Tuesday August 21, 2018

Patient safety findings in PH hospitals (Part 2)

LAST week, a reporting of the findings of one of two Philippine studies on patient safety in hospitals demonstrated the cases of hospital-associated infections in a public Philippine hospital, which involved medical devices, such as ventilators, central lines and urinary catheters. The other study documented ICU cases of hospital-associated infections in public and private hospitals in the country.

These studies were reviewed by three public health researchers (Reema Harrison, Adrienne Cohen and Merrilyn Walton) from the University of Sydney in Australia. Their findings were published in the International Journal for Quality Health Care in 2015.

There is no accessible data on patient safety cases in the official website of the Department of Health. It is hoped that DOH personnel who read this article will send us those data for publication here in a future issue.

The remaining two studies, which I promised last week to report today, were published separately in 2011 and 2009.

The 2011 James study found that doctors had recommended unnecessary or inappropriate treatments in 69 percent of cases in a public hospital and private clinics. Moreover, overuse of antibiotics had been noted in 47 percent of cases, while unnecessary hospitalization was observed in 34 percent of cases reviewed. These findings involved no cases of hospital-associated infection. However, inappropriate and unnecessary treatment and antibiotic overuse are cases of medical or medication errors.

This case reminded me of when my wife was delivering my third child in a large hospital in Cebu City when I noticed that she was ordered to be given antihypertensive medication. I noticed this in the nurses’ station when I accidentally saw it written in her records. When I asked the nurse about it, I was informed that the doctor had ordered it. When I asked if her blood pressure had been high, the nurse confirmed that all was normal. Thus, I requested that such order be cancelled. That was a case of aborted medication error.

In the 2009 Gill study, 30.7 percent of the newly born infants (neonates) reached the neonatal intensive care unit (NICU) with infection from drug-resistant bacteria that they got from the delivery room. The study involved 1,827 neonates in a NICU in a public hospital.

Moreover, of those neonates that were not infected during delivery, 45.6 percent became colonized with drug-resistant bacteria in the NICU. Of these neonates studied, 33.7 percent died due to hospital-associated infection.

The settings of these two studies must be something Cebuanos must take note of. They are public hospitals and private clinics. It is, however, not disclosed in which part of the country these studies took place. Be selective, nevertheless.