Becker's Hospital Review

159 FINANCE CMO / CARE DELIVERY 500+ Patients Potentially Infected by Dirty Endoscopes at Buffalo VA Medical Center By Mackenzie Bean B uffalo (N.Y.) Veterans Affairs Medical Center notified 526 pa- tients of a potential infection risk associated with improperly sterilized endoscopes used at the facility, according to The Buffalo News. Hospital officials learned of the sterilization shortfalls during a review of the facility's cleaning processes for endoscopes. They discovered a hospital employee may not have followed certain steps in the man- ufacturer's instructions for properly sterilizing the devices. The em- ployee was "immediately relieved from the position," the hospital said Aug. 16 in a statement cited by The Buffalo News. Buffalo VA Medical Center did not disclose how the issue was dis- covered, how many endoscopes were involved or what reprocess- ing steps were skipped. Hospital officials said risk of infection from the endoscopes is "very low" and that their actions to notify patients "does not mean veterans were infected," according to the statement. The hospital will offer affected patients infection screenings at no cost. The Food and Drug Administration in June published a list of reus- able medical devices that hold the greatest risk of infection trans- mission if not appropriately reprocessed. The list included numerous types of endoscopes. n Structured vs. Unstructured Hand Washing Techniques — Which Is More Effective for Removing C. Diff? By Anuja Vaidya A study, published in the American Journal of Infection Control, examined the efficacy of the structured World Health Orga- nization–recommended hand-washing technique to remove Clostridium difficile from hands. Researchers conducted a prospective comparison of three hand-washing techniques — unstructured, WHO-recommended and a novel technique, called the WHO shortened repeated technique to remove C. diff. The study included 10 participants who performed each technique. Their hands were contaminated with a nontoxigenic strain containing 90 percent C. diff spores. The median effectiveness of the unstructured, WHO and WHO-SR techniques in log10 colony forming unit reduction was 1.30, 1.71 and 1.70, respectively. The study shows washing hands with a structured technique was more effective than washing with an unstructured technique. Addi- tionally, the WHO-SR technique was significantly more effective than the unstructured technique. n Study: Patients Feeling Intimidated During Physician Visits May Act Like Hostages By Morgan Haefner F earful or confused patients may feel helpless and like they are negotiating for their healthcare, sim- ilar to how a hostage would feel, according to a recent study. For the report, researchers — led by Leonard Berry, PhD, a professor in the Mays Business School at Texas A&M University in College Station — analyzed prior research and patient testimonials. Here are five takeaways from the study. 1. When patients feel intimidated by physicians, a feel- ing the researchers define as "hostage bargaining syn- drome," it is a "real phenomenon that many patients experience, particularly those with a serious disease or in a state of great vulnerability," Dr. Berry told Reuters. 2. Despite physicians' efforts to foster active conversa- tion, families of cancer patients and patients in intensive care units may feel dependent on physicians to direct their treatment path. When medical errors or unexpect- ed side effects occur, this could increase feelings of pow- erlessness, the researchers noted. 3. "is story (of a parent whose child is receiving ex- tended inpatient care) could just as easily be that of a 70-year-old man with coronary artery disease who is unsure about the cardiologist's recommendation for sur- gery but hesitates to question it, or a 27-year-old wom- an with cancer who does not express her fear of treat- ment-related infertility to her oncologist," according to the study. 4. e study noted physician-patient relationships are not like consumer service relationships, in which cus- tomers may feel comfortable asking about bad service. Instead, healthcare can create an unequal power bal- ance leaving the patient feeling in need of the physi- cian. Patients exuding symptoms of hostage bargaining syndrome may "worry about being perceived as trou- blemakers or 'difficult' for fear that it could affect the quality of care they receive," the researchers said. 5. To combat hostage bargaining syndrome and side effects like depression and loneliness in the medical field, Dr. Berry told Reuters physicians should pursue "shared decision-making," among other strategies. Shared decision-making is when physicians provide patients treatment options and patients discuss which option they prefer. n

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