CT Center for Patient Safety Newsletter

April 2014

In This Issue

Handwashing

Opioids Addiction and Heroin

Coming UP

Our Legislation went Nowhere

Handwashing

Valerie Curtis is one of those remarkable individuals who make a difference because of her passion - hand washing. It has always been a puzzle to all of us that more providers do not wash their hands as the norm. Atul Gawande pointed out that often the less than vigilant nurse or the doctor does not see the infection that has resulted in his or her lack of rigorous hand washing. When ether was first introduced, doctors immediately began to use it during surgery. The benefit was immediate - the patient quit screaming and moving.

But with hand hygiene the benefit is not as direct. Valerie Curtis, London School of Hygiene and Infectious Diseases, began to study why individuals did not wash their hands. It turns out that 45% of what we do every day is from habit. Her challenge was to begin to understand what could make people change a habit. It turns out that it is the YUCK and ICK factor.

At a St. Francis Hospital infection prevention event last week, we had the opportunity to have our hands dusted with powder that turned purple in the presence of germs. Yes - YUCK - I thought my hands were clean.

Click the link to read more about Valerie Curtis and her passion: why the YUCK factor works and why telling people something is the right thing to do - might not be effective.

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Dear Members,

Telemedicine is here in Connecticut. ASAP URGENT CARE has an ad that offers an alternative to the ER. They offer online doctor visits in addition to in-office visits. Three of these URGENT CARE establishments have been set up and they are near New Haven. My guess is that these are Yale System doctors and providers would have access to your medical records if you are a part of that electronic system.

There is so much I want to know about this. I know the VA uses telemedicine to work with veterans on certain health conditions. And I know that in rural areas, telemedicine is used to connect specialists with their patients.

How do you feel about this? Is there a down side, or do you think that you might get better, coordinated and more focused care?

Please let me know. After all, healthcare is supposed to be about the patients so your experience counts.

Jean

Opioids Addiction and Heroin

Most opioids are prescribed, not by pain management specialists, but by primary care docs and dentists - in other words, providers who sometimes respond to pain with a prescription. No group is more worried about this than the doctors who deal with ongoing, chronic pain, or cancer pain as their specialty. They are seeing over-prescribing, inappropriate use and misuse of these relatively new drugs that now flood our market.

What Are Opioid Abuse and Addiction?

Opioids, also called opiates, are a class of drug. This class includes drugs derived from the opium poppy, such as morphine and codeine. It also includes synthetic or partially synthetic formulas, such as Vicodin, Percodan, oxycodone, and heroin. Some opioids, such as oxycodone, codeine, and morphine, are prescription pain medications. We do not want appropriate pain medication to lead to addiction. Today, more deaths are caused by prescription drug overdoses than we saw only a few years ago.

How serious is this problem?

The number of deaths and hospitalizations caused by prescription drugs has risen precipitously in the past decade, with overdoses of pain medications, in particular opioids, sedatives and tranquilizers, more than doubling between 1999 and 2006, according to a new study.

In fact, by 2006, overdoses of opioid analgesics alone (a class of pain relievers that includes morphine and methadone) were already causing more deaths than overdoses of cocaine and heroin combined.

There are some actions you can take. Following a procedure get five or ten pills, not 30. When you are better, take unused medication to your police station - they have a safe disposal box for your use. Please, never flush them down the toilet and allow them to get into our water supply.

Coming UP

Online access to your hospital's infection rates at the Connecticut DPH website. We are now tracking Central Line infections as well as some surgical infections.

We have been fortunate to receive a grant from the CT Health Foundation to do research on what newly insured individuals do or do not know about their health insurance coverage. It turns out that many of us do not understand the terminology in our policies and what medical care our health insurance actually covers and does not cover. We will be convening a panel discussion in May and will provide you with an extra early notice of the event.

Our Legislation went Nowhere

Our legislation went nowhere. We attempted to introduce a bill that would have required a provider to tell their patient the total cost of a procedure. We knew that we had next to no hope of seeing it pass. We did believe that a meaningful discussion might raise awareness to the plight of patients; patients who are suddenly finding unanticipated costs in their health care bills that they have to pay out of pocket.

Keep those stories coming!