Billy boy 2012-07-13 08:43:48
Don’t Let A Hospital Make You Sick
By Dr. Ranit Mishori
Publication Date: 02/08/2009
When I told one of my hospitalized patients the other day, “We’ll be sending you home
tomorrow,” she wasn’t exactly pleased at the news. Yes, she told me, she was feeling
better than when she’d arrived two days earlier. But shouldn’t she stay until she felt 100
percent? Isn’t a sick person always safer in the hospital than at home?
My answer-and plenty of studies support it-was an emphatic “no.” From hospital-acquired
infections to medication errors to surgical mistakes, being a hospital patient carries a
risk of its own, known as “preventable complications.” Millions of these occur every year.
An Institute of Medicine study estimated that nearly 98,000 Americans die each year due to
medical errors. “It is a very serious problem,” says Joe McCannon, vice president of the
Institute for Healthcare Improvement.
Preventable complications also are expensive, costing our health-care system billions of
dollars every year in additional medical expenses. In fact, the financial toll has been so
high that, in October, Medicare stopped paying hospitals to treat patients for some
problems caused by events during their hospital stays. These new rules, which cut directly
into hospital reimbursement, are controversial, but they have forced hospitals to look for
ways to prevent errors.
The problem is not that we have an epidemic of negligent doctors and nurses. Rather, it’s
that the health-care system has grown so complicated that there is a greater chance than
ever of things falling through the cracks.
Reduced staffing is one source of trouble, according to research. Take something as simple
as bedsores: One study showed that the lower the nurse-to-patient ratio in hospitals, the
higher the rate of bedsores. It makes sense: Moving patients in bed usually prevents this
problem, but nurses are needed to do that. And once bedsores get going, they can lead to
Another problem is that hospitals produce massive amounts of data, including lab and X-ray
reports, medication lists, doctors’ orders, and dietary restrictions. It is easier than
ever for critical communications to get lost, and hospitals often don’t have thorough
Dr. Carolyn Clancy, a health-care quality expert, warns, “Almost nothing in health care
has that much built-in checking.”
But rest assured: Finding solutions has become a priority for hospitals. In the meantime,
there are measures you as a patient can take to counter some of the more-common types of
The Risk: About 1300 times a year, surgeons operate on the wrong person or remove the
wrong limb or organ. Also, doctors leave surgical instruments inside the body once in
every 5000 surgeries. This is the stuff of headlines, but such incidents are rare,
considering that more than 20 million surgeries occur every year. Far more common
preventable problems are stitches coming loose, blood clots forming during or after
surgery, and infections. These can lead to very serious outcomes.
What You Can Do:
Inquire about taking antibiotics before or immediately after surgery to minimize the risk
Make sure your surgeon has a plan to prevent blood-clot formation.
Ask the surgeon to mark the surgical site with a pen in front of you, while you are still
Speak up if you sense something is wrong. This may seem a little intimidating, but if your
busy doctor or nurse has in fact overlooked something, your concern may be the only
warning he or she gets. “It’s astonishing how many people see something wrong but don’t
say anything because they figure the people in charge know,” says Dr. Carolyn Clancy.
Well, sometimes they don’t. You just may prevent a preventable error.
The Risk: Giving the wrong drug, administering the wrong dose, mixing drugs that interact
badly, or giving a medication to which a patient is allergic-all can be deadly.
Unfortunately, such mistakes are not rare. Adverse drug events cause one out of five
injuries or deaths to hospital patients in the U.S.
What You Can Do:
Always inform your doctors if you have drug allergies.
Make a list of all the medications you were taking before the hospital stay.
When a staff member gives you a drug, make sure you are getting the right one. Ask what it
is and what it is for.
Before you leave, ask for a list of all the medications you received during your stay and
those that you are expected to take. Compare the list with the medications you were taking
before coming to the hospital to make sure you are not taking the same drug (with a
different name) twice.
The Risk: The Centers for Disease Control and Prevention report that 99,000 patients a
year die from hospital-borne infections. Germs are everywhere: on surfaces, doorknobs-even
your doctor’s necktie.
What You Can Do:
Ask anyone who examines you to wash his hands.
Ask your doctor or nurse to clean her stethoscope before it comes in contact with your
If you need a urinary catheter, make sure it is kept in for the shortest possible time.
If you need a “central line” (an IV tube going into a major blood vessel), ask if they
have tubes that are coated with antibiotics.
If you have an IV, make sure it doesn’t stay in place for more than a week. Let the
nurses know if it becomes loose.
Every time a line or regular IV needs to be inserted, ask whether the hospital staff
follows sterile procedures before inserting the tube or needle.
The Risk: More than a quarter of a million cases of these pressure ulcers were reported to
Medicare in 2006. They result when parts of the body-heels, ankles, tailbone, buttocks, or
hips-rub against surfaces such as wheelchairs or bedsheets. They are not only painful but
also highly prone to infections that can spread to the bones or blood. The cost of these
preventable complications was about $11 billion last year alone.
What You Can Do:
Change position every two hours or ask the nursing staff or a family member to help
Check for redness or sores on the skin to help find the ulcers as early as possible.
Keep the skin as dry as possible.
Keep your knees and ankles from touching. Use small pillows or pads to keep them
Ask about special mattresses and pressure-reducing devices. Most hospitals should have