LBmuskoka's picture

LBmuskoka

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A Picture of Poor Health

Take a close look at the numbers, what is wrong with this picture....

Source Mother Jones

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Tabitha's picture

Tabitha

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what is wrong is the numbers are not substainted, or at tleast the article says that.

LBmuskoka's picture

LBmuskoka

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Oops sorry Tabitha, the numbers in that picture are substantiated, they come from WHO.  It was the numbers in the original article saying the US was lagging behind other countries, the above graph was used to dispute the other article ... my bad for not providing both links.

 

Sadly Canada is one of the leaders in Hospital Infections and I have to wonder why.

 

I had an interesting conversation with someone in the health field who came from Sweden and now works in Ontario.  His comment was 'poor design' and cost cutting.

 

One of the proven reducers of infection spread is something very simple - hand washing.  The fellow above pointed out that in Sweden sinks are placed at every room exit to facilitate hand washing. 

 

The other issue he raised was wearing work clothes to work.  If hospital staff wear their uniforms while travelling to hospitals there is a likelihood of bringing infections into and out of the hospitals. 

 

This led to a discussion about using disposable gowns and masks - standard procedure is that one removes both before leaving the infected room and immediately disposing of them.  In the rush of a busy budget conscious hospital the question becomes, is this happening enough?

BetteTheRed's picture

BetteTheRed

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I wonder how much of it might be attributed to the use of antibiotics in factory farmed animals? A lot of these infections are a result of antibiotic resistant bacteria. 

revjohn's picture

revjohn

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Hi LBmuskoka,

 

LBmuskoka wrote:

Oops sorry Tabitha, the numbers in that picture are substantiated, they come from WHO. 

 

Even so the article indicates that there is a discrepancy in determining which infections were attributed to hospitals and who died from those infections.

 

Kevin Drum wrote:

That's a modest difference, and it gets even more modest when you read about these estimates, which are very, very rough and depend strongly on exactly how you count infections and how you attribute deaths.

 

Given that the goal of hospitals is actually to cure and not kill the estimates appear alarming.  

 

Given that a large proportion of people who are in hospital are health compromised to begin with I would expect hospital populations to have higher incidences of infections and deaths than general populations.

 

I also wonder if something like an outbreak of norwalk virus at a senior's centre attached to a hospital (such as in the neighbouring community of Simcoe is experiencing) inflates those statistics in any way.

 

Which is not me saying that there are acceptable rates of infection and death.  It is me questioning how, given the pre-existing conditions of a hospital in general, these percentages compare to general population and normative conditions.

 

Stats are funny (in an odd and not a ha-ha sense) that way.

 

Grace and peace to you.

John

 

 

carolla's picture

carolla

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LBmuskoka wrote:

........I had an interesting conversation with someone in the health field who came from Sweden and now works in Ontario.  His comment was 'poor design' and cost cutting.

 

One of the proven reducers of infection spread is something very simple - hand washing.  The fellow above pointed out that in Sweden sinks are placed at every room exit to facilitate hand washing. 

 ..........

This led to a discussion about using disposable gowns and masks - standard procedure is that one removes both before leaving the infected room and immediately disposing of them.  In the rush of a busy budget conscious hospital the question becomes, is this happening enough?

Hi LB - unfortunately I couldn't see the pic/graph you posted - something weird still happening with that for me.  But from the gist  of it ... I do agree with your Swedish friend regarding design.  Where I work, we do have rigorous infection control - it is a life threatening issue - I say that from daily exprience, and from having worked through the SARS epidemic some years ago.  And as RevJohn commented ... hospitals contain many more germs, and many more frail and immunocompromised people.

 

 Design is indeed a problem in many of our hospitals - handwashing sinks are at a premium.  Because of that, our staff procedures centre first on rigorous utlilization of hand sanitizers (for applicable conditions, with  hand washing when proven more effective) at 4 specific points of contact with every patient.  Staff are (covertly) observed & compliance is audited (we have several staff members who are exclusively assigned to infection control matters)   Sanitizer is dispensed to patients hands when their meals are delivered.   Patients are encouraged to ask staff to sanitize their hands before touching them.  Sanitizers are actually the method of choice now for majority of conditions, as opposed to hand washing.  Easier on staff skin too.

 

Utlization of suitable protective equipment (gloves, gowns, proper masks & faceguards) is mandatory when in proximity to any patients on specific precautions - not only for staff but also for their visitors.  Staff are tested every couple of years for 'mask fit' - so staff know which masks fit their face best.   Gear is donned & doffed on each entry & exit to the patient room.  Yes - it is very expensive, and time consuming, and often uncomfortable to wear, and it creates substantial 'waste' products.  And it is lifesaving.

 

We have a number of 'negative pressure' rooms - for those on airborne precautions, so air from the room is hepa-filtered and expelled from the building, and does not enter the hallway or hospital air circulation.

 

If an admitted patient has ANY loose stools, specimens are sent immediately  for culturing to ensure prompt identification & treatment of any infections. 

 

All newly admitted patients who have been in any hospital within a particular time frame are routinely swabbed (in multiple body locations!) for MRSA.  

 

Cleaning services are extremely important in infection control - not just for the rooms, beds, furniture, curtains, bathrooms etc, but also for all the equipment used in contact with patients - even simple stuff like stethescopes, wheelchairs, blood pressure cuffs, therapy equipment,  etc.  Some hospitals contract out cleaning service to reduce costs & I think this is not necessarily the best practice.   Availability of clean gowns & linens for patients is important, and sometimes supply is compromised, also based on cost.  

 

And these are just some of the day-to-day routine measures - not venturing into the ICUs or operating rooms, delivery suites, etc. etc.  So yup - it's expensive.

 

Re the practice of not wearing uniforms & shoes outside of hospital - no longer a required practice.  It's far less likely (I think) to 'bring something in'  than to communicate it from patient to patient due to poor practices once in the workplace.

 

Anyway ... enough from me!!  But keep washing your hands out there folks!! 

LBmuskoka's picture

LBmuskoka

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Again I apologize, I used the chart to show our Canadian rate versus other industrial nations, the article is related to the US.

 

Here is a better article, but without the pretty graphic ;-)  Canada carrying high health-care-related infection rate: WHO

 

What's more, Canada's "health-care-associated infection" rate — at 11.6 per cent — is one of the worst among developed countries, according to the Report on the Burden of Endemic Health Care-Associated Infection Worldwide 2011.


In the United States, it's as low as 4.5 per cent, the report says, while the European Centre for Disease Control says Europe's is 7.1 per cent.

 

(As an aside the above article also gives a hint to where Kevin Drum made his mistake in his first article, more Americans die from infections than Europeans even though they have a statistically lower infection rate)

 

As Carolla points out cleaning is the most effective way to prevent the spread of infection.  In study after study it has been proven but it relies on two factors, funds for the cleaning products and human vigilance.

 

Our current health care climate is one that is focussed on "cost cutting", the question that needs to be answered given our nation's poor performance on infection control; is what role does this focus play?  Are hospitals faced with increasing budget pressures (and my local hospital is one of them) contributing to higher rates by reducing staff?  Do staff reductions lead to poorer vigilance because staff are "rushing" from one patient to another?

 

And yes, statistics are funny, and I know I could be wrong but until proven otherwise I don't accept that our Canadian patients are more compromised than our European or American counterparts, and if they are, don't we think that is something to be concerned about as well?

 

 

Statistically, the probability of any one of us being here is so small that you'd think the mere fact of existing would keep us all in a contented dazzlement of surprise.
      Lewis Thomas

 

seeler's picture

seeler

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My question is not related to the topic but to RevJohn's post on the thread.

 

revjohn wrote:

Kevin Drum wrote:

That's a modest difference, and it gets even more modest when you read about these estimates, which are very, very rough and depend strongly on exactly how you count infections and how you attribute deaths.

 

Grace and peace to you.

John

 

 

I have reread the thread up to this post.  I cannot find any post by Kevin Dunn.  In fact, I don't remember ever seeing anybody with the user name "Kevin Dunn" on the WonderCafe.

 

How can a person 'quote' somebody who hasn't posted?

 

BetteTheRed's picture

BetteTheRed

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Kevin Drum was the author of the original article on Mother Jones news. He's a blogger with them.

seeler's picture

seeler

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Thanks

ninjafaery's picture

ninjafaery

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As a person who provides personal care to people in a residence, I also practice infection control on a routine basis and have the fitted mask in case of an outbreak of something nasty. There are lots of germs around. I also know that the rate of non-compliance is too high. I believe the reason might be that staff don't change the practices they use (or don't use) at home when they are working.

There are signs everywhere reminding us of proper handwashing measures and sanitizers in every room, but it still gets overlooked sometimes.

Another area of concern is dishes and cutlery. Everything should go into the dishwasher/sanitizer, but I still see things just hand washed and dried with a tea towel. Not good.

I wonder though if some bacteria have become resistant due to the overuse of antibacterial products resulting in strains that don't respond well to treatment (MRSA). I think simple soap and water is sufficient in most cases.

 

As for the waste problem, it must be addressed IMO -- and soon or we will be overrun with bio garbage. Mountains of used gloves, gowns, briefs etc. -- even washcloths are disposable now. No one gets a "real" wash with soap and water anymore. They use disposable sponge bath kits.

Is there no way that these items can be safely laundered or washed and sterilized like they used to be? Surely to goodness the technology must be available to at least allow items to be reused a few times. This really  bothers me.

 

 

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