Ten states require hospitals to screen all ICU patients for the antibiotic-resistant superbug. New research, however, shows that approach may not work.
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Month: April 2011
Hospitals’ high-tech tools track who’s washing their hands
My lede:
More hospitals are exploring new technological alternatives to the traditional “secret shopper” method of monitoring whether physicians, nurses and other health professionals clean their hands when they are supposed to.
Systems using wireless, infrared, radio frequency identification and alcohol-sensing technology offer the promise of more accurate data on hand-hygiene compliance while gently reminding forgetful health professionals to wash up before interacting with patients. So far, hospitals are using the technology to gauge their hand-hygiene performance and encourage compliance while steering clear of using the data in punitive ways.
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Humanizing anatomy: a medical student’s first patient
My lede:
Most people do not choose their names, but they can choose to love them, loathe them or change them. About a decade ago, one woman was known as Mercedes — like the German luxury car. It was not the name her parents gave her. It was not how she was listed on her death certificate.
Mercedes was the name she was given by a medical student dissecting her cadaver as part of the gross anatomy course at Indiana University School of Medicine Northwest in Gary.
“Why do you call her Mercedes?” asked anatomy instructor Ernest F. Talarico Jr., PhD.
“Because,” the student said, “she’s going to enable me to purchase a bunch of Mercedes.”
For Talarico, the student’s comment was the wake-up call that things needed to change. “That wasn’t what we were trying to communicate or trying to teach,” he said.
The experience of dissecting a cadaver in a lab always has separated the medical profession from the rest of society, but ideas about what — beyond basic anatomy — that rite of passage should teach have evolved.
In the late 19th and early 20th centuries, dissection was seen as a transformative event, and medical students used black humor to defuse tensions surrounding what was then seen as a quasi-legal and ethically questionable activity. In the mid-20th century, anatomy became an opportunity for physicians in training to develop a skill that medical sociologists called “detached concern.”
Today, most medical schools opt for a more humanistic approach that uses ritual ceremonies to thank cadaver donors, encourages students to reflect on their experiences and, in some cases, allows students to meet and correspond with donors’ loved ones.
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1 in 3 patients harmed during hospital stay
My lede:
One-third of hospital patients experience adverse events and about 7% are harmed permanently or die as a result, according to a study that detected patient safety problems at a far higher rate than other methods.
The study, in April’s Health Affairs, echoes two reports issued in November 2010 that showed rates of adverse events hovering near 25% among hospitalized Medicare patients nationwide and at 10 North Carolina hospitals.
The findings draw attention to the safety troubles that have lingered in U.S. hospitals in the 12 years since the Institute of Medicine’s headline-grabbing report “To Err is Human.” The study cited research estimating that up to 98,000 patients die each year due to preventable medical errors.
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Walmart’s anti-hunger program
Chicagoans’ irrational hatred of Walmart appears to continue unabated, as evidenced by a zoning hearing held Monday regarding a proposed grocery store in the well-to-do Lakeview neighborhood. Among the many misguided or myopic reasons to oppose the mere opening of a Walmart store, perhaps this one reported by the Chicago Tribune’s Dawn Rhodes counts as the dumbest:
“I don’t want them in this neighborhood, and I wish they would hear us saying no,” said Erin Edwards, 27, who works for North Side Anti-Hunger Network. “I’m all for job creation. But it would be wonderful for the people in this neighborhood to have the small stores that can provide fresh produce and to be able to pay their employees well so they wouldn’t have to need our services.”
Guess what, Ms. Edwards? Walmart is an anti-hunger program. The new Walmart grocery store could save shoppers anywhere from 20% to 33%. Walmart, all by itself, accounted for a 10% drop in U.S. food prices from 1985 to 2004, saving individuals nearly $900 a year and households more than $2,300 a year. And Walmart is slashing prices even further to compete with Target, whose prices are slightly lower in Chicago.
So, those people in low-wage jobs who might occasionally take advantage of whatever food pantry services the North Side Anti-Hunger Network provides will benefit far more from vigorous, open competition for grocery shoppers — including Walmart. How many Chicago families could pass on help from a food pantry with a weekly grocery bill that’s 33% cheaper, or an annual savings of $2,300?
Those savings would dwarf the slightly lower wages (perhaps 2%) offered to the few hundred people who will staff the Walmart. That cost-benefit comparison assumes, by the way, that there are hundreds of higher-wage, entry-level jobs that would somehow magically appear if only Walmart could be prevented from opening its store. Are those small stores that supposedly pay so well hiring hundreds of new workers in our still slumbering economy?
Hate Walmart, if you must. Picket. Try to organize their workers, if you want to press your luck. But rest assured that you’re not doing poor folks any favors by denying them a valuable shopping choice.
Financial ties to industry widespread on clinical guideline panels
My lede:
More than half of the people serving on cardiovascular guideline-writing committees between 2004 and 2008 had financial conflicts, according to a March 28 Archives of Internal Medicine study that sheds new light on the pervasiveness of financial ties to industry among the experts who make the clinical recommendations that shape medical care.
The new data arrived only days after an Institute of Medicine panel proposed wide-reaching standards on how clinical guideline panels should manage and limit conflicts of interest.
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Medical oaths less of a moral compass for physicians
My lede:
Most physicians take part in a medical school oath ceremony, but few believe that the rite of passage has strongly shaped their sense of professionalism, according to an article published March 14 in Archives of Internal Medicine.
Nearly 80% of 1,032 practicing physicians surveyed in 2009 said they took part in a medical school oath ceremony using the original or modified version of the Hippocratic Oath, the Osteopathic Oath, the Prayer of Maimonides or the Declaration of Geneva. However, only 26% said the oath they took significantly influenced their practice of medicine or provided moral guidance in their medical careers.
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