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.

Dianne serves on a state committee to improve disclosure of hospital infection rates, which was passed by law in 2006. South Carolina is one of twenty-five states that require public reporting of hospital-acquired infections, including central line-associated bloodstream infections and surgical site infections for a number of surgical procedures.

Elizabeth Cohen: You write about how nurses tried to give you drugs to which you'd had "horrendous adverse reactions" even though doctors had explicitly written in your chart you shouldn't have those drugs. A friend of mine had a similar problem, and we decided maybe he should have hung a sign around his neck with a list of the drugs he wasn't supposed to get.

EH: That doesn't sound like a bad idea. [A doctor once told me about] a registered nurse who had a "Do Not Resuscitate" order tattooed on her abdomen. She said she felt it was the only way her wishes would be respected.
...
EC: When you were being treated for leukemia, you were very, very sick. You said sometimes you were barely conscious. How'd you keep up the stamina to keep double-checking everyone's work?

EH: I was lucky to be able to maintain my strength and do it as long as I did, and my girlfriend at the time, Jackie, was willing to sit by my side and advocate for me, and she was very skilled at doing it. You wonder, how many people die from illnesses because the strength to keep up vigilance runs out?

CMS-adopted federal regulations also include protections to prevent hospitals from billing patients when payments are withheld. These newly effective regulations could apply to several hundred thousand hospital stays of the 12.5 million covered annually by Medicare, reports the NY Times.

The logic that hospitals shouldn’t be handed extra federal taxpayer dollars for delivering unsafe care should give them a monetary hint to take more evidence-based precautions.

One bill (SB 1058), “Nile’s Law,” requires hospitals to report their infection rates to the California Department of Public Health which will be published on the health department’s website by 2011. Hospitals must develop better infection control procedures and training programs. Also, Nile’s Law requires California hospitals to screen certain high-risk patients for the antibiotic-resistant superbug MRSA (Methicillin-Resistant staph aureus). This newly signed law makes California the 25th state to require public reporting of hospital acquired infections and the 4th state to require antibiotic-resistant MRSA screening of certain patients.

Nile’s Law is named in honor of Carole Moss’s 15-year-old son, Nile, who died from a MRSA infection after a visit to the hospital where he was getting an MRI. Carole has fought to keep Nile’s story alive so that other patients could be more informed. Watch her interview about Nile here.

The second bill (SB 158) signed expands the responsibilities of the Department of Health’s hospital infection advisory committee by requiring the constant monitoring and evaluation of hospital infection prevention strategies, including more detailed training of infection control staff. And my favorite: a facility-wide hand hygiene program.

We are thankful to all the California advocates who helped ensure this hard-fought victory!

So, the Committee set out to find whether other state hospital associations were doing anything to encourage their members to systematically implement these simple, life-saving practices (handwashing, full draping of the patient, cleaning the skin with proven cleansers, avoiding catheters in the groin when possible, and removing the catheters as soon as possible) and to monitor the results.

The Committee found that only eight state hospital associations even gather comprehensive information about the rate of central-line-associated bloodstream infections (among the most common types of hospital-acquired infections) and another 12 said they had started doing so. Only 13 states were using or planned to use the Johns Hopkins model.

While most US patients cannot yet count on their hospital to aggressively prevent these hospital-acquired infections, eventually we will be able to identify those who are. Twenty-four states now require public reporting of these infections -- almost all include central-line bloodstream infections.

Last year, the Center for Disease Control and Prevention reported that approximately 94,000 people develop serious MRSA infections each year and almost 19,000 of them die. 86% of these MRSA infections are picked up in hospitals and other health care settings, like nursing homes and dialysis centers.

The Toolen family shouldn’t have been punished for going to the hospital, but fortunately, more people are noticing the devastation MRSA can cause. If Governor Schwarzenegger signs SB1058, which is now on his desk, California will become the fourth state to require hospitals to screen patients for MRSA on admission. The three other states are Illinois, Pennsylvania and New Jersey. Research published earlier this year in the Annals of Internal Medicine found that universal screening is associated with substantially reduced rates of MRSA clinical infection. Skeptics have said universal screening would “limit a hospital’s flexibility to design infection prevention programs” but most hospitals have been too lax in protecting patients. Patients deserve better.

Similar legislation has failed in the state the past four years. But this year with the help of Carole and many other dedicated advocates, including those with personal hospital infection experiences, the bill has passed the General Assembly and is being sent to the governor for signature into law.

View Carole's story about her son Nile:

After experiencing a life threatening hospital infection herself...

Cole now advocates nationally for better infection prevention safety standards and requiring hospitals to make public their infection and death rates. "Consumers have a right to know if there is an infection problem at their hospital. When we choose a restaurant it is not just based on reputation, but by the letter grade for cleanliness in the window. We should be able to make the same informed decisions about our healthcare."

Both SB158 and SB1058 would require public reporting of hospital acquired infection rates, as well as screening for the 'superbug' MRSA and improved hospital cleaning practices. California currently lags behind 22 other states which have laws requiring public reporting.

Cole, who is still healing and undergoing daily hyperbaric oxygen treatments, is urging fellow survivors and family members of victims to contact their legislators and ask them to support these bills.

Thanks Alica for the great work to pass real reform for hospitals in California!