Super Pillow

November 23, 2011

I’ve always had a ‘thing’ about bringing my own pillow (if possible) whenever I overnight away from home. And, that includes when I’m admitted to hospital… my non-allergenic, frequently washed pillow comes too plus a supply of my own pillowslips.

Why? There are lots of reasons why but chief amongst them is hygiene. I’ve never liked the idea of burying my head in someone else’s pillow. The crisp, white pillowslips found on hospital/hotel pillows, do not reassure me. According to an article in yesterday’s paper, my reservations are well-justified…

A recent clinical trial carried out by Bart’s Hospital and the London NHS Trust, concluded that the risk of infection from bedding is “grossly underestimated”. “Dead skin, bodily fluids and dandruff found on hospital pillows made them a potential source of more than 30 types of infection”. Read on… if you dare!

Pillow aims to halt the spread of superbugs

Carol Ryan

AN IRISH company has invented a pillow that may help to reduce the risk of picking up a hospital-acquired infection (HAI) such as MRSA from lying on contaminated bedding.

Gabriel Scientific’s “SleepAngel” pillow was the subject of a clinical trial by Barts and the London NHS Trust, which found its product to be more hygienic than regular hospital pillows.

Several international studies have found that hospital bedding can harbour bacteria if they become contaminated with the bodily fluids of a patient who has an infection.

While regular washing is a standard infection-control measure in all Irish hospitals, the Barts study concluded that the risk of infection from bedding is “grossly underestimated in clinical practice”, and that regular cleaning may not be enough.

The inventors of the SleepAngel pillow, Billy Navan and David Woolfsen, both worked in the health industry and saw the problems caused by superbugs in Irish hospitals. They thought the risk of infection from pillows was being overlooked in hospital hygiene policies and spent nine years creating their infection-control pillow.

Most of that time was spent searching for a material that could keep germs out of the interior stuffing while still allowing the pillow to “breathe”. A membrane normally used in heart stents was incorporated into a specially designed filter.

During the Barts study, their product was put to work alongside standard NHS pillows in UK hospital wards. Both were used on cardiac, vascular and respiratory wards and tested after three months.

The results showed high levels of contamination in the standard pillows. Some had bacteria levels which were described by Dr Arthur Tucker, who led the study, as a “bio-hazard”. Dead skin, bodily fluids and dandruff found on the pillows made them a potential source of more than 30 types of infection ranging from flu to leprosy. The SleepAngel pillows tested negative for interior contamination and were much less likely to have bacteria on the outside.

There was also some unpleasant news about domestic pillows – apparently you are never alone in bed because after two years of use, one-third of a pillow’s weight is made up of dust mites, dead skin and bacteria.

Infection control has become a big challenge for hospitals in recent decades. Dr Brian O’Connell, medical director at the National MRSA Reference Laboratory in St James’s Hospital, explained that the superbug problem first surfaced in Ireland during the 1980s and quickly became “endemic” in some hospitals. Rates of infection have declined in the past few years but cross-infection still creates a huge extra workload for hospital staff and puts patients at risk.

Of real concern is stopping the spread of MRSA, a strain of the common Staphlococcus aureus bacteria that has developed resistance to antibiotics, making it difficult to treat. If the bacteria gets into the system through a break in the skin it can cause infections but, in more serious cases, can lead to life-threatening diseases.

The HSE Infection Control Action Plan estimates that about 25,000 in- patients develop a HAI every year in Ireland.

The cost of treating and preventing HAIs is €23 million per year and about one-third of infections are thought to be preventable.

Source: HEALTHplus – The Irish Times


A good day?

March 10, 2011

I like it…

On Tuesday, Olivia O’Leary shared some thoughts on International Women’s Day.

Then yesterday, our new Taoiseach, Enda Kenny revealed his new Cabinet.

And, guess what?…

The Labour deputy leader, Moan Joan Burton, the party’s Finance spokesperson for the past nine years, did not get the portfolio with responsibility for public sector reform, for which she had been widely tipped. Instead, she was given Social Protection.

Also… two prominent female Labour TD’s, Roisín Shortall and Jan O’Sullivan were not promoted.

Add to that… there are fewer women in this new Cabinet than in the outgoing government.

Progress… eh?

As far as I can see, the only concession made was that a woman was appointed to the position of Attorney General…

Labour’s Máire Whelan, is the first woman to occupy the post of legal adviser to the government. Hur…ray!

Apart from all that, the good news is… this new coalition government has promised major health reform. The new Minister for Health, Dr James Reilly, is committed to developing a new universal health insurance (UHI) system which aims to end 2-tier healthcare and give everyone equal access to GP and hospital treatment based solely on medical need.

Bring it on!


Less Can Be More

November 27, 2009

I attended the sixth and final debate of the Pfizer Health Debates Series in association with the Irish Times. The series, which included six debates across Ireland in 2009, offered attendees an opportunity to hear important health issues being discussed in an open forum by leading commentators.The debates also provided an opportunity for audience engagement and open discussion.

The motion for the final debate was “This house believes that reduced health spending should not lead to poorer healthcare“. It transpired that the wording of the motion was somewhat misleading as both sides seemed to be in agreement that it isn’t about spending more money; it isn’t about cutbacks; it’s about spending more wisely. The motion was carried by a large majority.

These public debates have provided an opportunity for those attending to articulate perspectives and concerns through a question and answer session following each debate. They have been successful in raising awareness of the many wrongs in the Irish health system while also acknowledging the many good parts. At a time when the health service is facing cutbacks of over €1 billion, the positive message to take away from this debate is that money is not the sole factor in health. Better organisation will lead to better outcomes. Increased spending on healthcare does not necessarily lead to better results. Less can be more.


Look on the bright side

July 31, 2009

I’ve read two newspaper articles in the past week which have totally resonated with me. Life can be a bitch at times. I’m going through a difficult time with my health at the moment. I’ve been in hospital for weeks undergoing treatment following a complex operation on my skull.  Following the surgery I developed a complication known as osteomyelitis. In layman’s terms, this is infection of the bone and it’s a bugger to stamp out. I have also developed a fairly severe form of colitis which has complicated the treatment for the osteomyelitis. In order to stay sane, I really need to look on the bright side.

smiley face sticker

Last weekend, I read a case study in one of the Sunday mags about a woman who’d suffered a severe facial injury in a car accident.  She says “I began to see that it was an accident, that I couldn’t change it, that I had no control over it but that I could control how I would learn to live with it.”  I like her attitude. I can’t change what’s happened to me but I can control how I cope with the conseqences.

On Tuesday, the Irish Times Healthplus supplement featured an article titled “Look on the bright side”. Again, the words jumped off the page at me. “If you’re looking for what’s going to go wrong, you will always find it. If you’re looking for what works, life just gets a lot easier.”

I like this philosophy. It definitely helps to look on the bright side :D


About Turn

April 8, 2009

Harney has reversed her decision on the CF unit.

u-turn2Full credit goes to the Cystic Fibrosis Association of Ireland (CFAI) for launching a major campaign to get the Minister for Health to honour her commitment to provide isolation rooms for CF patients. However, it is still too early to celebrate this victory as the building of the unit is dependent on a ‘build now, pay later‘ funding scheme which may yet prevent it from going ahead. It ain’t over ’til the fat lady sings!

The Minister for Health and the HSE promised to build by 2010, a new 120-bed facility with 30 en suite rooms for CF patients, at St Vincent’s hospital in Dublin. This €40 million unit will also have isolation facilities for patients with other conditions. Last month, following a reduction of 26 per cent in its capital budget, the HSE announced it didn’t have the funds to go ahead and that construction would be delayed until 2011 at the earliest. The uproar that ensued following this announcement has embarrassed Harney into making a u-turn on this decision and yesterday, she announced an alternative plan to fund this vital facility. She has proposed a scheme whereby payment will be made at the end of the construction phase. Builders will be asked to tender for the project on the basis that they would not be paid until the facility is completed, in about two years’ time. This is a different way of funding this project as it involves the construction company financing the development up to the final phase of construction.

The Government, the Minister for Health and the HSE have all failed in their duty of care to Irish people with CF. How a nation treats it’s most vulnerable citizens, is what determines it’s right to call itself civilised. Ireland has been found seriously wanting in this regard. I refuse to applaud Mary Harney for her ‘innovative’ plan to solve the CF accommodation crisis. She could have proposed this unusual funding plan years ago and saved a great deal of heartache in the process. But then it’s not about saving lives, is it? It’s all about saving face.

Cystic Fibrosis Scandal

Source: Irish Times


Patient Empowerment

April 6, 2009

The public, armed with useful non-jargon information, is rightly demanding a say in how healthcare is organised and delivered. Historically the patient has been expected to follow blindly the doctor’s advice with little input or participation in his/her treatment. The ability of patients to act as consumers and therefore participate in their own treatment has been severely hampered by medical secrecy and arrogance. The patient, on the whole, was not seen as having the training or intellect to understand complex medical issues and was therefore treated as a passenger and not a participant in their treatment. This lack of participation by the patient was caused in large part by a lack of appropriate information on which to make informed decisions.

The almost universal access to the internet has turned a bright light into what had been relatively dark corners. Patients, armed with useful non-jargon information, are becoming consumers of healthcare. They are insisting on doctors being measured, the publishing of meaningful outcome data, and access to healthcare based on their needs and not services based around what the health workers want.

patient-empowerment

Patients need to have a platform from which to make informed decisions and demand that they are participants and not passengers in their treatment. They can begin to measure around data points that are meaningful to them the quality of the treatment they receive and, most importantly, begin to shape the health service from a patient’s and not an employee perspective.

In France, (where the health system frequently ranks at the top of the World Health Organisation’s best providers) 40 per cent of health provision is supplied by the private sector. The French enjoy choice, clean hospitals and friendly staff, not to mention some of the highest quality outcomes in the world. France has embraced an agnostic system where providers are chosen and survive based on ability and quality of outcomes and not idealism.

For too long, patients have been allowed to suffer while high-level discussions take place around the politics of health.  France and others have proven that the discussion must centre around the patient and their needs. Most importantly, the patient must be at the centre of that debate and not be kept on its periphery.


The above is the opinion of Ken Anderson, former commercial director general, Department of Health, UK. He is singing my song. The best and the most efficient health systems in other countries are based on universal provision where the money follows the patient. With further health cuts promised in the present economic downturn, we have never been more in need of new leadership and a new direction for our health service.

Source: Irish Times online.


Fighting For Life

April 5, 2009

irish-war-crimes

People with cystic fibrosis are fighting a war against political negligence. After years of empty and broken promises, the Cystic Fibrosis Association of Ireland has had enough. It’s mounting a campaign, Irish War Crimes, to reverse the decision to delay the building of a new cystic fibrosis unit in Dublin. A campaign truck will travel the State over the next week and politicians will be canvassed locally and nationally to increase pressure on the Government to find funding for the unit.

At any given time there are up to 30 CF patients in St Vincent’s hospital queueing for the eight single en suite rooms.  Many CF patients are refusing to go into hospital to have lung infections treated because of the risk of cross infection. The new facility, which would have had about 30 single rooms for CF patients, had been promised for 2010 but last week it emerged that funding would not be available until 2011 at the earliest.

Seán O’Kennedy, Cystic Fibrosis Association chairman, said he made no apologies for the hard-hitting campaign. “People living with CF are fighting an ongoing war against CF but unfortunately they are also fighting a war against an Irish medical system that is totally insufficient for their needs.”

Seán added “The support from everyone, politicians on all sides of the Government, medical professionals, the general public and the media has been astounding and all are on board to wage a war against this injustice and human rights issue”.

People with CF deserve a chance at life.  They deserve proper healthcare.  They deserve to be free from the fear of cross-infection, the fear of watching their friends die. These are basic human rights.  The ultimate price of inefficiency, bureaucracy, politics, mismanagement and apathy is human lives. Twenty- five people with CF died in Ireland last year. As Orla Tinsley, leading campaigner asks, “Are human lives the new currency?”.

Source:  Irish Times online and The Cystic Association of Ireland.

The HSE recently published a HealthStat programme which aims to provide a snapshot of health services by measuring performance. In terms of CF care in Ireland, it deserves a great big fat red rating!

Red = Unsatisfactory, requiring urgent attention.


Time For Action

April 1, 2009

Here’s a follow-up to my recent post  ‘Did Not Attend‘ and the comments it generated. A new study has found there is a high rate of non-attendance by patients at hospital appointments and these ‘no-shows’ are placing a significant drain on time and resources. Now, there’s a surprise!

take-a-number

PATIENTS WHO do not attend their hospital appointments are a serious drain on time and resources, according to studies conducted by the medical profession.

Figures produced for two of Dublin’s biggest hospitals show that almost 25,000 did not attend appointments at St James’s Hospital last year and and the figure for St Vincent’s Hospital was almost 27,000.

A report in Britain estimates that those who do not attend (known as DNAs), cost the NHS almost €1 billion a year. No equivalent figures are available here, but the most comprehensive study carried out in the Republic to date, by Beaumont Hospital’s dermatology department, has indicated the extent of the problem.

More than one-third (36.5 per cent) of all patients did not attend their appointments in January and February last year, according to research carried out by consultant dermatologist Dr Gillian Murphy and by student doctors Hafsah Sazli and Sheena Gendeh.

An examination of other departments in the hospital indicate that the DNA rate at the dermatology department was not exceptionally high. “My students looked to see if it was disease specific and it wasn’t,” said Dr Murphy.

According to the research, 26 per cent gave not receiving their appointments as the most common reason why they did not attend. A further 22 per cent forgot their appointments, 17 per cent gave medical reasons such as a cold or diarrhoea and 12 per cent claimed they had cancelled but their names had not been taken off the list.

Other factors were wrong addresses, patient cancellations, a mistaken appointment date and work commitments. Emergencies such as a family bereavement, a broken down car or a cancelled babysitter accounted for only about 3 per cent of DNAs.

Appointments are more frequently broken by the elderly, mostly above 80 years of age, and patients with a record of previously broken appointments are more inclined to be serial absentees.

Dr Murphy said DNAs were not only a waste of hospital time, but also increased the burden on GPs whose workload was automatically doubled if they had to re-refer a patient for a hospital appointment.

Beaumont Hospital estimates that there are an average of 13-16 DNAs at the dermatology department alone on every day the clinic opens. It takes one-two hours a day to deal with the non- attendee administration.

“For all the additional work that is done in processing that information about those people, you could actually employ another secretary,” Dr Murphy said.

Luckily, modern technology offers two obvious and very cost-efficient solutions. Text messaging has been used with some success in the UK and e-mail could also be used as a back up.

Trials of a system called Managed Appointment Reminder Service (MARS) sends out a text message reminder to all patients’ nominated mobile phone at an agreed date ahead of the appointment. It has proved to be extremely successful in bringing down rates of DNAs.

Not only is it beneficial to the patient, but it also cuts down enormously on administration costs if a reply service can be updated automatically. Getting through to the relevant department can be a major problem for patients wishing to cancel.

The fundamental problem with text message, however, is that elderly people, who are more likely to miss appointments, tend not to use it.

However, Beaumont is examining if it would be possible for an elderly person to give the mobile phone number of a relative who then calls to remind that person of their appointment. Not only does it ensure that more appointments are kept, it facilitates cancellation of appointments by people who cannot keep their appointment. This in turn allows those appointments to be reallocated to others awaiting appointments.

Dr Murphy said more research needed to be done to ascertain why less than half of all patients receive their appointments in the first place, a figure which the hospital has found to be very puzzling.

However, she also said that patients must take responsibility for their own treatment and especially the nearly third of all patients who forget about their appointments or claim that they have cancelled but there is no record of such a cancellation.

“If people were more careful about their appointments, took them more seriously and were given a timely reminder closer to the date, the situation would improve.”

Source: The Irish Times Healthplus

It seems that The Biopsy Report and it’s merry band of commenters are a way ahead of the posse. We didn’t need the results of any study to know how to tackle the serious drain on hospital resources. Our health service is awash with reports that have never been acted upon. We don’t need any more reports, we need action!


Fighting MRSA

March 28, 2009

Hospital cleaners may one day use ionic liquids to clean wards. Scientists at the Queen’s University, Belfast have come up with a new way to kill off bacteria, including the hospital superbug MRSA. In this era of finite resources in our health service, any development which declares war on the superbugs, is to be welcomed.

hospital-guide1Many types of bacteria, such as MRSA, exist in colonies that stick to the surfaces of materials. The colonies often form coatings, known as ‘biofilms’, that protect them from antiseptics, disinfectants, and antibiotics. Ionic liquids are up to 250 times better at killing ‘difficult to treat’ biofilms. Ionic liquids are essentially salts which are liquid at around room temperature. The liquid can be sprayed onto a surface where it will kill any existing bacteria. Significantly, the liquid doesn’t evaporate so once it is on a surface, no bacteria can withstand the treatment. It continues to destroy any bacteria that arrive subsequently provided the ionic liquid has not been wiped off. The liquid has low toxicity but has not yet been tested for use in human treatments.

The development was carried out by eight researchers from the Queen’s University Ionic Liquid Laboratories (QUILL) centre, supported by a grant from Invest NI. The research has been published in the journal, Green Chemistry. The Queen’s University group plans to introduce commercial products based on the technology, and is also studying possible uses with humans, eg as hand washes.

The prevalence of superbugs in Irish hospitals is thought to cost the HSE about €200 million a year. Poor cleaning, overcrowding, inadequate facilities, lack of infection control staff, poor management and a lack of accountability have all contributed to unacceptable levels of infection and death within our health system. Almost every year, we hear of a new breakthrough in the war against the superbugs. It remains to be seen if ionic liquids will become the weapon of choice.

Source:  The Irish Times and BBC News Channel (NI).


Health Access

March 26, 2009

Do you agree that all patients should be entitled to equal access to healthcare whatever their lifestyle choices? This was the motion put forward for last night’s Health Debate, the first of six debates to be held across Ireland in the 2009 Pfizer Health Debates series in association with The Irish Times. These debates on healthcare are open to the general public, free of charge, through advance registration and provide a forum for those attending to articulate perspectives and concerns. I couldn’t resist the temptation.

Last night’s debate was chaired by Irish Times columnist, Fintan O’Toole. Well-known economist, Jim Power argued against the motion along with Prof Charles Normand, professor of health policy and management at Trinity College, Dublin. They went head to head with Labour’s health spokeswoman, Jan O’Sullivan and Dr Donal O’Shea, consultant endocrinologist who spoke in favour of the motion. Before the debate commenced, the chairman asked the audience for a show of hands on the motion. Interestingly, there was fairly equal distribution of those ‘in favour’, those ‘against’ and the ‘don’t knows’.

Did you know that obesity accounts for 40% of all cancers? Add smoking to the equation and it becomes a 70% causal factor. Last night’s debate raised many philosophical as well as practical arguments. Should people who adopt risky lifestyle behaviours like smoking or abusing alcohol, be given the same access to healthcare as people who adopt healthy lifestyles? Is equity of healthcare, a fundamental right for everyone? Should people be judged by their lifestyle choices? How do we define which patients are worthy of treatment? Should our limited resources be put into educating people to change their behaviour? Who decides on these huge moral issues?

diet-shakeThe debate was opened to questions from the floor giving the audience an opportunity for engagement before the final show of hands was taken. The motion was overwhelmingly carried in favour of equal access to healthcare for all patients regardless of lifestyle choice.

I voted against the motion and for good reason. I happen to believe that hard decisions need to be taken to stop the drain put on hospital resources through risky lifestyle behaviours. Look at the problems in A&E with the drunks and drug addicts. Are you happy that they get the same priority of treatment as the genuinely sick and the elderly? Instead of waiting to treat the problems caused by unhealthy lifestyle choices, healthcare resources could be allocated to educating people to take responsibility for their lives. I also believe that people with serious illness are being denying optimum treatment by our failure to prioritise treatment on the basis of genuine need. The poor survival rate in this country for cystic fibrosis sufferers, is the direct result of a system that refuses to make decisions. The cervical screening programme is another example of the failure to prioritise. It was rolled out last year, 21 years after the government first agreed on the need for such a programme. It’s time people woke-up to the fact that patient’s lives are being lost through lack of government leadership. Our health service is rudderless and it remains to be seen if Captain Harney and her First Mate Drumm, will stay with the sinking ship.

The next debate in the series takes place in Cork in UCC, on 29/04/09 and will discuss the hot topic of co-located hospitals. This issue has already generated much discussion nationally so it should be a lively debate.


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