Thursday, June 17, 2010

Hospital Acquired Infection and Health Worker Causes of Incidents

Lately there has been a lot of scare about MRSA, methicillin resistant staphylococcus acquired by bed riden hospital patients and the elderly in nursing care facilities.These and other types of infections acquired in clinical settings are called Nosocomial Infections. There are several that contribute to hospital setting morbidity and mortality annually.

Some 2.5 million infections in hospitals occur in this setting. It is actually considered the 4th largest killer in the U.S after AIDS, cancer and accidents. This problem may actually be costing the US taxpayer some 30 $billion dollars annually. Studies indicate that one in twenty patients gets infected in the hospital.

Why has this persisted in the era of greatest medical findings and technolgy, drug therapy? Bio-medical scientist and clinical pharmacologist believe that in the era previously, so many antiobiotics may have been given as a "knee-jerk" response to every cough, cold, or sneeze and that over several generations the "bugs" (bacteria, viruses) have out smarted some of antiobiotics by creating in their own DNA codes to resist them.

How health workers handle sanitation is another area. Do doctors and others wash their hands after seeing one patient and going to the next room? do spills on clothing, ties or lab jackets transmit the "bug" room to room? Are the air flows in rooms with communicable disase functioning such in a TB ward? Are colonoscopes, brochoscopes, and other surgical equipment autoclaved and if so at the correct temperature?

Another curiosity are Iatrogenic Effects". These are health worker induced(normally accidental) occurences that cause morbidity and mortality. Dosing of drugs is perhaps one of the biggest areas that is of concern. Writing correct medical records for change of shift is another. This is a vulnerable time where important lab that is in transit may be missed.

Usually at the beginning of July in teaching hospitals new Interns fresh out of medical school ready to "take on the world" and invade the ERs of America get started. There is a wide range of teaching competencies from medical school to medical school. While some schools teach very hands on some prefer being more academic but less hands on. They all get to blend in a residency program together.During this time morbidity and mortality rates do go up. those who were once Interns now hold down even more repsonsibility by becoming a Supervising resident who is now in charge of 2 or 3 or more interns. This can be a heavy responsibility.things do get misplaced.

The Journal of the American Medical Association has regularly attributed very conservativelly an annual mortality of 300,000 due to Iatrogenic causes. But ,other observers report it as high as 700,000.

It may be the "practice of medicine" which is to heal the sick that may have more benefit in prevention and sanitation as a major method of treatment. Physicians are not to blame, but rather poorly designed logistics that could help double check what is going on better . The president's campaign to put medical records online especially prescirptions will help pave the way for other measures to come, but much more needs to be done to prevent both Nosocomial Infections and Iatrogenic Effects.

Dr. Marcus Wells is a previous Clinical Associate at the NIH at the National Heart, Lung, & Blood Institute. He has served with the US Health & Human Serives, US Public Health Service and the US Commissioned Corp. Dr. Wells also holds a Master's degree from Emory University.

Tricky Food Labels

Should we be reading and trusting our food labels more often? How many times do you go to your grocery store and actually read the labels to see how much fat grams,total calories, cholesterol, sugar and additives the company has put inside. Even after it took a while to get the FDA to make this a mandate , many of us are still whimscally ignoring labels. But, that just may be what the food industry is hoping for.

In a morning talk show on NBC several prepared "diet meals" were investigated for their calorie amount and determine whether it was consistent with the actual amount in them by having them checked by a nutritionist.

Healthy Choice(HC), Lean Cuisine(LC),and Smart One(S1) were the primary meals that were focused on. What was found was shocking. First of all the GMA Grocery Manufacturing Association doesn't find it a problem for food makers to have great disparity in the amount of calories labelled on a box and the actual amounts inside them.The head of the GMA felt is was irrelevant essentially to the customer and that wide ranges of calories was OK.

If that wasn't enough that government agent that "protects" the citizens with discrepancies , the FDA, actually allows food companies to have a discepancy in calorie labels up to 20%!

First the good news. There were some meals that had less calories than that which was stated on the food lable.

Examples of this were :

1)HC Roast Beef Merlot it was actually 17% lower in fat calories than it's fat label

2)LC Primavera was 19% fewer calories than it's food label

3)LC Rose Marie actually had 60 % less fat than its package label

But, now for the bad news:

1)S.1. Shrimp Marino had 10 % more calories than its label

2) HC Lobster Cheese Ravioli had 17 % more fat than its label

3)LC Primavera was also higher in calories

4) S.1. sweet and sour chicken actually was 11 % more in total calories but , get this, it had 350 %(percent) more fat

Susan Roberts, a nutritionist at Tufts gave her opinion about this practice and felt that this may be the cause of how"sneaky" calories get into our diet and cause overweight and obesity and also when many of us are thinking our "diet" meal is helping us lose weight, it actually may be causing you to gain weight!

Latest studies show today that less calories particularly fat and that from red meat can extend both quality and the length of life by preventing heart disease, and cancer. Higher fiber diets in oats, bran, green leafy vegetables and fruits can combat cancer and diabetes.

Tomatoes have lycopene that helps men protect the prostate. Pomengranate and Grape Extract have antioxidants that can help fight against chronic disease and premature aging.Almonds and fish with more omega oil are considered smart foods that help the brain.Broccoli helps with reducing bladder cancer, watermelon helps lower blood pressure, papaya helps fight gall bladder disease because of it's high amount of vitamin C. Fermented soy may help fight against breast cancer and bone loss.

These choices along with exercise by simply walking can help reduce your risk of heart disease, cancer and diabetes.

Dr. Marcus Wells is a previous NIH Clinical Associate at the National Heart, Lung & Blood Institute. Dr. Wells served in the US Health & Human Services, US Public Health Service, US Commissioned Corp and holds a Master's degree from Emory University.

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