One of the many reasons our family likes to stay out of hospitals is to avoid nosocomial infections.  Those are infections you get while you’re in the hospital (not what sent you to the hospital in the first place).

Now we have even more reason to steer clear of hospitals.  Many of you have heard of the study in the April 2008 issue of Pediatrics that tells us 1 out of 15 hospitalized kids are harmed by hospital errors, including mix-ups of medicines, bad drug reactions and overdoses.

As parents, we ask of no one in particular and everyone in general:  What are we supposed to do?  We want to take our sick or hurt children to a place that will, at the bare minimum, do no harm, and in theory, do some good.  But the risks associated with a hospital stay are pretty serious.

The National Initiative for Children’s Healthcare Quality worked on a tool that helped investigators get a more accurate count of numbers of children harmed while in the hospital.  Prior to the use of this tool, the count of children harmed by hospital error was much lower because errors were supposed to be voluntarily reported, and we now know that wasn’t happening.

I can accept the fact that no one is perfect, but the bar for standard of care is pretty low.  As our children’s advocates, we have the responsibility to insist that bar be raised. 

Hospital staff: please worry less about political fall-out and more about doing what you have to do to stop mistakes from occurring, or worse, reoccurring.  And strive for transparency – it will relieve unnecessary suspicion and mistrust on the part of patients and their families and will serve to keep everyone working toward an error-free environment.  Ask questions, involve the family in patient care, stay focused on the tasks at hand, and communicate thoroughly with those taking over your patients when shifts change.

Families: as much as possible, stay with your loved one in the hospital and ask questions about everything that is being done. If something doesn’t seem right, don’t be afraid to ask about it. If someone’s feathers get ruffled because you ask questions about what they’re doing, just remember: better that than a mistake.

MRSA is in the news these days and it can be scary.  MRSA (Methicillin-resistant Staphylococcus aureus) is a bacterium that causes infections in and on the body.

It’s considered the super bug of staph (Staphylococcus aureus) infections because this strain is resistant to some of our antibiotics.  This resistance makes it harder to treat.

A MRSA infection on the skin may cause boils or pimples or it may cause an infection that runs so deep it has to be drained.  Treatment for such an infection may or may not include antibiotics. 

MRSA may also infect wounds or get into the lungs, the bloodstream or the urinary tract.

About 25 percent of us walk around with staph bacteria on our bodies or maybe up our noses, but we don’t become infected.  Of the 25 percent, about one percent carries MRSA. 

Should the staph get into the body through, say, a cut, we could get an infection.  Usually these infections aren’t serious, although it’s possible for them to become dangerous.  They may even cause pneumonia.

The good news is, staph is usually treated with antibiotics.  The bad news is, there are strains of staph, like MRSA, that have developed resistance to some of our antibiotics.  This super bug keeps changing and adapting, making it necessary for us to develop new antibiotics in a hurry.

To the disgrace of everyone involved, MRSA infections are exploding in healthcare settings, with MRSA now causing up to 40 to 50 percent of the staph infections in U.S. hospitals.

MRSA has also expanded from hospitals and other healthcare settings out into the community, where it is referred to as Community-Associated MRSA (CA-MRSA).

CDC tells us that in 2003, 12 percent of MRSA infections were acquired in the community.

Prevention is key to remaining MRSA-free and CDC recommends the following:

• Wash your hands thoroughly for at least 15 seconds. Use soap and water or an alcohol-base hand sanitizer.
• Cover your cuts and scrapes with a clean bandage to prevent bacteria from entering the wound.  If you have to touch another person’s wounds or bandages, put a barrier between your hands and the soiled materials or open skin.
• Don’t share personal care items like nail clippers or scissors, razors, towels and so on. 
• Wipe down shared gym equipment before and after use.
• Using the dryer rather than line drying helps kill bacteria.

MRSA is identified with lab tests.  Should your provider determine you have a MRSA infection, there are plenty of antibiotics that do work, although you may not even need to be on antibiotics.

The New England Journal of Medicine published a study not long ago about kids and the medical care they receive.  The results are not good.

Children in the United States get appropriate medical care only 47 percent of the time when visiting healthcare professionals.

The study followed 1,536 children over a four-year period.  Researchers found that even basic care was suboptimal for kids visiting pediatricians or hospitals.

• Only 19 percent of seriously ill infants with fevers had correct lab work done
• Only 46 percent of kids with asthma were taking the correct meds
• Only 31 percent of kids ages 3-6 had their weight measured at annual checkups
• Only 68 percent of the time do kids with acute illnesses get the correct care
• Only 53 percent of the time do kids with chronic conditions receive correct care

The kids in the study were from middle-income families with health insurance.  The kids most likely to receive good care…or so we thought.  What’s happening to kids with little or no insurance?

This study unearthed a huge problem.  Now what are we going to do about it?

We have soap. 

We have hand sanitizers – the stuff we squirt on our hands and rub in when we don’t have soap and water. 

Oh, and we have germs.  Boy, do we have germs. 

What we don’t have is forward motion on this whole keeping-the-hands-clean concept.

What’s wrong with us?  The latest handwashing survey put out by the American Society for Microbiology and the Soap and Detergent Association says we’re washing our hands less often than we were two years ago.

Now, I don’t want to point any germy fingers, but you guys are really tanking on this.  And then you lie about it.  Tsk, tsk, tsk.  Eighty-nine percent of men say they wash their hands every time they use a public restroom, but only 66 percent were spotted actually doing it.

We women are doing our fair share of not washing and lying about it.  Ninety-six percent of us say we wash our hands in a public restroom but only 88 percent of us are actually doing it.

So, I suppose it’s not a question of who’s lying and who isn’t, but who’s lying more.  Not much ethical ground to stand on here.

Our hands go around picking up germs all day long off of escalator rails, chair arms, table tops, buffet tong handles, other people’s hands, money, door handles, the place on the door where we push so we don’t have to touch the door handle, and, well, lots of other places.

If we rub our eye, blow our nose or eat a peanut, the germs that we’ve picked up with our hands will be go right in and make themselves at home in our bodies.  Gastro bugs love to send us running for the toilet or reaching for anything that’ll hold liquid.  Respiratory bugs delight in making us cough and hack and sneeze and feel miserable.

That’s just the regular stuff.  Let’s not even talk about liver or kidney failure, pneumonia or other ills that send us to the hospital.

Apparently, keeping our hands clean actually makes a difference.  Fifteen seconds of soap and water or a squirt of hand sanitizer could be the difference between taking a day off because we’re sick or taking a day off because we’re not sick. 

Gesundheit!

Although no parent can bear to think of their child being terminally ill, we know it does happen. When it happens, each of us wants the right to use any drug available to save our child.

The U.S. Court of Appeals for the District of Columbia Circuit decided that a terminally ill patient does not have a constitutional right to experimental drugs, even if those drugs could potentially save that patient.

In a dissent written by Judge Judith W. Rogers, she said that courts have established the right “to marry, to fornicate, to have children, to control the education and upbringing of children, to perform varied sexual acts in private, and to control one’s own body even if it results in one’s own death or the death of a fetus…but the right to try to save one’s life is left out in the cold despite its textual anchor in the right to life.”

Parents of terminally ill children should have access to experimental drugs that have undergone preliminary safety testing but are not yet FDA-approved. Period.