Wednesday, June 10, 2009

When the treatment is worse than the disease

The University of Missouri Health Care System is re-evaluating its current policy on healthcare workers with latent tuberculous infection, which currently encourages but does not mandate treatment. The impetus for the review is a healthcare worker who had tested positive for latent tuberculosis via positive skin testing many years ago but declined to be treated, and recently developed active disease, exposing over 200 persons to tuberculosis. I suspect that most hospitals have similar policies and am not aware of a hospital that either prohibits those with latent but untreated infection from working or mandates treatment of latent tuberculosis. By definition, latent tuberculosis is not contagious but every person with latent infection has a small chance of developing active infection, which is contagious.

Isoniazid (INH), the standard drug used to treat latent tuberculosis given daily for nine months, is not an innocuous drug. In just the past few years, I have seen two deaths (both persons in their early 40s) and another healthy man who required a liver transplant due to the liver toxicity caused by the drug. Thus, I believe the drug is too toxic to require latently infected healthcare workers to be treated. Like the vast majority of healthcare workers, I have a TB skin test placed yearly. But I have decided that should my skin test convert to positive, I would not take INH because I believe it is too dangerous. We sorely need safer drugs for this condition. And we need better tests to detect latent tuberculosis--those currently available have many false positives and false negatives.

2 comments:

  1. FOR IMMEDIATE RELEASE


    ECT Solutions and American Dawn Inc. To Launch The Next Generation Patient Gown for the 21st Century


    NEW ORLEANS, Louisiana (June 18-21, 2009) – ECT Solutions and American Dawn Inc. (ADI) have joined forces to design and manufacture an innovative patient gown for the 21st Century, to be launched at the 2009 Clean Show in New Orleans’ Morial Convention Center. The recent front page Wall Street Journal article, May 11, 2009, describes the present patient gown as being “…around as long as the Band-Aid.”

    In clinical trials, the ECT gown has been described as fulfilling a long void for a patient gown that facilitates the delivery of quality care while maintaining patient comfort, privacy and dignity. The ECT gown promotes compliance with Joint Commission Safety Standards and helps reduce the risks of hospital acquired infections (HAI.)

    The U.S. patented ECT gown is designed by nursing clinicians who recognize the need for change. The ECT patient gown is certain to be the new standard, solving the challenges modern medicine and technology poses to patient care providers. The unique features of the ECT gown were developed from twenty years of hands-on nursing experience.

    The well-designed, cost effective ECT gown, increases efficiencies, lowers operating costs and helps improve positive patient outcomes. Competitively priced, the ECT patient gown provides sustainable value to the bottom line.

    Come and see the American Dawn Inc. LIVE DEMONSTRATION of the new next generation gown at Booth #5036.


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    Contacts:


    Eric Trouillot
    Marketing Director, ECT Solutions LLC
    Phone: 954-592-7378
    Fax: 954-510-0686
    etrouillot@ectsolutions.info

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  2. It's great to see how many people are addressing the issue of those dreaded gowns we learned to hate. Unlike many developers of gowns, we have created the next generation in Patient Gowns we call The ECT Patient Gown. With the clinical value it offers along with addressing the Patients modesty and safety issues makes the ECT Patient Gown a product to consider. Priced to compete with the standard telemetry and I.V. gowns used today helps hospitals maintain their cost thus making the ECT Gown more appealing. The ECT Patient Gown was designed from the nursing point of view, recognizing the need for a better patient gown. Providing care to patients wearing the current hospital gown requires lifting the gown to access devices such as JP drains, central lines or gastrostomy tubes. With The ECT Patient Gown, the healthcare provider has easy access and visibility to these devices, while maintaining patient comfort, privacy and dignity. The ECT Patient Gown facilitates patient care while enhancing a culture of safety as mandated by The Joint Commission. The ECT Patient Gown helps meet The Joint Commission's safety goals, including goal # 7 and #13 which encourages patient involvement in their own care. With the advent of the CMS legislation (effective October 2008) to not reimburse for hospital acquired infections (HAI), The ECT Patient Gown helps reduce the risk of HAIs. The strategically placed openings in The ECT Patient Gown reduce stress on the incision sites, reduces the risk of dislodgement, facilitates early ambulation, all of which lower the risk of HAIs. Please visit www.ectsolutions.info for more details.

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