Saturday, April 21, 2012

Rapid Response Teams

The Rapid Response Team

While sitting in the waiting room at a hospital waiting for the patient to come out of surgery, I heard over the loud speaker, “Rapid Response Team to 2 west, Rapid Response Team to 2 west, Rapid Response Team to 2 west”.  The words broke the otherwise silence of family waiting patiently reading or texting.
They were unaware of the importance of the words they just heard.  The excitement ran through my body because in the middle of a sunny afternoon, hospital staff were acting on a fairly recent system to save patients who might otherwise die.
The Rapid Response Team, also known as the Medical Emergency Team is in place at many hospitals to be called by patient, family or staff when a patient is in need of fast intervention.  Unexpected cardiac arrests in hospitals are usually preceded by signs of instability (1) and these patients are often cared for by junior staff. (2)
Following the Australian model the Rapid Response Team or RRT brings ICU level care to the patient’s bedside using interdisciplinary teams.(3)
Although there is still some controversy such as would this method be abused or are highly trained physicians being taken away from one patient to care for another(3), those of us know the importance of the RRT also know that we would rather be in a hospital that uses them, than not.
Look for the signs on the wall of your hospital and see if there is a RRT in place.

Thursday, April 5, 2012

Health Literacy at it's Worst!

The High Cost of Health Literacy

I have been following the story of John Gonzalez, a 70 year old man from Long Island who spent six months in jail after killing his elderly mother.  He was let out with time served and will have five years probation.  The reason he was let go is because the judge and everyone on the case felt bad for him because he was diagnosed with cancer and thought he would soon die.  He was the only person who could care for his mother and out of desperation, took her life and tried to take his own.  The Newsday article by Andrew Smith reads in part; He suffered from diabetes, joint pain and other maladies. Then, when he got a letter from his doctor informing him that a spot on his hand was skin cancer, his poor English led him to believe he was going to die soon and no one would care for his mother, Brown said.
I can only imagine how many other times Mr. Gonzalez has used the healthcare system and didn’t understand the diagnosis and treatment.  The article also reads:  After she died, he tried to kill himself by taking all the insulin he had and slashing his wrists. He was unconscious for four days and, as a result of the insulin overdose, he wrecked his kidneys and now needs dialysis at least three times a week.
So now, not only is a woman dead, but Mr. Gonzalez will be getting medical treatments that will cost the economy plenty – just because he didn’t know where to go for proper information or an interpreter who could help him understand.
More to come – You can count on it!

Monday, April 2, 2012

C. diff

Washing Hands Can Make a Difference

Wash your hands before eating takes a whole new turn after reading this article in LI Newsday.
A recent article in Long Island’s Newsday by Delthia Ricks explains in detail the problems with the bacterial infection Clostridiumdifficile, also known as C. diff.  This bacterial infection, known to cause severe pain, diarrhea and high fever is a serious problem in hospitals throughout the country.   In 2009 there were 337,000 cases Ricks reports in the article, more than doubling the number from the less than ten years earlier.
The spores can live for months and can be spread if not killed with bleach in a room where the spores might be living in a patient’s room.  To clean hands from the spores soap and water must be used.  The hand sanitizers won’t do it.
So how does this change what we already know?  As a patient safety educator I will let people know that soap and water must be used when someone enters the room to treat a patient.   If you feel uncomfortable asking someone to wash their hands, carry this article with you and tape it to the patient’s wall. 
When a family member or friend visit – leave the flowers home and bring a container of Clorox wipes.  Grab some gloves and wipe down the room.  The tray table, bed rails, door and door knob, TV remote, call bell and sink.

Wash your own hands repeatedly with soap and water and if you touch anything wash again.  Your hands may be clean when you come in but anything you touch can be contaminated which will start the process of contamination over again.
A recent discussion at a group training caused an outburst by a woman when I suggested that unless hands are noticeably soiled, antibacterial lotion can be used.  She was upset by this comment because her mother suffered from C. diff.  Her knowledge on the subject made me and my colleague Jeff, who has been offering these programs with me, to rethink how we discuss infection prevention.  If C. diff is as big a problem as it is said to be then we have a right to insist on soap and water.

NY State information on C.diff
Pamphlet on C.Diff