Tuesday, November 24, 2009

And a course of leeches?

We all know that washing one's hands reduces the transmission of bacteria, and that the practice is particularly relevant and necessary in hospitals and other health care facilities. Hospitals positively reek with the scent of disinfectant, and we've seen a million TV shows with doctors scrubbing up and unwrapping sterile medical supplies. Hospitals are clean as clean can be, right?

Except... "The Centers for Disease Control based in Atlanta says half of hospital infections could be prevented if caregivers cleaned their hands before touching patients, but 60% of health care workers don't do so," says this article on Ohio's Channel 9 website.

Wait, what? Health care professionals don't wash their hands between patients? I guess it must not be that important after all.

Except... "Every year, 100,000 people [in America] die from infections they get in a hospital, nursing home or other medical facility. That’s more people than die of AIDS, breast cancer and car accidents combined." The problem is that while most bacteria is harmless as long as it stays on the skin, if certain kinds enter the "body through a cut or incision, it can become deadly." Touching one patient after another without handwashing allow a bad strain of bacteria from one person to be transferred to dozens of people healing from surgeries and wounds.

That's ... bad.

"'We have the knowledge to prevent these infections but what has been lacking is the will,'" says Betsy McCaughey, former lieutenant governor of New York, consumer advocate, and founder of RID (Committee to Reduce Infection Deaths). "'Numerous hospitals have reduced their infection rates by 90% in pilot programs with cleaning and screening,' she says ... . Denmark, Holland and Finland had similar rates of infection to ours; they now have have rates below 1%, after changing the way they intake patients."

Wow. That would be 90,000 deaths per year that could be avoided. Imagine if a car company introduced new technology that prevented 9 out of every 10 current passenger deaths. It would be an instant hit. Everyone would be clamoring for it. Unless ... it were prohibitively expensive. That must be the big hurdle in this case: cost.

"'And it’s affordable. The data show that hospitals actually become more profitable by taking these steps,'" says McCaughey. A Leapfrog Group study says that "'hospital-acquired infections add more than $15,000 to a patient's hospital bill, amounting to more than $30 billion a year wasted on avoidable costs.'"

So ... what's the holdup? Accountability. McCaughey, among others, are pushing for a nationwide report-card system that will make available to the public the infection rate for each hospital. That way, each hospital will self-police and try to lower their infection rate as drastically as possible as a way of keeping business in a competitive marketplace.

Colleen O’Toole, president of the Greater Cincinnati Health Council, says we'll get there ... eventually. "'We think that the hospitals here and across the country are going to be reporting infections in some standard way in the not-too-distant future. The question you're asking is how to get from here to there.'"

Sigh. How about a placard reading: "No, seriously, wash your hands, people" at the door to every room? How about a memo: "We are no longer in the dark ages, medically speaking, so act like it."

In the meantime, the article concludes: "All our experts advise patients and families to speak up when they visit doctors, hospitals or nursing homes. Ask every doctor, nurse or technician to wash his or her hands."

Personally, I'm going with the placard.

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