FacebookTwitterGoogle+RedditEmail

Handwashing and the Bottomline

by YVES ENGLER

What makes the hospital environment a major killer? The federal Centers for Disease Control and Prevention predict that by the end of 2007 one of every 22 patients will have got an infection while hospitalized — 1.7 million cases a year — and that 99,000 will have died, often from what began as a routine procedure.

A New England Journal of Medicine study from a few months back concluded that 19,000 people a year die from preventable infections acquired during the insertion of catheters.

While some medical infections will always occur, through aggressive cleanliness campaigns several European countries have all but eliminated MRSA, one of the most deadly hospital-acquired diseases. The New England Journal of Medicine study reports that catheter-related blood stream infections dropped 66 per cent with some minor changes (including rigorous hand-washing, thorough cleaning of the skin around catheters, and wearing sterile masks, gowns and gloves as well as removing catheters from patients as soon as possible and avoiding inserting catheters in the groin area).

According to a 2004 Canadian survey published in the American Journal of Infection Control, up to half of all hospital-acquired infections were found to be preventable if infection control procedures were adequate. And a similar six-year old American study concluded that up to 75 per cent of deadly infections caught in hospitals could be avoided by doctors and nurses using better washing techniques. (Studies show that over half of the time physicians fail to clean their hands before treating patients and that 65 percent of physicians and other medical professionals go more than a week without washing their lab coat.)

Nevertheless, it is wrong to entirely blame front-line medical workers for these unnecessary infections. Aside from the need to have proper supervisory controls in place, a culture of respect, proper staffing levels, ongoing education programs and proper shift scheduling have all been shown to improve the health and safety of hospitals – for both patients and workers. (“By nearly doubling cleaning staff hours on one ward,” US News and World Report explains, “a hospital in Dorchester reduced the spread of MRSA by nearly 90 percent.”)

The biggest barrier to improvement, however, is our economic system, which focuses on cures and technology because that’s where the biggest, quickest profits can be found. Billions of dollars are spent annually on the development of new drugs and medical technologies, but little is spent on basic hospital infection control – even though this would save a greater number of lives. There has been little economic incentive to do so. Some company makes a profit when a new MRI machine is purchased, but the bottom line that benefits from better hand-washing techniques is only measured in lives.

It has taken a public outcry just to get some states to force hospitals to track and report hospital-acquired infections. But, unlike restaurants and cruise ships, the body that inspects and accredits US hospitals, does not measure cleanliness.

The profit motive outside the hospital door also causes infection-control problems. More than 70 per cent of hospital-acquired infections are resistant to at least one common antibiotic. Infections resistant to antibiotics significantly increase the chance of death.

This increase in deadly multi-resistant viruses is, in large part, attributable to our overuse of antibiotics, which is connected to drug companies’ bottom lines. Doctors, faced with patients demanding quick cures, and encouraged by a pharmaceutical industry that spends tens of billions on advertising, over-prescribe antibiotics.

“Prescribing antibiotics has become so common that many doctors literally are just phoning it in,” a recent USA TODAY article explains. According to an analysis of 1.5 million insurance claims for antibiotic prescriptions in 2004, 40 per cent of people who filled an antibiotic prescription had not seen a doctor in at least a month. Without seeing the patient, how can doctors determine whether their symptoms were the result of a viral infection – which don’t respond to antibiotics – or a bacterial infection that do.

This over-prescription of antibiotics increases the growth of multi-resistant organisms. And in the case of the Clostridium difficile “superbug”, which has killed many hospital patients over the past few years, antibiotics perturb the bacterial flora in the intestine. This opens the door to the super-bug. (One study found, according to the Times of London, that “reducing the number of prescriptions for broad–spectrum antibiotics [which kill a wide range of bacteria] from about 53 per 1000 admissions to 17 per 1000 caused the number of cases of C difficile to fall by two thirds.”)

Additionally, half of all antibiotics sold each year are used on animals, according to the New Scientist magazine. Industrial farmers give their animals constant low doses of these drugs to treat infection but also as a growth hormone. The administration of low doses is especially problematic since it becomes a feeding ground for organisms to mutate. Data show a strong correlation between increased use of antibiotics on animals and the emergence of resistant strains in the animal population with mirrored increases amongst people.

To end this practice, the European Union recently banned antibiotic growth promoters. Washington and Ottawa, kowtowing to the animal industry, have done little.

Hospitals can be much safer and healthier places. Tens of thousands of lives can be saved if real health outcomes can be given priority over profit-making opportunities.

YVES ENGLER is the author of two books: Canada in Haiti: Waging War on the Poor Majority (with Anthony Fenton) and Playing Left Wing: From Rink Rat to Student Radical. He can be reached at yvesengler@hotmail.com

 

More articles by:

Yves Engler’s latest book is ‪Canada in Africa: 300 years of Aid and Exploitation.

CounterPunch Magazine

minimag-edit

bernie-the-sandernistas-cover-344x550

zen economics

Weekend Edition
July 28, 2017
Friday - Sunday
Diana Johnstone
Collateral Damage: U.S. Sanctions Aimed at Russia Strike Western European Allies
Jim Kavanagh
Donald the Destroyer: Assessing the Trump Effect
Carl Boggs
The Other Side of War: Fury and Repression in St. Louis
Eva Golinger
There is Still Time to Prevent Civil War in Venezuela
Anthony DiMaggio
“A Better Deal”? Dissecting the Democrats’ “Populist” Turn in Rhetoric and Reality
Jeffrey St. Clair
Scout’s Honor
Conn Hallinan
Middle East Chaos
Mumia Abu-Jamal
James Baldwin: Word Warrior
Joshua Frank
The Fire Beneath: Los Angeles is Sitting on a Ticking Time Bomb
Myles Hoenig
It Wasn’t Russia, It was the Green Party!
Andrew Levine
Enter Scaramouche, Stage Right
Brian Cloughley
Time to Get Out of Afghanistan
Gary Leupp
The Trump Revolution Devouring Its Own Children
John Wright
Trump’s Hezbollah Gaff Was No Gaff
Alan Jones
“Finland Station” and the Struggle for Socialism Today
Robert Hunziker
Plastic Chokes the Seas
Eric Draitser
Enough Nonsense! The Left Does Not Collaborate with Fascists
Vijay Prashad
The FBI vs. Comrade Charlie Chaplin
Ishmael Reed
Trump’s Irish-Americans “Without Hearts”
Jane LaTour
Danger! Men Working
Yoav Litvin
The Unbearable Lightness of Counterrevolution
Charles Derber
Universalizing Resistance: How to Trump Trump
Gregory Barrett
Two Johnstones and a Leftish Dilemma: Nationalism vs. Neoliberalism
Joseph Natoli
Choosing the ‘Arteries that Make Money’
CJ Hopkins
Intersectionalist Internet Blues
Pepe Escobar
China and India Torn Between Silk Roads and Cocked Guns
Ralph Nader
Can the World Defend Itself From Omnicide?
Howard Lisnoff
Agape While Waltzing at the Precipice
Musa Al-Gharbi
Want to Shake Up Status Quo? Account for the Default Effect
Angela Kim
North Korean Policy Must Focus on Engagement Not Coercion
Hiroyuki Hamada
Delivering Art in the Empire
David Macaray
Talking Union
Binoy Kampmark
Refugee Conundrums: Resettlement, the UN and the US-Australia Deal
Robert Koehler
Opening Gitmo to the World
David Jaffee
No Safe Space for Student X
Thomas Knapp
The State is at War — With the Future
David Swanson
What’s Missing from Dunkirk Film
Winslow Myers
There Is Still Time, Brother
Robert J. Burrowes
Biological Annihilation on Earth Accelerating
Frederick B. Hudson – Dr. Junis Warren
Robot Scientists Carry Heavy Human Hearts 
Randy Shields
Not My Brother’s Reefer
Sam Lichtman
Where are the Millennials?
Louis Proyect
Death Race: the Cruelties of the Iditarod
Charles R. Larson
Review: Norman Lock’s A Fugitive in Walden Woods
July 27, 2017
Edward Curtin
The Deep State, Now and Then
FacebookTwitterGoogle+RedditEmail