A new Consumer Reports poll finds that 18 percent of Americans say they or an immediate family member have gotten a dangerous infection after a medical procedure and over a third report that medical errors are common in everyday medical procedures. The full poll is available here.

Here are more highlights from the poll:

• The risk of an infection increased 45 percent if a patient spent the night in the hospital.
  
• Fifty-three percent of Americans polled said these infections required additional out of pocket expenses to treat the infection.
  
• Sixty-nine percent had to be admitted to a hospital or extend their stay because of the infection.
  

If you don’t know someone who’s suffered a hospital infection or medical error, meet Kerry O’Connell, a construction company executive from Colorado. Kerry fell off a ladder while painting his house and needed arm surgery. In the hospital, he acquired MRSA, a deadly antibiotic-resistant infection that cost him months of time, eight surgeries, and $20,000 out of pocket to repair.

You may know someone who has suffered a hospital acquired infection, but you probably don’t know how common they are. While we have made infection-reporting progress in twenty-five states, many states do not require hospitals to report infection rates or medical errors to the public. In spite of hospitals’ efforts to keep their mistakes a secret, a third of you do feel that medical errors are common. Maybe more people would feel that way, and take precautions, if the real stats were widely available.

Nearly 200,000 Americans die each year from preventable medical errors and hospital-acquired infections, according to a 1999 Institute of Medicine report and the CDC. Medical errors injure too many people, acknowledges A Healthy Blog, “But it doesn’t have to be this way.”

I’d like to point you to four of those brave patients, who debuted their videos to lawmakers at the Massachusetts State House and encouraged them to take an active role to improve patient safety. The videos were produced by the Consumer Health Quality Council, a project of Health Care for All in Massachusetts.

Click here to view the stories of Taylor, Brian, Antonio and Marie, who fell through the cracks of an unsafe medical system and now their families have become activists in their honor.

Medical errors and hospital infections injure millions of patients each year and combined represent the third leading cause of death in America.

Stories like these send the powerful message to lawmakers and the public that we are taking action. The stories were picked up by Boston media outlet NECN and helped build momentum for a landmark patient victory in Massachusetts.

Last week, the Massachusetts legislature approved regulations to ban drug company gifts to doctors and mandated disclosure of fees for consulting. “Massachusetts is now the only state to require disclosure by device makers, as well as drug companies, and just one of two states to make disclosures public, officials said,” reported the Boston Globe. A national bill to report payments to doctors (“Physician Payments Sunshine Act”) has been re-introduced in Congress and is very likely to pass this year, said Kathleen Meriwether at a national biotech summit.

Requiring transparency and accountability in our medical system will do more to keep patients safe. By shedding light on the errors that too frequently occur we are driven to demand better.

Every patient has the right to life-saving information such as hospital infection rates. We just need every hospital in America to realize this. We want tragic experiences, like the ones told in these videos, to be eliminated by an improved standard of care and operation across the board.

Quaid's experience was not just an isolated blunder. More than 2.6 million patients are victims of infections and preventable medical errors each year, and 200,000 of them die.

In response, Quaid has started a patient organization called the Quaid Foundation and is pushing for bar coding systems at patients’ bedsides to avoid medication errors. He recently told reporters, “Individually, nurses, doctors and pharmacists are good people, but they’re hamstrung by working in a broken system that’s obsessed with protecting its bottom line,” reports the Health Blog.

Oprah also brought on Dr. Oz, who offered an eight-step checklist with some good pointers for avoiding medical harm: urging hospital staff to wash their hands before touching you, asking doctors to clean their stethoscopes, and marking your body where doctors should operate.

But we were concerned with a few of Dr. Oz’s statements. On why there are so many medical mistakes, Dr. Oz said, “It’s a busy place.” Quaid echoed this sentiment when he acknowledged that nurses work 24 hour shifts and “mistakes happen.”

Yes, they do, but most of these human errors are preventable! There are many different ways to prevent medical errors. We’d like to emphasize a few:

• Nurses should not be working 24 hours in a day.
• We need a national hospital infection reporting system so that patients can find out if their hospital has been providing unsafe care, and to make better choices about their medical care. Dr. Oz urged patients to go to hospitals that are accredited by the Joint Commission. Just because a hospital is accredited by the Joint Commission doesn’t guarantee that it is safe. In 2004, the Government Accountability Office found that, over a three-year period, the Joint Commission failed to identify “serious deficiencies” at hospitals determined to potentially jeopardize patient safety. Last year the Joint Commission told hospitals to improve their reporting of hospital infections that result in serious harm or death to the patient.
• Not every patient is able to follow Dr. Oz’s checklist, especially if they are chronically ill or unconscious. If you receive hospital treatment, have someone with you at your bedside, especially on weekends and nights. If a friend or loved one is unavailable, Consumer Reports Health blog advises how to find a good patient advocate.
• Better drug safety laws and enforcement. Changes to drug packaging and labeling would help prevent medication errors. And we need a better system to report drug side effects to the FDA.

Using CDC data, the JAMA study found that central line associated blood stream infections in the ICU have decreased by 50%. These are encouraging numbers. Almost every state that has passed a disclosure law includes reporting on blood stream infections in the ICU. Increased public awareness has helped put pressure on hospitals to do more to prevent infections. But our work is not done. As the Health Blog points out, “mixed in with more efforts at prevention in hospitals have been stories of missteps such as failures to wash hands.”

The JAMA study omits data from non-ICU or nonhospital populations, “where the majority of the health care-associated MRSA burden is likely to exist.” The CDC estimates that 19,000 people die a year from MRSA and 95,000 patients get serious MRSA infections in the hospital.

And MRSA is not the only killer. The LA Times recently reported on also dangerous “gram-negative” drug-resistant bacteria that are no longer responding to drugs that used to treat them.

Only PA hospitals are required to monitor and report on infections throughout the facility. All hospitals need to get to this point. It's time to move beyond the ICU and start collecting data on all hospital infections. And government agencies should take the lead on hospital infection reporting.

A few years ago, he was skeptical of hospital infection reduction—thinking hospital infections were the norm for ICU patients-- until his hospital made some changes designed to eliminate hospital infections.

I was skeptical when my hospital embarked several years ago on an initiative to reduce the number of hospital-acquired infections in our intensive care unit.
…
What was the result of all that effort?

After two years, we saw a 50 percent decline in our ICU infection rate, with a 21 percent (or $702) reduction in cost per ICU discharge. I was no longer skeptical; in fact, I often joked, "If this trend continues, I'll be out of a job as an infectious-disease consultant."

Jain talks about the need for hospital staff to “come clean” and adopt good hygiene practices on the job. Even though CDC research shows that proper hand hygiene can substantially cut infection rates and even eliminate them altogether, nearly 60 percent of health care workers fail to wash their hands while on duty. It’s no surprise then, that Jain has witnessed his own ICU colleagues ignore safe procedures.

Hospital workers have given several reasons for not scrubbing their hands: “not thinking about it,” “being too busy,” “having other patient needs take priority” and “not having role models.”

Maybe we need a “carrot-and-stick approach,” as Jain advocates. He is trying this in Memphis hospitals with the “Come Clean. Clean Hands Save Lives,” initiative. Similar approaches have been shown to reduce infection rates.

Saving patients’ lives can be as simple as encouraging doctors to pay more attention.

Here's the CMS press release.

It's about time.

In my home state of Texas, I was able to see where my doctor went to med school, how long he’s practiced medicine, and if he’s board certified. If my doctor had been disciplined by the licensing board because of substandard care – I would be able to see information about that too. The rules vary from state to state, but you’ll likely find valuable information to determine whether your doctor is right for you.

Knowing the background information on your doctor could your life.

Retrieving such life-saving information hasn’t always been easy, and some states have stronger laws than others. Patty and David Skolnik successfully lobbied the Colorado Legislature in 2007 to pass the Medical Transparency Act, also known as “Michael’s Law” in honor of their son. Michael’s unwarranted surgery rushed by a neurosurgeon led to a 32-month nightmare of brain surgeries, infections, pulmonary embolisms, respiratory arrest, vision impairment, paralysis, psychosis, severe seizure disorder, short-term memory loss, multiple organ failure, near total dependence and death. They later discovered multiple malpractice cases and formal complaints against the physician. The Colorado law requires public disclosure about a doctor’s medical license, criminal background and malpractice settlements, and disciplinary actions against that doctor in any of the 50 states.

Attorney Rohn Robbins said it nicely: “The Medical Transparency Act promotes physician accountability and makes available to the public information which may prove valuable in making informed and intelligent decisions.”

The Colorado Citizens for Accountability, for the launch of Patients Right to Know, will help us all find information about our doctor or potential doctor. It also highlights which states do not provide valuable information like Michael’s Law in Colorado.

Help promote PatientsRightToKnow.org (and medical transparency) by sharing this nifty PSA on your blog or website!

• A 30% reduction in C. difficile
• A 25% reduction in urinary catheter infections
• A 50% reduction in MRSA infections

• A 30% reduction in C. difficile
• A 25% reduction in urinary catheter infections
• A 50% reduction in MRSA infections

Unlike Jonathan Swift’s “A Modest Proposal,” this HHS plan is actually modest. You can read the full plan here.

While the plan pulls together a great deal of what hospitals and other should be doing, it has no recommendations for requiring that prevention targets are met. It calls for a federal interagency committee to take over the details of how the national effort will be evaluated and coordinated. And lots of meetings and more research.

The Plan lays out targets for hospitals to meet in five years that fall short of the significant successes that many U.S. hospitals have accomplished by implementing similar strategies. Meanwhile, millions more patients will enter the hospital and get infected from MRSA, VRE, C. difficile, or other dangerous pathogens.

For a patient lying on an operating table about to get surgery, five years is too long a wait before the procedure is safe. For a patient that’s confined to a dirty hospital bed, five years may be too generous for developing standardized methods to measure whether doctors are complying with hand hygiene.

What do you think? Can we afford to wait another five years until we can expect serious action (and results) from our health agencies? In five years, will we be forced to cite this same dark figure from 2002—that 1.7 million hospital-acquired infections occur in U.S. hospitals and contribute to 99,000 deaths per year?

The HHS will be taking your emailed comments until Friday, February 6. Tell the HHS that you deserve swifter action on eliminating deadly hospital infections!

17. Up to a quarter of all women giving birth in European and American hospitals in the 17th through 19th centuries died of puerperal fever, an infection spread by unhygienic nurses and doctors.

18. TV kills! University of Arizona researchers determined that television remotes are the worst carriers of bacteria in hospital rooms, worse even than toilet handles. Remotes spread antibiotic-resistant Staphylococcus, which contributes to the 90,000 annual deaths from infection acquired in hospitals.

19. It is now believed President James Garfield died not from the bullet fired by Charles Guiteau but because the medical team treated the president with manure-stained hands, causing a severe infection that killed him three months later.

Handwashing is proven to prevent the spread of potentially deadly hospital infections. At a Pennsylvania hospital, one medical team was able to reduce central line-associated bloodstream infections 90% in 90 days after adopting rigorous hand hygiene. In Michigan, good hygiene practices led to a two-thirds reduction in device-related infections in over a hundred intensive care units.

Federal health agencies have warned hospitals of the link between poor hand hygiene and infection for decades. This is the kind of advice that should stick like germs. So why don’t all hospital staff follow a basic handwashing regime 100% of the time?

Some people have a hard time following rules, whether they forget or just don’t feel like it; and too often, hospital staff is no exception. But until handwashing gets the respect it deserves, we shouldn’t be ashamed to ask our doctors if they’ve washed their hands before touching us.

Hospitals were supposed to begin reporting by June 1, 2008. It’s nearly 2009 and still, the program has not begun because Texas lawmakers left out one important thing: they failed to fund the law.

As reported by the Dallas Morning News, the state should get this life-saving information to Texas patients. The health department asked the 2009 Legislature for $3.5 million for the next two years get this program off the ground. While it sounds like a lot of money, hospital infections cost the health care system billions of dollars. The CDC estimated that these infections cost up to an astounding $27.5 billion each year in hospital costs alone. The Texas health department estimates 130,000 to 160,000 hospital acquired infections annually.

The $11 billion state budget surplus is expected to further deplete in the upcoming session to pay its share for Hurricane Ike and rising Medicaid costs and enrollment. But state Sen. Jane Nelson thinks the prospects for public reporting in Texas are hopeful. “Now…we are better positioned to seek the funding needed to begin collecting data,” she said.

Over a thousand Texans sent letters to the Texas Legislative Budget Board to finally fund this law that would save lives and reduce costs. In this time of rising costs, rather than giving hospitals an extended break from improving the safety of patient care, the legislature should fund this program.

And Joyce Allen, featured in The Seattle Times, who not only suffered “excruciating” pain as a result of a severe MRSA infection and is now crippled for life, is one clear example of why hospitals urgently need to change course.

Despite the fact that hospitals have seen MRSA outbreaks for decades, many hospitals still aren’t doing enough to protect patients from getting infected, and more people are getting sick or dying as a result. It’s inexcusable that a surgeon would refuse to wear a mask during surgery, or be careless about handling medical instruments in between patients.

Last year the CDC reported that MRSA caused over 94,000 life-threatening infections and nearly 19,000 deaths in 2005 nationwide, most of them occurring in hospitals. In Washington hospitals alone, 4,643 patients had MRSA in 2006, up from 815 MRSA patients in 2000, reports The Seattle Times. In 2006, 190 Washington patients died from MRSA compared to 58 patients six years earlier. With MRSA infections killing more people per year than AIDS, implementing good infection prevention and control practices should be common sense. From The Seattle Times:

Federal veterans hospitals screen all patients for MRSA, which has reduced their cases to near zero. Yet not a single community hospital in Washington screens every patient for the pathogen.

Many hospital officials say widespread screening is unnecessary and too burdensome. They say broad infection-control measures, such as washing hands and wearing protective garments, can thwart MRSA's spread.

It’s true that hand-washing is an effective and easy way to prevent MRSA. Unfortunately, hospitals have not succeeded in improving hand hygiene, especially among doctors. Screening patients upon admission allows health care workers to focus on those with the greatest potential to spread the bug - and save lives. Washington passed a law in 2007 that requires hospitals in the state to disclose the rate at which patients acquire certain infections during treatment, but it doesn’t include MRSA infections.

After The Seattle Times Culture of Resistance series was published, the WA Department of Health said it would begin to require hospitals report MRSA cases. The Department did not comment on whether those numbers would be made available to the public. Currently, only four states have laws requiring screening and isolation of MRSA patients: Illinois, Minnesota, New Jersey and Pennsylvania.

While we’ll be working hard to get more infection disclosure and MRSA screening bills passed, it’s good to know we can also take steps everyday to help protect ourselves from getting infected, such as hand-washing and not sharing personal items like bar soap, razors and towels.

Imagine you’re trapped in a stale hospital room, desperate to escape the sights and smells of your surroundings. Even flowers and big balloons aren’t enough to calm your fear of death in a place that can’t feel like home. Indie musician, Conor Oberst, may be the next Bob Dylan but he may also know a thing or two about the dangers of hospitals, as he panics and pleas “I Don’t Want To Die (In The Hospital)” in his latest solo album. Listen to his foot-stomping song here (click on Track 6).

Can you make a sound to distract the nurse
Before I take a ride in that long black hearse?
I don’t wanna die in the hospital
You gotta take me back outside
…
I don’t give a damn what the doctors say
I ain’t gonna spend another lonesome day
I don’t wanna die in the hospital
You gotta take me back outside
…
Is there still a world at my windowsill?
All there ever was I remember still
I don’t wanna die in this hospital
You gotta take me back outside

The fear of dying in a hospital is painfully real for thousands of patients who fall victim to hospital-acquired infections and medical errors each year:

• 94,000 patients colonized with serious Staphylococcus aureus (MRSA) infections each year and 19,000 of them die. (CDC)
• 13 out of every 1,000 patients or approximately 7,178 inpatients on any one given day may be infected or colonized with Clostridium difficile (C. diff), and between 165 and 438 of those patients die.
• More than 2.6 million hospital patients are the victims of infections and preventable medical errors each year, and almost 200,000 of them die, making medically-induced harm the third leading cause of death in America, behind heart disease and cancer.

Help me get my boots on
Help me get my boots on
Help me get my boots back on

I gotta go, go, go
Cause I don’t have long

FDA regulations allow blood to be stored up to 42 days before it must be trashed.

Stored red blood cells experience changes that promote the release of biochemical substances called cytokines that can lower a patient’s immune function and render them more vulnerable to infection, the researchers said.

‘We’re not talking about hepatitis, HIV or other things that are transmitted in the transfused blood, but an increased susceptibility to infection as a result of the transfusion,’ Dr. David Gerber of Cooper University Hospital, one of the researchers, said in a telephone interview.’

Many hospitals use the oldest blood available first, to ensure that it doesn’t go to waste, reports Infection Control Today Magazine. Gerber said that he does not endorse shortening the 42-day FDA policy, saying it could shorten the already finite blood supply, but that further study on blood transfusions is needed.

This study adds another scary element to the already horrific stat we know about bloodstream infections -- they account for 25% of all hospital infection-related deaths of adults and children in intensive care units.

Still, not enough U.S. hospitals deliver the kind of life-saving information patients and their families need to seek and receive quality care. Helen Haskell of Columbia, SC, felt stranded in the system when her 15-year-old son, Lewis, died from a medication error following a breast bone surgery. The Institute of Medicine estimated that as many as 98,000 Americans die each year from preventable medical errors in the hospital. A devoted patient safety advocate and founder of Mothers Against Medical Error, Helen helped pass the Lewis Blackman Hospital Patient Protection Act in 2005, which requires all doctors to wear identification tags. Patients can know whether a doctor or medical resident is attending a patient. “Our greater challenge will be to follow where the Lewis Blackman Act can lead us—to address the larger issues of patient safety and medical care that are now coming to the forefront across the country,” said Helen after the bill’s passage.