Incidents of harm resulting from medical care

[VentMedic]

http://www.emsresponder.com/features/article.jsp?id=5774&siteSection=4

We Don't Mean to Hurt Patients
Incidents of harm resulting from medical care are all too common. How can EMS reduce its share?

By Mike Taigman

quotes from article

Five Million Mistakes
Last December Don Berwick, MD, president and CEO of the Institute for Healthcare Improvement (IHI), set a 24-month goal: to protect patients from five million incidents of harm over the next two years. Research indicates that more than 15 million instances of medical harm occur in U.S. hospitals each year--a rate of over 41,000 a day. That means 35.2% of all people admitted to hospitals in America will experience some sort of injury while being cared for. The IHI defines medical harm as "unintended physical injury resulting from or contributed to by medical care (including the absence of indicated medical treatment) that requires additional monitoring, treatment or hospitalization, or results in death."

What, you may ask, does this have to do with me and my EMS service? For one thing, my guess is that many of the infections and pressure ulcers that are listed as "hospital acquired" get their start in the backs of our ambulances. Think about it: We treat or transport millions of patients each year. Many of the sickest patients admitted to hospitals start their healthcare journeys in the backs of our ambulances.

MRSA also can be transmitted through infected equipment. One study cultured the neckties worn by 42 physicians at the New York Hospital Medical Center of Queens and found that nearly half of them contained bacteria. Another study that looked at the stethoscopes of nurses and physicians in emergency departments found staph and 13 other pathogenic microorganisms. Analysis of the cleaning habits of ED staff found that 45% cleaned their stethoscopes annually or never. There are several pieces of equipment we use that touch multiple patients during the course of a shift. Backboards, stethoscopes, blood pressure cuffs, blankets and stretcher straps are not regularly decontaminated between patients in most EMS services. It is time for us to develop equipment, systems, practices and protocols to ensure we're not transmitting infections from one patient to another during the course of our care.

http://www.emsresponder.com/features/article.jsp?id=5774&siteSection=4

Related article:
White Coats and Neckties Banned in British Hospitals
http://news.yahoo.com/s/ap/20070917/ap_on_he_me/doctor_dress_code;_ylt=ApW4sY7gupWbSm6RYH.pW9lZ24cA

LONDON - British hospitals are banning neckties, long sleeves and jewelry for doctors — and their traditional white coats — in an effort to stop the spread of deadly hospital-borne infections, according to new rules published Monday.

 

[BossyCow]

Just saw something similar on a Canadian news show. They filmed healthcare workers, working around patients and going from patient to patient without washing hands in between. One of the Doc's interviewed said that in the Netherlands they have almost eliminated MRSA and Staph by very agressive infection control policies.

 

[Ridryder911]

Thanks for posting Vent.. I do believe that Mike has opened a can of worms (as he usually does) that most do not want to address or admit. There are many other instances that he addressed as well in the article of errors of treatment. Fortunately, most of our treatment is very limited and dosages and occurrences can be limited.

I have witnessed, accidental over dosage, wrong ventilator settings, etc. Yes, we are all human and I myself make multiple mistakes, hopefully not fatal, but attempt to still learn of them.

Once in a while I will culture steering wheel and leave a petris dish in a EMS unit. It is amazing the cultures one will obtain. I believe in "spot checking" witha U/V light as well of medics hand, to display the "supposed clean hands" they thought they had. I am always amazed of medics not washing their hands prior to gloving up. Remember, gloves only give partial protection and one of the main reasons of gloving is for the patients sake. As well, as be sure to wash after removing gloves.

R/r 911

 

[BossyCow]

And all those areas that we don't think of as contaminated. One day I was looking at the key pad for the entrance into the ER. Hmmmm do I really want to touch that without gloves? This is touched by everyone bringing a pt to the ER.

I'm astounded too by the way we sometimes act like the gloves are magical germ killing garb. They are a barrier only, they can take whatever ickies we touch and transport them to the next thing we touch.

 

[Airwaygoddess]

Ambulances.....

This brings on a whole new meaning to the importance of cleaning and decon of ambulances. I would just like to point out how many nursing home patients are positive for MRSA, and that ambulance equipment is not properly cleaned after these type of transports, or for that matter all transports. I hate the attitude of "we are too busy for that" or "that's grunt work" I have seen too many nasty infections in my career. Sigh.....

 

[daemonicusxx]

I think its a good idea that we pay closer attention to infection control procedures, but the medics and EMT's are not the only ones that need guidance on how and why we need to do this.

supervisors and dispatchers should also understand this. if it takes me 30 minuites more than normal to clear up from the er due to decon, i should be alloted that time.

i just have big issues when im trying to clean my equipment properly to prevent the spread of infection, and my pager is burining up with "how much longer are you gonna be, granny keeps calling and is impatient, and wants to know when you are gonna be there" messages. supervisors calling, dispatchers calling.

PT spewed MRSA'fied sandwiches with a little bile added for flavor all over the back of my ambulance. left to right spray. all in the groves. this is gonna take me longer than a couple of minuites, as i cant find a water hose.

i liked the one where the comms sup wanted to know if we could get back on the road and let the 3rd rider clean up while moving... yea, like he is going to be able to do that with his seat belt on. i would have let him explain to that kids parents why her son was critically injured due to we didnt want to roll a call, and we wanted more money.

what happens when i step on the brakes and all that spew comes rolling into the cab?

i guess in the private services, priority's are all kinds of messed up. you can try to explain to the bosses all day long, but they would never understand.