Articles Posted in Surgical Complications

In response to an increase in superbugs, medical centers are taking an aggressive stance by implementing strict hygiene standards and educating patients about antibiotic resistance. Superbugs are bacterial infections resistant to medical treatment, such as antibiotics. A global increase in the number of antibiotic prescriptions coupled with a lack of new antibiotics produced in the last few decades created strains of bacteria resistant to antibiotics. According to the Centers for Disease Control and Prevention, superbugs (and antibiotic resistance, more generally) present one of the world’s “most pressing public health problems.”

Filled with infectious diseases and compromised immune systems, hospitals are a breeding ground for superbugs and their patients are uniquely susceptible. Thankfully, hospitals are stepping up and setting new standards to prevent the spread of infection. In an article by the Wall Street Journal, several hospitals detail new procedures meant to improve hygiene and stop germs from spreading. In addition to routine hand washing, medical staff at these hospitals also clean stethoscopes, blood pressure cuffs, IV poles and pumps, bed railings, and computer keyboards. Stethoscopes, in a surprise to hospital staff interviewed by the WSJ, usually carry the same number of germs as a doctor’s hands after just a single physical examination.

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After a lack of response from management, a group of nurses is going public about the poor treatment of patients at Montefiore Hospital in the Bronx. Speaking to The Daily News, the nurses describe “horror stories” of overcrowding, understaffed medical personnel, unsanitary conditions, and a management structure who seems oblivious or unconcerned about these serious problems. The deteriorating quality of care at the Bronx hospital endangers both patients, who are more likely to become sick with infectious diseases, and nurses, who are frequently attacked by mentally ill residents at the hospital.

In response to the allegations of overcrowding, understaffing, and inadequate medical care, a Montefiore spokeswoman pointed towards the Bronx hospital’s high ranking on Indeed.com – a website where employees review their employer. While Indeed may believe Montefiore is a pleasant work environment, their nurses disagree and, according to The Daily News, they have ample evidence. In one example, emergency room patients wait an average of 64 minutes before meeting with a healthcare professional – almost double the national average.

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After the rapid pace of consolidation in the healthcare industry over the past decade, many patient advocates are beginning to study the effects of these mergers and acquisitions on the quality of patient care. While many of the business executives in charge of these restructurings tout improved patient health as a benefit, it appears the opposite may be true – at least in the short-term – for many patients. The study, which was reported by STAT, found that new patient populations, unfamiliar infrastructure, and new settings for physicians caused the bulk of problems related to possible declines in patient health after a hospital merger.

Since 2014, there have been more than 100 hospital or healthcare mergers each year. Last year alone, there were 115 mergers and this trend is likely to continue. For that reason, it is important to learn about its effects on patient care. After thoroughly reviewing several randomly chosen mergers and acquisitions, STAT found a disturbing pattern of patient neglect. In two examples, a surgeon and an anesthesiologist ended up in the wrong part of the hospital after being summoned for a time-sensitive procedure. In another example, an ER doctor was given only thirty minutes of training before being put to work in an Emergency Room. According to STAT, “[The Doctor] had not been brief on how to obtain backup help in the case of an unexpected emergency.” Therefore, when multiple ambulances arrived with several critical patients, the hospital was overwhelmed and ineffective in treating the majority of patients. In all of these circumstances, the hospital had reorganized itself and not properly trained the medical staff at the hospital.

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A Georgia doctor who wanted to be known as the “dancing doctor” will no longer be a doctor in the State of Georgia. In a fantastic story by the New York Times, the dermatologist, whose name is Dr. Windell Davis-Boutte, would stop in the middle of her surgeries and perform a dance routine to popular hip-hop and rap songs. Then, the doctor would post them to her social media account, which was deleted after more than 100 patients came forward and several lawsuits were filed against the now-disgraced doctor.

Davis-Boutte advertised herself on her website as having “MASTERFUL SURGICAL EXPERTISE, having sought additional extensive training by some of the most famous surgeons in the world.” The patients who were harmed during her surgeries provide a different story. One patient, who was included in a video of the former dermatologist dancing to the song “Cut It” received a botched liposuction, breast augmentation, and Brazilian butt lift operation all on the same day. In the video, one of the 20 provided to the New York Times, the former doctor prods the midsection of the patient and then finger rolls her skin to the beat of the song. According to the newspaper, once the hook begins she starts “slicing the air with her scalpel… then making incisions, her scalpel moving rhythmically to the song.” The day after the surgery, the patient had a “collapsed lung and suffered from anemia because of her acute blood loss.”

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A new report by Christiana Care Health System showed that medication errors occurred in 47 percent of ICU Transfers. The study which followed 985 patients at almost 60 different ICUs across the East Coast who were transferred from the ICU to a non-ICU area in the same hospital or medical unit.  According to the study, an average of 1.88 errors occurred per patient transferred out of the ICU, a startlingly high number.

The report, authored by Andrea Tully and detailed in MDMag.com, found that the most common errors related to anti-infectives, hematologic agents, and intravenous fluids, electrolytes or diuretics. The patients with the highest risk of a medication error were patients taking the most medications and patients in need of renal replacement therapy. While 75 percent of these medication errors were deemed “Category C” which meant no actual harm or minimal harm caused to the patient, a full 25 percent caused harm to the patient. According to patient care advocates, these numbers are unacceptable.

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New York hospitals rank among the lowest in the nation for patient safety, according to a non-profit group. The Empire State ranked 48^th out of the 50 states, a one-spot improvement from last year. Overall, almost 6 percent of hospitals received an “F” for patient safety – a notable increase from the nationwide average of under 1 percent. A total of 137 hospitals in New York were graded, according to NBC New York.

The rankings, which are released every year, are released by Leapfrog Group and rank 2,500 hospitals across the country. The grades – ranging from an “A” to an “F” – are based on the rate of hospital errors (including medication errors), accidents, infections, and the number of preventable pressure ulcers, among several other factors. Leapfrog Group ranks hospitals individually and then aggregates the data and ranks each state collectively.

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A recent study highlighted the improving areas of medical care in the United States. Released by the Agency for Healthcare Research and Quality, the study tracked seven main criteria related to healthcare between 2000 and 2014 – person-centered care, patient safety, healthy living, effective treatment, care coordination, and affordable care.

Here is the breakdown on how America’s healthcare system changed according to each of the metrics:

1. Person-Centered Care. The study defined “person-centered care” as whether or not a patient achieves their healthcare outcomes, not merely whether a disease has been effectively treated or managed. Overall, the trend for this metric has markedly improved since 2000. A full 83 percent of patients who had visited a doctor in the last 12 months reported improvement in person-centered care. Perhaps as important, none of the patients indicated their care “worsened” on this metric during the fourteen-year period.

2. Patient Safety. Keeping a patient safe while in a hospital or doctor’s office also saw an improvement during the study. Overall 66 percent of patients reported an improvement in this metric, which reflects broader trends of data available in this area. Between 2008 to 2014, the number of infections related to a central venous catheter dropped from 1.9 per 1,000 patients to 0.67 per 1,0000. Similar improvements in patients receiving hip joint replacement surgeries. In 2009 a full 16.4 percent of Americans undergoing this notoriously tricky procedure reported “adverse effects”, a number that dropped to 9.8 percent by 2014.

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