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Opening Remarks
As hundreds gathered around round tables in the conference ballroom to await the highly anticipated keynote address by renowned infection control expert Betsy McCaughey, IAHCSMM president Lisa Huber took to the microphone to introduce to the crowd a large number of IAHCSMM representatives and pay tribute to their ongoing dedication to the association and the professional. Huber also used the opportunity to personally thank vendor partners for their generous support and honor the speakers who have helped raise the bar for education quality and service excellence.
“With each meeting, I always learn things that I didn't even know that I didn't know,” she said, “and I always end up leaving the meeting feeling refreshed, enriched and recharged.”
On behalf of the Association, Huber expressed her sincere admiration and appreciation for the nearly 600 attendees from 14 different countries who made the trip to Orlando to advance their professional knowledge and development – a large number of whom were first-time attendees.
“In all honesty, with the economy the way it is, we weren't quite sure how big a meeting we would have,” Huber acknowledged. “I know that many of you paid for this trip on your own and used vacation days in order to be here,” which just validates the level of commitment to quality, patient safety and the profession as a whole.
Keynote Address – Betsy McCaughey
Renowned health policy expert and former Lt. Governor of New York State Betsy McCaughey drew a standing-room-only crowd Monday morning for her keynote address, Surprising New Research on Preventing Hospital Infections: The Importance of Cleanliness. In 2004, McCaughey founded the Committee to Reduce Infection Deaths (RID), a nationwide educational campaign to stop hospital-acquired infections. Since RID's inception, it has made hospital infection a major public issue, providing compelling evidence that preventing infections improves hospital profitability, as well as saves lives.
“I travel all over and speak to many different groups of people, but this group is my most important because research shows that you are number one at preventing infections,” McCaughey told attendees. At least 90% of HAIs are preventable and those those facilities that do prevent them are more profitable (without having to invest any capital outlay), she assured.
Although the Centers for Disease Control and Prevention reports that 1.7 HAI occur each year, McCaughey said the true figure is much higher. That notion was supported by statistics for Methicillin-resistant staphylococcus aureus (MRSA). The superbug accounted for 800,000 infection in 2007 – a whopping figure that still only accounted for 8% of HAIs that same year. Also alarming is the fact that 64% of staph infections were MRSA – and that figure is growing, according to McCaughey.
The good news is HAIs can be prevented through change and a commitment to doing what's right on behalf of the patient. She referenced the success of the Dutch “search and destroy” model of HAI prevention, and also offered example after example of US-based facilities that have been equally successful at reducing HAIs when these proactive processes, policies and procedures were implemented and followed. The University of Pittsburgh Medical Center Presbyterian Hospital, for example, managed to reduce the incidence of MRSE by more than 90% in its ICUs and a neighboring VA facility achieved an 85% reduction. What's more, in Iowa, 29 healthcare institutions managed to eradicate Vancomycin-resistant enterocci – with collaboration between acute care and skilled nursing facilities playing a key role in the success. At prestigious Johns Hopkins, due diligence led to a zero rate of central line infections.
McCaughey stressed that many infections are spread via contaminated caregiver hands and improperly cleaned environmental surfaces, such as bedside tables, call buttons, phones, remotes and bedrails. In fact, a Tufts University study revealed that even after a room was terminally cleaned, a significant amount of germs, such as VRE and C. difficile, could still be found on the surfaces. Patient privacy curtains are another problem because they're typically the first thing caregivers touch with their gloved hands before seeing the patient, and the last thing they touch upon completing the examination. McCaughey suggest either laundering the curtains after each patient or switching to disposable curtains.
So can a hospital afford to take all the necessary precautions? “The answer is the can't afford not to,” stressed McCaughey, adding that HAIs account for $30.5 billion in direct care costs alone (and the Centers for Medicare and Medicaid Services is no longer reimbursing for preventable infections).
“Hospital infections are the next asbestos and are going to be the cause of major class action lawsuits,” she warned. “We want to get the message to hospitals before that happens.”
For more resources, statistics and recommendations on preventing HAIs, visit the RID website at www.hospitalinfection.org.
What can CS managers do to better prepare their staff to make sound decisions (even during the most challenging of times)? According to David Narance, RN, CRCST, an 18-year OR veteran who now serves as manager of sterile reprocessing for MedCentral Health System in Mansfield, OH, the key to success lies in the development of critical thinking pathways that are based on best practices.
Narance spoke enthusiastically – and, at times, humorously – about how his these pathways have helped pave the way for his own success as a manager, and, above all, for the success of his CS team. While challenges are sure to arise and mistakes will undoubtedly happen, he told attendees that it's these very trying times that can ultimately provide an excellent educational opportunity that will prevent similar errors from happening in the future. An animated story-teller, Narance drew from his past to drive home his messages. One such example he shared was how, as a young orderly, he was asked to transport a patient to another location. When he arrived to the patient's bedside, he began questioning how he was supposed to move the patient from their current bed to the one he brought with him. Unaware of any other options, he scooped the lightweight patient up in his arms and gently placed her on the other bed – all under the watchful eye of a startled supervisor who quickly shared her story with another superior, as opposed to taking the time to show him how to raise and lower the bed.
His message? When someone is new on the job, it's important for managers to train them in a way that will give them the confidence that the staff can get the job done well in the manager's absence. “Decision-making becomes a learned skill. It's not something that we're born with, so be sure to use every opportunity that presents itself as a reason to inform and educate,” Narance noted. Some of his most tried and true strategies for building critical decision-making skills: allowing staff to make mistakes; fostering a culture where staff are not afraid to admit their mistakes; adopting the principle of “teaching moments” when issues arise; avoiding hard instruction (reprimanding) in public; measuring error rates; regularly reviewing policies (monthly and quarterly); and engaging employees so they play an active role in process development and improvement – and, ultimately, in quality and patient safety.
“Don't just tell staff to do something. Show them how to do it and then explain why it's so important,” said Narance. “It's the development of these critical thinking skills that will increase productivity, reduce error rates, improve customer service, and boost morale.”
7:00 a.m.
Registration
7:30 a.m.
Attendees being seated
7:45 a.m.
Introduction / Grand Processional
8:15 a.m.
Announcements
8:30 a.m. –
10:00 a.m.
Keynote Speaker:
Surprising New Research on Preventing Hospital Infections: The Importance of Cleanliness
10:00 a.m. –
10:15 a.m.
Break
10:15 a.m. –
11:30 a.m.
Concurrent Sessions:
Critical Decision Making for CS Staff: Pathways of Excellence
Decontamination: Is the Medical Device Clean & Disinfected? Safe for Bare Hands