Search the KHIT Blog

Wednesday, October 15, 2014

Are we about to descend into mass national psychosis?

Ms. Peel, that is just irresponsibly inflammatory and unhelpful. You are out of your depth. Stick to your privacy knitting. It's "Ebola," not "EHRbola."

More Deborah Peel.

Unjustified sanguinity regarding the relative safety of paper charts commencing at 13:34.

BTW: Just up at THCB:
Angry Nurses Tell of Ebola Patient’s arrival at Texas Hospital
...After arriving at the emergency room with high fever and other symptoms of the disease , the nurses said the patient was kept in a public area , despite the fact that the he and a relative informed staff that he had been instructed to go to the hospital after contacting the Centers for Disease Control in Atlanta to report possible Ebola symptoms.

The nurses said the patient was  “left for several hours, not in isolation, in an area” where up to seven other patients were. “Subsequently, a nurse supervisor arrived and demanded that he be moved to an isolation unit, yet faced stiff resistance from other hospital authorities,” they alleged.

Duncan’s lab samples were sent through the usual hospital tube system “without being specifically sealed and hand delivered. The result is that the entire tube system … was potentially contaminated,” they said.
The statement described a hospital with no clear rules on how to handle Ebola patients, despite months of alerts from the Centers for Disease Control and Prevention in Atlanta about the possibility of Ebola coming to the United States.

“There was no advanced preparedness on what to do with the patient. There was no protocol. There was no system. The nurses were asked to call the infectious disease department” if they had questions, but that department didn’t have answers either, the statement said. So nurses were essentially left to figure things out on their own as they dealt with “copious amounts” of highly contagious bodily fluids from the dying Duncan while wearing gloves with no wrist tapes, flimsy gowns that did not cover their necks, and no surgical booties, it alleged...
National Nurses United
A dicey time right now, epidemiologically. The TV and radio news have been about little else today. And, the crazies are out in full force trying to foment xenophobic and domestic political hatred and panic. See, e.g., the racist hashtag "#Obola."



...Long promised as the panacea for patient safety errors, electronic health records, in fact, have fragmented information, too often making critical data difficult to find. Often, doctors or nurses must log out of the system they are on and log into another system just to access data needed to treat their patients (with, of course, additional passwords required). Worse, data is [sic] frequently labeled in odd ways. For example, the results of a potassium test might be found under “potassium,” “serum potassium level,” “blood tests” or “lab reports.” Frequently, nurses and doctors will see different screen presentations of similar data, making it difficult to collaborate.

Another technological issue is the flatness of electronic records: Much of the information looks the same — a series of boxes to check and pre-formatted text that makes highlighting an urgent or important issue difficult. Electronic records, with their cut-and-paste functions, create what doctors call “chart bloat.” The announcement that Duncan’s electronic records totaled 1,400 pages illustrates this phenomenon. Poor record presentations may well have contributed to the hospital spokeswoman’s initial statement that Duncan’s temperature was only 100.1, when in fact the hospital’s records show it increased from that to 103 by the time Duncan was discharged four hours later...
From the Dallas Morning News.

In my email inbox this morning.


Sadly, it has reached the point where we will not feel safe unless we ban travel to and from Liberia, Sierra Leone, and Guinea. The reason this is a sad moment is that there is a good chance it could interfere with the flow of health care and resources to and from these countries. Not only that, but, historically, when a country suffering from a growing epidemic has felt cut off from the rest of the world, the fear quotient has risen, and people afraid of the contagion have attempted to flee. Unfortunately, when people hastily attempt to escape imposed restrictions, they tend to take fewer precautions, which increases their chances of catching the dreaded disease.

But first and foremost, although we are members of the world health community, we must worry about our own public psyche here in the United States. If our leaders can’t give us a sense that we are protected, we must achieve it by imposing a ban.

- Marc Seigel, MD

More to come...

No comments:

Post a Comment