hospital

Just about every doctor and nurse in hospitals own a Sharpie^® at one time or another. Some use them for marking patients and others to label their lunch. It turns out that two different studies on infection risk found that good old fashioned Sharpies out-perform surgical markers in protecting patients from the risk of infection.

The 2008 study was conducted in Canada at the University of Alberta followed in 2009 with a study on reducing surgical site infections (SSIs) at Duke University in the U.S.

So long as an alcohol-based Sharpie is capped (and the outside properly swabbed) between uses on patients, the risks of passing on four common resistant bacteria – Staphylococcus aureus (MRSA), E. coli, vancomycin-resistant Enterococcus faecalis (VRE) and Pseudomonas aeruginosa – are much lower with a Sharpie than with a surgical pen.

Changing from surgical markers is a great way to do some cost-cutting at your facility while keeping down the risk of wrong-site surgeries. Why not kill two birds with one stone and still have a pen to make your more subtle points?

Success Is Inside!

It’s hard to believe that in my lifetime I’d ever see layoffs in the nursing field. Like many of you, I remember the good times when there were billboards around my city advertising signing bonuses for nurses at local hospitals. That’s all changing. Two recent articles in the Wall Street Journal (1) (2) and one in the Washington Post are focusing on the fact that, while there is still a nursing shortage, there is now a shortage of nursing jobs. That sounds like a contradiction in terms but it’s not.

In a March 2009 report, the AHA revealed that 53% of the hospitals surveyed were operating at a negative margin or in plain English, they’re losing money. Hospitals in some areas of the country are reducing hospital staff. Just a year ago hospitals that were taking just about any skilled nurse who walked through the door are now finding it easier to be selective in their hiring. In short, this ain’t your mother’s nursing profession anymore.

If the news from nursing wasn’t already bad enough, there’s a news story about Dean Health System which announced its intention to “immediately” lay off 90 employees. This included a nurse who was assisting in a surgical procedure and was called out of surgery to be told she was laid off! Okay, I can understand cost cutting, but don’t you think it’s a little extreme to lay someone off in the middle of a procedure? Has the world just gone crazy? What if they’d laid off the anesthesiologist? Or the surgeon? I shudder to think of the consequences (Dr. Smith, please report to HR, stat!).

The good thing about legal nurse consulting is that medical malpractice and personal injury litigation is recession proof. Now that we’re seeing financial stress on hospitals and doctors, I believe we’re going to start seeing more and more medical and nursing malpractice as well as the delivery of substandard healthcare.

A recent study in the New England Journal of Medicine, showed that a fifth of Medicare patients were rehospitalized within 30 days of their initial discharge! When the pressure is on to cut healthcare costs by reducing care, testing and length of stay; as nursing shifts come under more pressure with fewer nurses covering more patients; and as healthcare continues to devolve into what I call the “Dark Ages of Medicine;” you can be sure that Certified Legal Nurse Consultants will be on the front lines working with attorneys to redress the wrongs that are certain to happen.

One of the things I like best about being a self-employed entrepreneur is that the only person who can lay me off – is me (and that isn’t happening any time soon)!

Stay busy!

Success Is Inside!

Really, I mean that. Tom says that being around so many nurses has taught him one thing (well, two if you count never turn your back on a proctologist). Hospitals are great places to visit loved ones when you’re well, but they’re a horrible place to be when you’re sick. Studies have shown the longer you’re in a hospital recovering, the more likely you are to develop an infection, iatrogenic injury or even die.

Tom usually blogs about technology, but this one was too good for me to pass up. ECRI has come up with a list of the Top 10 Health Technology Hazards! That just sounded like fun. For your legal nurse consulting business, this is an eye-opening list of just what can (and will probably) go wrong with healthcare technology. ECRI even ran the list in order of importance. Here we go:

1. Alarm Hazards. You know you ignore them or worse – turn them off.
2. Needlesticks and other Sharps Injuries. This is really low-tech. We’ve been maliciously sticking unsuspecting patients with needles for years.
3. Air Embolism from Contrast Media Injectors. This I read AFTER my MRI?
4. Retained Devices and Unretrieved Fragments. Suddenly patients find themselves setting off the metal detectors at the airport or they are billed for a missing forceps.
5. Surgical Fires. Another reason why CRNAs shouldn’t smoke at work.
6. Anesthesia Hazards Due to Inadequate Pre-Use Inspection. More likely due to pre-use use by the CRNA and/or the anesthesiologist.
7. Misleading Displays. Especially the one showing brain activity.
8. CT Radiation Dose. Everyone else leaves the room during the x-ray, why shouldn’t the patient?
9. MR Imaging Burns. You stick a damaged headset and goggles on the patient, then ram him into the magnetic bore and wonder why he comes out with his hair on fire?
10. Fiber-Optic Light-Source Burns. Another way to set a patient on fire is by resting a hot “cold light source” on him during surgery.

The ECRI report also lists five of last year’s hazards that didn’t cause enough harm to make this year’s Top 10. They are still described as “significant” concerns. ECRI has taken the time to identify problems that any Certified Legal Nurse Consultant realizes are avoidable. I’d get a copy of this list and keep it handy when screening your medical malpractice cases. For a limited time, you can use the link above to visit ECRI and download a free copy of the report.

It’s like Tom always tells me “Technology is fun – in the right hands.”

Success Is Inside!

P.S. Have you seen any med-mal or products liability cases in your legal nurse consulting business related to these topics? What, in your opinion, is the biggest health technology hazard? Comment here.