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The publication last week of the HIQA report into patient safety at Midland Regional Hospital, Portlaoise has the potential to mark an historic watershed for patient safety in Ireland. Were that to happen, no doubt it would offer some consolation to the parents and families of the at least 8 babies who needlessly died there in recent years. More importantly, it would see a shift in focus by hospital managers away from a budget-led approach which to date has seen the issue of patient safety and health outcomes receive little attention when key decisions about the health service are being made.
Bedsores, more properly known as pressure ulcers or pressure sores, are a type of injury that affects areas of the skin and underlying tissue. They are caused when the affected area of skin is placed under too much pressure.
There are far more people killed by negligence in our hospitals that die on our roads and yet we hear almost nothing about it. Why is that? It seems that almost every type of accident that can befall a person and that could be attributed to the wrong or negligence of another is investigated by one or another state safety agency except medicine. We have the Marine Casualty Investigation Board, the Road Safety Authority, the Rail Accident Investigation Unit, the Irish Aviation Authority’s Air Accidents Investigation Unit, the Food Safety Authority of Ireland, the Health & Safety Authority and on and on. Every non-medical critical event gets investigated so that lessons may be learned. Why then don’t we investigate accidents in medicine, and lets leave out the majority of the 80,000 or so adverse events that happen in our state-funded hospitals each year – let’s just focus on the top 1% of those being the mistakes that cause catastrophic injuries or serious harm up to and including death.
There are far more people killed by negligence in our hospitals that die on our roads and yet we hear almost nothing about it. Why is that? It seems that almost every type of accident that can befall a person and that could be attributed to the wrong or negligence of another is investigated by one or another state safety agency except medicine. We have the Marine Casualty Investigation Board, the Road Safety Authority, the Rail Accident Investigation Unit, the Irish Aviation Authority’s Air Accidents Investigation Unit, the Food Safety Authority of Ireland, the Health & Safety Authority and on and on. Every non-medical critical event gets investigated so that lessons may be learned. Why then don’t we investigate accidents in medicine, and lets leave out the majority of the 80,000 or so adverse events that happen in our state-funded hospitals each year – let’s just focus on the top 1% of those being the mistakes that cause catastrophic injuries or serious harm up to and including death.
Last month I wrote about the revelations of gross failures by medical and nursing staff at maternity unit of Midland Regional Hospital in Portlaoise. Sadly since then, further revelations by RTE’s Prime Time tell us of a fifth baby to die at that unit due to a similar lack of care and I think what we can fairly call a lack of interest in providing even ‘acceptable’ standards of care by the staff and management there.
‘Tell the truth and shame the devil’, ‘honesty is the best policy’, ‘the truth shall set you free’; it might all sound easy when we are teaching our children the importance of honesty in life, but as adults, we all experience moments when our ability to confront the truth in an open and frank way gets tested. For healthcare providers, the challenge of coming clean with a patient who has been harmed by his or her care is probably the toughest morality test of all.
On admission to hospital for surgery you are warned of the possible risks and complications connected with any procedure. These range from increased pain and anaesthesia complications to infection and blood clots. More often than not, the patient emerges from the operating theatre better off and in an improved state of health, however frightening statistics have emerged recently from The State Claims Agency identifying a large number of incidents in which patients in Irish hospitals have been victims of serious surgical system errors. Among the adverse events were 62 cases where surgeons marked incorrect body parts for surgery, 400 foreign objects such as swabs or surgical implements left inside patients after surgery, 1,000 surgeries where the incorrect patient medical records were referred to and 365 patients who had incorrect identity bands attached to their wrist when they arrived in theatre for surgery. Under the Medical Practitioners Act 2007, the Medical Council of Ireland are obliged to “protect the public by promoting and better ensuring high standards of professional conduct and professional education, training and competence among registered medical practitioners.” This implies that we should be confident in and willing to place our absolute trust in our medical professionals to carry out their duty with the highest possible standard of excellence. Despite the complex system of safety measures in place in our hospitals to ensure patients are treated with the highest standard of care, the incidence of surgical system error in Ireland is still excessive. The vast majority of surgeries are carried out successfully, but occasionally mistakes do occur and some surgical errors can have catastrophic effects for the patient. Research from the United States tells us that patients who are injured as a result of a mistake in the course of being operated on are seven times more likely to subsequently die in hospital. Surgical error is also the eighth leading cause of death in the US and results in 100,000 fatalities every year.
Recently I was reading the latest Road Safety Authority (RSA) report on road accident statistics. The 2010 RSA Report is their most recent and it looks back on a decade of road safety improvements. From the statistics, two things jumped out at me. The first is the extraordinary reduction in the number of people killed on our road each year. In 2001 411 people were killed on Irish roads, by 2010, that annual toll had come down to 212.
Abdominal surgery refers to the broad range of surgical procedures performed within the abdominal cavity. With surgeries affecting all the abdominal organs including the stomach, spleen, pancreas, small intestine, kidneys, large intestine, gallbladder, as you can imagine, abdominal surgeries are very common. Abdominal surgeries are performed either by open incision or by keyhole incisions through which surgical instruments are placed together with lights and cameras to allow the surgeon to visualise the abdominal area once the abdomen has been ‘inflated’ with carbon dioxide gas.
The Inquest and the Coroner’s Court are an ancient part of the Irish legal system, going back to medieval feudal times, but one not well understood by many people. Perhaps most associated in our minds with scenes of grief following accidental or violent deaths, the Coroners Court is a place the no one wishes to find themselves, but if you do, it would be well to know a little about the process and what can be achieved through it.

Pseudomonas and Hospital Acquired Infections

By Cian O'Carroll Monday, 23rd January 2012 | 0 comments
Filed under: Medical Negligence, Hospital Acquired Infections.
  The recent outbreak of pseudomonas infections at Belfast’s Royal Maternity Hospital is a frightening example of the consequences when hospital related infections are not controlled properly. With seven babies infected, three of whom have died, this medical disaster is the most serious to affect a hospital on the island or Ireland in recent times.
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