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    Friday, April 30, 2010

    Researchers say novel cleaning methods reduce hospital-room bacteria by nearly 90 percent.

    Two "studies on new cleaning methods show that they can reduce bacteria, including hard-to-remove Clostridium difficile spores, by almost 90 percent," according to research presented at the 49th Interscience Conference on Antimicrobial Agents and Chemotherapy in San Francisco. In the first study, cleaning with "ultramicrofiber mops and cloths plus copper biocide removed 80...to 85 percent of bacteria," and the "antibacterial effect of the copper biocide persisted for 23 hours after cleaning." In the second study, researchers used an "automated UV radiation device," the Tru-D, to "decontaminate hospital rooms. ... Tru-D reduced methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus bacteria by 89 percent and C. difficile spores by 83 percent" in 40 hospital rooms

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, April 26, 2010

    PHYSICIAN URGES RETURN TO MORE PERSONAL CARE

    In an op-ed for the New York Times Dr. Dena Rifkin, a physician at the University of California-San Diego, writes that since the Institute of Medicine's report on deaths caused by medical errors, "there has been tremendous focus on how many mistakes physicians and hospitals make, how much they cost and how to prevent them." She says that many hospitals reacted with a "brisk and multifaceted" response, but that "none of these interventions, however well meant, address a fundamental problem that is emerging in modern medicine: a change in focus from treating the patient toward satisfying the system."

    A close family member was recently hospitalized after nearly collapsing at home. He was promptly checked in, and an electrocardiogram was done within 15 minutes. He was given a bar-coded armband, his pain level was assessed, blood was drawn, X-rays and stress tests were performed, and he was discharged 24 hours later with a revised medication list after being offered a pneumonia vaccine and an opportunity to fill out a living will.The only problem was an utter lack of human attention. An emergency room physician admitted him to a hospital service that rapidly evaluates patients for potential heart attacks. No one noted the blood tests that suggested severe dehydration or took enough history to figure out why he might be fatigued.
    A doctor was present for a few minutes at the beginning of his stay, and fewer the next day. Even my presence, as a family member and physician, did not change the cursory attitude of the doctors and nurses we met.Yet his hospitalization met all the current standards for quality care.

    It has been 10 years since the Institute of Medicine’s seminal report on deaths caused by medical errors (numbering at least 44,000 a year). Since then, there has been tremendous focus on how many mistakes physicians and hospitals make, how much they cost and how to prevent them.

    The response at most hospitals has been brisk and multifaceted. Hospital accreditation committees now audit charts for outdated abbreviations and proper signing of notes. Electronic prescription systems are rapidly becoming the norm. Pay-for-performance interventions by insurers promise to reward those who make the grade and to refuse payment to those whose treatments cause complications like hospital-acquired infections.

    But as we bustle from one well-documented chart to the next, no one is counting whether we are still paying attention to the human beings. No one is counting whether we admit that the best source of information, the best protection from medical error, the best opportunity to make a difference — that all of these things have been here all along. The answers are with the patients, and we must remember the unquantifiable value of asking the right questions.

    She adds that medical professionals "are paying attention to the details of medical errors," yet "no one is counting whether we are still paying attention to the human beings."

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Friday, April 23, 2010

    Illinois consumers can view hospital quality data on state-sponsored website.

    Six years after Illinois passed "legislation in 2003" calling "for a Hospital Report Card and Consumer Guide" to "document hospital-acquired infections and the adequacy of nursing staffs," as well as "to compare hospitals' performance on 30 leading medical procedures with wide variation in outcomes and costs," the "report card and consumer guide are" now "a reality" for "11 conditions," with "more data" to "be added in the months ahead."

    For the first time, consumers can pore over abundant data -- much of it previously unpublished -- about Illinois hospitals and surgery centers on a state-sponsored website." These "data include information about what these medical providers charge, how many procedures they perform, how often they deliver recommended care, and how consumers rate their care." The Tribune adds that "some of the information comes from Medicare Compare, published by the federal government, but it is presented on the state website in a much more accessible form."

    But Public report cards ranking performance may not encourage hospitals to improve.
    One might assume that public report cards ranking their performance would encourage hospitals to improve, but a new...study " published in the Journal of the American Medical Association "finds that isn't the case." Investigators "examined medical records from 86 hospitals in Ontario that admitted patients with heart attack or heart failure." The researchers found that "even after report cards were released, the hospitals, in general, didn't show improvement.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, April 19, 2010

    MEDICATION EXPIRATION DATES

    Is the expiration date a marketing ploy by drug manufacturers, to keep you restocking your medicine cabinet and their pockets regularly? You can look at it that way. Or you can also look at it this way: The expiration dates are very conservative to ensure you get everything you paid for. And, really, if a drug manufacturer had to do expiration-date testing for longer periods it would slow their ability to bring you new and improved formulations.

    One of the largest studies ever conducted that supports the above points about "expired drug" labeling was done by the US military 15 years ago, according to a feature story in the Wall Street Journal (March 29, 2000), reported by Laurie P. Cohen. The military was sitting on a $1 billion stockpile of drugs and facing the daunting process of destroying and replacing its supply every 2 to 3 years, so it began a testing program to see if it could extend the life of its inventory. The testing, conducted by the US Food and Drug Administration (FDA), ultimately covered more than 100 drugs, prescription and over-the-counter. The results showed that about 90% of them were safe and effective as far as 15 years past their original expiration date.

    In light of these results, a former director of the testing program, Francis Flaherty, said he concluded that expiration dates put on by manufacturers typically have no bearing on whether a drug is usable for longer. Mr. Flaherty noted that a drug maker is required to prove only that a drug is still good on whatever expiration date the company chooses to set. The expiration date doesn't mean, or even suggest, that the drug will stop being effective after that, nor that it will become harmful. "Manufacturers put expiration dates on for marketing, rather than scientific, reasons," said Mr. Flaherty, a pharmacist at the FDA until his retirement in 1999. "It's not profitable for them to have products on a shelf for 10 years. They want turnover."

    If the expiration date passed a few years ago and it's important that your drug is absolutely 100% effective, you might want to consider buying a new bottle. And if you have any questions about the safety or effectiveness of any drug, ask your pharmacist. He or she is a great resource when it comes to getting more information about your medications.

    First, the expiration date, required by law in the United States, beginning in 1979, specifies only the date the manufacturer guarantees the full potency and safety of the drug -- it does not mean how long the drug is actually "good" or safe to use. Second, medical authorities uniformly say it is safe to take drugs past their expiration date -- no matter how "expired" the drugs purportedly are. Except for possibly the rarest of exceptions, you won't get hurt and you certainly won't get killed.

    Even 10 years after the "expiration date," most drugs have a good deal of their original potency. So wisdom dictates that if your life does depend on an expired drug, and you must have 100% or so of its original strength, you should probably toss it and get a refill, in accordance with the cliché, "better safe than sorry." If your life does not depend on an expired drug -- such as that for headache, hay fever, or menstrual cramps -- take it and see what happens.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Friday, April 16, 2010

    Sharing hospital room may increase infection risk during stay

    Sharing a hospital room increases your risk of picking up an infection during your stay, a new study shows." The work, by researchers from Queen's University in Kingston, Ont., "found that each new roommate raised a patient's risk of picking up an infection in hospital by about 10 percent." The study's senior author, Dr. Dick Zoutman, said in a statement, "That's a substantial risk, particularly for longer hospital stays when you can expect to have many different roommates."

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, April 12, 2010

    A BETTER ANSWER FOR DOCTORS WORRIED ABOUT HIGH MALPRACTICE INSURANCE PREMIUMS ?

    Tom Baker, a professor at the University of Pennsylvania Law School, is the author of “The Medical Malpractice Myth. Says that our medical liability system needs reform. But anyone who thinks that limiting liability would reduce health care costs is fooling himself. Preventable medical injuries, not patient compensation, are what ring up extra costs for additional treatment. This means taxpayers, employers and everyone else who buys health insurance — all of us — have a big stake in patient safety.

    Eighty percent of malpractice claims involve significant disability or death, a 2006 analysis of medical malpractice claims conducted by the Harvard School of Public Health shows, and the amount of compensation patients receive strongly depends on the merits of their claims. Most people injured by medical malpractice do not bring legal claims, earlier studies by the same researchers have found.
    On the other hand, risk managers, for example, and spurring anesthesiologists to improve their safety standards and practices. Even medical societies’ efforts to attack the liability system have helped, by inspiring the research that has documented the surprising extent of preventable injuries in hospitals. That research helped start the patient safety movement. When it comes to rising medical costs, liability is a symptom, not the disease. Getting rid of liability might save money for hospitals and some high-risk specialists, but it would cost society more by taking away one of the few hard-wired patient safety incentives.
    Besides, there’s a better answer for doctors worried about high malpractice insurance premiums.

    Critics point to defensive medicine as the hidden burden that liability imposes on health care. Yet research shows that while the fear of liability changes doctors’ behavior, that isn’t necessarily a burden. Some defensive medicine is, like defensive driving, good practice. Too often, we can’t distinguish between treatments that are necessary and those that are wasteful. Better research on what works and what doesn’t — evidence-based medicine — will help. And it will address the more general challenge of avoiding costly but unnecessary care.
    Just as we need evidence-based medicine, we also need evidence-based medical liability reform. The research shows, overwhelmingly, that the real problem is too much malpractice, not too many malpractice lawsuits. So medical providers should be required to disclose injuries, provide quicker compensation to deserving patients and — here’s the answer for doctors worried about their premiums — shift the responsibility for buying malpractice insurance to hospitals and other large medical institutions. Evidence-based liability reform would give these institutions the incentive they need to cut back on the most wasteful aspect of American health care: preventable medical injuries.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Friday, April 9, 2010

    Which Antiseptic Is Best To Reduce The Risk Of Staph Infection?

    The chemical antiseptic chlorhexidine does a better job than povidone-iodine in reducing the risk of surgical site infections, even in carriers of Staphylococcus aureus, according to two new randomized studies.Researchers in the U.S. found that chlorhexidine and alcohol, used for preoperative skin cleansing, reduced infections by 41% compared with povidone-iodine.

    And Dutch investigators found that screening and decolonizing patients who are nasal carriers of S. aureus, combined with washing with chlorhexidine soap, reduced the risk of infection by 58%.

    The two prospective studies are reported in the New England Journal of Medicine and offer "valuable insights for controlling surgical-site infections. An accompanying editorial, wrote that the findings "offer remarkably safer strategies for all patients who require surgery."

    Overall, the researchers found, the rate of infection was 9.5% in the chlorhexidine group, compared with 16.1% in the povidone-iodine group. The chlorhexidine/alcohol scrub proved more protective against superficial incisional infections and deep incisional infections.

    The researchers concluded that better skin antisepsis could result in a "significant clinical benefit."

    The study is a "landmark", according to the University of Michigan Health Systems in Ann Arbor.If the study is eventually translated into national guidelines," the impact would be huge. That would include those undergoing cardiac surgery, patients receiving an implant, and those with a compromised immune system.

    In the Netherlands, researchers enrolled 808 people who were positive for S. aureus and underwent a surgical procedure that was expected to keep them in hospital for at least four days.

    They found:
    In the mupirocin/chlorhexidine group, 17 of 504 patients (or 3.4%) got an S. aureus infection, compared with 32 of 413 patients (or 7.7%) in the placebo group.

    The benefit was greatest for deep surgical-site infections, where the relative risk was 0.21, with a 95% confidence interval from 0.07 to 0.62.

    The time from admission to the onset of S. aureus infections was significantly shorter in the placebo group than in the mupirocin/chlorhexidine group, at P=0.005.
    The "weight of evidence" is now firmly on the side of chlorhexidine and alcohol as a preoperative skin cleansing, rather than povidone and iodine.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Monday, April 5, 2010

    At What Age Should Mammograms Should Begin?

    The Journal of the American College of Radiology urges women to begin seeking mammograms every year beginning at age 40. The suggestion is "at odds with controversial advice by the US Preventive Services Task Force that women put off mammograms until age 50 and even then just get them every two years, in most cases." A professor of radiology at Harvard, charged that the USPTF "didn't pay enough attention to the results of studies

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com

    Friday, April 2, 2010

    Are Statin Medicines Good For Everyone?

    Statins like Lipitor have gotten great publicity-with some advocating putting it in the drinking water. New research,however, shows that statin drugs may negatively impact some patients with cardiac disorders. A new study presented at the 75th annual international scientific assembly of the American College of Chest Physicians found that statins benefit patients with systolic heart failure (SHF), but not those with diastolic heart failure (DHF). These patients experienced increased dyspnea, fatigue, and decreased exercise tolerance. “It is possible that statins would help patients with systolic heart failure more than patients with diastolic heart failure due to the cholesterol-lowering and anti-inflammatory effects of statins. US Pharm. 2009;34(12):10.

    Please remember, as with all our articles we provide information, not medical advice.
    For any treatment of your own medical condition you must visit your local doctor, with or without our article[s]. These articles are not to be taken as individual medical advice.


    Deepen your understanding of "medical malpractice"... www.MedMalBook.com

    For more health info and links visit the author's web site www.hookman.com