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by jrockway 5162 days ago
contact with our health care system the fifth leading cause of death in this country

Whoa. Can anyone give this in-passing snippet some context?

4 comments

From wikipedia: http://en.wikipedia.org/wiki/Nosocomial_infection

"In the United States, the Centers for Disease Control and Prevention estimate that roughly 1.7 million hospital-associated infections, from all types of microorganisms, including bacteria, combined, cause or contribute to 99,000 deaths each year"

Yeah, hospital-acquired infections are huge. In fact, they're a huge reason why we have so many aggressively resistant strains of organisms.
More the other way around.

Widespread over-the-counter antibiotics, over prescription and agricultural use are the reason there are so many resistant organisms. Healthy people with the organisms going into hospitals full of sick people is the reason they get there.

Poor hospital cleaning, high occupancy rates and especially people using keyboards is the reason they are huge.

> people using keyboards

Never thought about that before, though I do know that keyboards are filthy. Is there any evidence that the rate of infection increased since medical professionals began to use keyboards for data entry? But I guess that kind of data would be buried under a lot of other factors that emerged over the last 2-3 decades.

Also, how would you go about fixing that? Tablets might be easier to clean, but you're still touching a surface. Speech recognition would be cool, but then you're spraying microscopic drops of saliva all over the place. Is paper just as unsanitary, or does the fact that fewer people share the same sheet of paper somehow mitigate the risk?

Some keyboards have silver in the keys.

Some keyboards have a squishy membrane cover which can be sprayed and scrubbed.

But, really, people need to wash their hands (soap and hot water) before they touch a patient.

The problem is the number of patients and the amount of data that has to be entered into different systems means you would spend 90% of your time washing your hands or taking gloves on and off.

Imagine programming where everytime your hand went between the keyboard and mouse you had to go and wash your hands!

The problem is that adding more computers is always a 'good thing' - how can more info about a patient be bad?

Hand sanitizer?

It takes all of 2 seconds to squeeze it onto your hands, and you can apply it on your way to the next patient.

100 years ago patients died because of doctor's neck ties. He would lean over one patient with the tie dragging on their wound, then go to the next patient transferring the infection

Of course we are far too advanced to do anything so stupid today.

Now we examine a patient, go to the computer at the nurses station and type up the results, then the nurse comes along and rubs their hand over the keyboard and mouse, then you go the next patient ....

You can get washable waterproof medical keyboards but they are expensive, and get broken and replaced with whatever IT have on the shelf. Funnily enough I have never seen a waterproof mouse.

The Institute of Medicine report "To Err is Human: Building A Safer Health System" states: "At least 44,000 people, and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that could have been prevented". Some improvements have been made since then but it's still a huge problem.

http://www.iom.edu/Reports/1999/To-Err-is-Human-Building-A-S...

It depends on quite what you consider a cause of death.

Medical errors officialy account for between 100,000 and 200,00 deaths per year, and between 20-35% of people who die in hospital are discovered at autopsy to have been misdiagnosed. BUT consider you are treating an 80year old man for pneumonia and when he dies the autopsy discovers he had undiagnosed prostate cancer - is that 'really' a medical error death?

Then there are around 100,000 deaths due to hospital infections. 30,000 of them from MRSA alone = twice the number of people who die of AIDS. The rates in nursing homes and other 'medical' facilities are probably much higher but aren't as well monitored or reported.