Becker's Clinical Quality & Infection Control

12 INFECTION CONTROL & PATIENT SAFETY California Hospital Fined $40k After Physician Left Patient Mid-Hysterectomy By Brian Zimmerman C alifornia public health officials Aug. 31 fined St. Joseph Hospital in Eureka $40,000 after discov- ering a physician left a patient in the middle of a hysterectomy to perform an emergency cesarean section in 2014, according to the Eureka Times Standard. Here are five things to know. 1. The California Department of Public Health said the violation was likely to cause serious injur y or death to the patient, according to a 2015 report. Health department inspectors conducted inter views at the hospital and deter- mined the violation was caused by a lack of available specialists on staff. 2. e physician, an on-call laborist, told investigators there was no general surgeon available to take over the hysterectomy. In its report, the department said the hospital vio- lated state laws regarding staffing and patient safety. Additionally, the department found the physician violated rules barring on-call laborists from scheduling elective surgeries during an on-call shi. 3. e hospital responded to the state's find- ings in September 2015, saying it corrected the identified issues and made changes to prevent scheduling conflicts among on-call physicians. 4. St. Joseph Hospital's Interim CEO David Southerland told the Times Standard patient safety is a top priority for the hospital. "We deeply regret that this incident oc- curred," Mr. Southerland said. "Ensuring patient safety and delivering extraordi- nary care is fundamental to our hospital's mission and values. We perform rigorous internal reviews of our quality and safety on a regular basis. We are confident that our focus on continuous improvement will uphold our commitment to providing a safe environment for our patients." 5. St. Joseph was among 10 hospitals fined by the state Aug. 31. In total, the state issued more than $618,000 in fines for violations that occurred between 2012 and 2016. n Every Extra Patient on Nurse's Caseload Increases Mortality Risk 7% By Anuja Vaidya M issed nursing care and higher nurse work- loads increase the risk of patients dying following common hospital surgical proce- dures, according to a study published in the Interna- tional Journal of Nursing Studies. Researchers gathered data from the RN4CAST study (2009 to 2011). The study combined routinely collect- ed data on 422,730 surgical patients from 300 gen- eral acute hospitals in nine countries. It also includes survey data from 26,516 registered nurses. The study shows nurse staffing and missed nursing care were significantly associated with 30-day case- mix adjusted mortality. Increasing a nurse's workload by one patient was linked to a 7 percent uptick in odds of a patient dying within 30 days of admission. Additionally, a 10 percent increase in missed nursing care was associated with a 16 percent increase in the odds of a patient dying within a month of admission. "The analyses support the hypothesis that missed nursing care mediates the relationship between registered nurse staffing and risk of patient mortal- ity. Measuring missed care may provide an 'early warning' indicator of higher risk for poor patient outcomes," study authors concluded. n Positive Mood on Day of Flu Shot May Boost Viral Protection By Brian Zimmerman O lder patients who are in a good mood when they receive a flu shot are likely to display higher levels of antibodies in the weeks following vaccination than their grumpier counterparts, according to a study published in the journal Brain, Behavior and Immunity. For the study, researchers assessed the moods, physical activity levels, diets and sleep habits of 138 adults ages 65 to 85 who received the 2014-15 flu shot. Researchers conducted assessments three times a week over a six-week period prior to vaccination. The team also analyzed antibody levels present in 136 study participants' blood at four and 16 weeks post-vaccination. Among all factors measured, good mood over the six-week observational period was the only factor associated with higher levels of antibodies. Additionally, when the patient was in a good mood on the day of vaccination, the correla- tion was even higher. "Interestingly, we found the effects of positive mood on the day of vaccination appeared to be more pronounced than positive mood over the six-week period surrounding vaccination as a whole," the researchers concluded. "This suggests the day of vaccination may be a particularly salient time-point at which positive mood influences immune re- sponses to vaccination." n

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