Patient Safety--Infections

“I’ve got a medical trivia question for you, Jaded Julie. What disease was called ‘the old man’s friend'?”

“You certainly should be an expert on that ‘old man’ stuff, Old Man. It’s not a disease, but I always thought that a young wife was an old man’s friend, especially if he had money.”

“Get serious, Julie. The ‘old man’s friend’ was pneumonia (Streptococcus pneumoniae) (1). When an old man was suffering at the threshold of death, the Grim Reaper would arrive in the form of pneumonia and administer the coup de grace.”

“(Coo de what? I guess it means ending the old man’s misery.) Interesting story, Curmudge, which most likely is the introduction to a lesson.”

“It is, of course. Modern antibiotics came along and ended S. pneumoniae’s reign. People felt that most any bacterial infection could be zonked by an antibiotic. Unfortunately however, the bugs got smart and evolved into drug-resistant strains. Now we have infections from bacteria like MRSA (methicillin-resistant Staphylococcus aureus) (2), Stenotrophomonas maltophilia, Pseudomonas aeruginosa, vancomycin-resistant enterococci, and others (3). These are enemies of people of all ages and certainly not anyone’s friend.”

“(One might be my friend if the ‘old man’ were my rich uncle, but I’d better not say that out loud.) MRSA is the one with the greatest amount of well-deserved bad press. It appears most commonly as a skin infection.”

“Right, Julie, but ‘in health care settings, MRSA is a frequent cause of surgical wound infections, urinary tract infections, bloodstream infections (sepsis), and pneumonia.’” (4)

“I shudder at the thought, but I know some things that we can do.”

“With infections as potentially serious as these, ‘we’ is everyone, from health care workers like you to folks like me who might become patients.”

“Let’s start with patients, Curmudge, and what they might do to minimize nosocomial infections.”

“Noso…what? Oh, I suppose you mean infections acquired in the hospital.”

“Of course I do. Curmudge, you’ve known what nosocomial means since you were 70 years old.”

“Just kidding, Julie. So what can hospital patients do to avoid infections?”

“Stay out of the hospital, but sometimes being in the hospital can’t be avoided. Once you‘re there, don’t stay a minute longer than is necessary. Have a single room, and wash your hands (or have your hands washed) as thoroughly as you expect your caregivers to wash theirs. Learn the 15 Steps You Can Take to Reduce Your Risk of a Hospital Infection (5). And if you have a choice, go to the hospital with the best safety record. An increasing number of states are requiring hospitals to report their infection rates (6).”

“As I have said all along, health care quality and safety go hand-in-hand. It’s no secret that a hospital with a culture of quality and safety is also a great place to work. The patient-to-be should inquire about the cultures in the hospitals in his/her community.”

“So now that we have alerted the potential patient about what to do and look for, are we going to talk about what a hospital can do to reduce its infection rate?”

“Next time, Julie.”

Affinity’s Kaizen Curmudgeon

(1) Personal communication many years ago from Ed Zeiss, MD, who as fate would have it, died from pneumonia at an advanced age.
(2) http://www.mayoclinic.com/health/mrsa/DS00735/DSECTION=prevention
(3) http://en.wikipedia.org/wiki/Nosocomial_infection
(4) http://www.medicinenet.com/mrsa_infection/article.htm
(5) http://www.hospitalinfection.org/protectyourself.shtml
(6) http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=109&STORY=/www/story/03-08-2007/0004542368&EDATE= and http://www.abouthealthtransparency.org/node/125