wnyc.org / 93.9fm / am 820

Good for you lillym, #29. The outrageous infection control practices of a few doctors and nurses here in the U.S. are indeed appalling. However, I will bet you and I will surely win, that the rate of infections in Italian hospitals is not better than in the U.S. It is not better in Denmark and Holland either and they are the best in terms of practicing hand sanitation.

The hands must be sanitary, 99.99% of pathogens inactivated, immediately before taking care of a patient or touching food and what you describe does not achieve that; not even close. All the infection rate reporting will not achieve it either until people get serious about hand sanitation immediately before touching the patient or handling food. However, the reporting is good because it will force the hands of the administrators to provide the capability.

When I came to USA I was horrified to see how dirty restaurants and hospitals are. I worked in an ice-cream shop in Italy(just serving and not directly touching ice-cream), and we had inspection twice a week: They swiped the floor for lab analysis, they checked the surface of egg shells (we had to wash them first), our nails had to be cut short and no jewlery allowed, we had to put our uniform on when we get inside the shop, no piercings or tatoos,and obligatory hair net PLUS the hat. In New York City I saw nurses sitting on the building steps, sitting in the subway in their uniforms, nurses with very long nails, nurses and doctors picking their noses and ears, talking on their dirty cell phones, wearing their hair loose, and lots of jewlery. Once I even saw a doctor with the stetoscope (!) around his neck in the subway and stetoscope was touching the hand rail. I just hoped he was going to some costume party.
One thing we can do is to bring disifectant wipes when we are visiting patients and disinfect as much as we can in their room. I already do that when sleeping in hotels and using airplane seat buttons.

Brian Lehrer actually got it right #14. Her current full name is Betsy McCaughey Ross. Her maiden name was Elizabeth Peterkin.

Even when HCWs clean their hands between patients as required the first surface they touch contaminates the hands again. Hence sanitizing between patients is virtually useless. Yet this is all they are required to do.

The solution is to sterilize the hands immediately before the patient and patient surround are touched by hands; each time. This will have to be done multiple times during the patient visit. Therefore, a hand sterilizing device must be located at bedside, be small, be safe, non irritating, and very fast. Such a device exists, and it has been demonstrated to work by independent testing. It takes 3 seconds and eventually will get down to 1 second to sanitize the hands against all pathogens including C. diff.

Einstein described insanity as doing the same ineffective thing over and over again. Would you believe that hospital administrators have absolutely no interest in discussing or learning about the device? They just whip the poor nurses to wash more between patients.

Brian, great topic, congratulations. Your guests should know better. Not reporting infection data is hardly the most alarming aspect of the problem.

With proper reporting of the extent of the hospital acquired infections (HAI) problem as done by Pennsylvania, lawyers can begin to sue the hospitals for causing infections by inaction in fixing the problem. The first class action lawsuit for $50 million was filed this week in Canada and the coming deluge will swamp the hospitals. The medical insurance companies will soon start to deny claims relating to HAI, $5.5 billion annually, and that will put more pressure on the hospitals and hospital administrators to finally do something.

All surfaces in hospitals, whether filthy or cleaned once in awhile, are covered by pathogens. Overloaded HCWs wash their hands or use alcohol rubs between patient visits. Typically they do this less than 40% of the time; hands are generally contaminated. Hence they go from patient to patient with contaminated hands and clothing.

Next post; what to do to end HAI?

re: 19, 21

My mother was taught and alway taught her students that hospital clothes were not to be worn outside the hospital, especially around one's family, and street clothes were not to be worn uncovered in the hospital, especially around patients.

I learned to blow kisses at my mother at a very early age as she walked through the door, because she would not kiss me before she at least washed her face. I remember sitting near her while she "performed her ablutions" waiting eagerly for her to be what we called "family ready".

re: 22

At the end of her life when my mother was in and out of the hospital she would not be able to relax until I had come with (non-latex for me) gloves and a container of cleaning cloths and wiped all surfaces (bed rails, bedside stand, telephone, IV pole, WC) thoroughly. The staff would ask what I was doing, and when I told them they just shrugged.

Not only were the emergency, examination, and patient rooms filthy, not dirty, filthy, the staff (excluding the doctors) were rude, loud, and dismissive of patients and their families. The recent incident at Kings County Hospital were a woman died after lying on a waiting room floor for an hour is typical.

There are many types of passive observations which infection control departments of hospitals can run-- such as looking at how fast soap dispensers in staff-only areas have to get replaced, or the hand sanitizer containers refilled outside of patient rooms-- those would not violate patient privacy. Handwashing is known to be the single best preventative behavior. About other ways of transmitting infections between patients-- how often does the TV remote control get cleaned, for example, or the faucets or bed table surfaces and controls, or even the telephone? Stethescopes cannot go from patient to patient without being cleaned either!

I have been to Beth Israel many times. I believe they give good care, hence the 0 blood line infection rate, but it is the dirtiest hospital I have ever seen! If public areas are dirty that will bring dirt into patient's rooms automatically.

My grandmother is currently in St. Luke's Hospital in Manhattan. I've been shocked by the conditions there. When I visited her on Sunday, the mens' room toilet was clogged and covered in feces. I reported it, and was told they had already made a request to have it cleaned. I was back on Monday, and it was still clogged, but someone had flushed it and it had overflowed onto the floor. It was still that way when I left last night- no one even mopped! It's easy to see how infections can occur when visitors are tracking all kinds of viruses and bacteria through the hospital!

Suggestion for reducing infections:
Prohibit all hospital employees from wearing scrubs to and from work. It seems obvious to me that infections can be transmitted to patients or brought home to family using this conduit, especially if the employee uses public transportation.

i am loving this. so cool!

I live near a lot of hospitals. I always see doctors and nurses walking around with scrubs and uniforms. Shouldn't they change when they enter the hospital?

My father had life-long ventricular arrhythmia, his official cause of death, but the arrhythmia episode that killed him was caused by the urinary infection, which turned into sepsis.

My mother, who had been hospitalized after a stroke, suffered a second, fatal stroke after a urinary infection caused by the catheter had caused her blood pressure to drop, triggering an atrial arrhythmia attack that caused a clot and a stroke.

Both of my parents were actually killed by the catheters, although the hospital records do not reflect that cause of death.

#16 what age group you teach? adults? teenagers? high school or college in Queens?

I'm a teacher. And administrators will retaliate QUICKLY AND SEVERELY if you report anything (e.g., fights, students needing social worker attention, children with signs of abuse at home, teachers injured or attacked by students).

****> How should the state government deal with this problem of administrator retaliation?

Mandatory inspections. Excellent idea. Get the NYState Department of Health Commissioner for an interview some day. Interview Dr Peter Provonost of Johns Hopkins as well

betsy ross? - you silly-billy. but she is also a good joe. in my humble. maybe that's where you were going?

Great flag design, Betsy! LOL (Sorry Brian I coudn't resist)

Both my parents died as the result of urinary infections that were caused by catheters. Neither death was classified as related to a hospital-caused infection, because both my parents were elderly and had cardiac problems that were activated by the infections and caused their deaths.

hey david!

:(
next time move your web streams at night!

the stream is dry... time for xmradio

Yes, mine is down too.

fyi....seems like internet stream is having difficulties.

wow, late to the party today. sorry

haven't hear much, but rid is a great organization and betsy gets my vote.

Public officials expose and punish restaurants for unsanitary conditions and electronic stores for violations such as fraud and false marketing. Why exclude hospitals from the public eye with life and death in the balance?
Hmmm.

Of the two institutions that have always seemed to have it down pat and be on the ball, both now are among the lowest rated in service and falling even farther fast: those two are hospitals and airlines. One could always count on both to get it right (for a high percentage of the time) and today no one wants to go near either unless one has too and even then with hesitation and resolve.

This is scary. I hope they keep the nurseries clean for all those cute cuddly adorable babies.

I bet though a lot of people's houses are as dirty if not dirtier than the hospitals.

This is a law giving a privilege that there is always a way around. Think like a lawyer, you will find the clue or loophole somewhere.

It is difficult to understand that you place your trust with these hospitals as patients and these institutions can't provide infection rates. These is so critical to positive outcomes during a stay in the hospital. The personnel at hospitals make good salaries for this responsibilty and they should be working hard especially for post operative patients to insure their safety.

Maybe Doctor Peter Provonost of Johns Hopkins' hospital and the checklist protocol which he designed should be required for these local hospitals.