Raza overall rates of cancer deaths have fallen dramatically in the last three decades, but argues that most of this is due to reductions in smoking and increases in screening - not to better treatments.Ī recent BMJ study found that 12% of care, across all medical settings, resulted in patient harm, and that half of that harm was preventable. One final example of the Third Law (and I’m sure others could provide endless other examples) comes from oncologist Azra Raza, in a recent WSJ article and new book The First Cell. Most urine tests result in unnecessary courses of antibiotics, which contributes to our problem of antibiotic resistance. The Infectious Diseases Society of America and Choosing Wisely also warn about the risks of routine urine tests. Unfortunately, the Third Law also applies: the United States Preventive Task Force has repeated pointed out, most recently last month, that testing for asymptomatic patients has no benefits but some potential harms. “Once a clinician sees bacteria in the urine, the reflex is, you can’t ignore it. Most seniors, it appears, have asymptomatic bacteria in their urine, so when a zealous clinician orders a urine test, odds are high that it will show positive results - and result in a course of antibiotics. Jerome Leis and Christine Soong in JAMA Internal Medicine last month and expounded on this week in The New York Times. Here’s a second example of healthcare’s Third Law, with an equally catchy phrase: how efforts to identify urinary tract infections are creating a “culture of culturing,” as posited by Drs. Research has shown, and many clinicians acknowledge, that moving during an inpatient is good for patients, but trying to do some good by avoiding falls is leading to the opposite reaction of the “epidemic of immobility.” One study found that previously mobile patients spent 83% of their hospital stay in bed, which helps lead to those disability rates. Hospitals and nursing homes have all sorts of alarms when patients try to move on their own, and are required to track falls, but don’t track how often patients move. Covinsky said: “Older patients face staggering rates of disability after hospitalizations.” The article cites Kenneth Covinsky, a UCSF geriatrician, whose research found that one-third of elderly patients leave the hospital more disabled than when they came on. Unfortunately, not moving can be as dangerous as falling. The result of the new penalties, which was not intended but which should not have been surprising - was a “climate of fear of falling” for hospital staff.Īs a result, more efforts were made to keep patients from moving in order to help assure their safety. In fact, falls are said to be the leading cause of fatal and non-fatal injuries among the elderly. That is understandable falls can result in serious injuries, including broken hips, concussions, and/or laceration, especially for already fragile patients. We should.įall prevention become a big thing with CMMS implemented penalties for hospital falls the goal was that falls never happen. We’ve read about epidemics of obesity, diabetes, opioid addiction, even vaping, but an immobility epidemic is not something we hear much about. The investigation concludes that well-intentioned efforts to prevent falls - particular in hospitals and nursing homes, and especially for elderly patients - were resulting in “an epidemic of immobility.” I was reminded about this by a Kaiser Health News investigation on fall prevention, as published in The Washington Post and elsewhere.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |