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Curbside Consult with Dr. Jayne 1/9/12

January 9, 2012 Dr. Jayne 1 Comment

The New Year is ringing in slowly from a news perspective. Maybe everyone’s just a little saggy from the holidays. I did manage to find some thought-provoking tidbits for the week.

Almost 40,000 new laws have recently gone into effect, now that 2012 is here. The biggest changes involve immigration, civil rights, budget woes, abortion, and other hot-button issues. Some less-reported but no less interesting legislation:

  • Georgia will require those who drive golf carts on the road to have brakes, back-up lights, and a horn.
  • Illinois allows motorcyclists to run red lights if they don’t turn green (the lights, not the motorcyclists) in a reasonable amount of time.
  • Nevada is requiring fire performers and their apprentices to register with the state fire marshal.
  • Utah nixes happy hour.

Congressman Edward Markey has asked HHS Secretary Kathleen Sibelius to tackle the issue of alarm fatigue. Specifically, he requests that the Institute of Medicine look at the issue and recommend solutions.

The New York Times reports on a new Medicare study that claims hospital workers only recognize and report medical errors and accidents one out of seven times. Daniel R. Levinson, inspector general of the Department of Health and Human Services, also notes the following:

  • More than 130,000 Medicare beneficiaries experienced at least one adverse event in a hospital during a one-month timeframe.
  • Although hospitals have systems to report adverse events, staff failed to report most of the harmful incidents.
  • Hospital administrators are aware of underreporting by staff.
  • Hospitals fail to connect adverse events with systemic quality concerns, resulting in few changes to policies and procedures.

I’m trying something new this year. My goal is to complete all of my required Continuing Medical Education and Maintenance of Certification activities at the beginning of the year rather than waiting until December is halfway out the door. I’ve been doing pretty well so far, plowing through piles of journals and article links that people have sent.

The Journal of Hospital Infection publishes a study on the hazards of lidless toilets, especially in spreading pathogenic bacteria like Clostridium difficile, one of the nastiest hospital-acquired bugs. In my hospital, the only commodes with lids are those little space-shuttle style ones found in the ICU patient rooms. Now that I think of it, you don’t see too many staffers wearing full protective equipment when helping patients in that way. Something to think about. Kind of makes my kvetching about dirty keyboards less relevant.

PLoS Medicine publishes some interesting thoughts on a topic dear to most health care workers and an increasing number of IT workers: “Poor Diet in Shift Workers: A New Occupational Health Hazard?” It cites data (including some from the Nurses Health Study) linking shift work to type 2 diabetes in women. Potential underlying mechanisms include poor diet and exercise, poor sleep, and disruption of circadian rhythms. Knowing the differences between day-shift menus and night-shift menus in most hospital cafeterias, brown-bagging it is probably the safest option if you’re looking at interventions.

David Blumenthal penned the recent A Piece of My Mind column in the Journal of the American Medical Association. It’s titled, “A Physician Goes to Washington… and Safely Returns,” which actually encouraged me to read it, unlike most of the pieces in JAMA which sound like something to read with a glass of warm milk when you have insomnia. I was hoping for some juicy revelations or HITECH wisdom, but it’s mostly about what it’s like to spend time in government service.

I’ve finished my stack of mandatory reading for the day, so am heading to lounge with a bit of fluff – Explosive Eighteen by Janet Evanovich. I can’t believe they’re finally making a movie of her first book One for the Money – it’s due out the end of this month and I’m counting down.

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