Death by abandonment

– a subject with which the LHC is all too familiar

HAVING a nosocomial infection (NI) is another way of saying that someone is afflicted with any of a number of diseases he or she may have picked up while in hospital.

It’s a malady that is peculiar to those who have been abandoned by their families, a situation to which the Linden Hospital Complex (LHC) can relate, as it’s an issue with which it has been dealing for a number of years.

For that matter, in the last few months it has had as many as eight such patients, many of whom eventually died.

According to the experts, nosocomial infections (NIs), also called healthcare-associated infections (HAIs), are a range of hospital-acquired infections contracted because of toxins that exist in a certain location.

What this means, in essence, in the case of the LHC, is that the eight patients at reference did not enter the institution with a nosocomial infection, but because they’d been left there for months by uncaring relatives, their already weakened bodies became susceptible to whatever germs that might be lurking around.

Laurette Smith Gray, a social worker attached to the LHC, has been managing the welfare of such patients, and she noted that many of them, upon arrival at the hospital, would be very mobile and responsive.

But after a few months, she said, they become bedridden and unresponsive. Many of them do not leave alive, she said, since the process of having them transferred to a social facility for the elderly is rather lengthy. In the circumstances, they automatically become residents of the hospital.

THE CHALLENGES
While the issues of abandonment and continuous care for such persons are grave concerns to the institution, their biggest challenge is preventing them from contracting a nosocomial infection, and it’s affecting the entire in-patient population, since they, too, can deteriorate in health and die.

Even visitors and medical practitioners are at risk, she said, and this is why the management of the LHC is calling upon the residents of Linden and it’s environs to desist from abandoning their loved ones there.

She, however, made the point that while in most cases, those who are left abandoned are elderly persons, there are instances where the middle-aged and minors are just as vulnerable, the latest being a disabled child.

Noting the undue pressure it puts on the hospital to care for such persons, many of whom would have been long discharged, Gray said, “It therefore means they are no longer under medical management, but they fall as social patients.

“The hospital does not have the capacity to hold persons who are not patients that are not in dire need of medical attention.”

Due to the lack of space, she said, the hospital is finding it difficult to attend to new admissions. “When we have patients as social cases,” she said, “it then puts the hospital in a situation where we are pressed for space; where we may have to turn away some persons; where we may have to send persons away without fully assessing their condition before they are fully discharged. “So, what we would like is for family members to take up their responsibility and to look into the care of their relatives.”

THE MANY RUSES
A new development, she said is that residents have lately taken to using the hospital’s ambulance service to get their relatives admitted to the hospital, knowing fully well they are not in need of medical attention. Some are even using taxis in furtherance of their schemes.

What complicates matters even further, Gray said, is when the time comes for them to be discharged, as by this time their relatives no longer want to have anything to do with them. They don’t answer their phones, and if hospital staff happen to go to their homes, they stay indoors and hide.

“We are not responsible for keeping persons as long as they have not met the criteria for admission,” Gray said. “The relatives are expected to take their relatives home and provide for their continued management.”
Colwyn Allen, Quality Assurance Officer at the LHC, who is also a registered nurse and founder of the Healthy Living and Wellness Health Club, noted that caring for NIs is very burdensome.

He said, too, that in-patients that come into contact with these neglected patients are exposed to many other infections. “Maybe you come with your baby to see the paediatrician who has the common cold, and next day, after being exposed, your baby starts with the diarrhoea or vomiting,” Allen said.
He said that bedridden and long-term patients are the ones who mostly carry the infections, since their immune system tends to decline the longer they stay in hospital.

HOW IT’S CAUSED
According to Healthline.com, NIs are contracted mostly in the intensive care unit (ICU), where doctors treat serious diseases, and that one to 10 persons admitted to a hospital will contract these infections. Persons are at risk up to 48 hours after hospital admission, and as medical care becomes more complex and antibiotic resistance increases, the cases of nosocomial infections will grow.

Some of the most common NI are urinary tract infections (UTIs), surgical site infections, gastroenteritis, meningitis and pneumonia, and are caused by mostly bacteria, some forms of funguses and viruses.

Symptoms of NI may include: Discharge from a wound, fever, cough, shortness of breath and nausea, vomiting, and diarrhoea.

Ms. Gray related that those who believe that they are doing their relatives a good turn by leaving them in the hospital, are doing the exact opposite.

PREVENTION
Allen is urging all medical practitioners to be extra cautious not only when dealing with neglected patients but all in-patients, especially when using intravenous devices and catheters.

“We have been holding many programmes for nurses, doctors and healthcare workers, showing them ways in which they can minimise the transmission of such infections,” he said, adding:
“We have been stressing on the use of Personal Protective Equipment (PPE); these are measures that protect the nurse from the patient, and the patient from the nurse.”
According to Healthline.com, NIs are mainly spread through person-to-person contact. These include unclean hands, and medical instruments such as catheters, respiratory machines, and other hospital tools. Hospitals and healthcare staff should follow the recommended guidelines for sterilisation and disinfection.

Taking steps to prevent Nis, the site says, can decrease one’s risk of contraction by 70 per cent. Some general measures for infection control include: Observing hand hygiene, which involves washing hands before and after touching people in the hospital, cleaning surfaces properly, with recommended frequency and making sure rooms are well ventilated.
Visitors are advised to wash their hands both before and after visiting relatives, as hand contact is one of the most prevalent ways of contraction.

While the LHC will continue to strive to minimise the spread of NIs amongst the inpatient population, sensitisation of the need for relatives to be cared for at home will also be done continuously.

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