Current Centers for Disease Control and Prevention (CDC) guidelines urge medical professionals to wear gowns and gloves when they are working with patients who are infected with antibiotic-resistant bacteria. Now, a new study shows that if these simple requirements were spread to all patient's rooms in an intensive care unit (ICU), they may be able to provide some protection against at least one deadly superbug.
About one out of every 20 patients acquire an infection from a hospital that they didn't have when they were first admitted, according to the CDC. The health agency's director Dr. Tom Frieden previously said to CBSNews.com during a press conference that the most acute sources of antibiotic-resistant germs are hospitals.
One antibiotic-resistant bacteria that is often found in health care settings is methicillin-resistant Staphylococcus aureus (MRSA). It can live harmlessly on the skin or in the nose, but if it infects a person's bloodstream, it can be deadly.
Hospital-linked invasive MRSA in particular infected more than 90,000 people across the U.S. and killed 20,000 people each year about a decade ago, the CDC reports. Since then, hospitals have made a bigger push to improve cleanliness. In 2011, there were just 60,000 people who were sickened, and only 10,000 died because of the bacteria resistant to methicillin antibiotics.
The new study, published on Oct. 4 in JAMA, found that wearing disposable gowns and gloves may help fight against MRSA's spread. The study looked at 20 medical and surgical ICUs in 15 states, where the researchers took 92,000 cultures from more than 26,000 patients from January to October 2012.
MRSA infection was 40 percent less likely in hospitals where all health care workers were required to use disposable gowns and gloves in the ICU, compared to establishments where they were only required to wear protective clothing during a standard isolation routine. The researchers added that workers were more likely to wash their hands after leaving the room if the entire ICU required the protective clothing.
Wearing the gowns and gloves were not shown to change the care the patient received; previous studies have found wearing gowns and gloves might increase likelihood of pressure sores, falls or other unintended physical injuries resulting from medical care. But, the new research showed there was a slight decrease in the amount of adverse events that happened to the patients when hospital workers suited up.
"We set out to find whether having healthcare workers wear gowns and gloves for all ICU patient contact could decrease the acquisition of antibiotic-resistant bacteria such as MRSA without causing any harm to the patient - and the answer was yes," lead study investigator Dr. Anthony D. Harris, professor of epidemiology and public health at the University of Maryland School of Medicine, said in a press release.
"From a public health perspective, it's important that we evaluate interventions that may continue to drive these infection rates down, especially as concerns persist about antibiotic-resistant bacteria," he added.
However, the protective gear was not shown to reduce the rates of vancomycin-resistant Enterococcus (VRE), another bacteria that's a culprit for hospital acquired infections. VRE typically live in the human intestines and female genital tract, but it can sometimes cause infections of the urinary tract and bloodstream. It can also cause an infection if it gets in wounds caused by catheters or surgical procedures.
Because of the VRE results, the researchers determined that requiring gloves and gowns in all ICU scenarios did not decrease overall MRSA and VRE infection rates significantly. However, they argued that it didn't mean gowns and gloves weren't worth wearing at all.
"Infection control studies such as this are important to advance the science and lead to important discoveries that can decrease health care-associated infections," senior author Dr. Daniel J. Morgan, assistant professor of epidemiology and public health at the University of Maryland School of Medicine, said in a press release. "In conjunction with the evolution of hospital cleaning practices, increased handwashing frequency and other measures, patients in hospitals can be safer than they've ever been from HAIs."
In an accompanying editorial, Dr. Preeti N. Malani, an associate editor of JAMA and clinical associate professor of internal medicine at the University of Michigan Health System, said that the study's results didn't provide evidence that glove and gowns could help against MRSA and VRE. She pointed out that the overall MRSA and VRE acquisition decreased from 21.4 infections per 1000 patient-days to 16.9 among the ICU centers, but it also went down in the ICU centers that served as a control that didn't require the garb.
However, Malani agreed that wearing gowns and gloves may help prevent bacterial transmission in some scenarios.
"Even though the results of Harris et al failed to demonstrate an overall benefit of universal use of gloves and gowns to reduce acquisition of MRSA or VRE, this approach may be worth considering in some instances," she wrote. "For example, if MRSA transmission is prevalent in a high-risk setting such as a surgical ICU with a large number of patients with newly implanted medical devices. If implemented, gloving and gowning should be just part of an overall strategy that includes efforts to optimize hand hygiene and prudent use of antimicrobials."
Other studies have shown that taking extra steps to ensure cleanliness can help stop MRSA transmission. A New England Journal of Medicine study showed that ICU patients at centers where all were subjected to a universal decontamination routine were 40 percent less likely to get a bloodstream infection of any type compared to centers who just isolated people who tested positive for MRSA. Universal decontamination involved getting a nose swap with bacteria-fighting ointment twice a day plus a once-daily antiseptic wipe bath.
The CDC has more on superbugs and health care-associated infections.
Mortgage Assignment - How Real Estate Investors Profit
Mortgage assignment is a common practice among lenders. A mortgage deed, also called a deed of trust or trustee's deed or deed of trustee, gives a lender a security interest in the property mortgaged in return for money received. Lenders and mortgagors of deeds of trust often sell mortgages to third parties, like other lenders. If a trustee is assigning beneficial interest under a deed of trust, it should be recorded in writing. Mortgage assignment is a document that indicates that such an assignment of contract has happened. Once an assignment is recorded, a new lender stands in the shoes of the original lender.
Although a lender is not required to inform a borrower prior to mortgage assignment, s/he must send a notification after a mortgage sale has taken place informing the borrower how to make mortgage payments in the future. The borrower can negotiate mortgage terms with the new lender and seek mortgage modification.
A mortgage deed refers to a deed accompanied by a mortgaged loan note. Every mortgage deed involves two steps: a promissory note and a mortgage. A note has details like amount owed, term of loan, etc. and is proof of existence of a mortgage. The mortgage is the means through which a borrower pledges or mortgages property as security for money received. The note and mortgage are two sides of the same coin and are inseparable. A mortgage follows the note and thus assignment of mortgage note results in assignment of a mortgage. In other words, a mortgage cannot be assigned without transferring the note. Therefore, assignment of note and mortgage happen simultaneously.
Mortgage assignments are beneficial to both home sellers as well as buyers. For home sellers it can be an easy way to sell a home that has been on the market a long time. The benefit for home buyers is that they can buy a house without going through the process of qualifying for a bank loan and making a large down payment. There are many real estate companies offering attractive assignment programs that benefit sellers and buyers alike. Using the benefits of such a home mortgage assignment program will help you sell your home quickly or buy a home without dealing with bank formalities.
Once a mortgage has been transferred, it means that obligation of loan has transferred. In order to validly assign a mortgage, a mortgage assignment document should have the following details:
- description of the real estate so that there is clarity about the property
- the name of the original party as well as the third party
- contact information
- the date when the mortgage assignment became valid
Assignment of mortgage should be recorded before the government authority that deals with property ownership, property taxes, etc. If you are a borrower and you receive a notice that your mortgage has been transferred to another lender, you should get in touch with your lender and confirm it. You should also secure details of the person to whom the mortgage was sold to.
If you are a new lender and do not have a valid mortgage assignment document, you will be disadvantaged if you have to move for foreclosure. In the event mortgage payments stop, you may want to move the local court for foreclosure and take ownership of the property mortgaged. If there was no legal document created when you assign a mortgage, you will have no right to file for foreclosure. Therefore, it is important to document when you assign a mortgage. Click here to view our sample mortgage assignment form, also referred to as an assignment of mortgage form or mortgage assignment letter.
One drawback of mortgage assignment is that it all depends on a third party. For many, getting mortgages assigned is a kind of real estate investing practice. The third party to whom the mortgage is assigned to is a real estate investor who reaps the benefits of one of the party's desperateness. The investor third party is only concerned about reaping mortgage assignment profit from the mortgage assignment investing deal s/he has entered into and has no regard for the financial well being of the parties involved.
Mortgage Assignment FAQs
What is mortgage assignment?
Mortgage assignment, also called assignment of trustee's deed or assignment of deed of trustee, is the process of selling an existing mortgage to a third party. The borrower gets notice to make mortgage payments after the date of assignment of the mortgage deed to the new mortgagee. A mortgage assignment form satisfies lawful conveyance of the mortgage. An assignment of mortgage form also signifies that an assignment of contract has occurred and mortgage has been transferred.
Who can assign a mortgage?
A mortgage holder or a borrower can assign the mortgage to a third party. A lender can also assign a mortgage to another lender. In some cases, a homeowner can engage in assignment of mortgage, but the lender must give permission.
What are my benefits if I engage in HUD mortgage assignment program?
Homeowners can avoid foreclosure and can refinance their mortgage with the help of a mortgage assignment program offered by the U.S. Department of Housing & Urban development (HUD). In a real estate investing business, mortgage assignment program helps a real estate investor to sell his/her home really quickly.
What are the drawbacks of mortgage assignments?
There are a few drawbacks to assignment of a mortgage that you should be aware of. In case the buyer defaults on payments, you might have trouble collecting. Another disadvantage is that mortgage assignment depends on a third party-the new buyer, who is only concerned about getting mortgage assignment profit from a mortgage assignment deal.
Can you explain the process of mortgage assignment?
It is always advisable to utilize the services of a professional realtor or investor in the mortgage assignment investing business. Once you assign such a firm the task of mortgage assignment by signing a sales contract, they will do all the paperwork necessary for a mortgage assignment program. You will be required to submit additional documents related to the mortgage in order to assign the mortgage. The mortgage will then be advertised. Once a buyer is located, your realtor will require you to sign remaining paperwork and will prepare closing documents.
Documents required for a mortgage assignment are:
- loan details including loan number, loan type and terms of loan
- an authorization to discharge Loan Information
- purchase contract and addendum to contract identifying conditions of mortgage assignment
- seller's disclosure document
- mortgage assignment letter
- document assigning insurance contract
- an acknowledgement document by seller
- mortgage modifications, if any