in person and online.

Let me introduce you to a few.

Two of my new acquaintances  are military veterans.  One got a new hip then MRSA.  Another got a new knee, then MRSA.  The second one had to have his new knee removed and will soon have his leg bones fused and have an unbend-able knee.  If he makes it through this surgery, he will have to learn to walk again using a shoe lift and a walker.  The alternative to that was amputation and a prosthesis.  He wouldn’t hear of that.   He is 86 years old.

I met a young mother in Washington DC in November.  She got MRSA when she went into the hospital to have her baby.  She suffers with it herself, but the worst of it is her baby has it.  They have had continuous outbreaks since her baby was born 9 months ago.  She talked with me in the hotel hallway and literally cried on my wide shoulders.  Her heart is broken.  She has another child and a husband that she worries sick over. Her worry is that they will get MRSA too.  She is a very young woman who is now on SSI disability because of MRSA.

Another friend, a mutual friend of my husbands and mine, had a colonoscopy.   He had a polyp too far up to remove through the scope.  His doc said it will be a piece of cake to remove that polyp through his abdomen.  So, he did.  He got MRSA.  He had to have a long section of bowel removed and now has a colostomy.  After being treated for the MRSA, he got C Diff and spent a lot of time in the VA home locally and got treated for that with IV antibiotics.  A weeks worth was around $7000 he said, but “thankfully”  his insurance covered it. 

A mentor of mine who is also a MRSA victim, injured her ankle years ago.  She had surgery and got MRSA.  She went into sepsis and nearly died and still they were not telling her about her infection….what it was.  She has fought with the legislators in Illinois to get the first MRSA bill passed into law with mandatory Active Detection and Isolation .

I didn’t personally  know the latest victim I have become aware of, but the cause of her death was published in the local paper.  She was a beautiful 67 year old wife of a prominent local pathologist.  She at one time climbed Mount Kilimanjaro.  She was the secretary at the local medical center’s chaplains desk.  What a tragedy.

Another is an ICU RN by profession.  She contracted MRSA at work.  She has had repeated bouts of MRSA related infections.  Currently she lingering illness from recent flu and is seriously ill.  She will go to the ER this morning and we hope she gets the treatment she needs.  She had MRSA pneumonia with sepsis several years ago and she is very frightened of a recurrence. 

I could go on and on.  The stories are incredible.  These people are all intelligent, trusting and until MRSA, healthy people.   Too often the argument regarding MRSA prevention isn’t about all of these suffering patients or their families.  It is all about money and a lot about saving face.  Savings lives and stopping unnecessary suffering rarely comes into the conversation. 

MRSA is brutal, no matter how old you are or in what medical condition you are in.  We have to break the chain of infections by getting hospital screening right and educating everyone on the dangers of MRSA and how to stop the spread of the disease.

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.