Feel better about your healthcare provider – the number of serial killers is down!


I do not like thee, Doctor Fell,
The reason why – I cannot tell;
But this I know, and know full well,
I do not like thee, Doctor Fell.

The number of serial killings committed by healthcare providers has leveled off in the U.S. in recent decades, although it is rising internationally, Eindra Khin Khin, MD, said here at the annual meeting of the American Academy of Psychiatry and the Law.

According to the literature, the number of cases of healthcare serial killings overall rose from 10 in the 1970s to 21 in the 1980s, 23 in the 1990s, and then to 40 in the years 2000 to 2006, said Khin Khin, who along with her colleagues presented a poster on the topic.

One reason the rates of healthcare serial murders are rising internationally, but not in the U.S., is electronic medical records (EMR), Khin Khin, of George Washington University in Washington, told MedPage Today in a phone interview. She noted that several serial killers, including physician Michael Swango, first got into trouble in the U.S. and then went overseas…

“At least in the [United] States, because of incidents in 1990s and 2000s, we’ve really beefed up on the credentialing system, and institutions have started to communicate with each other better,” she continued. “People are not shedding enough light on the international phenomenon, and the global community has a little bit to catch up on in implementing guidelines and regulatory measures.”

In terms of the site, the vast majority of killings (72%) occurred in a hospital, with the remainder occurring in nursing homes (20%), patients’ homes (6%) and outpatient settings (2%)…

As to the method used, the majority of killings — 52% — were done via lethal injection, followed by unknown methods (25%), suffocation (11%), and water in the lungs (4%). Air embolus and oral medications were each used in another 3%, while equipment tampering and poisoning accounted for 1% each.

Followed by an entertaining segment describing motivation and telltale signs you may have a serial killer onboard.

The researchers recommended several steps for preventing healthcare serial killings, such as educating staff members on the issue, designating a national or international regulation and monitoring body, routine institutional monitoring of high-alert medication use and monthly mortality/cardiac arrest rates, and consensus guidelines for managing suspicious situations.

I imagine that the Feds can data mine the ACA digital record-keeping protocols for serial killers just as they now do for rip-off artists hustling Medicare. Every little bit helps, eh?

How many criminals work in nursing homes in your state?

More than 90 percent of nursing homes employ one or more people who have been convicted of at least one crime, federal investigators said in a new report…

The report was issued by Daniel R. Levinson, inspector general of the Department of Health and Human Services, who obtained the names of more than 35,000 nursing home employees and then checked with the Federal Bureau of Investigation to see if they had criminal records…

The inspector general said that no federal law or regulation specifically required nursing homes to check federal or state criminal history records for prospective employees. Ten states require a check of F.B.I. and state records, Mr. Levinson said, while 33 require a check of state records, and the remainder do not have explicit requirements.

Given the patchwork of requirements, people convicted of crimes in one state have been able to obtain jobs at nursing homes in other states. Moreover, Mr. Levinson said, “Some states allow individual nursing facilities to make decisions regarding the employability of individuals with criminal convictions, while others rely on a state agency…”

Federal rules say that nursing homes must not employ people who have been found guilty of abusing, neglecting or mistreating patients. But F.B.I. records do not always indicate if the victim was a nursing home resident…

“Even some of the better nursing homes have problems with theft, rampant theft of residents’ clothing and personal possessions, including jewelry,” Dr. Harrington said. “People convicted of crimes are often left alone with nursing home residents because the supervision of care is, in many homes, very inadequate.”

The new health care law offers $160 million to states to improve criminal background checks on prospective employees at nursing homes and other providers of long-term care.

Yup. Let’s fork over more money to states to continue the wonderful job they’ve been doing.

States Rights are a delightful 2-way street. When federal programs invest taxpayer funds mandated for a better, safer life for all, states battle for the money – and may even succeed at a half-competent job.

But, when the other side of the coin involves responsibility to citizens, especially those with limited means – no one is faster than a governor or a member of a state legislature to abdicate responsibility. But, hey – it’s just your mom or dad, eh?

Robot companions

Nothing Eileen Oldaker tried could calm her mother when she called from the nursing home, disoriented and distressed in what was likely the early stages of dementia. So Ms. Oldaker hung up, dialed the nurses’ station and begged them to get Paro.

Paro is a robot modeled after a baby harp seal. It trills and paddles when petted, blinks when the lights go up, opens its eyes at loud noises and yelps when handled roughly or held upside down. Two microprocessors under its artificial white fur adjust its behavior based on information from dozens of hidden sensors that monitor sound, light, temperature and touch. It perks up at the sound of its name, praise and, over time, the words it hears frequently…

After years of effort to coax empathy from circuitry, devices designed to soothe, support and keep us company are venturing out of the laboratory. Paro, its name derived from the first sounds of the words “personal robot,” is one of a handful that take forms that are often odd, still primitive and yet, for at least some early users, strangely compelling…

But building a machine that fills the basic human need for companionship has proved more difficult. Even at its edgiest, artificial intelligence cannot hold up its side of a wide-ranging conversation or, say, tell by an expression when someone is about to cry. Still, the new devices take advantage of the innate soft spot many people have for objects that seem to care — or need someone to care for them.

Their appearances in nursing homes, schools and the occasional living room are adding fuel to science fiction fantasies of machines that people can relate to as well as rely on. And they are adding a personal dimension to a debate over what human responsibilities machines should, and should not, be allowed to undertake.

Ms. Oldaker, a part-time administrative assistant, said she was glad Paro could keep her mother company when she could not. In the months before Mrs. Lesek died in March, the robot became a fixture in the room even during her daughter’s own frequent visits…

“I’m the only one who can put him to sleep,” Mrs. Lesek would tell her daughter when the battery ran out.

He was very therapeutic for her, and for me too,” Ms. Oldaker said. “It was nice just to see her enjoying something.”

RTFA. This is just a touch of the discussion, considerations ranging from ethical to practical, including the absurdities required by lawyers and Libertarians.

I think anyone who’s experienced long-term companionship with a dog or cat will understand exactly where some of these designs are heading – and why. The usefulness of helping someone to be happy – especially in trying times – seems to me to be the easiest thing in the world to understand. Leave the rest for seminarians to discuss in some ivory tower.

American hospitals flush tons of drugs down the drain

U.S. hospitals and long-term-care facilities annually flush millions of pounds of unused pharmaceuticals down the drain, pumping contaminants into America’s drinking water, according to an ongoing Associated Press investigation…

One thing is clear: The massive amount of pharmaceuticals being flushed by the health-services industry is aggravating an emerging problem — the common presence of minute concentrations of pharmaceuticals in U.S. drinking-water supplies, affecting at least 46 million Americans…

The Environmental Protection Agency told assembled water experts last year that it believes nursing homes and other long-term-care facilities use sewer systems to dispose of most of their unused drugs. A water utility surveyed 45 long-term-care facilities in 2006 and calculated that two-thirds of their unused drugs were scrapped this way, according to the National Association of Clean Water Agencies…

The EPA is considering whether to impose the first national standard for how much drug waste may be released into waterways by the medical-services industry, but Ben Grumbles, the EPA’s top water administrator, says a decision won’t be made until next year, at the earliest.

It certainly won’t be made until after Bush leaves office.
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