Vital Times 2014 - (Page 59)
PEERING OVER THE ETHER SCREEN
Germs and the Pseudoscience
of Quality Improvement
By Karen Sibert, MD
N
o one wants a hospitalacquired infection - a
wound infection, a central
line infection, or any other
kind. But today, the level
of concern in American
hospitals about infection
rates has reached a new
peak - better termed paranoia
than legitimate concern.
The fear of infection is leading to the arbitrary
institution of brand new rules. These aren't based on
scientific research involving controlled studies. As far
as I can tell, these new rules are made up by people who
are under pressure to create the appearance that action
is being taken.
Here's an example. An edict just came down in one
big-city hospital that all scrub tops must be tucked
into scrub pants. The "Association of periOperative
Registered Nurses" (AORN) apparently thinks that
this is more hygienic because stray skin cells may be
less likely to escape, though there is no data proving
that surgical infection rates will decrease as a result.
Surgeons, anesthesiologists, and OR nurses are
confused, amused, and annoyed in varying degrees.
Some are paying attention to the new rule, and many
others are ignoring it. One OR supervisor stopped an
experienced nurse and told to tuck in her scrub top
while she was running to get supplies for an emergency
aortic repair, raising (in my mind at least) a question of
misplaced priorities.
The Joint Commission, of course, loves nothing more
than to make up new rules, based sometimes on real data
and other times on data about as substantial as fairy dust.
A year or two ago, another new rule surfaced,
mandating that physicians' personal items such as
briefcases must be placed in containers or plastic
trash bags if they are brought into the operating room.
Apparently someone thinks trash bags are cleaner.
Now one anesthesiology department chairman has
taken this concept a step further, decreeing that
no personal items at all are to be brought into the
operating room-except for cell phones and iPods.
That's right, iPods, not iPads. This policy (of course)
probably won't be applied uniformly to high-ranking
surgeons or to people like the pacemaker technicians
who routinely bring entire suitcases of equipment into
the OR with them.
What's particularly irrational about this rule is that cell
phones likely are more contaminated with bacteria than
briefcases or purses, even if they're wiped off frequently.
And I have to ask how an iPhone 6+ meets eligibility
criteria while the barely-larger iPad mini doesn't.
Again, please show me the data demonstrating that this
(continued)
Annual Publication 2014 | 59
Table of Contents for the Digital Edition of Vital Times 2014
AND NOW, A WORD FROM THE EDITOR
PRESIDENT’S PAGE
ON YOUR BEHALF: CSA Fights and Wins in 2014
ADAPT AND PROSPER: A Guide to Survival
POLITICS AND MEDICATION SAFETY: The CSA 2014 Annual Anesthesia Meeting
DR. CSA GOES TO WASHINGTON
CALIFORNIA ANESTHESIA RESIDENCY IN 2014
A NEW YEAR AND NEW LEADERSHIP IN THE CSA
CAUTIOUSLY OPTIMISTIC – CSA FINANCES IN OUR 2014-15 FISCAL YEAR
THE ASA ANNUAL BOARD OF DIRECTORS’ MEETING: Building for the Future
ANESTHESIOLOGY™ 2014
CONSOLIDATION IN THE HEALTHCARE MARKETPLACE: What’s in your Future?
IF I COULD SPEAK
PEERING OVER THE ETHER SCREEN: Germs and the Pseudoscience of Quality Improvement
THE ETHICAL CONSULTANT: Perioperative ‘Do Not Resuscitate’ Orders
THE VALUE OF CSA MEMBERSHIP
UPCOMING MEETINGS
MY WEEK ON HAWAII'S BIG ISLAND
Vital Times 2014
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