Especially when we’re sick and vulnerable, we rely on health-care providers to treat us. We depend on their knowledge, training, skills, and compassion. We expect them to help us to heal so that we can return to our duties and responsibilities as employers or employees, spouses, parents, neighbors, and friends.
We certainly don’t expect to get worse as a result of being hospitalized. However, there’s a chance that, in fact, we will get worse as there are 5 ways a hospital stay can make us sicker.
5. Post-Hospital Syndrome
Dr. Harlan Krumholz of the Yale School of Medicine has coined the term “post-hospital syndrome” to identify a temporary period during which patients are susceptible to an illness following a hospital stay. This requires their readmission within 30 days of their initial discharge.
The cause of readmission ranges from a hospital-acquired infection (HAI), stress experienced during hospitalization, sleep deprivation during the hospital stay, a lack of nutrition or exercise, lowered immune system functioning, and depression. Research conducted in 2009 shows that, among Medicare patients, 2.6 million discharged patients (20 percent) were readmitted to the hospital within a month of their discharge.
4. Hospital Food Errors
A Pennsylvania Patient Safety Authority study found that, between January 2009 and June 2014, hospital staff committed 285 errors related to patients’ meals—181 of which were related to allergies—due to charting errors and communication mistakes.
Eight caused “serious harm to patients.” In one case, a patient with a seafood allergy was given fish and had to be “injected with epinephrine, given several intravenous drugs,” and relocated to an intensive-care unit for observation.
Other patients who were supposed to fast were given food or food that did not accord with their prescribed diets. The errors occurred throughout the “dietary process,” from the ordering to the delivery of meals.
Contaminated medical equipment, faulty surgical incisions, and too many antibiotics contribute to HAIs caused by bacteria, fungi, and viruses. The magazine Consumer Reports rated hospitals based on their number of infections related to surgical sites, catheter or urinary tract infections, and bloodline infections. A year later, they added C. diff and two common “drug-resistant bacterial infections that can spread easily and are potentially fatal.”
According to the US Centers for Disease Control and Prevention, nearly 650,000 patients acquired almost 722,000 HAIs in 2011. Daily, 200 patients die of these infections during hospitalization.
High rates of HAIs occur even in prestigious hospitals such as Johns Hopkins Hospital in Baltimore, Mount Sinai Hospital in New York City, and Ronald Reagan UCLA Medical Center in Los Angeles. “Strict infection-control protocols, [limited use of antibiotics, and] cleaning hospital rooms and medical equipment” are effective measures in the reduction or elimination of these infections.
In US states with lax reporting requirements, many hospitals “upcode” HAIs, assigning them false billing codes which are difficult to detect. In this way, these hospitals avoid the loss of federal payments due to penalties for the occurrence of HAIs.
One proposed solution is to require hospitals to report all HAIs, including the names of infected patients, the effects of the infections, and the infections’ root cause[s]. This proposal also suggests increasing the number of hospitals targeted by audits.
2. Poor Staff Hygiene
In some cases, patients are worse off after hospitalization due to poor staff hygiene. Sometimes, doctors don’t wash their hands as often as they should. Nurses, tasked with reminding physicians and surgeons to do so, don’t think it’s their responsibility to “police the doctors.”
If they were to offer such reminders, nurses said, they’d fear reprimands. Doctors also don’t want to be taken to task by nurses because it implies that the doctors aren’t aware of the need for sanitary practices.
To combat the problem of poor staff hygiene, Internet sites grade hospitals on patient safety. The federal government also maintains an online database based on patient records.
1. Sick Doctors
Although doctors often feel obligated to work while sick, they put their patients with weakened immune systems at risk of infection when the doctors do so. In a survey of health-care providers (including 280 doctors) at the Children’s Hospital of Philadelphia, 83 percent admitted to working while sick at least once during the past year.
Their symptoms included diarrhea, fever, and cold or flu symptoms. These health-care providers worked while sick because they didn’t want to let their colleagues or patients down.
In addition, they indicated that peer pressure was a consideration because colleagues criticize doctors who take sick days. Previous surveys have shown similar results, indicating that doctors respond to workplace pressures to work when ill.