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“What Would Have Been Helpful” – Patient
Empowerment |
We hear or see the
words patient empowerment, but I do not believe we truly
understand the impact these two words have in the lives
of many patients and their families. In November, 2006,
I received an email from Ms. Teri Mittelstadt asking
some basic information about the unfortunate sudden
death of her mother in November 2004. I was moved by
her sense of guilt over the death of her Mom (2 years
ago) and realized how important patient empowerment and
disclosure can be to a family. I asked Teri to share in
her own words her thoughts with us with the hope that we
see the value of patient empowerment to patients and
family. Patients are ready to be empowered as you will
see from the information Ms. Mittelstadt gathered on her
own about MRSA. - Maryanne McGuckin, President,
MMI
“Dear
Maryanne,
I lost
my mother, Barbara, to an MRSA infection in November of
2004. Two months earlier my mother had been diagnosed
with bladder cancer, for which she underwent surgery 6
weeks prior to her death. The doctors performed a
radical cystectomy leaving her with an ileal conduit
that drained through a stoma into an external reservoir.
The surgery was a complete success, in fact, there was
no need for either chemotherapy or radiation therapy
following the procedure. It was an MRSA infection that
took her life, not the cancer for which she sought
treatment. We now believe that her MRSA infection was
contracted either during surgery, or during
postoperative care.
My
mother was a registered nurse who had worked at a blood
bank for the last 14 years of her career, however she
had been retired for about 13 years prior to contracting
her illness, so I’m confidant that she didn’t contract
her infection while working. Prior to surgery, my
mother was the picture of health. She walked daily for
exercise, enjoyed gardening, and was a VERY active 70
years old woman. Following surgery, her doctors gave
her a clean bill of health, with no trace of cancer
anywhere to be found. So what went wrong?
On
Thanksgiving - November 25th 2004, my mother began
complaining of general nausea (she had no fever,
diarrhea or vomiting). Not understanding that this
could have been a symptom of an infection I called her
surgeon and asked if he could prescribe something for
nausea thinking perhaps she had food poisoning. He
didn’t seem alarmed and just said he couldn’t prescribe
something for nausea. If she wanted something (we were
out of town) she could go into the local hospital and
they could give her something. He never expressed
concern or led me to believe that I should be alarmed.
He never even suggested that I should take her to the
hospital – he only said to take her if I wanted
something prescribed for nausea. I took my mother to
the hospital the next morning, where she died 10 hours
later from a massive infection. This began my search to
find out what went wrong, where did this infection come
from, and how could it have been prevented. I only
recently learned that the culture indicated an MRSA
infection.
Looking back at my mother’s ordeal, I now realize there
are certain things that would have been helpful to know,
and steps that could have been taken that may have
possibly even prevented the tragedy which unfolded for
her. Had my sister and I understood the dangers of
hospital-acquired infections, particularly MRSA, we
would have taken several steps to help insure that my
mother did not fall victim to them. Like most people, we
assumed that reputable hospitals take every precaution
necessary to insure their patients are cared for in a
safe and sanitary way. It was only after her passing
that we found this is not necessarily the case. My
mother had a stoma, which needed to be cleaned and
dressed by a nurse daily during her post-operative
recovery period. She also had an incision from her
surgery that needed the dressing changed. Knowing what
I know now, I would have insisted that greater
precautions be taken to insure that proper sanitation
techniques were used during each and every step of her
care. Areas of greatest importance would include:
1. Hand
Sanitation: Each and every person entering the room
would have been required to wash their hands thoroughly.
This would have been the single most important thing we
would have insisted upon, and controlled. Infection via
the hands is among the most common method of contracting
MRSA. Keyboards, mice, wheelchairs, stethoscopes, gowns,
television ear-plugs, privacy curtains, and other pieces
of hospital equipment are breeding grounds for MRSA, and
all have been found to be sources of MRSA. Proper hand
sanitation reduces the risk of MRSA being passed via any
of those methods.
2.
Hospital Equipment: All
equipment in the room would have been required to be
disinfected adequately. Present data exists that show
the presence of MRSA on many types of hospital and
patient room equipment.
3. Air
Hygiene: I would have requested that air
sterilization procedures be in place to reduce the
chance of contracting MRSA. Proper air filtration has
been found to greatly reduce the possible spread of MRSA,
through the use of HEPA filters and ozone.
http://www.hubmed.org/display.cgi?uids=16517004
4.
Patient Equipment: I
would have insisted on either new or disinfected privacy
curtains. These have now been found to be breeding
grounds for MRSA.
http://www.medicalnewstoday.com/medicalnews.php?newsid=38138&nfid=crss
5.
Staff Screening: I
would have requested information on staff screening
procedures. I now know that roughly 10% of hospital
staff are carriers of MRSA (if the internet stats are
reliable).]
6.
Testing: I would have requested that my mother be
tested upon discharge to find out if she had been
infected during her stay and then had her put on the
appropriate antibiotics.
In
closing, I now understand that there are many things
that could have been done to reduce the risk of
infection by MRSA, and had I been informed about the
dangers of this type of infection, I am convinced that
my mother would be around today. Knowledge is power and
unfortunately I wish I had been much more informed so
that I could have tried to protect my mother from the
thing she feared the most, which was a hospital error.
I
appreciate the opportunity to share her story.
- Teri Mittelstadt |
RHHP needs no special hardware, as it uses the nurses' station
computer to play its downloadable files.