Hospital Resorts To Cameras To Ensure Employees Wash Hands 273
onehitwonder writes "Long Island's North Shore University Hospital is using sensors and video cameras to make sure employees wash their hands, according to an article in today's New York Times. Motion sensors detect when hospital staff enter an intensive care unit, and the sensors trigger a video camera. Feeds from the video camera are transmitted to India, where workers there check to make sure staff are washing their hands. The NYT article notes that hospital workers wash their hands as little as 30 percent of the time that they interact with patients. The Big Brother like system is intended to reduce transmission of infections as well as the costs associated with treating them."
Let me be the first to say... (Score:5, Funny)
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How about a sensor that detects if they actually have germs on their hands. If so sterilizing boiling water comes out killing the germs.
Sheesh. Luddites.
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How about a sensor that detects if they actually have germs on their hands. If so sterilizing boiling water comes out killing the germs.
Boiling water isn't hot enough to sterilize (autoclaves run hotter). Maybe a plasma - it would look cool too.
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How about a sensor that detects if they actually have germs on their hands. If so sterilizing boiling water comes out killing the germs.
Boiling water isn't hot enough to sterilize (autoclaves run hotter). Maybe a plasma - it would look cool too.
And you can't have germs on your hands if you don't have hands.
-or-
Please do not reach into sterilizer with remaining hand.
Groan (Score:3)
One puzzle is why health care workers are so bad at it. Among the explanations studies have offered are complaints about dry skin, the pressures of an emergency environment, the tedium of hand washing and resistance to authority (doctors, who have the most authority, tend to be the most resistant, studies have found).
But... hang on a bit... how come 20 years ago this wasn't an issue?
Re:Groan (Score:5, Insightful)
But... hang on a bit... how come 20 years ago this wasn't an issue?
Who says it wasn't?
Re:Groan (Score:5, Informative)
In the environment that I work (a casino), there is frequent contact with chips, cards, and money that have been handled by large numbers of people over short periods of time so illnesses frequently spread. Of course its recommended that dealers and floor/pit men regularly use hand sanitizers throughout their shift, but if you've ever tried to regularly used hand sanitizer then you would know that you cant regularly used hand sanitizer without fucking up the skin on your hands.
Re:Groan (Score:4, Informative)
but if you've ever tried to regularly used hand sanitizer then you would know that you cant regularly used hand sanitizer without fucking up the skin on your hands.
I was about to say that. I know several doctors who work in hospitals and the skin of their hands is all dried and peeling off. They are the ones catching basic diseases because the skin of their hands has become too thin from all the washing. I think a future axis of research should be more about maintaining a healthy but innocuous surface bacterial flora. See what is going on right now with fecal transplants [wikipedia.org] !
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Fecal transplants make sense. I'm actually still wondering how babies manage to obtain a healthy internal ecosystem. When born those intestines are still pretty empty. Now of course a newborn starts off with milk so has time to develop their bowels, they still have to get it from somewhere.
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Re:Groan (Score:5, Interesting)
Then you should switch type/brands! The use of sanitizer instead of soap and water for dentists and doctors here in Sweden have dramatically decreased skin problems as hand sanitizer in most cases are better in preserving skin moisture than (even mild/re-hydrating) soap. Sure there are brands that doesn't contain re-hydrating compounds and sure there are people just not "compatible" with sanitizers but in general it's a win.
Re:Groan (Score:5, Insightful)
Alcohol bad for skin (Score:4, Informative)
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Frequent washing with soap and water followed by drying with a paper towel or air is also bad for the skin. And would take too long, given that medical people need to do it between every patient.
Certainly hand sanitizers aren't a replacement for hand washing. They don't actually remove dirt for a start. But soap and water on it's own won't work either. It does need a mix of both of those, plus surgical gloves, all as appropriate.
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Alcohol doesn't remove all the crap underneath and around fingernails.
It does a better job of getting in there and killing shit (literally!) in ten seconds than most people will probably do with a two minute hand wash, let alone the ten second nod to cleanliness which represents the typical hand washing experience.
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I recall hearing that Howie Mandel ran into serious issues with his hands from obsessively cleaning them with hospital grade anti-biotic soap. For those who don't know, he is a celebrity who is also a germaphobe (Mysophobia). His obsessive cleaning of his hands resulted in killing off the healthy bacteria which is present on all of our hands / skin. This let other microbial things take hold and he developed some warts on his hands (plus they were badly peeling etc).
I do admit that the reports of people gett
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It was an issue 20 years ago; the literature on this goes back decades, and none of the attempts to fix it have worked. This is one of the main causes of deaths in hospitals, and it's high time hospitals do something about it.
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much more than decades, It started with Semmelweis in the 1840s he was unable to convince doctors and eventually died in an asylum
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It was an issue 20 years ago; the literature on this goes back decades, and none of the attempts to fix it have worked. This is one of the main causes of deaths in hospitals, and it's high time hospitals do something about it.
I assume that it's an issue that gets slightly more play now because we are(unfortunately) on the downswing in terms of antibiotic efficacy.
Sanitation has always been better(and probably cheaper and less risky, in terms of morbidity/mortality and extended hospital stays); but the golden age of antibiotics was probably the high point for being able to fix sanitary fuck-ups after you've already committed them. Alas, we appear to be leaving that golden age, at least until somebody comes up with a clever new st
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Superbugs have nothing to do with it; if anything, they result in higher revenues to hospitals. The real reason is in the article: Medicare won't pay for the treatment of hospital infections anymore.
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You're a libertarian. Why should hospitals do something about it if they make money regardless. If their profit is increased by enforcing certain sanitation regimes, they should do it. If their profit isn't increased they shouldn't bother. Right?
Now you might suggest that it IS more profitable to do the sanitation thing right. But do you have any data to show that. What if hospitals lose money that way, but it's healthier for patients. The hospital's bottom line should be the priority, right?
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Well the insurance company's bottom line would decide what they request/contract hospitals to do. But the hospital's bottom line that would decide whether they do it.
And patents would choose which hospital to use based on whether they got infected last time. ... in the libertarian (anarcho-capitalist) utopia.
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The evidence is right in the article: hospitals institute these measures because their customers refuse to pay or go elsewhere if they don't; no government regulation was needed. That's the way a free market is supposed to work.
The problem here is that the "customer" is itself a government-established monopoly that pe
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But... hang on a bit... how come 20 years ago this wasn't an issue?
20 years ago hospitals could hand out antibiotics like candy to deal with bacterial infections. So they got complacent. Now they are suffering the consequences in the form of antibiotic-resistant bacteria.
Antibiotic use was not the solution or cause (Score:2)
20 years ago hospitals could hand out antibiotics like candy to deal with bacterial infections.
You seem to be implying that just prescribing antibiotics solved the problem 20 years ago. Not true. This was every bit as big a problem 20 years ago. The only difference was that we didn't pay as much attention to the problem back then. Sure there are some new complications relating to antibiotic resistance now but that was part of the equation back then too. The problem is one of prevention, not treatment. No amount of antibiotics can solve the problem and even if they could, prevention is MUCH chea
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... complaints about dry skin, .... the tedium of hand washing
Reminds me of a workplace I worked at last year. Large open-plan office containing a lot of marketing types (seems they select for good-looking women) and some IT contractors like I was. The bathroom had this poster over the basin about how to properly wash your hands (photos with about a dozen steps to follow). (Obviously supplied for free by the soap supplier, but quite incongruous in a non-med environment.)
However, once you where finished washing, you had to pull open the bathroom door by a fairly greas
Use a paper towel (Score:2)
However, once you where finished washing, you had to pull open the bathroom door by a fairly greasy/grimy handle.... Made me glad to be able to knee the door open when entering, just before I was about to handle my privates.
I typically use a paper towel to open the door and then throw it in the nearest trash receptacle afterwards. If the company doesn't provide them you can of course keep some napkins in your desk for the purpose. A tad OCD I'll admit but I know a lot of doctors who recommend the practice. Of course a better solution is to design entrances and exits that don't require touching a door like you see in modern airports these days. The less I have to touch in a public space the better.
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A tad OCD I'll admit
... Or one could just hang around inside until the next user entered, then quickly get a foot in the door. Especially considering the scarcity of paper towels and/or receptacles, and the abundance of coffee :-)
Reminds me that the women's door was completely removed, ostensibly for repairs.
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Why? TFA
One puzzle is why health care workers are so bad at it. Among the explanations studies have offered are complaints about dry skin, the pressures of an emergency environment, the tedium of hand washing and resistance to authority (doctors, who have the most authority, tend to be the most resistant, studies have found).
But... hang on a bit... how come 20 years ago this wasn't an issue?
It was. The first thing you should ask anyone getting ready to examine you when in the hospital is "Did you sanitize your hands?"
This has been an issue for along time (Score:2)
But... hang on a bit... how come 20 years ago this wasn't an issue?
It WAS an issue 20 years ago. This has been a huge issue for a long time. It also turns out to be a shockingly difficult problem to solve. I've actually worked in an infection control department (about 10 years ago) at a hospital and seen first hand the difficulty they had in getting people to take basic hygiene measures to control hospital transmitted infections. Part of the problem is economic, part is attention, part is habits, part is social, part is work process design. Kind of like spam there see
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In places which care about your health, hand washing and ready availability of sinks for same are the law.
In California, everyone now has to be a certified food handler to work in the kitchen, and about time, too. I'd like to see a law mandating that the health report be posted in the front windows...
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But... hang on a bit... how come 20 years ago this wasn't an issue?
Probably because 20 years ago you were young enough not to be worried about this stuff. Everybody's got a period in their minds when the problems we had today weren't such a big deal. That period is their childhood, when, for almost everybody, someone else worried about the problems for them.
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Boy, have they got that right. And the worst thing about it is having to break through the crust when you've just finished a nice run of avoiding tedium.
I only wish it could be a creosote crust [wikipedia.org].
Not well thought out (Score:5, Insightful)
You're Cube Man #3,948 and every day, for 8 hours straight, you watch these TV feeds. It all looks the same. There is no audio. There is nothing interesting happened. Whenever you see someone wash their hands, you push a button.
Pop quiz: How long before you're bored senseless and start making mistakes... or not caring?
Psychology tells us that repetition and boredom leads to mistakes. This system is a band-aid, it does nothing to address the environmental conditions that are causing the behavior -- those are what need to be tweaked. You cannot make lasting changes to a person's behavior through threats, manipulation, guilt, and shame. Temporary, yes. But it wears off, and you're left with the situation of having to increase the level of abuse repeatedly, creating a vicious cycle that demoralizes people and makes them resentful.
Is that really the psychological state you want a guy whose job it is to cut people open and prescribe them powerful and potentially deadly medications? Come up with something better, people. This kind of social engineering has never been effective. The airline industry licked this problem a long time ago -- they're called checklists, copilots, training, and redesigning the environment and paying close attention to work loads. And the reason all of that was implimented is because the government got sick of corporations cutting corners on safety, training, and creating cultures of fear.
More people now die in hospitals than plane crashes. I think if government regulation of the industry worked to reduce the risk of flight to such a low level that it has become the safest mode of transport, that we can at least make our hospitals achieve half of that success. 30% is pretty damn pathetic, guys.
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How long before some management clown makes the number of button-pushes per hour a KPI for your job?
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You mean, someone will actually watch those CCTV feeds in real time? That's odd.
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You cannot make lasting changes to a person's behavior through threats, manipulation, guilt, and shame.
Whether it is a good idea or not doesn't change the fact that you most certainly can make lasting changes to a person's behavior through threats, manipulation, guilt, and shame. Given that a majority of the population has had lasting changes in behavior do to these things makes it strange that you would even suggest that it can't happen.
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Just do this: http://en.wikipedia.org/wiki/Reamde [wikipedia.org]
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You're Cube Man #3,948 and every day, for 8 hours straight, you watch these TV feeds. It all looks the same. There is no audio. There is nothing interesting happened. Whenever you see someone wash their hands, you push a button.
Wrong solution. This is a job for the Mechanical Turk. 1c to watch a 60 sec video and press a button to say whether or not the person sanitized their hands. With a reference image/video to show to those who don't know what sanitizing hands means.
That would cost 60c per hour of video. At that price you can have 3 or more different people do the same task in order to confirm the answer, and it still costs less than having an employee do it.
And boredom isn't an issue. Once Turks get bored of that, they'll move onto a different task from someone else. ...Mind you, patent confidentiality might be an issue.
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You cannot make lasting changes to a person's behavior through threats, manipulation, guilt, and shame. Temporary, yes. But it wears off, and you're left with the situation of having to increase the level of abuse repeatedly, creating a vicious cycle that demoralizes people and makes them resentful.
What if you are able to instill the habit of hand washing that then continues even if the monitoring is stopped. You sound like you think they are deliberately deciding to not wash their hands. It's most likely something that slips their mind because they are busy. If they form a well established habit then they don't need to think about it anymore. They will do it on auto-pilot without thinking.
Could you automate this further? (Score:2)
I'm picturing an xbox kinect-ish system that tracks each person entering, follows their movement and the movement of their limbs, and remembers if your hands got close enough to the sink / sanitiser. Then only if you head towards ICU and attempt to open the door, an alarm sounds so that your peers in the room notice, and a video recording is kept.
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Even easier - instead of washing hands or using alcohol based sanitizers constantly, causing the skin to dry out, crack and make the doctor/nurse more susceptible, make sure they wear new gloves with each patient. Switching gloves takes no more time than washing hands, and if there's enough different colors all over the place, it would be pretty obvious if one doctor saw 5 patients wearing blue, blue, blue blue and blue gloves. This also has the benefit that it's really easy to tie proximity card tracking
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All day? It's not necessary to wear the gloves during the "talking" part of the process, only when he's actually touching the patient. That's more than half the time.
Have you ever been to doctor? I mean the proper sort, not the kind with a bone through his nose.
Accuracy (Score:2)
The NYT article notes that hospital workers wash their hands as little as 30 percent of the time that they interact with patients.
Actually the hospital workers wash their hands as little as 30 percent of the time that they interact with patients if not encouraged to wash hands.
The other issue is that every interaction with a patient does not necessitate washing of hands. For example, walking into a treatment room and stating "the doctor will be in in a minute" does not require washing of hands.
I loathe the medical "profession" (Score:5, Insightful)
I can't stand the pillar the medical profession puts itself on. Let's run down the list of examples for how the medical profession doesn't give a shit about patients, shall we?
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Despite the fact that hospitals are increasingly a cesspool of MRSA and other diseases, we continue to cling to the idea that we should treat people with transmissible diseases in close proximity to others, instead of having doctors travel to the sick patients, treat them, disinfect, and move on to the next patient. Gee, what could possibly go wrong with concentrating sick and weak people in one area?
>
This one makes sense for many reasons. A doctor in a hospital can see many more patients than a travelling doctor, so you need far less doctors. That is not just a money issue, it's also a manpower/education issue: you can't hire more doctors if there are no more doctors.
Also bringing patients to a hospital means bringing patients close to a complete array of equipment, medication, and various other specialists that can quickly check on a patient when needed. Some diseases have symptoms that overlap, but re
flipside: incentive to find money (Score:2)
The down side to your model is that private hospitals have an incentive to increase the price to you as much as possible. If their operating model is to increase revenue to shareholders then there will be a drive to find financial profit where ever possible.
Re:I loathe the medical "profession" (Score:5, Informative)
I can't stand the pillar the medical profession puts itself on. Let's run down the list of examples for how the medical profession doesn't give a shit about patients, shall we?
As a physician I'm quite interested in the subject. :-) Things have been bad in the past, but is getting better on all fronts. Let's take your issues one at a time:
There's a cap placed on residency hours per week and hours in a row, now. Yes, it's sometimes broken, but it's a lot better than 20 years ago. And, no, it's not routine practice to fake your timesheets. Or at least where I trained ~15 years ago, and not in the training program I assist overseeing. That being said, in some subspecialty fellowships I wouldn't doubt that it's more common to do this -- But they do this to gain more experience as you may only get a once in a decade experience if you stay on call and extra 2 hours. Who would deprive themselves that?
Penmanship is not taught in medical school. But electronic perscriptions are becoming more commonplace in the last few years (both on the outpatient and inpatient sides). And the last couple decades have brought on more responsibility of the patient to know what they are taking. The outpatient medication errors are the combined fault of the physician, the pharmacist, and the patient.
I wouldn't say that anyone routinely operates on the wrong body part. But mistakes do happen. It's now standard of care to do a "time out" with the patient, nurse, and physician all in the operating room to agree on the patient's name, date of birth, and procedure to be performed before any sedation is administered or incisions are performed. But I once had a patient respond to a different name who expected to have the same procedure performed. Fortunately he was tripped up by the date of birth.
As for washing hands, that's a culture change. My hospital has random people anonymously assigned to watch people enter and leave patient rooms to make sure we always wash in and out. (The people are people that work on the floors anyway.) A couple verbal warnings and suddenly everyone's compliant. No need for technology.
And the younger generation of physicians are more humble. But that's also because they tread medicine as more of a job and less of a calling. I guess you can't get everything. :-(
Re:I loathe the medical "profession" (Score:4, Interesting)
Yeah, last time I had surgery, they wouldn't even lead me to any answer. It basically went :
Doctor : Why are you here?
Me : Surgery.
Doctor : What kind?
Me : Eye surgery to correct strabismus.
Doctor : Which eye?
Me : Left.
They didn't just read stuff asking me to confirm it, I actually had to give them the information. I assume this way there's much less risk of a patient just confirming all the surgeon's questions.
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Surgeons routinely fuck up "which leg" or "which eye."
I was knocked off my bike, and had a big tear in the flesh of my right elbow, which needed cleaning and stitching up. Despite the fact that it would have been impossible for the surgeon to get the wrong arm, in pre-op they drew a big arrow with a permanent marker towards the injury. Because that is procedure.
So I think procedure has mostly cleared up this source of error now. And if there's a mistake about where the arrow is drawn, it happens in pre-op, not in surgery. And for things as obvious as a leg or
Great idea. Forget it. (Score:2)
Many, many studies have shown that this type of method is less effective than proper training and motivation.
Would be better to find out why the people are not washing their hands, and fix that problem.
Lack of knowledge, facilities?
Here's an article about a better way to do it; looking at the entire system and finding ways to make getting good hygiene simple and faster.
(OK, it's from a hand-dryer company, but still illustrative of the approach.)
http://www.exceldryer.com/presskit/CaseStudy-NMH.php [exceldryer.com]
Is there... (Score:2)
Is there a doctor in the house?
Better way (Score:2)
Give each a pass card that's charged at a wash station, the charge is only good for 30 minutes or so. Don't let them do stuff without a charged card. Put an led on it to show its charge level.
Or it can be passive with an RFID that gets logged when they wash their hands, then hold them accountable.
30%? For ****'s sake! (Score:2)
I always found it rather strange that bacterial infections could spread so easily in a "sanitary" environment like a hospital. Bacteria can spread through the air, i.e. by someone sneezing and someone else inhaling it, but contact (touching surfaces containing the bacteria) is the most common method of transmission.
When the hospital staph only wash their hands 30% of the time when they interact with patients, it's no wonder that this crap can spread so easily.
It's ridiculous that something which should be
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I always found it rather strange that bacterial infections could spread so easily in a "sanitary" environment like a hospital.
Being full of sick people, hospitals are not all that sanitary (not really a joke).
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Hilariously topical malapropism.
Offshore sanitation! (Score:2)
Feeds from the video camera are transmitted to India, where workers there check to make sure staff are washing their hands.
Offshoring of hand sanitation with soap monitoring... The new little "bubble".
Retarded... (Score:2)
This solution is absolutely retarded. All you need to detect washing of hands is a cheap inertial reference sensor on a little tag worn on the upper body. A three-axis accelerometer and a three-axis angular velocity sensor is it. The change in posture and the sways propagating to the upper body are quite a distinctive signature, especially when you couple it with the signature of walking to the sink, and all the other things that are known to happen when you use a particular sink. You could probably tell wh
Congratulations! (Score:2)
As a survivor of childhood cancer, my wife has been in many, many hospitals. Most are very good with basic hand washing. Most have sanitizer dispensers near the door to the room, inside the room and in the hall. But one hospital in particular stands out in my memory as having employees that seldom washed their hands. It appeared to be a hospital-wide problem as they did not h
Re:Trust (Score:4, Interesting)
Part of the problem is that the medical education system is deliberately set up to ensure a continuous shortage of doctors. As a result, all doctors have extremely high pay and are almost immune to any kind of employee discipline; they know that the hospital needs them more than they need it. We let the AMA run medicine like a medieval guild, while almost everyone else is exposed to ruthless market competition – it's no wonder that we get nonsense like this, and that health-care costs have been rising faster than inflation for decades.
Re:Trust (Score:5, Informative)
Doctor's may be immune to discipline but nurses are not.
Nursing schools are cranking out young, low wage nurses, for which the hospitals are looking for any reason to get rid of the higher paid and older nurses... I know a nurse, she's in her 50s, been an RN all her life and still is forced to work x-mas and Thanksgiving otherwise her hospital will replace her with the girls coming out of the local nursing school.
Reminds me of the programming industry...
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Doctor's may be immune to discipline but nurses are not.
Nursing schools are cranking out young, low wage nurses, for which the hospitals are looking for any reason to get rid of the higher paid and older nurses... I know a nurse, she's in her 50s, been an RN all her life and still is forced to work x-mas and Thanksgiving otherwise her hospital will replace her with the girls coming out of the local nursing school.
Reminds me of the programming industry...
Are you saying that if you get sick on Thanksgiving it would be best, medically speaking, to only have inexperienced nurses treating you? As a patient, you would feel okay knowing that the experienced nurses were home with their families, while you were being treated by newbies?
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It's called seniority. Something you have to earn.
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That's life. Deal with it.
There's an attitude that leads to malpractice. My wife is a nurse, so I'm sympathetic about the pain of working holidays. However, the GP is right. On holidays you don't have elective surgery or regular appointments, but there's still the ER and patients in wards. There's no excuse for substandard care - ever. I'm sure my wife would agree as sloppy medical care infuriates her.
Not that such issues keep hospitals from constantly increasing the patient/nurse ratios. Why pay nurses to do silly things like car
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People didn't get sick or hurt on weekends 50 years ago? She knew working holidays and weekends wa part of the job when she went into the field.
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Yes, of course. Being a nurse myself for the last 20 years I know of rotating holidays. They are a pain in the ass.
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And by the way, people get hurt or sick everyday, whether it is a holiday or not.
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This is not special to America, in France where I live, medical studies are being severely subject to quota, the result is that the country must now import doctors from other parts of the world, especially Africa, the Middle east and Eastern Europe, when there's lots of unemployment in other fields, and while the country has perfectly all the abilities to train its own doctors. In the same time, those parts of the world are badly missing those migrating doctors.
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We let the AMA run medicine like a medieval guild, while almost everyone else is exposed to ruthless market competition ...
Therefore we should expose doctors to "ruthless market competition"? No. We should be tempering labor laws and industry regulation to ensure high quality staff, not pretending that the market is a cure-all.
Ironically, conservatives in the US argue against "socialist" medicine, while holding up the US medical system as the best in the world. Can't be both a "medieval guild" and an exemplar of capitalism. I'd say its closer to a guild and that's part of why it works so well.
quit ****** whining (Score:2)
every successfull fast food/retail chain uses micromanaging horse-shit.
its about time doctors had to be as consistent and quality-oriented as the fry cooks at mcdonalds, especially when a major cause of death is medical errors.
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According to this [jstor.org], "it has been estimated that hospitalacquired infections are responsible for 80,000 deaths in the United States and 5,000 deaths in the United Kingdom." "Compliance rates were ... lower among physicians (32%)." So only 32% of doctors are washing their hands, killing 80,000 people per year. I will let the reader decide whether they want to compare this to the deaths caused by automobiles (32,367 [wikipedia.org]) or handguns (31,672 [cdc.gov]), but apparently keeping hands clean in hospitals is a serious public healt
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You might try to calm down a bit.
This is about washing your hands before you put them on the next patient, a major cause of death by the way
Is hyperbolic. Cross contaminating illness is an important source of morbidity (illness without death) and a lesser source fatal disease. It is by no means "a major cause of death". Unless you want to go back to the 1800's with postpartum fever [wikipedia.org] - but that was caused by major lapses of even basic hygiene, not just hand washing.
With the advent of alcohol based hand sanitizers, this whole argument has been pretty much kicked. Unless you are working on a surgical field where
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You're right, "major" was a bad word. It should have been more on the line of "larger than most would imagine".
The point of the article was that since the workforce in the hospital is too maliciously ignorant to actually care for their patients enough to wash/sanitize their hands, camera surveillance has been implemented to try and enforce it. This has nothing to do with micromanagement, as the AC suggests - it is all about the workforce not caring enough about their patients, people who are already in a we
Not a major cause of death? (Score:2)
It is by no means "a major cause of death".
So tens of thousands of deaths each year [wikipedia.org] (source CDC) is not a major cause of death? What do you consider a major cause of death? And hundreds of thousands of non-lethal infections. Even ignoring the pain and suffering component the financial cost is enormous.
Unless you are working on a surgical field where near absolute sterility is required, using the hand sanitizer after every patient contact and washing your hands after a few rounds of the hand sanitizer works as well as OCD hand washing.
The effectiveness of alcohol based hand sanitizers is debatable and they are known to be less effective [cdc.gov] than hand washing.
Then there are a number of other vectors for microbial transmission that this 1984-esque system doesn't address - stethoscopes and other instruments, pens, ties, lab coats.
All true but hand transmission is the biggest among them and we know that hand washing is an effective mitigation technique.
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you're more likely to be ill leaving the hospital than entering it
A quick Google suggests you're being dishonest. So, yeah, citation needed.
Why are you lying? If you have to lie to prove your point (which is sad because you were on the right side) then your point isn't worth making. If you have to resort to lies then you shouldn't do it online where people have the capacity to verify your statements simply by highlighting, right clicking, and selecting search Google. You can't browbeat people into cowing online no matter what your wife and kids tolerate.
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I take part of that back - you're quoting the article. Double check the article, it appears that they're lying. Google "illness caused by hospitals study" and read a few of the links. Sorry for thinking you pulled it out of your ass. The rest applies.
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This is not about leadership incompetence, it is about the apathy of the workforce.
You have no idea what you're talking about. Sure there are some apathetic and lazy people, just like in any field, and they should have their heads handed to them. A far bigger factor is the incredible time squeeze of increasing patient/staff ratios. My wife is a nurse and she sometimes comes home hungry because she literally hasn't had time to eat lunch. To a programmer that means they grabbed a sandwich or some junk food while at their desk or in a meeting, to her it means literally not finding 10-15 minu
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Could you please crawl back into your sanctimonious moralising box and take a copy of "The Checklist Manifesto" with you. When you've understood a bit of the theory of safety management, you could crawl back out and apologise to the families of the many thousands of patients who have died or been seriously hurt as a result of HCAIs.
http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/HCAI/EpidemiologicalDataHCAI/hcaimandatorysurveillanceresults/ [hpa.org.uk]
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take a copy of "The Checklist Manifesto" with you
I haven't read Gawande's book (looks interesting though) but the basic idea of checklists for safety goes at least as far back as the crash of the army test flight of the Boeing 299 (later dubbed the B-17) in the 1930's. They work, and they can and should be applied to medicine. From the blurb I looked at, it seems that in medicine he's mostly talking about surgery (he is a surgeon). That's far from the only place that nosocomial (hospital acquired) infections get transmitted.
I don't know about the UK (you
Re:Trust (Score:4, Informative)
So they don't trust their hospital staff to wash their hands, but they do trust Indian staff to report them.
As the article says - it is mostly about cognitive load. People focus on the hard things and forget the easy things. Checklists deal with exactly the same phenomena and have produced great results in healthcare as well as exactly the same bogus complaints about lack of trust.
The article points out that something like 100,000 deaths per year are due to infections acquired while the patient was in the hospital and dirty hands are the primary means of transmitting those infections between patients. This is a problem that absolutely must be fixed. simple "trust" has not been sufficient so far.
The indians who do the watching do not have any harder problems to distract them. They may grow bored, like anyone who has to watch the same thing over and over again, but that's manageable. Maybe they give the indians a bounty to encourage them to focus, maybe they just rotate them through other tasks frequently enough that boredom does not overwhelm them.
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Bored?! Indian's won't get bored. India's avg IQ is 79.
If it's true, it shows that the real idiots are people who think that IQ scores mean much.
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they don't trust their hospital staff
When it comes to health, someone needs more than trust.
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Couldn't they at least out sourced to a country that is at least clean, if not cleaner than us like the Japanese or one of the Scandinavian countries?
The primary purpose of outsourcing is to save money by having a task performed in a low wage country. Neither Japan nor the Scandinavian countries fall into that category.
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India ? (Score:3, Informative)
Something is very wrong somewhere
First, in UK hospitals, the following happened ...
http://www.disclose.tv/forum/uk-allows-muslim-nurses-to-not-wash-to-protect-their-modest-t87289.html [disclose.tv]
Now, in US hospitals, they have to snoop on their staffs, and then send the video feed to India, where they got many pairs of cheap eyeballs to spot those who have failed to wash their hands
What has actually happened to common sense ?
Re:India ? (Score:5, Informative)
Well, that's great, apart from the fact that I can find only one source of that story (and a huge amount of forums linking to the same story).
I'll google it for you [google.co.uk]. Not even the Daily Mail has a story with that headline.
I get this kind of shit emailed to me every day from colleagues. I've debunked every single email that I get, and have now set up a rule that deletes any email from certain people that are sent to the office.
The one this morning that I heard about was "Nigel Farrage's - Tory party's worst nightmare". If the man has such great policies, why do his supporters need to attribute thirteen year old diatribes to him?
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I've been tempted to ask a doctor whether he's washed his hands but that seems a little like criticizing the chef who is going to cook your meal. Maybe he'll spit in your food.
Re:India ? (Score:4, Informative)
You didn't do much research! This is a true story from 2010.
http://www.dailymail.co.uk/news/article-1265136/NHS-relax-superbug-safeguards-Muslim-staff--just-days-Christian-nurse-banned-wearing-crucifix-health-safety-reasons.html [dailymail.co.uk]
http://www.telegraph.co.uk/health/healthnews/7576357/Muslim-staff-escape-NHS-hygiene-rule.html [telegraph.co.uk]
Re: (Score:3)
I did almost post links to both of those articles as they were the nearest thing to what the GP had posted.
I the GP's article, it says
The UK Department of Health recently announced that it would loosen hygiene rules for Muslim and Sikh doctors and nurses. From now on, Muslim female staff will not need to wash their hands before procedures as it compromises their modesty.
Nowhere in the Telegraph and Daily Mail articles did I see anything about "not having to wash their hands". That is what I took issue with. The EU Times appears to make a habit of taking (albeit concerning) stories and then changing the facts a bit to get people to scream at their monitors.
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It's not so much common sense as it is a rush to get to patients. I have all three of Dr. Atul Gawande's books where he discusses at length how the medical profession works. He talks about how there's only so much time to see patients and washing hands before seeing each one to avoid moving infections between patients takes precious time. Proper washing takes at least 30 seconds. Multiply that by the number of patients seen on rounds, and it adds up.
Even when his hospital added gel dispensers to walls,
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If you are worrying about the 30 seconds to wash your hands then how much time were you really planning on spending with the actual patient?
Rushing is where mistakes are made. Measures that try to see as many patients in the shortest amount of time are asinine. If the medical center has more patients than it can care for in a certain amount of time then they should hire more medical staff.
Maximizing profits at the expense of patients is inexcusable.
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You're thinking of the washing that you do in the bathroom. I looked up Gawande's words [counterpunch.org] and found that I understated the time to wash. Here's how he describes it.
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I agree that desperate measures are needed. Too many people needlessly get infections when proper cleanliness on the part of hospital staff would have prevented it. (Full disclosure: my father died in hospital. He had major surgery on his heart, then caught MRSA following surgery. The guy in the same room as him brought the infection in, the room was put under "infection protocol" meaning the staff and visitors are supposed to follow cleanliness guidelines and wear disposable garb, but he got it anyways
Re: (Score:3)
> What has actually happened to common sense ?
Common sense? You mean the body of ideas that tells you such gems as to swim against a riptide, pour water on a grease fire, and that this time its going to work and he can change?
No, Common sense is really the problem here. The problem is that people are not machines. Machines can be relied on to do something, do it every time, and do it even when there is no feedback mechanism. People cannot, they are not neat simple machines. They are dirty bags of mostly
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Well I just had surgery, and let me tell you, serious institutions have taken steps to prevent some of those problems, even to the point of occasional absurdity. I was going in to have an incision reopened to remove more of a mass that had grown but the first surgery didn't completely remove.
You can't get much easier than a recent, visible, incision to tell you where to go. Still, I was asked by multiple people what the procedure I believed I was in for was, where it was, and why we were doing it, including
Re: (Score:2)
Wow, these guys are employing chaps across the world to do the job...
They handle(d) tech support so well that we're giving them grants to monitor safety! This isn't about $$, I assure you!