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Any attendee who wondered why they received a packet of tissues upon entering Victoria Nahum's session on the human impact of hospital-acquired infections didn't have to wait long for the answer. While a number of educational sessions effectively dealt with the subject of HAIs, Nahum took the topic to the next level by offering a very personal – and gut-wrenching – account of how HAIs can affect patients and their families (and also the caregivers who contributed to the incident).
Nahum described how three different members of her family (herself being one of them) suffered from HAIs in a ten-month period (each from a different healthcare facility, and even in different states. The first victim was her father-in-law who acquired bacterial pneumonia after he was admitted to the hospital for a heart attack in Nov. 2005. Thankfully, he survived the infection. In March 2006, it was Nahum's turn. Ten and a half months after after undergoing breast augmentation, this typically vibrant, energetic woman in her 40s who ran a cluster of eight radio stations began experiencing unprecedented fatigue, followed by “crushing joint pain” and burning pain that radiated to her limbs. Finally, she became so fatigued that she no longer had the strength in her arm to make her bed (even after a full night's sleep). A doctor informed her that she had an autoimmune disease that had been triggered by the implants. Rather than removing the implants, the doctor suggested Nahum keep them in place and take medication to control the disease's symptoms. Unhappy with the medications' side effects and still feeling uneasy about the cause of her symptoms, she listened to her inner voice and had her implants removed. The physician discovered staph bacteria covering her left breast.
“The good news was we at least found the cause and were able to fix it,” she said.
Unfortunately, there was no good news when, a mere six months later, her son, Josh, a skydiver, experienced a severe jackknife landing that fractured his femur and skull. While he was on what appeared to be good road to recovery in rehab, Josh became nauseous and developed a sky-high fever. A lumbar puncture revealed the unthinkable: the presence of gram-negative staph in his cerebrospinal fluid. Later that night, Josh coded, became comatose and required a ventilator to breathe. His spinal cord injury led him to become a ventilator-dependent quadriplegic.
“He died two weeks later from the bacteria he acquired during his care, which caused so much pressure to build up in his brain that his brain was actually forced into his spinal column,” a solemn Nahum revealed.
“No family member should ever experience this amount of pain and have to say goodbye to someone they love” because of an HAI, she stressed.
Sadly, statistics show it's happening with alarming frequency. “It may seem hard to believe, but 180 patients will become infected with an [HAI] during our time here together in this room today. And approximately 271 will die from these infections. It's that number that pains me every day. To me, 271 represents youth and happiness lost and dreams that are unfulfilled. It represents husbands and wives having to go home alone to an empty home without their loving [spouse]. As a parent who lost a child through something that I later learned was unpreventable, it's something that is unacceptable.”
But each and every persona in attendance can help make a meaningful difference. Nahum used one example of how just one change can dovetail into something far greater. When a small Italian village was subjected to an ice storm, which led to trees collapsing and blocking the streets because of the weight on their branches, one young couple (and many others in the village) found themselves relegated to their home. As a result of being bored and homebound, a bambino boom ensued. A science-driven individual explored the reason behind the boom (aside from the obvious) and credited it to precipitation and a one-degree temperature change that led to the ice, which led to the storm, which led to the trees collapsing...and, finally, to couples being stuck in their homes with little else to do with their time. Nahum then shared that the young couple in the story were her grandparents and the baby born nine months after that storm was her father. “Had that one-degree change in temperature not happened, I wouldn't be here before you today,” she joked. “It just goes to show how one thing can affect each one of us here today.”
“You are the people behind the instruments and you have an incredible responsibility. Change just one thing, whatever that is, to do what's right and that will create a ripple effect that will continue to carry. Don't ever forget that you have a hand in changing the fate of the world.”
In an ongoing quest to drive widespread safety and instrumentation quality, IAHCSMM has become increasingly focused on fostering more effective partnerships with allied health organizations. As such, the Association was honored to have Leslie Stewart, BA, RN, CGRN, national treasurer of the Society of Gastrointestinal Nurses Association (SGNA) on hand to educate attendees on endoscopy, the increasing role of the endoscopy technician – and CS' vital role in education, quality assurance and standard compliance.
Stewart, who presently serves as nurse manager of endoscopy service at Jersey Shore University Medical Center and as director of the endoscopy product line for Meridian Health, offered valuable insights on the evolution of endoscopes, as well as the endoscopy profession.
“An endoscopy technician's roles are so broad and varied. They may be involved in direct patient care and they have to be specialists in equipment handling,
tandards compliance and education. They also must have terrific communication skills,” she explained, adding that endoscopy technicians must also have a firm grip on anatomy, physiology and pathophysiologiy to perform their responsibilities effectively. “Because these professionals often serve as the third and fourth hand for the physician, they require a high degree of competency (supported by ongoing education and certification).”
Of course, an endoscopy technician's ability to best serve the patient by meeting patient safety requirements and quality standards is also dependent upon the availability of properly – and consistently – processed endoscopy equipment.
“It's so important that our two organizations work together because as the recent reports have shown, any shortcuts that happen will have disastrous consequences,” Stewart noted, referring to the two separate scope-related incidents that occurred at VA facilities in Tennessee and Florida.
“I can't stress enough the importance of ensuring that these devices have been properly cleaned so the high-level disinfectant can reach every nook and cranny and do its job effectively.” Stewart also stressed that it's imperative that CS staff (or any other professional in charge of processing scopes) perform the following eight steps to high-level disinfection of scopes (in this order):
“If you don't perform each of these eight steps, in that order, you'll break the chain and open the door to infection.”
11:30 a.m. –
1:30 p.m.
STERIS Membership Luncheon
1:30 p.m. –
2:45 p.m.
General Session:
Change One Thing; Change Everything
2:45 p.m. –
3:00 p.m.
Break
3:00 p.m. –
4:15 p.m.
Concurrent Sessions:
Endoscopes
New Technologies and Best Practices for CS Disinfection
4:15 p.m. –
5:30 p.m.
Concurrent Sessions:
PPE and its Importance to Me
Integration opportunities with Sterile Processing Information Systems