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Doctors should be "horrified" by their hand hygiene-studieshealthalerts.com.au article posted on: Thursday 22nd October 2009
Research into the success of a NSW-based project which aimed to improve hospital hygiene has found nurses had the best handwashing practices, and they were also more willing to improve.
Doctors would be shocked by the results, said Associate Professor Mary-Louise McLaws who is director of Public Health Programs at University of NSW.
"No doctor thinks 'I'm going to work today to infect my patients'," Dr McLaws said.
"Doctors are going to be horrified when they see these data."
A Clean Hands Save Lives campaign was introduced to all of NSW's public hospitals in early 2006, and its success in changing staff behaviour was monitored over the following year.
All staff were urged to use an alcohol-based solution to wash their hands both before and after patient contact, as posters were erected and themed t-shirts also worn to promote the campaign.
Dr McLaws said it resulted in an overall improvement in hand hygiene but the gains were not uniform and doctors were the poorest performers.
The proportion of nurses who cleaned their hands after patient interaction rose from 54.5 per cent before the campaign, to just over 65 per cent at the end.
Doctors' figures rose from 29.6 per cent to just under 39 per cent.
They were even outranked by allied health workers, as their hand hygiene rates went from 40 to 48 per cent.
"This hand hygiene rate among doctors and other allied health workers is a wake-up call," Dr McLaws said.
"Previous studies we've done have shown that nurses look to doctors for their hand hygiene compliance behaviour, yet it is doctors who are letting the side down.
"We need to empower nurses to be strong advocates for their patients and to guide and remind doctors who enter their wards to cleanse their hands."
The World Health Organisation (WHO) has identified hand hygiene as a key element in reducing rates of hospital acquired infections, which affect as many as 200,000 Australians each year or one in 10 hospital admissions.
The research is published in the Medical Journal of Australia.
Source: AAP NewsWire
United States Orthopaedic doctors resist disclosing consulting fees
healthalerts.com.au article posted on: Tuesday 13th October 2009
A United States study has found that 40 per cent of orthopaedic physicians did not disclose financial agreements they had with U.S. device makers.
While medical journals and professional societies generally require doctors to disclose possible conflicts of interest--such as payments from medical device makers or pharmaceutical companies - some doctors are still reluctant to come clean. That's particularly so in the case of orthopedic physicians, whose relationships with device makers are particularly tight due to the high-tech nature of their jobs, according to a new research study published in the New England Journal of Medicine.
To conduct the study, a team of researchers, led by Brigham and Women's Hospital associate professor of orthopedic surgery Dr. Mininder Kocher, looked at reports made of payments given to doctors by five companies making replacement hip and knee joints. These disclosures were part of a settlement agreed upon by several device makers with the U.S. Department of Justice.
The researchers compared these reports with the number of physicians giving presentations at the 2008 annual meeting of the American Academy of Orthopaedic Surgeons, where a total of 344 doctors presenting papers had received industry payments.
Dr. Kocher's team concluded that nearly 30 percent of doctors didn't disclose direct financial arrangements with the device makers in the settlement, and that 50 percent didn't disclose payments indirectly related to their presentations. However, doctors getting $10,000 or more were more likely to disclose.
To learn more about the study: read this Health Day News piece
- POLICY WATCH
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Australia's "Community Rating" system gets top marks
healthalerts.com.au article posted on: Monday 30th March 2009 Australia’s private health insurance model, which boasts community rating as one of its key features, represents international best practice. Community rating facilitates affordable access to private health care for all Australians. It means that everyone pays the same premium for their health insurance and health funds are prevented from discriminating against members on the basis of health status, age or claims history. The new United States administration is working with US health funds to overhaul the existing “risk rated” system in favour of a model which resembles the Australian example. US health funds are working on a set of proposals to make health insurance more affordable. Health Insurers Offer to Drop 'Risk Rating' The offer from America's Health Insurance Plans and the Blue Cross and Blue Shield Association is a potentially significant shift in the debate about overhauling the nation's healthcare system to rein in costs and cover an estimated 48 million uninsured people. In a letter to key senators, the two insurance industry groups said their members are willing to "phase out the practice of varying premiums based on health status in the individual market" if all Americans are required to get coverage. "The offer here is to transition away from risk rating, which is one of the things that makes life hell for real people," said health economist Len Nichols of the New America Foundation, a public policy center. "They have never in their history offered to give up risk rating." Insurers are trying to stop the government insurance plan, proposed by many Democrats and advocacy groups, to offer consumers another choice for affordable care and to increase competition. "This letter demonstrates that insurance companies are open to major insurance reform, and are even willing to accept broad consumer protections," said Senator Jeff Bingaman, a moderate Democrat from New Mexico. "It represents a major shift from where the industry was in the 1990s during the last major healthcare debate." Story Continues Below Advertisement To try to win political support, the industry has already made a number of concessions, including offering to end the practice of denying coverage to sick people and pledging support for a national goal of restraining cost increases. The latest offer goes beyond that. Insurance companies now charge very high premiums to people who are trying to purchase coverage as individuals and have a history of medical problems, such as diabetes or skin cancer. Even if such a person is offered coverage, that individual is often unable to afford the high premiums. About 7 percent of Americans buy their coverage as individuals, while more than 60 percent have job-based insurance. "This changes everything," said Karen Ignagni, president of America's Health Insurance Plans, the leading trade group. "When you have everyone in the system, and you can bring [financial] assistance to working families, then you can move away from health status rating." The companies left themselves several outs, however. The letter said they would still charge different premiums based on such factors as age, place of residence, family size, and benefits package. "If the goal is to make healthcare affordable, this concession does not go far enough," said Richard Kirsch, campaign manager for Health Care for America Now, a group backed by unions and that is trying to build support for sweeping healthcare changes. "It still allows insurers to charge much more if you are old." Also, the industry did not extend to small businesses their offer to stop charging the sick higher premiums. Small employers who offer coverage can see their premiums zoom up from one year to the next, even if just one worker or family member gets seriously ill. Ignagni said the industry is working on separate proposals for that problem. "We are in the process of talking with small business folks across the country," she said. "We are well on the way to proposing a series of strategies that could be implemented for them." |
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