Medicare has announced that it will no longer pay hospitals for the extra costs of treating patients with complications due to medical mistakes-infections, hospital-acquired bedsores, etc.
Medical mistakes are the eighth leading cause of hospital deaths among Americans.
Examples: Mistakes in drug use, such as giving the wrong dose or even the wrong drug, account for tens of thousands of deaths annually in hospitals and outpatient facilities. Hospital-acquired infections result in 80,000 to 100,000 deaths—the vast majority of which are preventable.
Most hospital mistakes are relatively minor. A patient might be given an unnecessary test, or a drug that's not optimal for his/her condition. But some mistakes are life threatening-and, in most cases, completely avoidable.
Medication Mistakes
It's estimated that hospitals in the US make more than 15 million medication errors annually, causing the deaths of 40,000 to 80,000 patients. Name confusion is the most common cause of drug-related errors.
Example: A patient who's supposed to get Celebrex for arthritis might be given Cerebyx (for seizures) or Celexa (an antidepressant) instead.
Handwritten prescriptions should not be allowed in hospitals. It's common for pharmacists to accidentally substitute drugs with similar-sounding names...give the wrong dose (by confusing the numbers "3" and "8," for example)...or miss a decimal point (confusing 1.5 mg with 15 mg). To prevent a medication mistake in the hospital…
- If possible, choose a hospital with a bar-coding system that automatically matches drug prescriptions/labels with coding on patient bracelets. Only 7% to 8% of hospitals now use this technology. Prescriptions are entered directly into computers and the computers are programmed to recognize potential errors.
- Question any drug that looks different from what you've been getting. If you've been taking blue pills for two days, and then are given a green pill, ask what it is...what it's for...why you're being given something different from before...and who ordered it.
- Notice changes in side effects and report them to your doctor or nurse. You may have been given a wrong drug and/or dose.
Infections
The Centers for Disease Control and Prevention estimates that an average of 4% to 6% of hospital patients develop hospital-acquired infections annually. In some hospitals, the percentage is much higher. With the emergence of antibiotic-resistant organisms, such as the potentially deadly methicillin-resistant Staphylococcus aureus, some of these infections are life threatening. Ways to prevent unnecessary infections…
- Watch health care workers wash their hands. Not washing hands accounts for half of all hospital-acquired infections. Don't let health care workers touch you or equipment that's attached to you, such as intravenous (TV) lines—unless they wash their hands. They should wash even if they're putting on gloves—the outside of the gloves could get contaminated from germs on the hands.
- Check those catheters. Bladder or blood vessel catheters are open doors to infection. Every time a nurse comes into the room to monitor your catheters, ask him to check them for cleanliness, and to make sure that the entry site is clean and sterilized each time. It's also important to sterilize the connections every time a catheter bag is changed.
- Food-service workers who come into your room should touch only the trays they bring and retrieve and the food on the trays. If they touch anything else—for instance, they prop up a patient in the bed next to you—ask them to change their gloves before giving you your tray,
Key protection: If you have time, get a pneumonia vaccination from your doctor as far in advance as possible before entering the hospital. Hospital patients often have weakened immune systems—and pneumonia is among the leading causes of hospital deaths. In patients who develop pneumonia while hospitalized for another condition, the mortality rate can be as high as 70%. The pneumonia vaccine protects against 23 strains of the most common bacterial pneumonia.
Bedsores
Also known as pressure ulcers, bedsores occur when circulation to the skin and underlying tissues is blocked in immobile patients. This usually occurs on the elbows, hips, buttocks and/or heels. Older patients, and those with diabetes or other diseases that cause circulatory problems, have an especially high risk for bedsores.
Warning: Bedsores are often painless until damage is already extensive. Patients and health care workers have to watch for them. Self-defense...
- Move your arms and legs as often as you comfortably can.
- Change position or ask friends/family members to help you change position about every hour or two.
Also important: Ask them or nurses) to inspect areas that you can't see to make sure sores aren't developing.
Falls
Falls are the second leading cause of accidental deaths in hospitals, and the main cause of broken hips. They often occur when patients need to use the bathroom but don't get a response after pressing the call button and attempt to climb out of bed without waiting for assistance.
Other causes: Unsteadiness due to sedation from medications...tripping over IV lines and other obstacles...and slipping on wet floors. To ward off falls…
- If a nurse doesn't respond when you press the bedside call button, use the phone (assuming you are able to call the main switchboard. Ask for the nursing station on your floor. Someone will always answer.
- Have a friend/family member bring you a pair of slippers with nonskid soles.
Important: For safety's sake, don't get up without assistance, even if you think you're strong enough to do so. Some hospitals have bed alarms that alert the nurses if you try to get up on your own—but many don't.
Surgical Safety
Under the new rules, Medicare won't pay hospitals for treating complications from serious preventable errors, such as recovering a sponge or other object that was left inside a patient after surgery.
Patients have little control over surgical outcomes, but they can pick a surgeon who has a lot of experience with a particular procedure. Statistically, the error rate is significantly lower when surgeons do a procedure at least 100 times a year.
Also important: Before surgery, use a marker to write an "X" on the body part-knee, hip, elbow, etc-that's supposed to be operated on. Some hospitals already do this, but some don't.
There aren't reliable statistics on the frequency of "wrong-site surgeries, but it happens frequently enough that the Joint Commission on Accreditation of Health Care Organizations, a nonprofit organization that evaluates and accredits health care organizations, issued an emergency alert in 2001 about the rise in frequency. It now advises marking the surgical site ahead of time.
