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A look at Hospital Safety



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In 2004, a study of Australian hospitals revealed that 18,000 preventable deaths occurred each year. Imagine the uproar if 55 people died every day on the roads of a country whose population is just 21 million. Needless to say there was considerable publicity given at the time but statistics clearly didn't deter people from seeking hospital treatment. Australia retains one of the highest rates of hospitalization among the developed nations.

Hospital environments carry many risks and deaths occur because many of the people admitted are critically ill or injured. However, there is also a myriad of safety issues concerning the environment, accidental spills, x-ray exposure, toxic chemicals and that is all before you address the usual problems of infection, nutrition, hygiene and general patient care. There are many variables within a hospital environment including visitors who may resist being ordered to wash their hands. In Scotland in 2008, there was considerable controversy after an outbreak of Clostridium Difficile caused the deaths of several elderly patients. Unfortunately this is a class of patient whose immune system is already compromised by multiple health problems. Exposure to a bacteria which may be insignificant in a healthy visitor can be a fatal complication in a bedridden grandmother. Alcohol handwashes , much loved by hospital administrators are ineffective against C. difficile.

While on the subject of hygiene, it continues to astound many that doctors are among the worst offenders regarding adequate handwashing between visiting patients. Florence Nightingale would throw up her hands in horror. There are many other infections that can pose a risk in the hospital setting. Many surgical procedures are accompanied by the routine administration of antibiotics and this can lead to problems with resistance and ineffectiveness of medications.

Correct identification of patients is a critical issue and many hospitals would have mistaken identity cases on their files. Incidents arising from this can be as benign as a patient being served the wrong breakfast to something as dire as being given the wrong drug or having the wrong surgical procedure performed. Pathways must be in place to ensure that  correct identification of patients  is mandatory.

Some patients will have short, uncomplicated stays and require little in the way of nursing care. However, many will have extended periods in wards and the longer their stay, the higher the risk of an adverse event happening. Inadequate nutrition, getting the right medications at the right time, monitoring of their physical and mental health, and attending to basic hygiene issues all rely on all staff being able to do their allocated tasks without interference. Anyone who has ever had anything to do with hospitals would know this is difficult to achieve. There will always be issues of staffing, disruptions and unexpected dramas that interfere with the smooth running of the hospital ward. Many hospitals rely on agency staff to meet their staffing requirements and you then have the situation where patient handover may be sub-optimal and staff willl be unfamiliar with every patient under their care.

There is no doubt that many of the deaths in hospitals could be avoided. However, before starting the blame game, remember that the staff who work there are professional, dedicated people who are doing their best. Caught between hospital administrators who attempt to squeeze every cent out of every dollar and the public, whose demands are endless, In an age where everybody has an opinion and has been fed a diet of ER and House and are therefore experts, let's be thankful that our hospitals perform as well as they do.

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