John McCleary died at the age of 83. He lived a nice long life, you might say. Maybe, but John’s life was still unexpectedly cut short. Not by an accident or a heart attack or cancer, but by an infection he picked up as a patient in the hospital.
A few years back, John fell and broke the small bone in his lower leg. He was hospitalized for 12 days for treatment and rehab. When he returned home, he needed to use a walker but other than that he seemed fine.
The next morning he woke up so sick and weak he couldn’t sit up in bed. He ended up back in the hospital with pneumonia and was treated with ordinary antibiotics. His condition worsened and he developed a urinary tract infection. A culture showed that he had MRSA in his urine. “When he developed MRSA in his urine,” says his daughter Kathy Day, who is a nurse, “I said wouldn’t it be a good idea to culture his sputum? That’s when they diagnosed MRSA in his lungs and changed him over to a different antibiotic.”
What is MRSA?
MRSA (methicillin-resistant Staphylococcus aureus) is a strain of staph infection that is resistant to antibiotics normally used for staph infections.
One-third of us carry staph bacteria in our noses. Most of the time, we don’t get sick. Two in 100 people carry the MRSA strain.
John’s family was blindsided by his diagnosis, especially Kathy. “I suspect, but I’ll never know,” she says, “that he contracted it possibly from a roommate or he was in a room that was contaminated and never cleaned thoroughly enough. It had to have happened from one of those two things.”
Although you can get infected out in the community, most MRSA infections happen in the hospital or some other healthcare facility.
It’s a huge issue, but MRSA isn’t the only worrisome hospital-acquired infection. Other common infections include C. difficile, which causes diarrhea; surgical site infections; and urinary tract infections associated with catheters.
The family later found out that the same month John was admitted for his broken leg, two patients had died of MRSA infections after joint replacement surgery. In Kathy’s opinion, that constituted an outbreak.
“Basically, they were having a small outbreak,” she says, “and none of my family was given any education on infection control or any information or warning that they had this problem. Nothing. So we weren’t looking for any signs of infection practices at the hospital or paying much attention to that.”
10 tips for preventing medical errors and infections
Kathy had always tried to be a strong patient advocate, but after what happened to her father, patient safety and preventing medical errors became her passion.
She believes strongly that we need to engage as fully as possible in our own care. As a start, she offers these tips:
- Know your medical history and what medicine you’re taking.
- Be prepared for your medical appointment. These days visits are usually short. Narrow down questions to the ones most important to you when you’re in your doctor’s office.
- Speak up. “For instance,” says Kathy, “if we don’t think someone taking care of us has clean hands, we have to say something.”
- Speaking of clean hands, ask for clean hands all around — doctors, nurses, other caregivers and your visitors if you’re in the hospital. Keep hand sanitizer at your bedside. “You can also keep Clorox wipes nearby and ask your advocates (you should not be thinking about this yourself) to keep your frequently touched surfaces clean with the wipes.”
- Whenever possible, bring an advocate to medical appointments. “It doesn’t have to be a professional advocate, but a loved one, spouse, child — whoever you trust and love you know will be there for you. We need extra eyes and ears at a stressful time.”
- If your healthcare provider suggests a new medicine, test or procedure, always ask these five questions from the Choosing Wisely Campaign.
- Do I really need this test or procedure?
- What are the risks?
- Are their simpler, safer options?
- What happens if I don’t do anything?
- How much does it cost?
- Never sign anything until you’ve read it or if you’ve been medicated or sedated — especially consent forms (which Kathy says you can amend, by the way.)
- Have a living will, an advance directive and a medical power of attorney. “End of life can be torture or it can be gentle and peaceful and you get to choose.”
- If you’re in the hospital, get the contact information for your doctor or surgeon and the manager of the floor you’re on. “Ask until you get them. Put the numbers right in your cell phone or give to your advocate.”
- Check a doctor’s or hospital’s rating on one of several ranking sites, such as Hospital Compare, Physician Compare, Healthgrades, the Leapfrog Group and GetBetterMaine. “It also doesn’t hurt to ask your primary care physician who they would use,” recommends Kathy. “You need to ask physicians you’re considering how many times they’re treated your condition or done your surgical procedure and what their safety records are. If you’re having surgery, sometimes you can get information from a hospital patient safety officer or infection control department about the risk of infections for your particular problem and procedure.”
Why we need to be our own advocates
Sadly, John McLeay never fully recovered from his MRSA infection. After 21 days in the hospital, he went into a nursing home where nine weeks later, he passed away.
When he was first admitted for his broken leg, he and his family, including Kathy, expected a good outcome. She believes we should all expect a good outcome whether we are in the doctor’s office or the hospital. The reality is that our healthcare system is not perfect, mistakes are made and things are missed. That’s why it’s important to be an active participant and learn what we can do to be safe.
As Kathy says, we all need to speak up and be our own best advocates.
About Advantage Home Care
Advantage Home Care provides a wide variety of in-home senior services, including non-medical care.
Our Aging in Place blog is written by Diane Atwood, who also writes the blog Catching Health with Diane Atwood. If you have any topics you’d like us to cover, please let us know in the comment box below. Thank you!