Arkansas Blog

So do I -- a vital happy-go-lucky man who, with his wife, had a long list of things to do and places to see in retirement. A relatively minor in-and-out surgical procedure put a stop to those plans. The infection localized in his upper spine. Outcome: alive, but a quadriplegic. He lives in a nursing home because his wife cannot care for his physical needs although she tried for months. His days? He watches the drive for her car. Hers? Daily trips between home and nursing home, punctuated with visits to her doctor, primarily for stress related illnesses.
Watch that doctor, that nurse, that therapist, that aide, that chaplain. See how often they use the hand cleaner provided on the wall if you don't remind them. Then never leave your loved one alone if you can help it -- and hope the surgical suite staff do their jobs only after disinfecting thoroughly.

A friend died last week from staph infections that flared up following surgery performed in his hospital room. I was told that he had used up his Medicare allowance, was dismissed without further treatment, and died.

Frightening. I'm in and out of a nursing home several times a week.

My mom was in the hospital for a week in August--staph infection in her saliva gland. The doctors think that may have happened due to dehydration. Not sure how that happened because she drinks plenty of fluids. The right side of her face was swollen up pretty big. No sooner than I got her well, my oldest brother got a staph infection on his scrotum!! Of all places. He said he picked at an ingrown hair, it got infected, and he ended up spending 3 days at Baptist. The docs operated on the infected area. Now, his wife is recovering from staph on her right thigh. Their doctor prescribed for both of them an antibiotic to put in their nostrils. They were also told to bathe with a capful of bleach and to wash all their sheets and undergarments in bleach. My doctor told me on Monday that I am probably carrying the staph bug, but it has yet to manifest itself into an infection. Knock wood!

Big problem. I have an older customer who went in for foot surgery a couple of years ago and contracted staph. He finally ended up having surgery again to remove his little toe.

Fast forward to today, he went in three months ago to have rotator cuff work done on his left shoulder and after they cut him open they sewed him back up. Staph in his left shoulder. He has been at Woodland Heights for the last three months on an antibiotic drip and hopes to return to Parkway Village in the next month or so. Lost all movement in the left shoulder, arm and hand.

It's Hell trying to navigate a Walker with one good hand.

I am no medical professional, but my friends who are tell me that 90% of staph infection is caused by poor handwashing and lack of gloves.
Certain hospitals are noted for high rates of staph. Best advice is to have family members present at all times and make sure that EVERYONE washes their hands and puts on gloves before they come near the patient.

More staph is spread by neckties than unwashed hands (who wash their hands all the time). British health service has banned them. So should we, finally.

Sorry, brain-skid. DOCTORS wash their hands all the time, put on gloves, etc, etc, but their neckties seldom even make it to the cleaners. The Brits are taking action.

>>I am no medical professional, but my friends who are tell me that 90% of staph infection is caused by poor handwashing and lack of gloves.<<

My partner is a nurse & a director of nursing. She tells me over and over to wash my hands. Never a quickie wash. A thorough washing (way up past your wrist) is the only thing that will do it. Kills more germs than any disinfectant or method. When you visit a hospital DO NOT PUT YOUR HANDS ANYWHERE NEAR YOUR FACE. If you have cut or laceration that is healing DO NOT VISIT A HOSPITAL.

If you visit someone in the hospital wash thoroughly before and after leaving the room.
And those antibacterial soaps----useless. In fact they can help produce a more disease resistant strain of bacteria in your home.

In some hospitals the staph infections reside in their central air units. The air ducts must be cleaned and sanitized. The bottom-line hospitals and $ strapped public hospitals either won't spend the money or don't have the money to do it.

Other causes are doctors who are in a rush to do hospital rounds. There was one Md in NWA who the nurses chased around or else he would be stripping off patient bandages and tossing them on top of the patient's bed. Standard laundry washing will not kill certain staph strains, only strong bleach will do it.

Not enough rubber-plastic gloves creates another problem. If the infected patient's bedding is contaminated and the Nursing Assistant comes in to strip the bed without gloves then proceeds to the next room to strip and change a bed the staph is spread. Likely the Nursing Assistant is not allowed time to thoroughly wash their hands between rooms.

When I was hospitalized last year my sweetie happened to be there when they came in to change my bedding. She firmly (in her bossy voice) and politely insisted they wash their hands before proceeding. If you have a loved on in for surgery insist the personnel wash their hands (in the sink in the room) before changing the bedding.

When you visit a hospital DO NOT PUT YOUR HANDS ANYWHERE NEAR YOUR FACE.

Best thing will be a huge lawsuit in selected states provided the line of evidence is strong. The problem is finding an insider who would be willing to testify. Such an insider would never work again in healthcare, at least not in this country.

Now that Danny Glover did us all a lousy favor by limiting lawsuit awards in Ark you can expect little help in the way of litigation remedies. There's simply not enough award allowed for gathering up all the evidence/witnesses to win a major suit. Good luck.
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Unlike eLwood I don't feel that paying a single lawyer hundreds of millions of dollars for a single case is necessary. Recently Medicare passed a law that says MC won't pay for care that is required to treat a complication that occurs while the patient is in the hospital.

This means when the patient comes in for a carpal tunnel and ends up requiring 6 months of care and constant IVs, the hospital is on the line for that. It will get expensive enough in a hurry.

What will mean. Some hospital teetering on the brink financially will close and doctors may move on out of those communities.

People like msquare above, (and her staph colonized nose) will be banned from the hospital. Maybe most non-essential visitors, including clergy that flit from patient to patient, checking off names on their list and moving bacteria room to room. Florists will howl as Arkansas hospitals follow the lead from other states and ban those vases filled with bacteria laden water.

Handwashing will continue to increase. Note the bottles of soap outside the door of every room.

And unfortunately, MSRA STILL isn't going to go away.

A long time ago in a land far-far away (ok, 29 yrs ago on the east coast) I contracted staph infections twice after knee surgery. The second time left me in the hospital in isolation for a month, missing a chunk out of my surgical scar.

The culprit? Post-operative drains which can literally act as a conduit of any and everything airborne outside of the body into the body.

If you know someone is having surgery make sure to ask about post-op drains and prophylactic antibiotics. Drains shouldn't stay in longer than 48 hrs.

Unfortunately most Americans are clueless when it comes to causality.

Britain has been trying to deal with multiple antibiotic-resistant Staphylococcus aureus for several years. In America, where money makes the world go around, cataloging how many people you kill may not be in your best financial interest. Although British studies have indicated that failure to sanitize hands, clothing, jewelry, linens, equipment & facilities may be contributing to increased infection rates, it should be noted that washing your hands does not kill the micro organisms, it removes them. The failure of American medical establishment to follow these basic rules has been repeatedly documented. The excuses are legion. Europeans are also finding their livestock is infected with MRSA, but since we don't check, we don't have that problem.

I find it curious that some still repeat tired old excuses.
"Unlike eLwood I don't feel that paying a single lawyer hundreds of millions of dollars for a single case is necessary. Recently Medicare passed a law that says MC won't pay for care that is required to treat a complication that occurs while the patient is in the hospital.
This means when the patient comes in for a carpal tunnel and ends up requiring 6 months of care and constant IVs, the hospital is on the line for that." Posted by: mudturtle

How is a hospital "on the line" when no penalty is involved?
I thought that when costs for malpractice insurance did not go down after "tort reform" we'd stop repeating that falsehood. A business only pays when it must, and even then it's kept a secret. Try to bring a civil suit and you'll quickly discover who can afford more justice. In some countries criminal charges apply, but America prefers not to do that with white collar.

Imagine having to check the tires, fuel, weather and runway conditions of a commercial flight because you knew the people doing the work were: under-paid, under-trained, under-staffed, sleep deprived or any of the other excuses we get in order to mitigate culpability.

Now consider that these are merely the symptoms of a dysfunctional system. When we hear that our health is at risk and our medical system crumbling from: lack of rural health services, illegal aliens, too many old people, terrorists with biological , pandemics, injured vets or whatever the excuse du jour; what we are really saying is some people are more important than other people.

"Too many good docs are getting out of the business. Too many OB/GYN's aren't able to practice their love with women all across the country." George W. Bush

There is a word for this type of illness - iatrogenic, "induced inadvertently by a physician or surgeon or by medical treatment or diagnostic procedures". Kinda chilling, eh?

How is a hospital "on the line" when no penalty is involved?

Gee that's easy. That patient who stays in the hospital for 60 extra days runs up a $1,000,000 bill and the hospital only gets paid the $20,000 they were expecting for 48 hours. That's a $980,000 penalty. The poor patient above who ended up a quad will run up a $10,000,000 bill, the hospital doesn't get paid an extra nickle for years of care.

And that's true even if Aunt Sue had the bad bug in her nose and picked it just before she helped feed patient Joe Bob.

MSRA is bad stuff. It is in the UAF athletic facilities and in classrooms across the nation. It kills people who were never in the hospital. We aren't ever going to kill it. Probably not ever really contain it. Maybe if you get it, we ought to treat you like a cow with antrax and put you down rather than taking the risk that the doctors and nurses and family caring for you will spread it!

The last hospital I was in had a can of alcohol foam outside every single room with directions to use it before entering the room. Hand washing is a great first step, and second, and third. Unfortunately as long as people shake hands, use water fountains, deliver food trays, change linens, and visit the sick the MSRA is going to silently ride along and disperse.

>>Recently Medicare passed a law that says MC won't pay for care that is required to treat a complication that occurs while the patient is in the hospital.<<

Zatharus , you better hope the hell your not that patient. You can bet they want you out of there asap whether you need additional care or not.
I prefer the attorney looking over their shoulder rather than Russian roulette with Medicare rules.
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Let us pretend for a moment that the hospital personnel infect a patient with a disease that MC or insurance will not cover. This does not mean they treat the patient for free. Furthermore, if the patient does not have coverage, the rates charged generally go up, not down. So the patient now has a $10,000,000 bill which they can ill afford, for something the hospital was making a profit at while charging less. Assuming that the patient has no job (otherwise the hospital will take part of their wages) then the hospital will reduce its tax liability by calling the loss charity. Again note, they charged the uninsured patient more than the insured patient. I still don't see how the hospital is "on the line" unless said patient (who has no money now) hires a lawyer who gets an expert witness (a tattle-tale doctor "of the same specialty as the defendant") and convinces a jury. Now said patient gets to the appeals level, where many cases are dismissed or damages are severely reduced. Now compare the $10,000,000 bill with tort reform (Among other changes, Act 649, the tort reform law, limits punitive damages - which are meant to punish defendants for particularly bad behavior - to $250,000 or three times the amount of compensatory damages awarded if that amount is less than $1 million.) After all this, malpractice insurance (which is already figured into the bill as a cost of doing business) prevents the medical provider from suffering a loss except for punitive damages. I do not call this "on the line"; the term generally used is "off the hook".

"To really know is science; to merely believe you know is ignorance." Hippocrates