Did You Know...
healthalerts.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
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
healthalerts.com.au article posted on: Wednesday 29th July 2009
Restaurant staff are used to patrons taking a few minutes to check their bill before paying. People can make mistakes and no one seems to mind removing that “extra” bottle of wine from the bill!
So why not check your medical bill?
One privately insured patient recently received a nasty surprise when he checked his on-line claims history. He discovered his doctor had charged his Fund (and therefore him) for seven ECG procedures over a one week period, when in fact only one procedure had taken place.
It's easy to pick up an "extra six" bottles of wine on a restaurant bill, so perhaps taking the time to check medical accounts might also reap financial rewards.
Email healthalerts.com.au if you’ve had a similar experience.
healthalerts.com.au article posted on: Monday 30th March 2009
A report published on medicalsearch.com.au (26/3/09) has revealed that superbugs, bacteria that have developed antibiotic resistance, are not confined to Australia's hospitals as experts warn they are increasingly cropping up in the community.
A variant of the potentially deadly Staphylococcus aureus bacteria, which is resistant to its front-line treatment (methicillin), now accounts for up to 15 per cent of all community-based infections, says Dr Clare Nouse, of the Mater Children's Hospital in Brisbane.
healthalerts.com.au article posted on: Monday 30th March 2009
Researchers at the University of Oxford in the United Kingdom have found that obesity is as dangerous to health as smoking and similar to smoking when it comes to effect on longevity.
The study conducted by the Clinical Trial Service Unit at Oxford reports that Obesity causes kidney disease, liver disease and several types of cancer, but the most common way it kills is by causing stroke and, most importantly, heart disease. Obesity causes heart disease by pushing up blood pressure, by interfering with blood cholesterol levels, and by bringing on diabetes.
healthalerts.com.au article posted on: Monday 2nd March 2009
The benefits of a national cardiac register, as proposed by the Australian Health Insurance Association have been highlighted by a “Heart Device Dispute” in the United States.The New York Times has reported that the failure rate of a widely used heart device has sparked a debate between medical professionals and device manufacturers.
“But some experts say that debate would not be occurring if federal officials, medical device makers and more doctors had thrown their weight more fully behind efforts to develop a national database of patients who get heart devices.
“Dr. Alan Kadish of Northwestern University, who is also involved in the registry, said he did not think that manufacturers believed that they would “be fulfilling their fiduciary obligations to shareholders by funding” studies that compare the effectiveness of their devices to those of competitors.”
healthalerts.com.au article posted on: Friday 28th March 2008
A Fracture Risk Calculator has been developed by the Garvan Institute of Medical Research using data collected in the internationally renowned Dubbo Osteoporosis Epidemiology Study.
The study began in 1989 and included more than 2500 men and women aged 60 years or more from the Australian regional city of Dubbo. Osteoporosis fracture affects 44 % of women and 25% of men in Australia costing about $7.4 billion per year.
The Garvan Institute says the study contributed major changes to the understanding of osteoporosis in women and men, including risk of fracture, impact on quality of life, and even survival.
To assess your risk of fracture go to www.fractureriskcalculator.com
healthalerts.com.au article posted on: Wednesday 23rd January 2008
This is a call to arms for everyone who may someday be hospitalized, or who has a relative who may someday be hospitalized -- which is to say everyone.
These days, to spend time in the hospital is to be at risk of contracting a hospital-acquired infection. Some of these infections can be life-threatening. But there is a simple way to make that hospital stay safer, devised by Dr. Peter J. Pronovost, a physician-researcher at Johns Hopkins.
The method -- a five-item checklist to assure that proper precautions are taken to prevent infection -- has been thoroughly tested, first at Johns Hopkins and later in 108 intensive-care units in Michigan, where it succeeded beyond anyone's wildest dreams in saving lives and reducing costs for patients who received the major fluid tube called a central venous catheter.
According to Dr. Pronovost, whose findings in Michigan were published in The New England Journal of Medicine on Dec. 28, 2006, about half of intensive-care patients receive these catheters; about 80,000 a year become infected and 28,000 die, with an economic cost of $2.3 billion.
Five Simple Steps
Using the checklist, in 18 months the average I.C.U. at these diverse hospitals reduced its catheter-related infection rate to zero, from 4 percent. All told, the checklist saved more than 1,500 lives and nearly $200 million. The program itself cost only $500,000.
Dr. Pronovost, a professor of anesthesiology and critical care medicine, said in an interview that he distilled the five steps from a 64-page federal document on controlling hospital-acquired infections. When inserting a central venous catheter, doctors should do the following:
1. Wash their hands with soap.
2. Clean the patient's skin with chlorhexidine antiseptic.
3. Put sterile drapes over the entire patient.
4. Wear a sterile mask, hat, gown and gloves.
5. Put a sterile dressing over the catheter site.
Source: The New York Times, 22 January 2008
healthalerts.com.au article posted on: Monday 26th November 2007
The National Breast Cancer Centre has developed an online calculator designed to help women assess their level of risk of developing breast cancer.
The calculator tells women if they are at "low or average risk", "moderately increased risk" or "potentially high risk" of developing breast cancer. It also suggests what might have contributed to that risk.
One in eight women in Australia will develop the cancer, but generally it is not possible to determine the cause in any individual. However, studies have found common characteristics, such as age - three out of four cases are in women over 50 - and genetic factors.
The calculator only takes a few minutes to complete, and the relevant risk factor is explained at each stage.
http://www.nbcc.org.au/risk/
healthalerts.com.au article posted on: Thursday 1st November 2007
For years health authorities have warned of the growing threat posed by drug-resistant bacteria, but most of us have been half-listening. Not anymore.
A virulent strain of bacteria that resists many antibiotics appears to be killing more people annually than AIDS, emphysema or homicide, taking an estimated 19,000 lives in 2005, according to a study published last week in the Journal of the American Medical Association.
The recent death of a 17-year-old high school football player in Virginia is a tragic reminder that methicillin-resistant Staphylococcus aureus, or MRSA, can prey on otherwise healthy people.
The best defense against the potentially deadly infection is common sense and cleanliness. “We need to reinvent hygiene for the 21st century,’’ said Dr. Charles Gerba, professor of environmental microbiology at the University of Arizona at Tucson.
“You go to a grocery store, and hundreds of thousands of people have touched those surfaces every day. Microorganisms are evolving very rapidly.’’
Here are answers to common questions about community-acquired staph infections, or CA-MRSA.
What does CA-MRSA look like?
CA-MRSA is primarily a skin infection. It often resembles a pimple, boil or spider bite, but it quickly worsens into an abscess or pus-filled blister or sore. Patients who have sores that won’t heal or are filled with pus should see a doctor and ask to be tested for staph infection. They should not squeeze the sore or try to drain it — that can spread the infection to other parts of the skin or deeper into the body.
Who is at risk?
The vast majority of MRSA cases happen in hospital settings, but 10 percent to 15 percent occur in the community at large among otherwise healthy people. Infections often occur among people who are prone to cuts and scrapes, such as children and athletes.
MRSA typically spreads by skin-to-skin contact, crowded conditions and the sharing of contaminated personal items. Others who should be watchful: people who have regular contact with health care workers, those who have recently taken such antibiotics as fluoroquinolones or cephalosporin, homosexual men, military recruits and prisoners. Clusters of infections have appeared in certain ethnic groups, including Pacific Islanders, Alaskan Natives and Native Americans.
What can I do to lower my risk of contracting MRSA?
Bathing regularly and washing hands before meals is just a start. Wash your hands often or use an antibacterial sanitizer after you’ve been in public places or have touched handrails and other highly trafficked surfaces. Make sure cuts and scrapes are bandaged until they heal. Wash towels and sheets regularly, preferably in hot water, and leave clothes in the dryer until they are completely dry. “Staph is a pretty hardy organism,’’ said Dr. Gerba.
Remind kids and teenagers that personal items shouldn’t be shared with their friends, he added. This includes brushes, combs, razors, towels, makeup and cell phones. A teenager in Dr. Gerba’s own family once contracted MRSA, he said, and he eventually traced the bacteria to her cell phone. She had shared it with a friend whose mother worked in a nursing home. Dr. Gerba went on to discover MRSA on the friend’s cell phone and makeup compact and on a countertop in her home.
healthalerts.com.au article posted on: Tuesday 11th September 2007
Every two hours, Olympics-style theme music is piped over the audio system at OSF St. Francis Medical Center in Peoria, Ill., signaling to hospital staff that it's time to perform a vital task: repositioning patients in their beds to avoid wear and tear on sensitive skin.
Hospitals around the country are scrambling to put new programs in place to prevent pressure ulcers, commonly known as bedsores, after the federal Centers for Medicare and Medicaid Services announced last month that as of October 2008, it will no longer reimburse hospitals for treating eight "reasonably preventable" conditions. Pressure ulcers are among the most prevalent, costly and dangerous on the list: In addition to interfering with recovery, lengthening hospital stays and causing extreme pain and discomfort, pressure ulcers can increase the risk of infection, with nearly 60,000 deaths annually from hospital-acquired pressure ulcers.
Nursing homes and long-term-care facilities have made strides of their own in prevention, motivated in part by the costs of litigation for failure to prevent pressure ulcers. But in acute-care hospitals, where patients stay for much shorter periods, prevention has been sporadic. Acute-care hospitals treat about 2.5 million pressure ulcers each year, and as many as 15% of hospitalized patients may have pressure ulcers at any one time, according to the Institute for Healthcare Improvement. Estimates for the cost of treating all pressure ulcers in the U.S. range up to $11 billion annually.
To combat this, hospitals are pushing screenings of all incoming patients from head to toe for skin issues that could lead to pressure ulcers. They are using visual examinations, ultrasound and other technologies that can help identify skin with tissue damage. In some cases, they are photographing areas of a patient's skin to document how it changes from day to day.
Hospitals are also buying special beds with high-tech air mattresses that minimize or redistribute pressure. And they are adhering to strict monitoring schedules that include shifting patients every two hours, frequently cleaning and moisturizing soiled or sensitive skin, and making sure that at-risk patients have enough protein and other nutrients in their diet to help the healing process.
healthalerts.com.au article posted on: Wednesday 22nd August 2007
WASHINGTON — In a significant policy change, Bush administration officials say that Medicare will no longer pay the extra costs of treating preventable errors, injuries and infections that occur in hospitals, a move they say could save lives and millions of dollars.
Private insurers are considering similar changes, which they said could multiply the savings and benefits for patients.
Under the new rules, to be published next week, Medicare will not pay hospitals for the costs of treating certain “conditions that could reasonably have been prevented.”
Among the conditions that will be affected are bedsores, or pressure ulcers; injuries caused by falls; and infections resulting from the prolonged use of catheters in blood vessels or the bladder.
In addition, Medicare says it will not pay for the treatment of “serious preventable events” like leaving a sponge or other object in a patient during surgery and providing a patient with incompatible blood or blood products.
“If a patient goes into the hospital with pneumonia, we don’t want them to leave with a broken arm,” said Herb B. Kuhn, acting deputy administrator of the Centers for Medicare and Medicaid Services.
healthalerts.com.au article posted on: Wednesday 22nd August 2007
National Prescribing Service Limited (NPS) has launched its national medicines awareness campaign titled: Get to Know Your Medicines. The campaign aims to increase consumer awareness and understanding about the medicines they are taking in order to minimize the possibilities of side effects and interactions.
Every year in Australia almost 200 million prescriptions are dispensed representing ten medications per person.
“It is important to remember that 70% of Australians take at least one prescription medicine or non-prescription medicine at any one time,” explained NPS CEO Lynn Weekes. “Using medicines is more common among older people with 86% of people 65 years and over using medicines. Multiple use of medicines is more common in people aged 85 years and over.”
Dr Weekes explained “there is a high incidence of preventable adverse medicines events in Australia.”
Statistics gathered over the past 10 years clearly show numerous problems associated with taking medicines. More than 140,000 people are hospitalised every year as a result of medication-related problems with evidence showing that between 50-75% of these are preventable.
healthalerts.com.au article posted on: Wednesday 6th June 2007
Doctors are rethinking the use of stents for their heart patients.
The trend comes in the wake of studies questioning the necessity and safety of stents and the widespread adoption of better cholesterol-fighting drugs. Doctors say the drugs are proving to be a better option for some patients, further delaying their need for the device.
An estimated 1 million Americans a year receive stents to prop open clogged arteries and restore and maintain blood flow to the heart. The tiny metal scaffold-like devices are snaked into coronary arteries via a balloon-tipped catheter and have been hailed for relieving chest pain known as angina and reducing the risk of heart attacks and death.
But within the past year, studies on the newer drug-coated version of stents show a small risk of clots for some patients. And just as hospitals moved somewhat to older, cheaper bare metal stents to avoid a clotting risk, a widely distributed March study showed that drug therapy through the use of cholesterol-fighters known as statins, blood pressure pills and aspirin works as well as a stent.
healthalerts.com.au article posted on: Thursday 17th May 2007
There is a higher prevalence of chronic heart failure in patients in rural areas compared with urban areas, according to a recent study published in the Medical Journal of Australia.
The study, conducted by the Centre of Clinical Research Excellence in Therapeutics at Monash University, also found a significantly lower use of recommended diagnostic methods and pharmacological treatment.
Centre Head, Professor Henry Krum says the findings suggest that greater allocation of resources and improved access to specialists and diagnostic support need to be considered for rural and remote populations in Australia, to match those in metropolitan areas.
Very importantly, the study shows that the rate of use of evidence-based management for Congestive Heart Failure was low overall in Australia, and consistently low across all geographical regions (capital cities and metropolitan areas, 4.6%; large and small rural towns, 3.9%; and rural and remote areas, 3.7%). The AHIA believes focussed work needs to be undertaken immediately, to ensure that patients receiving Evidence Based treatments becomes regarded as the norm.
To view the study, go to the Medical Journal of Australia website at:
http://www.mja.com.au/public/issues/186_09_070507/cla10336_fm.html
healthalerts.com.au article posted on: Thursday 1st March 2007
Health Alerts brought to attention last year concerns raised overseas by medical professional bodies about the potentially fatal longer term effects of drug-eluting cardiac stents on certain types of patients. In just three years, these stents have effectively replaced bare metal stents, such that they are now used in 90% of cases in the US and Australia. But a growing body of expert medical opinion is questioning whether drug-eluting stents offer any advantages over bare metal stents for many patients or even distinct disadvantages for some patients.
For an animated explanation of how these two types of stents work, go to the website of the New England Journal of Medicine at : http://content.nejm.org/cgi/content/full/NEJMe068306/DC1
In response to the concerns raised and as part of the public debate, the New England Journal of Medicine published on its website on 12 February 2007 a series of items on drug-eluting stents and announced its intention to publish the full articles in the Journal edition of 8 March 2007. To preview the Abstracts on the NEJM website, go to www.nejm.org
healthalerts.com.au article posted on: Tuesday 16th January 2007
healthalerts.com.au article posted on: Wednesday 10th January 2007
healthalerts.com.au article posted on: Friday 15th December 2006
healthalerts.com.au article posted on: Thursday 9th November 2006