The World Health Organization’s new patient safety envoy will take on health care acquired infections in his new role, he announced last week. Liam Donaldson, England’s former Chief Medical Officer, pointed out in his first report as envoy that patient safety incidents occur in 4% to 16% of all hospitalized patients, and that hospital-acquired infections affect hundreds of millions of patients globally.
A WHO report outlined the problem.
High-income countries had pooled health care acquired infection rates of 7.6%. The European Centre for Disease Prevention and Control estimated that 4.1 million Europeans incur 4.5 million health care acquired infections annually. In the U.S. the incidence rate was 4.5% in 2002, or 9.3 infections per 1,000 patient-days and 1.7 million affected patients.
In Europe, these infections cause Read more »
*This blog post was originally published at ACP Hospitalist*
For those of you planning air travel to your next medical conference (and ACP Internist isn’t too shameless to plug Internal Medicine 2011 — we hope to see you there), TIME reports that there are five health risks that are rare yet have recently happened. Tips on avoiding these maladies include:
— E. Coli and MRSA on the tray table. Microbiologists found these two everywhere when they swabbed down flights. Bring your own disinfecting wipes.
— Bedbugs in the seat. British Airways fumigated two planes after a passenger posted pictures online about her experience. Wrap clothes in plastic and wash them.
— Sick seatmates. Everyone has experienced (or been) this person. Wash your hands.
— Deep vein thrombosis (DVT). Tennis star Serena Williams experienced a pulmonary embolism, possibly related to recent foot surgery. But DVT can happen to anyone restrained to a cramped position for long periods of time. Move around in-flight (but not during the beverage service, of course.)
— Dehydration. Dry cabin air may make it more difficult to fight off infections. Drink more water.
*This blog post was originally published at ACP Internist*
I’m diligently writing a detailed note in the patient’s chart as he speaks of his multiple concerns — severe depression, headaches, and dizziness. I’m not making good eye contact. Often this is effective because I can resist the allure of passively following his narrative to its own diagnostic suspicions. Instead I can record his intuitive guesses without persuasion, formulating my own independent ideas even as I value his. Except that as I write in his chart I notice streaks of red blood appearing among the black script. Am I hallucinating? Am I capable of making paper bleed? Am I, the doctor, bleeding?
With closer inspection I notice three small cuts on my chapped knuckles and fingers, products of the incessant and obsessive handwashing compelled by modern medicine. We are obliged to wash our hands before and after each patient contact, which leads to about 60 hand washings per day. In the dry winter air this can become punishing to the integrity of the skin barrier.
I apologize to the patient for marring his chart, yet it almost seems symbolic — physician blood spilled upon a script of human affliction. I know I should tear the page out of his chart and write a clean new one, yet the scrawls of black ink and stripes of red blood look like art. It is a poem, punctuated with living iron and crimson flourish. Despite having made poor eye contact in an attempt to distance and strengthen my consideration of his symptoms, ironically I see the commonality of our bleeding.
*This blog post was originally published at The Examining Room of Dr. Charles*
Can your dog give you MRSA? Sharing with your dog is wonderful — unless you’re sharing bacteria. Pets can harbor harmful germs to pass on to you.
Staphylococcus bacteria is a common cause for skin infections in people and animals. A virulent strain of staph, called MRSA, has made headlines for school outbreaks and fatal infections. MRSA infections are usually blamed on dirty locker rooms and contaminated gym clothes, but the source for an infection might be in your lap right now.
Here are five ways to avoid catching an infection from your pet:
1. Your pet’s mouth is not clean. It’s teeming with bacteria. Don’t let your pet lick your wounds. A dialysis patient once contracted a life-threatening pasturella bacteria infection from his beautiful golden retriever this way.
2. Keep open wounds covered. Contact between your wound and your pet could spread bacteria such as MRSA. Read more »
*This blog post was originally published at The Dermatology Blog*
Some interesting items this week involving hands. The one which has gotten much news coverage is the issue of handwashing. Take a look at some of the headlines:
High five! Handwashing on rise (Chicago Sun-Times)
For Many, ‘Washroom’ Seems to Be Just a Name (The New York Times)
93% of women wash their hands vs. 77% of men (USA Today)
All the above are reporting on the same study, but the difference in presentation is amazing to me.
The study doesn’t involve handwashing in a hospital or doctor’s office setting. The JAMA article (2nd reference below) does, but this article focuses on whether public reporting of handwashing compliance is helpful or not. Do we inflate our numbers to make ourselves look better? Read more »
*This blog post was originally published at Suture for a Living*