Becker's Hospital Review

7 INFECTION CONTROL & PATIENT SAFETY VA hospital deaths prompt House bill mandating safety reports By Anuja Vaidya H ouse lawmakers on Jan. 15 introduced a bill that would require the U.S. Department of Veterans Affairs to provide detailed reports on patient safety and care quality at its hospitals. The proposed legislation comes in response to a string of suspicious deaths at a VA hospital in West Virginia. The Improving Safety and Security for Veterans Act of 2019 aims to ensure that federal lawmakers are kept up to date on the quality and patient safety policies and pro- cesses at VA hospitals across the country. In addition, the bill would require the VA to send Congress a report on the investigation into the 11 suspicious deaths at Clarksburg, W.Va.-based Louis A. Johnson VA Medical Center. The veterans in the hospital's medical-surgical unit were improperly injected with insulin from 2017-18. Three of the deaths were ruled homicides. Reps. Guy Reschenthaler (R-Pa.), David McKinley (R-W.Va.), Carol Miller (R-W.Va.), Alex Mooney (R-W.Va.) and Jimmy Panetta (D-Calif.) introduced the legislation. "We cannot begin to understand the grief and anger of the families whose loved ones died under suspicious cir- cumstances at the Clarksburg VA," said Mr. McKinley. "The goal of this bill is to ensure transparency and accountabil- ity. It will also provide Congress with a better understand- ing of what happened in Clarksburg, and how to prevent it from ever happening again." n Vitamin C combo treatment ineffective for septic shock patients, study finds By Anuja Vaidya A treatment that combined vitamin C, hydrocortisone and thiamine didn't help patients with septic shock, according to a study published in the Journal of the American Medical Association. Researchers had high hopes that this mix of agents would provide a cost-effective treat- ment for septic shock patients, particularly aer reports from a well-regarded physi- cian Paul Marik, MD, of Norfolk, Va., who said in 2017 that the combination showed remarkable results in treating septic shock, according to NPR. But the JAMA study showed that this treat- ment may not be the one researchers have been waiting for. e study is the largest published to date on this subject, and it involved 216 septic shock patients from 10 intensive care units in Australia, New Zea- land and Brazil. e patients were randomized into two groups: 109 patients in the intervention group received a combination treatment of vitamin C, hydrocortisone and thiamine, while 107 in the control group received only hydrocortisone. Of the 216 patients, only the 211 who gave consent and completed the primary outcome measurement were included in the study. e study found that both groups had similar rates of death — 28.6 percent in the intervention group and 24.5 percent in the control group. Researchers found little difference in other clinical measurements between the two groups, including the amount of time before a patient received vasopressors, a group of drugs used to treat severely low blood pressure. Patients in the intervention group received vasopressors aer about 122 hours, while those in the control group received the drugs aer about 124 hours. n Childhood flu exposure determines ability to fight flu later in life, study finds By Anuja Vaidya A person's ability to fight off influenza is determined by the subtypes of flu they've had in the past, ac- cording to a study published in PLoS Pathogens. For the study, researchers from the University of Cali- fornia Los Angeles and University of Arizona in Tucson examined health records on 9,510 flu cases from the Arizona Department of Health Services. They found two flu virus subtypes, H3N2 and H1N1, have been responsible for seasonal flu outbreaks over the last several decades. The data also showed that those who were first exposed to H1N1 — the less severe strain of the two — during childhood were less likely to be hospital- ized if they were exposed to H1N1 again later in life, compared to people who were first exposed to H3N2. Similarly, those exposed first to H3N2 during childhoods gained extra protection against H3N2 later in life, com- pared to those who were first exposed to H1N1. "The second subtype you're exposed to is not able to create an immune response that is as protective and durable as the first," said Michael Worobey, PhD, a co-au- thor of the study and head of the University of Arizona's department of ecology and evolutionary biology. n

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