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What does bungee jumping and mountain climbing have to do with medical care? Similar risk of death. In Poland, more people die as a result of hospital infections than in car accidents.
Four newborns in a serious condition went to the University Children’s Hospital in Krakow. The children were infected with staphylococcus. They were brought at the end of January from another facility. Despite the doctors’ efforts, one of the babies could not be saved. The hospital in Krakow notified the Department of Healthcare about these infections.
– I try not to think about it anymore. So many years have passed – says Mrs. Iwona from Łódź. In 2002, at the hospital. Madurowicz, 17 children died as a result of sepsis infection. – The director of the hospital has been charged with failure to fulfill his duties. The trial lasted several years until the court finally acquitted him.
Hospitals are not only places where people’s lives are saved. 5-10 out of 100 people hospitalized have medical problems due to infection. In 2014, the European Center for Disease Prevention and Control surveyed 1000 hospitals, including 35 Polish institutions. The research showed that approx. 5-6 percent. hospitalized Europeans became infected in the hospital. However, according to the World Health Organization (WHO), the number of nosocomial infections in European countries is even more, i.e. 5-10 percent.
Celebrities suffer too
Overseas, the infections became loud thanks to Khloe Kardashian. Late last year, the American gossip website TMZ reported that the wife of Lamar Odom, a former basketball star, contracted staphylococcus. Most likely she caught the bacterium in the hospital where her husband is staying. Odome ended up there because he collapsed in one of the brothels. In countries such as the USA and Switzerland, the official infection rate is higher than in Poland, but we have no reason to be happy, quite the contrary. The high index shows reliable control and statistics. Meanwhile, in Poland, as emphasized by Professor Andrzej Gładysz, a former national consultant for infections and a member of the Provincial Medical Events Team in Wrocław, there are no statistics that would precisely inform which pathogen contributed to the patient’s disease or the dynamics of its development. There are only estimates.
Sometimes it is enough to wash your hands
– Unfortunately, recently we have noticed a decline in the behavior of procedures that prevent infection. There are far too many of them – comments Andrzej Gładysz.
Procedures are sometimes ordinary, thorough hand washing.
– I haven’t seen such sloppy stuff for a long time – says Marta from Warsaw. – I was with the baby for a blood sample and the nurse dropped the glove on the floor. When I saw that he was putting it on his hand, I was furious. At my insistence, she took another pair of clean ones, but did not wash her hands. Then I wondered if maybe she only washed them at home before going to work.
Professor Andrzej Gładysz, on the other hand, was raised by a case in one of the institutions, where the level of purchases of disinfectants or even disposable gloves was assessed.
– Purchases were half the actual demand. It was assumed in advance that hygiene expenses would be halved. The standards were met on paper, but in reality there were shortages, and in the neonatal unit, where hygiene should be the highest – says the outraged professor.
Some hospitals have old habits that may end badly for the patient. Professor Gładysz lists, for example, shaving instead of a haircut or a poorly prepared operating table.
Team to push
– I was supposed to be in the hospital for four days, and I’m in the second month – a patient of the Kluczbork hospital complained to the local press.
The facility assured that the infection did not come from the hospital, but during the stay at home. A staphylococcus got into the wound, causing the operated site not to heal. The 63-year-old had only a minor lipoma excised.
Unfortunately, the topic of contamination is neglected by policymakers. Andrzej Gładysz gives an example: – Hospital directors rarely come to our conferences devoted to this topic. I think I could list those interested in the problem on the fingers of one hand.
According to the requirements, in every hospital there is a team that deals with the problem of infections.
– Sometimes its members complain that they are being ignored or do not have the authority to enforce procedures – he says.
Sweeping under the rug
A small town of Skierniewice lived this story for several weeks. Karolina’s baby was hospitalized because of diarrhea. A swab was taken for examination. It was only after receiving the results that the mother found out that she had been infected while in hospital. As it turned out later, a doctor was the carrier of the drug-resistant staphylococcus MRSA.
Over 24 percent The complaints that go to the “Primum Non Nocere” Patients’ Association, which defends patients, concern nosocomial infections. This is the second most frequent problem raised by patients (perinatal complications are in the first place).
– There are infections in hospitals because bacteria are everywhere. However, if it does happen, the problem cannot be swept under the rug – convinces Adam Sandauer from Primo No Nocere.
He lists one of the absurdities. In his opinion, for years patients were convinced that if staphylococcus was injected from the skin from the skin to the body during surgery, the hospital had clean hands.
– And the button! The operating field should be prepared in such a way that the patient does not even become infected with skin bacteria – he argues.
In another association, “Prometheus”, “liverworts” seek help. – I dare say that 90 percent. cases of HCV infections are nosocomial infections. Now we are receiving people who became infected with the virus in the 90s. Until July 1992, no tests were carried out for the presence of HCV during transfusions or blood donations – says Jan Chojnacki, president of the National Association for Aid to HCV Patients. – Since January, the new state authorities have cut the funds for antiviral treatment that are already small – he argues.
In hospital, it’s better for a short time
Małgorzata Bulanda, head of the Department of Microbiology at the Jagiellonian University in Krakow, calms down a bit: – Compared to the situation from 15 years ago … It cannot be compared. It is much better. Of course, there are infections in units such as the ICU. This is due to the specificity of these branches.
Here, golden staphylococcus often takes its toll, sometimes in its worst form, resistant to drugs, the so-called MRSA. In hospital conditions, ordinary bacteria can “become malignant”. Moreover, acquire resistance to certain medications. “Sometimes it is because antibiotics are used too often in wards,” adds Bulanda.
Professor Stanisław Tyski from the National Medicines Institute warns patients and visiting relatives: – The patient’s stay in a medical facility should be as short as possible.
Bungee on the ward
In 2007, as many as six patients were infected with purulent streptococcus in one of Krakow’s hospitals. Some people had sespa. They fought for their lives for a month. One of the attendants was the carrier of the bacteria. During the court proceedings, it turned out that she periodically replaced one of the nurses during surgeries. She helped to put patients on the operating table, handed out the tools, disinfected the operating field, and even cleaned the room. It was only a year ago that the case ended in court.
The most common hospital infection occurs during the so-called performing invasive procedures. It is referred to when the patient has stayed in a medical facility for at least 48 hours. The patient is not always attacked by bacteria from the hospital environment. These may be “his own” pathogens.
– For example, the intestine is perforated and the contents with bacteria enter the abdominal cavity and the infection is ready – says Adam Sandauer.
The second possibility is infection by exogenous flora, i.e. flora living in the hospital environment. Pathogens are passed on to the patient through the hands of staff or medical equipment. In internal wards, the most common infections are those of the urinary tract, especially in catheterized patients. A patient in intensive care units is exposed to pneumonia, which is related to, among others, with intubation. And infections of operated sites or blood in the form of sepsis. These are difficult cases to treat. As is the fight against certain bacteria due to their resistance to drugs. For example, the stick of blue oil and methicillin-resistant strains of golden staphylococcus. Strains of intestinal bacilli are also still dangerous.
The court is not from treatment
Grażyna Garboś-Jędral became a cripple after 16 days in hospital, and was there because of a heart attack. In court, she pointed out a number of errors to doctors, including implantation of food salmonella into the spine during peripheral anesthesia. For 10 years she fought for compensation. But are the sick satisfied with making amends?
– The courts or the prosecutor’s office are not for treatment. In the case of the infected, compensation is the second thing planned. Nobody will come back to health. Therefore, first of all, they must be provided with professional help in institutions of high standards. Restored health and confidence in medical care. This should be important to everyone: the prime minister, president Kaczyński, me or you, and above all, it should be dealt with by the patient ombudsman – comments Adam Sandauer.