Should you be visiting a hospital patient any time soon, Betsy McCaughey has a few words of advice for you: Forget the flowers and ditch the chocolates.
Instead, bring bleach wipes, hand wipes and sanitary gloves. McCaughey (pronounced “McCoy”), who served as lieutenant governor of New York state during George Pataki”™s first term (1995 to ”™98), is the founding chair of the Committee to Reduce Infection Deaths (RID) ”” an educational organization that seeks to mitigate hospital and nursing home infections, state by state. Since its creation in 2005, RID has advocated successfully for reporting on infection rates in 37 states, including New York and Connecticut, along with Washington, D.C. And, McCaughey adds, “Medicare is now rating hospitals and nursing homes on infections.”
A passionate woman who tempers her forthrightness with humor, McCaughey tells WAG that it was her time spent as lieutenant governor ”” “a long time ago, before the Civil War” ”” that led to the establishment of RID.
“People came to me with their health concerns,” she says, adding that increasingly, these were variations on the same theme ”” an infection that developed during or after a hospital or nursing home stay. “Almost all were preventable.”
As she elaborated in a recent address to the Stavros Niarchos Foundation in Athens:
“The evidence is compelling that the single biggest predictor of which patients contract a health care infection is not their age or even the diagnosis that brought them to the hospital. The biggest predictor of which patients contract infections is actually what room or bed they”™re assigned to.
“If a patient is placed in a room or bed where a previous patient, even weeks before, had (the bacterial infections) MRSA or VRE or C. diff, for example, the incoming patient”™s risk goes way up. Why? Because of inadequate terminal cleaning.”
It”™s not just that you clean but what, how, when and where you clean as well, as RID”™s tips for infection-free hospital and nursing home stays suggest. (See sidebar.) Toilet seats understandably get a lot of attention. Bed rails, call buttons and side tables ”” not so much. And if you use sanitary gloves but don”™t wash your hands properly before putting them on, you”™re only contaminating the gloves.
In a nursing home in particular ”” where you might find yourself in the role of patient advocate ”” there are numerous questions to ask, including what is being done there to prevent bed sores? Is the patient receiving daily oral care, a lack of which can lead to life-threatening pneumonia?
Born in Pittsburgh, McCaughey was raised in Fairfield County before “crossing state lines,” as she puts it, to attend Vassar College on a scholarship and then earn her Ph.D. in constitutional history at Columbia University.
“I thought I”™d be a college professor,” says the metro area resident. And indeed, she taught at both institutions and wrote two books on constitutional history as well as studies for the conservative think tanks the Manhattan Institute and the Hudson Institute, which was founded in Croton-on-Hudson.
But she was always interested in health and health policy. Among her more than 100 scholarly and popular articles on the subject is a 1994 critique of the Clinton health plan for The New Republic that won a National Magazine Award for best article on public policy. When she was drafted to run for lieutenant governor, she focused on health issues. Now as a weekly syndicated columnist for the New York Post, her conservative views have a broader scope. But in the spirit of nonpartisanship, we ask her to assess health care overall, regardless of who sits in the White House. Not surprisingly, she finds our health-care system too hospital focused, whether it”™s the Centers for Disease Control and Prevention (CDC), which she says is “more involved with hospitals than with patients,” or physicians themselves.
“It used to be that you”™d go and pick a doctor and the doctor would listen to what you had to say,” McCaughey observes. “Now they”™re glued to a screen. Electronic reporting started out as a good thing, but it”™s turning doctors into robots. They”™re like travel agents,” she adds with a laugh.
“Very few doctors are in private practice,” she continues. “They work for hospitals. So what we are witnessing is the demise of the independent physician.”
While technology may have created another layer of challenges for the medical profession, McCaughey told the audience at the Niarchos Foundation ”” which included special guest, architect Renzo Piano ”” that technology can be an ally in the fight against hospital and nursing home infections:
“Fortunately, a new generation of automatic disinfection techniques is coming into play that can be used 24/7 with no danger to staff or patients, including diluted hydrogen peroxide systems installed in the HVAC systems and Far-UV lights. Reduce Infection Deaths (RID) is encouraging hospitals and public agencies to investigate these alternatives. The human and financial costs of hospital infections are so high, (as much as $94,000 for a central-line bloodstream infection), that investing in technologies to provide patients with a disinfected environment makes economic sense.”
Be hospital healthy
The Committee to Reduce Infection Deaths”™ (RID) website has 15 steps for mitigating infections in nursing homes and 10 for avoiding hospital infections. We”™ve conflated the lists to offer five salient points:
- Before visiting anyone in a hospital or nursing home, check your own health. Leave small children attended at home as RID says they are “germ machines.”
- Forgo gifts and instead bring the patient bleach wipes, premoistened wipes and sanitary gloves. Wash your hands before donning the gloves. Use the bleach wipes to disinfect the room, especially such neglected areas as guardrails, side tables, call buttons and TV remotes. Give the patient a hand wipe before s/he eats, keeping all food and utensils on the plate.
- Be a patient advocate. Ask the pertinent questions: Do attendants wash their hands before touching the patient? Does s/he need a special bed and foam padding to avoid bed sores and, if so, does s/he get turned every two hours? Has the patient been vaccinated against the flu and Covid? Is s/he tested regularly for MRSA and other infections? Does the patient require an antibiotic before surgery?
- Understand catheterization and IVs. Avoid a urinary tract catheter if possible or prolonged use of it. If you need a central-line catheter, ask for one that is antibiotic- impregnated or coated in silver-chlorhexidine. Make sure IVs are cleanly inserted and changed every three to four days.
- Don”™t neglect oral care. Keep the patient”™s mouth and teeth clean to avoid bacteria from being aspirated into the lungs, causing pneumonia. (Keeping the patient”™s head elevated and having him/her do deep breathing exercises will also help stave off pneumonia.)
For more, visit hospitalinfection.org.
