A CDC video now being shown to hospitalized patients and visitors urges them to insist they witness providers wash their hands by the bedside, even if the doctor or nurse says he or she already washed just before entering the room.
The video portrays a young woman—perhaps a relative or spouse—visiting a patient as a doctor enters the room to perform an examination.
"Doctor, I'm embarrassed to even ask you this," the visitor says. "But would you mind cleansing your hands before you begin?"
"Oh, I washed them right before I came in the room," the physician reassuringly replies.
"If you wouldn't mind, I'd like you to do it, again, in front of me," the young woman says, insistently pointing to the gel dispenser by the door.
"Sure, no problem," the physician replies, and proceeds to do as she's told.
"Thanks, doctor. I know how important hand hygiene is in preventing infections," the patient's visitor says.
It's unclear how providers will respond if more patients become more insistent about observing hand-washing behavior at the bedside, especially if the provider really did just wash or use the alcohol gel.
But also shown in a video is a nurse or a doctor in blue scrubs saying: "Doctors and nurses don't mind being asked to wash their hands because they want to prevent infection as much as you do."
The five-minute video contains an introduction by John Jernigan, MD, a deputy branch chief with the Centers for Disease Control and Prevention.
Jernigan warns: "You came to the hospital to get well. But you should know that each year in the United States, patients get more than one million infections in a hospital while they are being treated for something else.
"Examples of infections patients can get in a hospital include infections in their blood stream, surgical wound, or urinary tract as well as pneumonia. These infections can be serious and hard to treat. But there's one simple thing you and your family can do to help prevent these infections. Wash your hands, and make sure that everyone who touches you, including your doctor, cleanses their hands too.
"Patients and their loved ones who take an active role and become involved in their treatment may have a better experience in the hospital than those who don't. And make sure everyone around you washes their hands," he says.
The video appears to be doing a good job at convincing patients and their caregivers not to be afraid, and to not be embarrassed for asking. Premier Inc. healthcare alliance conducted a before-and-after survey at 17 Catholic Health Partners hospitals in Ohio, Kentucky, and Tennessee to determine whether patients who watched the video were more likely to speak up or consider doing so if they didn't see their caregiver wash or use sanitizer at the bedside.
About 440 patients or family members were surveyed before they saw the video. One month later, with a different group of patients, about 440 patients or family members were asked after they saw the video.
The results showed that after the video was shown, twice as many patients were willing to ask their doctors or nurses to perform hand hygiene than before the video was provided, said Premier Inc. spokesman Alven Weil.
Nearly 1,000 nurses and 611 physicians were also shown the video at points in time both before and after the video was widely shown throughout the hospital.
Interestingly enough, doctors and nurses said they were much more likely to get reminded about washing after the video was shown, Weil said.
Studies suggest that only 50% of caregivers actually wash their hands when they're supposed to before patient contact, although 90% think they do it when they should.
Hospital acquired infections are estimated to affect more than 1.7 million patients a year, kill 99,000 patients a year, and cost between $35 billion and $45 billion a year. And, under new federal reimbursement policy, payment for care required as a result of hospital acquired infections will no longer be approved, making prevention that much more urgent.
President Obama made a rare Sunday visit to the Capitol to urge a fractious Democratic caucus to pull together to pass landmark healthcare legislation, the Washington Post reports. Obama used the 45-minute session to stress the Senate's "historic opportunity to provide stability and security for those who have insurance, affordable coverage for those who don't, and bring down the cost of healthcare for families, small businesses, and the government," White House spokesman Bill Burton said in a statement. The Senate will reconvene Dec. 7 for an eighth day of debate and potentially the first controversial amendment, addressing the issue of abortion coverage.
While the Senate reform process continued to "crawl forward," as Senate Majority Leader Harry Reid (D-NV) called it, for the past seven straight days, the action may pick up somewhat Monday with the controversial amendment on abortion, which will probably be introduced by Sen. Ben Nelson (D-NE). Reid announced the move late yesterday afternoon during a rare weekend of the Senate in session.
The language in the amendment is anticipated to closely follow the "Stupak" legislation approved a month ago by the House. Basically, it would ban abortion coverage under the public insurance option, while prohibiting insurers from covering abortion services for any woman who receives federal subsidies to purchase insurance in the insurance exchange. Exceptions would be made in cases of rape, incest or to save a woman's life.
The current Senate bill, which is less stricter than the House bill, calls for insurers to guarantee that only private funds be used for abortions. The amendment unlikely will not get the needed 60 votes to be included in the Senate bill. However, attention will be paid to see if additional compromises are needed to obtain Nelson's support for the overall Senate bill.
Meanwhile, the public insurance option idea is receiving new life. Ten Democratic senators, including Nelson, Mary Landrieu (D-LA), Sherrod Brown (D-OH), and Russ Feingold (D-WI) met this weekend to discuss ways to resolve issues for the option.
Feingold, speaking Sunday on ABC's "This Week," said the talks are "exciting . . . they're getting closer" and that he was "cautiously optimistic" that they were "going to be able to pull everybody together." Feingold, an advocate of the public option, said that multiple approaches were being examined that either "creates a new public option or an expansion of current public programs."
One idea discussed would model the public insurance plan on coverage offered to federal employees, Nelson and Feingold said. That would let companies sell insurance to businesses in all 50 states under the oversight of the Office of Personnel Management.
One of the newer options under discussion is a model of a national nonprofit insurance plan—providing coverage similar to the way coverage is offered to federal employees. With this model, companies would sell insurance to businesses in all states under the oversight of the federal Office of Personnel Management.
Reimportation of prescription drugs from Canada also may come up for a vote this week. Sen. Byron Dorgan (D-ND), one of two lead sponsors on the measure, during a speech on the Senate floor on Sunday pulled out two bottles of the popular prescription drug, Lipitor, noting that the medication from the U.S. cost almost three times more than the medication ordered from Canada.
The measure, which has received bipartisan support from senators including Olympia Snowe (R-ME), Debbie Stabenow (D-MI), and Charles Grassley (R-IA), would save the federal government $19 billion over the next 10 years, according to the Congressional Budget Office estimates, Dorgan said.
The amendment, though, is seen as a major challenge to pharmaceutical manufacturers that pledged earlier this year $80 billion in drug subsidies and fees—including reducing the Medicare doughnut hole—over 10 years to support the healthcare reform effort.
Dorgan, however, said he was not part of those talks. "We don't do healthcare and leave behind the question of the cost and price of prescription drugs," he said.
Throughout the weekend, Senate Democrats intensified their yearlong effort to build consensus around some form of a public insurance plan to compete with private insurers. The Senate majority leader, Harry Reid, Democrat of Nevada, named 10 senators to seek a compromise. Under a leading proposal, the federal Office of Personnel Management would negotiate with insurers to offer one or more national health plans to individuals, families, and small businesses. The push for a deal on the public option indicated the pressure Democrats were feeling to resolve their differences if they hope to pass the bill by their self-imposed deadline of Christmas.
In a bid for compromise on one of the health bill's most divisive issues, Democrats wrestled with a new proposal on a government health-insurance plan that would give private entities a central role in running the program, the Wall Street Journal reports. In closed-door negotiations Sunday, Democrats on both sides of the issue who were assigned to find a compromise were nearing agreement on an alternative that would empower the government's Office of Personnel Management to run a new national health plan, congressional aides said. Under the proposal, the office would negotiate terms of the plan with private insurers, and contract with nonprofit entities set up by the private sector to run the program.
Senate Democratic leaders are struggling to preserve the fragile support of interest groups for an overhaul of the nation's healthcare system. The Senate wrestled with amendments that would impose additional cost-control requirements on hospitals, doctors, and drug companies, squeezing out savings beyond the considerable sums those groups had already volunteered to give up, the Washington Post reports. Of particular concern to seniors groups is an effort to strengthen a new independent board that would determine the future of Medicare, raising the possibility of cuts much deeper than those envisioned in the $848 billion healthcare bill.
Antiabortion lawmakers in the Senate plan to introduce an amendment to restrict insurance coverage of abortion in the health bill. Both sides agree the amendment likely doesn't have enough votes to pass, but antiabortion groups and Sen. Ben Nelson (D., NE) say they will continue insisting on tough language as a condition for supporting the overall bill. As it stands now, the Senate health bill would include abortion coverage in the new public plan and would allow women who receive government tax credits for insurance to enroll in a plan that covers the procedure. The tax credit would be segregated so none of it could go toward funding abortion, the Wall Street Journal reports.
Pushing Americans to receive swine flu vaccinations, the Obama administration released a new slate of television and radio ads to counter the illness. The public service announcements target children and their parents, young adults, and those in high-risk groups, such as people with asthma. The ads in English and Spanish come as a shortage of the vaccine is easing, with another 10 million doses expected to become available this week.
After a man who died while waiting to see a doctor in a Philadelphia emergency room, Puerto Rican civil rights activists called for the "overhaul of an inept healthcare system." Speakers called for an investigation into the circumstances of the man's death at Aria Health-Frankford Campus, and an inquiry has arleady been launched by the Pennsylvania Department of Health. The group will also push for an investigation by the federal Office of Civil Rights, officials said.
UnitedHealthcare's bid to acquire the membership renewal rights of Health Net customers in Connecticut was approved by state Insurance Commissioner Thomas Sullivan. The transaction shifts the number of major healthcare providers from six to five in Connecticut, and it drew strong opposition from physician groups leading up to the decision. Several physician organizations said the acquisition would mean fewer options, and that the cost of medicine and treatment would increase as insurance providers decreases.
