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HOPKINS INVESTIGATION CITES RISE OF MRSA IN CLINICAL SETTINGS
Johns Hopkins University infection control experts are warning healthcare workers to guard against an aggressive form of methicillin-resistant Staphylococcus aureus (MRSA), community-acquired MRSA, which resists regular antibiotics.
The alarm arises from an investigation into the 2004 infection of two healthcare workers in a crowded outpatient clinic at Hopkins for patients with HIV. The study showed widespread contamination. No patients became infected, but the staffers needed treatment and the hospital ramped up its infection control.
Health experts worry that the rise of MRSA infections in hospitals could overwhelm many common and effective drugs. Although rarely fatal, MRSA infections can lead to serious complications.
The Hopkins study calls for increased vigilance against infection in high-traffic outpatient treatment areas. Quick reporting also is vital.
The report will be published in Infection Control and Hospital Epidemiology.
ER OVERCROWDING WORST IN METRO HOSPITALS
Nearly two-thirds of hospitals in metropolitan areas operate with overcrowded emergency departments, the Centers for Disease Control and Prevention reports. Across the nation as a whole, up to half of hospitals are experiencing ER overcrowding.
Even more alarming is that while the CDC found shortages of on-call specialists and nurses in all emergency rooms, metro hospitals reported much more severe nursing shortages: More than half of metro ERs had more than 5 percent of their nursing positions vacant. These metro ERs also had higher patient volume and longer patient waiting and treatment times.
Most emergency rooms saw fewer than 20,000 patients in a year, but one in 10 handled more than 50,000.
About a third of hospitals reported having to divert an ambulance to another emergency department sometime in the previous year.
The report, “Staffing, Capacity, and Ambulance Diversion in Emergency Departments: United States, 2003-04,” is posted at www.cdc.gov/nchs.
WORKERS' HEALTHCARE COSTS TAP ON THE BRAKES
The wild inflation in healthcare premiums eased up a bit this year, but still rose more than twice as fast as workers’ wages, according to the Kaiser Family Foundation and the Health Research & Educational Trust.
Healthcare costs grew 7.7 percent this year, down from 9.2 percent last year, while the average worker’s pay grew only 3.8 percent and inflation ate up 3.5 percent. The annual survey, released this fall, showed the typical family health coverage now costing $11,480 a year, and single coverage averaging $4,240.
“Working people don’t feel like they are getting any relief at all because their premiums have been rising so much faster than their paychecks,” noted foundation president Drew Altman.
Meanwhile, the Citizens’ Health Care Working Group made six recommendations for overhauling the nation’s healthcare system, prompting AFL-CIO president John Sweeney to observe that Americans want much more than incremental improvements in their access to healthcare.
STUDY EXPLORES SOURCES OF DOCTOR ERRORS
Basic doctor errors frequently lead to missed or delayed diagnoses, says a new study in the Annals of Internal Medicine.
Typical errors include tests ordered too late, failure to create follow-up plans and failure to obtain an adequate history,
says the study of more than 300 closed malpractice claims.
Such errors often are preventable. While researchers said many of the errors involved failures in judgment, other leading factors included lack of vigilance or memory.
The responsibility for accurate diagnoses still lies with physicians, said the study’s lead author, Dr. Tejal Gandhi, but more use of nurse practitioners, electronic recordkeeping and better algorithms for making evaluations could help doctors arrive at better decisions.
