Two unrelated reports popped into my inbox this week. Sadly, both left me shaking my head and wondering what can be done to right the ship.
First, hand hygiene. It never ceases to amaze me that no matter how many bites researchers take at the apple, they come up with the same results: Significant opportunities exist for health care providers to improve hand hygiene. Or, to think about it in the bigger picture: Significant opportunities exist to reduce the spread of harmful bacteria.
Writing in the American Journal of Infection Control, researchers at Dartmouth-Hitchock Medical Center found low hand-hygiene compliance by anesthesia providers. The study wasn’t alarmist, but it did suggest that new and “novel approaches” to hand hygiene for the anesthesia work environment may be necessary.
Using video monitoring, the researchers found that lack of compliance with World Health Organization hand-hygiene protocols resulted in spikes in contamination of the 20 most frequently touched objects during a procedure.
Second, opioid usage. The CDC’s latest Vital Signs report illustrates the vast variation in how opioid painkillers are prescribed across the nation. Providers wrote 259 million prescriptions for painkillers in 2012, “enough for every American adult to have a bottle of pills,” according to the CDC. Southern states had the most prescriptions per person; the Northeast had the most prescriptions for long-acting and high-dose painkillers.
What’s causing this? A number of factors, according to the CDC:
- Providers don’t agree on when or how to prescribe painkillers.
- A growing number of people are using painkillers without a prescription just to get high or to sell them, or they are getting them from multiple providers.
- So-called pill mills — for-profit, high-volume pain clinics that dispense drugs to people who don’t necessarily need them.
The problem can be deadly: 46 people die everyday from overdoses of prescription painkillers, according to the CDC. As my colleague Marty Stempniak reported in February, hospital EDs are increasingly on the front lines.
The CDC’s Vital Signs report includes a series of recommendations aimed at curbing the overuse and inappropriate use of these dangerous drugs. In a press statement issued yesterday, American Medical Association President Robert Wah, M.D., agreed that something needs to be done “to put a stop to pill mills and illegal prescribing practices.”
Beyond calling for increased access to substance abuse treatment, he noted the important role IT can play.
“To combat this public health epidemic, the AMA supports enhanced educational opportunities for physicians, and robust prevention efforts, such as improved clinical decision support tools at the point of care through modernized and fully funded prescription drug monitoring programs that allow physicians to track their patients care in real time; broader implementation of take-back programs; and such overdose-prevention measures as increased access to the lifesaving medicine naloxone,” he said.
While there’s no obvious link between the APIC and CDC reports, one thing came through as I read them: Both utilized some iteration of the phrase “follow best practices.” After all, shouldn’t that be the hallmark for everything in health care?