As patient-safety penalties hit hospitals, expert wonders why they aren't improving more; could be eliminated by Obamacare repeal

This is the third year federal government will apply penalties to hospitals that fall short of patient safety standards, leading one Consumers Union leader to wonder why hospitals aren't working harder to eliminate the infections and complications that are causing them to loose money, Trudy Liberman writes in her column for the Rural Health News Service.

“What I am most frustrated about is the lack of urgency in the country and at the agencies for eliminating these infections," Lisa McGiffert, head of the Consumers Union Safe Patient Project, told Liberman. "They are aware of them, but there’s not a sense of urgency to stop them."

"The penalties, along with the entire program to eliminate hospital-acquired conditions, were authorized under the Affordable Care Act," Liberman writes. "They could be in jeopardy if the law is repealed. Some hospitals probably would be happy if they disappeared."

Penalties are levied against hospitals that have a high number of patients with avoidable infections and complications, including blood clots, urinary-tract and surgical-site infections, bed sores and falls. And this year, infections related to antibiotic-resistant infections, like methicillin-resistant Staphylococcus aureus (MRSA) and C. difficile, have been added to the list.

"The federal Agency for Healthcare Research and Quality says there were 3.8 million hospital injuries last year. That translates to 115 injuries per 1,000 patient stays," and "antibiotic-resistant bacteria infect some two million people annually. One quarter of a million cases occur in hospitals," Liberman notes.

Medicare will impose a 1 percent cut in payment to 769 U.S. hospitals who fell short of these patient safety standards in the fiscal year that ended Sept. 30. Eleven Kentucky hospitals were on the list, two more than last year, but five Kentucky hospitals that were penalized last year are not on this year's list.

Since the inception of the penalty program, Lieberman reports, 241 hospitals have been punished in all three years, but 347 that were penalized last year are not on the "bad-guy list."

Critical-access hospitals (by definition, rural) and specialized hospitals that treat psychiatric patients, veterans and children are exempt from the penalties.

"Larger teaching hospitals could lose as much as $1 million or more," Lieberman writes. McGiffert told her that the penalties have gotten the attention of hospital CEOs.

McGiffert said that as recently as 12 years ago, hospitals said infections were not preventable, but, “Now, most people in health care believe most infections are.” She also noted that government agencies have only recently started reporting hospital mistakes and other data to help patients.

McGiffert said patients should use the data to decide where they go for care when they have a choice. She suggested that they look for improvements from one year to the next, which could indicate that that particular hospital' emphasis on patient safety. She also encouraged patients to ask questions if the numbers show a hospital isn't performing as well as it has in the past.

Click here and follow the prompts to learn about Kentucky hospitals. You can compare three at a time. Click on the tab for "complications" to learn more about surgical complications and healthcare-associated infections in each of the facilities.

UK researchers develop video game to teach agricultural safety to college and high-school students

Screen shot of "Hazard Ridge" video game

Researchers at the University of Kentucky are using a video game to educate young people about the dangers of agriculture, a line of work that has one of the highest rates of workplace fatalities in the U.S., Olivia McCoy reports for UKnow.

Since 2013 researchers at the UK College of Education and the Southeast Center for Agricultural Health and Injury Prevention, in UK's College of Public Health, have been teaching agriculture students and high-school students ag safety using a 3-D game called Hazard Ridge, which "simulates an injury that has occurred in a small rural town where teens are disappearing and the town is going bankrupt," McCoy writes.

"Players serve as the investigator of this issue and learn how agricultural injuries have negative effects on the town’s economy and citizens," McCoy writes. "The game teaches investigative skills and educates on how to conduct a financial analysis of injury."

Jennifer Watson, research coordinator for the Southeast Center for Agricultural Health and Injury Prevention, "said one of the goals for the game is to 'overcome the culture of comfort'," McCoy writes. Watson told McCoy, "Spending their entire lives around dangerous equipment lulls those working and living on farms into a false sense of safety and lessens their belief that they are at risk for injury." She said preventive measures, such as the game, reduces the risk of injury or death. (Read more)

Girls are more likely than boys to have overuse injuries while participating in high school sports

Overuse injuries make up more than 50 percent of athletic injuries and are most common in children ages 13 to 17. Girls are at a higher risk than boys of overuse injuries while participating in high school sports, according to a study by researchers at The Ohio State University Wexner Medical Center and published in the Journal of Pediatrics. Tendonitis, stress fractures and joint pain are examples of overuse injuries, which happen when athletes perform the same motion again and again.

In the study, Thomas Best analyzed 3,000 injury cases during a seven year period of time associated with 20 high school sports such as soccer, volleyball, gymnastics and lacrosse. Best and his team discovered the highest rate of overuse injuries happened in girls' track (3.82), followed by girls' field hockey (2.93) and girls' lacrosse (2.73). The most common overuse injuries for boys occurred in swimming and diving (1.3).

"These young people spend more time playing sports both in competition and in practice," said Best, an endowed professor in Ohio State's department of family medicine. "So there's a correlation there between the amount of time that they're playing and the increased incidence of injuries."

Over the past 10 years, high school athletic participation and intensity has gone up. Best said some high school athletes spend more than 18 hours per week participating in athletics, and some play more than one sport at a time. The most common site of overuse injuries is the lower leg, followed by the knee then the shoulder, Best said. To avoid overuse injuries, Best recommends varying movement, playing more than one sport and prioritizing rest and nutrition.

"During this point of their lives, this is when girls are developing bones at the greatest rate," Best said. "It's incredible important that they're getting the proper amounts of calcium and vitamin D."

Ensure children's eye safety during fall sports season

Children are back in school, playing sports, and parents can take precautions to ensure their children's eye safety as they compete.

Although many parents are unaware of the risks posed to their child's eye safety, about 40,000 eye injuries take place in the United States during sports or recreational activities each year, says Prevent Blindness America. Some sport-related eye injuries lead to vision loss, with almost one-third of them occurring in children between the ages of 5 and 14, says the Kentucky Optometric Association.

“Eye injuries are the leading cause of blindness in children in America, and most injuries occurring in school-aged children are sports-related,” Benton optometrist Dr. Laurel Van Horn said in a KOA release. “The results of an eye injury can range from temporary to permanent vision loss, so it’s important that parents take the proper steps when their children play sports.”

Almost 90 percent of these injuries are preventable with proper use of eye protection on the playing field, says Van Horn. To prevent such injuries, the KOA provides the following tips for eye and vision safety while playing sports: Always wear protective eyewear, do not rely on street eyewear for protection, and refer to the American Society for Testing and Materials standards when shopping for protective eyewear. Click here to learn more or find an optometrist in your area.

Eye doctors warn about danger from fireworks, even sparklers; optometrists provide safety tips

The Fourth of July goes hand in glove with firework displays. Most families protect parents and children against the dangers of fireworks, but thousands still visit the emergency room every year, many with eye injuries.

According to a report from the U.S. Consumer Product Safety Commission, about 9,600 people were treated for injuries due to fireworks in U.S. emergency rooms during 2011; it says 17 percent of those injuries were to the eyes, and about 45 percent of those eye injuries involve children age 15 or under. Most eye injuries were bruises, cuts and other diagnoses that included foreign objects in the eye, and one in six fireworks-related eye injuries result in permanent vision loss or blindness, says the American Academy of Opthalmology.

“Celebrating the Fourth of July with fireworks is a great tradition, but safety needs to be the top priority,” Dr. Jon Shrewsbury, an optometrist in Beaver Dam, Ky., said in a Kentucky Optometric Association release.  “Children are especially vulnerable to injury from fireworks, particularly sparklers since they are handled at such close range.”

The innocent-looking sparkler can be very dangerous, especially to children, who are most likely to play with them. They heat up to 2,000 degrees or hotter, and are the primary cause of fireworks-related visits to emergency rooms. In addition to not allowing younger children to play with sparklers or fireworks and ensuring that older children are supervised by an adult when doing so, the KOA offers these tips to help protect and preserve eyesight during firework season:

· Discuss firework safety with children and teens prior to the Fourth of July holiday.
· Never leave them unsupervised near fireworks.
· Wear protective eyewear when lighting and handling fireworks of any kind.
· Store fireworks, matches and lighters in a secure place where children won’t find them.
· Be aware of your surroundings, and only light fireworks when family, friends and children are at a safe distance.

“If a firework-related eye injury does occur, always follow up with a full optometric eye exam,” Shrewsbury said. “An optometrist will help ensure that the injury heals correctly and will continue to monitor for future vision problems.” To find an optometrist in your area, click here.

New study finds texting and driving kills and injures more teens than drinking and driving, and is becoming more prevalent

A new study finds that texting while driving has become more dangerous among teenagers than drinking and driving, and it says the number of teens who are dying or being injured as a result of this habit has "skyrocketed."

Nationwide, more than 3,000 teens are killed and 300,000 are injured as a result of texting and driving, compared to 2,700 deaths and 282,000 injuries from drinking and driving, said researchers at Cohen Children's Medical Center in New Hyde Park, N.Y.

"A person who is texting can be as impaired as a driver who is legally drunk," said Dr. Andrew Adesman, chief of developmental and behavioral pediatrics at Cohen.

Adesman and his team found that the number of teens who text and drive exceed the number who drink and drive, that more boys admit to texting than girls, and that texting increases with age, writes Delthia Ricks of Newsday. While teens' texting is increasing, the CDC reports alcohol use among teen drivers has decreased by 54 percent over the past 14 years.

On Wednesday, officials from the National Highway Traffic Safety Administration described texting as among the worst of driver distractions, and Adesman says texting is as hazardous as "drinking and driving, binge drinking, drug and tobacco use, unsafe sex and tanning devices," writes Ricks.

"We have very strong taboos against drinking and driving. Kids don't drink and drive every day," Adesman said. "But some kids are out there texting and driving seven days a week -- and they admit it."

Kentucky ranks 10th in nation for injury-related deaths

Injuries are the third leading cause of death nationally, the leading cause of death for Americans between the ages of 1 and 44. Kentucky is among the nation's most problematic states, and it could take several more steps to prevent injuries, says a new state-by-state report on injury-prevention policy.

Kentucky ranks 10th in the nation for injury-related deaths, with a rate of 76.5 such deaths per 100,000 people, and the state spends about $26.8 million for injury-related medical expenses. New Mexico has the highest rate of injury-related deaths, 97.8 per 100,000 people, and New Jersey has the lowest at 36.1. The national rate is 57.9, so Kentucky's rate is almost a third higher than the nation.

Kentucky scored with only three of a set of 10 key indicators for injury prevention: its primary seat belt law, which most states also have; its prescription drug monitoring program, driven by heavy abuse of painkillers; and a strong law on youth sports concussions. Among the injury-prevention indicators that Kentucky lacks, it does not:

• Require bicycle helmets for all children.
• Require that children ride in a car seat or booster seat to at least the age of eight.
• Require helmets for all motorcycle riders. (It once did, but when the law was repealed, deaths rose 50 percent, the report says.)
• Does not require mandatory ignition interlocks for convicted drunk drivers.
• Does not allow people in dating relationships to get protection orders.

The report by the Trust for America’s Health and the Robert Wood Johnson Foundation concludes that millions of injuries could be prevented and billions of dollars could be saved in medical costs each year if more states adopted, implemented and enforced additional research-based injury prevention policies and programs. (Read more).

Report: Bounce-house injuries to children have skyrocketed

A new report out today in the journal Pediatrics warns that, on average, 31 children a day are transported to U.S. emergency departments for treatment of bounce-house injuries, including fractured bones and muscle damage. "If this was an infectious disease, we'd call it an epidemic and it would be on the front pages all over the country," said study co-author Dr. Gary A. Smith, director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. (Associated Press photo)

Randy Dotinga of HealthDay reports that in the 15-year period between 1995 and 2010, the rate of bounce-house injuries jumped 15-fold, with the number escalating in the last few years of the study. In the new study, published online Monday and in the December print issue of Pediatrics, researchers found the most common bounce-house injuries were fractures, strains and sprains. Concussions and cuts were more common in boys. The average age of those hurt was 7.5 years old. (Read more) 

Injury prevention policies in Kentucky lacking, study finds

Kentucky scored a dismal 3 on a scale of 10 in a safety study that assessed states against the the top 10 injury indicators in the country. The state had the 10th highest injury rate, with 76.6 Kentuckians per 100,000 dying from intentional or unintentional injuries.

Injuries are the third leading cause of death nationally, and the leading cause of death for Americans between ages 1 and 44.

The survey assessed states on whether they:
• Have primary seat belt laws.
• Require mandatory ignition interlocks for all convicted drunk drivers, including first offenders
• Require all motorcycle riders to wear helmets.
• Require booster seats to at least the age of 8.
• Require children to wear bicycle helmets.
• Allow people in dating relationships to get protection orders.
• Receive an A in the Break the Cycle Report, which examines teen dating violence.
• Have a strong concussion law.
• Have an active prescription drug monitoring program.
• Have a strong policy in emergency departments that allows researchers and officials to understand injury trends.

Kentucky got points for having a seat-belt law, a strong concussion law and a drug monitoring program. The state was close to getting credit for the booster seat indicator; it requires the seats for children until they are 7. Kentucky also reported more than 85 percent of injury discharges in its emergency departments, but the indicator only gave credit to states that do it more than 90 percent of the time. But Kentucky was far was perfect when it came to teen dating violence, receiving a F grade in the Break the Cycle report.

Because of its injury rate, the study concluded Kentuckains pay $26.8 million in lifetime medical costs due to fatal injuries and $3.3 billion for total lifetime work loss due to fatal injuries.

The study shows how injury prevention policies can help save lives. The report points out that after Kentucky repealed its universal helmet law in 1998, motorcycle deaths rose by 50 percent. (Read more)

UK center probes the science of muscles and exercise

Exercise is good for you. But it's not that simple. "Doctors and scientists have a lot of questions about why exercise is so beneficial, how muscles work and the role muscle strength plays in overall health," columnist Tom Eblen writes on the front page of today's Lexington Herald-Leader, and reports that some of those questions are being addressed by the University of Kentucky Center for Muscle Biology, which was created three years ago. "With outside grants of more than $12 million, center researchers are looking at everything from injury prevention in young athletes to rehabilitation for elderly stroke patients," he writes.



"Physical activity and muscle strength seem to contribute to everything from better memory to disease prevention. For example, even moderate exercise can help Type 2 diabetes, which has become epidemic among overweight Kentuckians. Muscles store most of the body's insulin." The center's director, Karyn Karyn Esser, told Eblen, "When you exercise and make muscles work, it creates a separate path for absorbing glucose." (Eblen photo: Caitlyn Kerins demonstrated equipment for measuring muscle control as faculty member Patrick McKeon watched.)

Two researchers are studying how to strengthen diaphragm muscles, which are essential in breathing, "to help patients get off ventilators. It is a huge problem: about 60,000 Americans are on ventilators at any given time, and it costs billions of dollars to care for them," Eblen writes. "The longer most people are on a ventilator, the more likely they are to die." And "muscle weakness is the main culprit in about 70 percent of ventilator patients." Other researchers are investigating why lifting weights can improve memory in the elderly, why certain patients lose muscle strength soon after being hospitalized, how injuries caused by repetitive motion can be avoided, and exactly how massage and ice help repair and strengthen muscles.

Eblen, who took up bicycling at 35 to lose weight and is still an enthusiast in his mid-50s, is writing a lot lately about exercise in response to Lexington's designation by Men's Health magazine as the nation's most sedentary city. And the center's Esther Dupont-Versteegden is even researching inactivity: "We know that people feel better when they exercise regularly, but why is that?" she asked. "What is inactivity doing to people?" (Read more)

Public Health Week tips remind us that safety is part of health

In celebration of 2011 National Public Health Week, being honored April 4-10, the Kentucky Department of Public Health offers tips on preventing injuries. Each year, injuries account for $80 billion spent on medical care and another $326 billion in lost productivity.

"Kentuckians can make a real difference in their homes and communities by committing to safe behaviors for themselves, their children and families," said Dr. William Hacker, commissioner of the department. "Implementing preventive measures into our daily routines can make a dramatic difference in both the overall health of our population and the amount of health care dollars spent on injury treatment."

To prevent injuries, the department recommends: wearing a helmet and protective gear while playing sports; wearing sunscreen with an SPF of 15 or higher; having a physical before starting a new sport; warming up before playing sports; putting away items like toys and shoes lying on the floor or staircase to prevent falls; monitoring children while they play; drinking lots of water to prevent dehydration; always wearing a seatbelt; and avoiding distracted driving by not talking on the phone, texting or eating.

"We need to realize that public health requires more than the obvious examples we all know, such as eating fruits and vegetables, getting vaccinations and quitting smoking," Hacker said.