Serial killer highlights hospital safety issues

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The case of the male nurse who killed eight patients on his ward has shocked the Czech public and opened up many questions regarding security in hospitals, the responsibility of doctors and the work of the police. Was it really necessary for so many people to die before the culprit was uncovered and are hospitals safe havens where patients are in competent hands - or a place where one must fend for oneself just like any other?

The Havlickuv Brod hospital killings have put all Czech hospitals under intense scrutiny. The public wants questions answered and the media reports coming out on the subject are not reassuring. This week Mlada Fronta Dnes published an in depth report on the general state of Czech hospitals, claiming that one's feeling of safety in hospital was an illusion. It cited ten of the most frequent malpractices which put patients at risk every day.

They include poor storage of medicines, poor records regarding when they are administered to patients, the possibility of a mix-up because patients do not wear identity bracelets and are identified by a bed-number. However patients suffering from Alzheimer's disease or patients who are confused after getting an anesthetic may easily end up in the wrong bed. There is no standard procedure in writing medical records - each hospital does things differently - which has resulted in doctors operating on the wrong organ or leg. Another practice is medicine being prescribed over the phone when a patient gets worse overnight and the nurse merely reports the symptoms to his doctor.

All these malpractices and more - are now under intense scrutiny and the health minister is demanding action. Motol, Prague's largest hospital, announced on Wednesday it was introducing identity bracelets without delay. Other corrective measures are expected to follow in hospitals around the country. David Marx from the Society for Quality Health Care says that patients themselves must learn to be more assertive in dealing with nurses and hospital staff.

"A patient should never be satisfied with an answer like - this is some medicine the doctor ordered and that is what I am giving you. The patient has a right to be informed about any medicine he is going to be given in advance and told what it is for - if not by his own doctor then by the head physician. Your health is more important than getting your car's brakes serviced and most of us would not settle for a simple answer where our car is concerned."

Of course in many cases patients are in no condition to keep an eye on what is being administered and in that case it is up to doctors and head physicians to make sure their orders are being fully adhered to and to take action if they are not. Suspicions of foul play should also be reported much sooner. In the case of the Havlickuv Brod serial killer the hospital botched its report to the police so badly it took a full month for the police to arrest the suspect. The health and interior ministers have held consultations on the matter and have promised to give both the police and health sector workers clear directions regarding how to proceed in such cases in order to ensure fast and effective action. Right now hospital security has become a top priority issue and many promises are being made - but it will be a while before Czechs feel totally safe in hospital.