Improving Patient Safety

July 27, 2010

In recent years a primary concern for patients being admitted to hospital has been the risk of contracting methicillin-resistant Staphylococcus aureus, commonly known as MRSA.

Many cases of MRSA arise from the transfer of germs from patient to patient due to lack of good hygiene. To address this, hospitals have revised their hygiene practice. Measures have included the introduction of hand-sanitising kits and tougher visitor regulations to reduce the risk of infections being brought in from outside. However, the concern over post-operative infections lingers.

The Royal College of Surgeons Ireland (RCSI) is introducing a Surgical Development Initiative for trainee surgeons which will focus on maximising patient safety and preventing infections following surgery. The RCSI initiative is being launched this month to the new group of surgical trainees who commence their basic surgical training in July. It has been developed specifically for trainees to improve practice in the areas of hand hygiene, the optimal use of antimicrobial prophylaxis, the care of wound sites after surgery and the prevention of bloodstream infection that can result from infected intravascular devices.

The RCSI’s new project is in line with the World Health Organisation’s (WHO) recent prioritisation of patient safety, to prevent healthcare-associated infection (HCAI) and its ‘Safe Surgery Saves Lives‘ initiative which is endorsed by RCSI.

In tackling post-operative infections, WHO has recently published it’s WHO Surgical Safety checklist. The 19-point checklist has shown improved compliance with standards and a decrease in complications from surgery in the eight pilot hospitals where it was used for evaluation. It demonstrated a decrease in mortality from 1.5 per cent to 0.8 per cent and a drop in surgical site infection (SSI) rates from 6.2 per cent to 3.4 per cent.

As someone who has battled against serious post-operative infections (MRSA, cellulitis and osteomyelitis), I welcome any initiative which will reduce the risk of surgical site and healthcare-associated infections.

The WHO surgical safety checklist is an essential aide to patient safety. This video demonstrates how the checklist is used at Great Ormond Street Hospital…

Information Source:  The Irish Times

At Long Last

July 21, 2010

Lying in the recovery room in a post-anaesthetic induced haze, I remember hearing the surgeon say, “we’ve taken multiple biopsies, you have a nasty osteomyelitis in your head but don’t worry, you’ll be fine.”

Exactly a year to the day later, the same surgeon had a look inside my head yesterday and declared it “mended.” Hallelujah!

It’s been a long journey. Thanks for keeping me company!


Watch how few people use the stairs at the beginning of this video. And then watch what happens when they make the stairs into a piano.


July 16, 2010

When I got out of bed this morning, I knew there was something significant about today’s date but I couldn’t think what? Having escorted my husband to the private hospital where he’s undergoing a minor operation today, I drove home deep in thought. It was another few hours before the penny dropped and then the memories came flooding back.

This day last year, I was re-admitted to a large, public hospital via the emergency department having been at home for only 6 days following a week of IV treatment in the hospital. I’d developed a nasty infection in my head following an operation some weeks earlier. At home, the pain in my head had gradually increased to a point where I could no longer bear it and I knew I needed help. As I sat in A&E going through the process of admission, the swelling around my eyes began to visibly worsen so I was rapidly hooked up to several drips and put in the queue for transfer to a ward. As luck would have it, a bed was found within hours and this was to become my home for the next twelve long days.

On arrival in the ward, my first reaction was the gloominess of my surroundings. I was transferred to a bed in a dark, cramped corner of the ward where I lay exhausted but grateful to have escaped A&E so quickly. On looking around the room, it soon became obvious that I was the youngest by far, by at least 25 years and I’m no spring chicken myself! Two of the patients were bed bound, a third was a psychiatric patient and the fourth lady (in the bed next to me, luckily) was a sprightly 90 year old who became a great buddy over the following days. We were soon doing the crossword together everyday but sadly, she was discharged home all too soon only to be replaced by a seriously ill, incontinent patient.

I’ll never forget the days spent in that ward. The two old dears in the beds nearest the windows complained whenever the windows were opened so they remained closed most of the time despite having two incontinent patients in the room. I used to take myself and my drip to sit by a window in the corridor, to escape the awful conditions in that room. I was also trying to escape the attention of the psychiatric patient who was very restless and needed 24 hour care with her own special nurse.

Every morning, a new agency nurse would arrive on our ward to care for the daily needs of our confused room mate. Each day, I would watch the same situation evolve where the mood of the psychiatric patient would gradually deteriorate to a point where her young nurse could no longer calm her and we would then be exposed to many hours of disturbed behaviour. After a few days of observing this situation, I could clearly see where these inexperienced nurses were going wrong so in order to save my own sanity, I decided to intervene. Every time a new nurse arrived, I would quietly warn them of the pitfalls that lay ahead and give them tips on how best to manage the situation. This worked a treat and our days became slightly less chaotic as a result.

The nights were another story. The agency tended to supply ‘carers’ rather than nurses for night time duty. Many of them were college students with little or no nursing experience who had simply enrolled with the agency as a summer job. Having put my eldest son through college and with my daughter still in college, I understood these ‘kids’ and often chatted with them quietly for hours while their charge slept soundly thanks to heavy duty nightime sedation. As my bed was nearest to the door, these carers tended to sit all night on a chair at the end of my bed, using the light from the corridor as a reading light. I would often settle down to sleep for the night with a hunk of a male student sitting just inches away from my feet!

Until this morning, I hadn’t given another thought to the time spent in that room. I was eventually transferred to another ward where I spent a much happier fortnight being nursed back to health in a lovely bright, airy room and where my companions were delightful. Sitting here a whole year later writing about my memories from that time, it feels like it was only yesterday. Today, it’s my husband’s turn to experience hospital life from a horizontal position. When I collect him from the day unit shortly, I know I’m going to find it very hard not to smirk at his tales of woe!

Failure To Diagnose

July 14, 2010

Headaches are a common symptom of many conditions and almost everyone will experience headaches at some point in their lives. Normally the average headache is nothing to worry about, despite the discomfort you might be experiencing. However, if you get a severe/sudden headache unlike any you have had before, you should always seek medical advice. Sometimes, a headache can be a warning of something serious that needs to be investigated so don’t delay in seeking help.

As I have a long history of chronic sinus infection, I’m well-used to getting headaches. I don’t panic when a headache occurs as I’m familiar with the signs and symptoms of acute sinusitis and have the necessary prescription medications to relieve the pain. However, if I develop a severe headache that I’m not familiar with/it continues to worsen, I will always seek medical advice. If the headache is considered a cause for concern, my GP/specialist will refer me for an urgent CT/MRI scan in order to rule out any serious cause. As I hold private health insurance, I rarely have to wait longer than 24 hours to undergo a scan. If, however, I had no health insurance and was a patient in the public health service, the story could be very different…

THE HSE has apologised before the High Court to the family of a young woman over deficiencies and failures which led to her death from a massive brain haemorrhage. The apology was part of a settlement of court proceedings.

“Louise Butler (21), Cappa Lodge, Sixmilebridge, Co Clare, died at Limerick Regional Hospital on November 16th, 2006, from a large subarachnoid haemorrhage, the court heard. She had worked as a security guard at Shannon airport.

Her family claimed the HSE had failed to properly diagnose she was suffering from the condition when she presented at the hospital just weeks earlier suffering with a serious headache.

Had she been properly diagnosed and referred for treatment after being admitted on October 6th, she would probably have survived, they alleged.

As part of the settlement yesterday of the family’s action for mental distress, the HSE apologised for the anguish and distress caused to the Butlers due to Louise’s tragic death.

The HSE also acknowledged there were failures and deficiencies which led to Ms Butler’s death and accepted her family did everything it could in the circumstances.

The settlement also includes a payment of €40,000 to Ms Butler’s family and was approved yesterday by Mr Justice Michael Peart. The action was brought by her brother James, Cappa Lodge, Sixmilebridge on behalf of the family.

They claimed they suffered mental distress and injury arising from their older sister’s death due to the HSE’s alleged negligence and breach of duty of care. The HSE had denied the claims.

The family claimed Ms Butler’s attended the hospital between October 6th-12th. It was claimed she was ill with a very substantial headache, which she had described as like “a hammer blow” to the back of her head, and photophobia.

She was discharged on October 12th without a CT scan being carried out. She was due to have a CT scan subsequently as an outpatient.

Despite the best endeavours of Ms Butler’s mother and the family GP it was claimed the scan was not arranged until November 13th. It was claimed Ms Butler never got the results of that scan as she collapsed the following day. The scan revealed she suffered a massive bleed in the brain and she died two days later.

It was alleged the HSE had delayed a CT scan which would have alerted medical staff to the existence of her condition. The family claimed their experts would argue, in October 2006, Ms Butler was suffering from a “sentinel” or “herald” bleed, which was a precursor to a large bleed.”

Information Source: The Irish Times 13/07/10

Ah, sure it’ll do!

July 10, 2010

Where else, except in Ireland, would you get away with this?

A New Beginning

July 7, 2010

Noticed anything different around here?

My son contacted me recently to ask if I was aware that ‘free’ advertising was appearing on my blog at the end of some of the blog posts. It was news to me and I wasn’t pleased to hear it as this is an ad-free blog.

Are you aware that if a blog is hosted for free, the hosting site has the right to put ads on the blog? The blog owner cannot see the ads as they are only visible to visitors to the blog. It’s one of the drawbacks of using a ‘free’ service to host a blog.

If your blog is hosted by WordPress, you will find the following statement in ‘Upgrades’ (on your Dashboard)…

We occasionally serve ads on as a way to pay our bills, purchase this (No-ads) to ensure that we will never show any ads on this blog.”

By paying a small annual fee to WordPress, it puts a stop to this practice.

As a belated birthday present, my son paid this charge on my behalf and while he was at it, he also upgraded my standard WordPress blog domain name ( to a custom domain name… ( This is also a paid upgrade.

From now on, this blog will be known as Biopsy Report (noThe‘) and the URL is I’d be grateful if you’d update your feed reader/blogroll/bookmarks accordingly. The old URL will automatically be re-directed to the new domain name so there’s no need to change it unless you’d prefer to.

The email address remains the same…

So, a new beginning for this blog. I just wish it also marked a new beginning with my health…

I’ve been in melt-down since the weekend with a return of the severe headache which floored me some weeks ago. Life came to a standstill once more as the searing pain reduced me to a zombie-like status. The pain has thankfully eased today but I’ve been left with little or no sense of smell and an altered sense of taste. It’s also left me feeling somewhat despondent as I’ve run out of reasons to believe that my head will ever settle down. My tolerance levels are severely challenged at the moment. I need a break.