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| A Need for Passion in Reducing Statistics Involving SSIs |
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by Bob Blumm, MA, PA-C, DFAAPA - September 26, 2011
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There is a need for every Nurse Practitioner and Physician Assistant to become both challenged and co-operate in the war against surgical site infections that is presently rampant and the cause of morbidity and mortality in our healthcare institutions. The challenge has come from the CDC and every company that has produced products that have the ability to change the numbers and decrease the statistics. Healthcare associated infections are one of the ten leading causes of death in the United States. This represents an issue that affects our patients, reimbursement, our patient’s families and our reputations as clinicians and hospital workers. 1.6 million people become infected in our institutions every year because we fail to educate patients and encourage each other to follow basic principles. 100,000 patients die because we fail to educate them prior to surgical procedures and we fail to follow simple, common sense rules that have proven to reduce infection. Simple rules that are relevant in other institutions are commonly neglected by health care professionals. One needs to look no further than the bathrooms of restaurants to see signs that warn employees that they need to wash their hands with soap after utilizing the facilities and before handling food yet health care providers fail on many occasions to sanitize their hands after examining a patient and prior to touching a new patient. We use the same stethoscope without applying alcohol or using a device that can be applied to the diaphragm as we go from patient to patient in the critical care areas. I can name more than fifteen areas where we fall short but it would depress both you and me. I am not the conscience of the healthcare community but as a contributor to the medical literature I have an obligation to share my concerns and to ask us as NPs and PAs to become passionate about this issue.
The American Heritage dictionary defines passion as a powerful emotion such as love or anger, strong sexual desire, lust or to be on the positive side, boundless enthusiasm like a participant at a sports event. Look at the World Series or the Super Bowl or Wimbledon or the basketball playoffs and you will discover enthusiasm or passion in the emotions and gestures of those that participate by their very presence. The entire world witnessed the extraction of the miners in Chile and we experienced passion as tears fell from our eyes as the depths of the earth gave birth to a community of cooperation and hope that brought forth every miner. We are capable of passion and experience it as we joins hands in marriage and look into the eyes of our chosen mate, as well hold a precious newborn and appreciate the miracle of birth, as we see our offspring achieve milestones in their lives and as we watch our professions become accepted as the answer to 31 million Americans that are entering the health care system. This is the birth and result of passion and we are called upon to utilize this same power to change the face of health care in this country and lower the rate of infection and medical error.
Infection comes from the Latin root meaning to corrupt or spoil. The ancients conceived that disease could result from invasion of the body by invisible agents. It was not until the end of the 19th century that the true nature of infection was discovered and that germ theory became an appreciated science. The early Persians used a bow called the Toxon and dipped their arrows in a “toxicom” to provide the points of the arrow with a vector which resulted in even flesh wounds becoming lethal. In Vietnam, bamboo was cut in a manner that sharp edges were provided and these were dipped in the dung of cows, dogs and humans. They were well placed in traps, which caused American soldiers to fall upon them and be wounded, and the side bamboos cut at an oblique angle provided for a second wound in the thigh or calf. This was one of the most feared traps in that war. I am sure that devices just as horrible have been created for humans to debilitate other humans in the wars in the Middle East.
Today the term MRSA is used to describe the Staph Aureus organisms that are resistant to methacillin and other strong antibiotic agents as determined by susceptibility testing. Science has discovered both CA-MRSA and HA-MRSA and both manage to infiltrate our patient population. The vector of these infections are the patients themselves as they are the usual carriers and these infections are then described as endogenous. The CDC has reported a precipitous increase of MRSA in our institutions and CA-MRSA in communities and sports events throughout the United States. PAs and NPs need to be aware of risk factors, patterns of the bacteria’s susceptibility and resistance to antimicrobial agents. We need to be cognizant of the proper role and administration of initial empiric therapy and what clinical situations should raise our awareness of MRSA. We have the ability as a team to isolate it, protect patients preoperatively and through education create actions by health care workers that will build walls of defense so that we may halt its insidious growth in our institutions. This must become a passionate war of our professions, one that we cannot afford to lose.
Bob Blumm
Robert M. Blumm has received national recognition as a distinguished fellow of the American Academy of Physician Assistants (AAPA). He is the past president of the Association of Plastic Surgery Physician Assistants, and was past-president of the American Association of Surgical Physician Assistants, past president of the American College of Clinicians and NYSSPA, as well as Chairman of the Surgical Congress of the AAPA. In addition, Bob received the John Kirklin MD Award for Professional Excellence from the American Association of Surgical Physician Assistants. Along with his associate, Dr. Acker, Bob was the first recipient of the AAPA PAragon Physician-PA Partnership Award. He has been a contributing author of three textbooks, written 300 plus articles and is a sought out conference speaker throughout the United States.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| Bob Blumm (LI, NY) |
on 27 Sep 2011 at 8:28 pm |
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Thanks for the big Amen and for covering the important things Dave.
Bob |
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| Dave Stton PA-C (Batavia, Illinois 60510) |
on 27 Sep 2011 at 5:17 pm |
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| I could not agree more, Bob. As a group, have we ever wondered when you last washed your Lab coat? was it w/ your home clothes, On the cool delicate cycle so It looks good-but didn't kill anything. P.acnes from your face, skin bugs SA, Strept, Viridians or S pyogenes from your mouth. We are our patients greates risk. I have seen MDs, put on a single Contact robe, Mask and gloves, look like Darth Vader and never take it off room to room. We must remember our patiients, our selves, our spouses and childrens lives are at risk. Wash your hands, shower, wash your clothes in hot water, use good surgical infectious technique, 5 min scrub even if your MD is in a hurry, and get your yearly Flu shot. Like the old Smokey the Bear cartoon-only you can prevent forest fires. Your patients trust you with their lives, don't let them down. Sorry for the Sermon but I am passionate on this. God Bless us All, Dave |
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