Ask the Editors
Why are these incidents regarding the spread of infectious disease in health care settings occurring and are they limited to healthcare?
There continue to be reports in the media about possible infectious diseases transmission in hospitals and other health care facilities being traced back to glaring breaches in infection control. In just reviewing the past few years of possible incidents, multiple Veterans Administration hospitals located in Florida, Missouri, Tennessee, Colorado, and Ohio have been investigated for failures associated with accepted infection control standards and instrument reprocessing protocols. In the majority of these, failure to properly clean and sterilize equipment associated with colonoscopy examinations have been cited as major lapses. Investigations also include two VA hospital dental clinics where, even though no evidence at this time has been uncovered indicating specific infection transmission to dental patients, the possible failure of clinic staff to comply with mandated infection control standards and protocols is under scrutiny. Allegations include improper use of gloves, burs, and procedures involved in instrument cleaning and sterilization of instruments.
Definitive documentation of microbial transmission resulting from failure to follow appropriate prevention practices has unfortunately further galvanized public attention questioning health care safety. One ongoing case is categorized as one of the largest hepatitis outbreak scares in the United States. It involves a large southwest endoscopy clinic in where, to date, 114 patients have been identified by health departments as having been potentially infected with hepatitis C virus at the clinic. As many as 50,000 other patients may have been exposed to infectious microbes as a result of unsafe practices within the facility. Included in the list of offenses was the routine re-use of anesthetic syringes and needles using the same multi-dose anesthetic vials on multiple patients, and improper cleaning protocols and procedures for endoscopes.
What do these and many other possible patient exposures result from? Accumulated evidence gathered over many years has shown human error and failure to comply with required and/or recommended procedures to be the major culprits. Despite documentation of multiple instances, we still find some people, including health care professionals, who feel taking shortcuts in certain infection control procedures is not particularly dangerous. However, please keep in mind that even the moist rigorous infection control practices do not guarantee against accidental breaches or some undetected, undetermined, transmission incident. We simply must do the best we can to minimize the potential for cross-infection.
While the potential for infections may not be eliminated even when proper infection control practices are followed, lack of compliance can unknowingly increase the potential for microbial cross-contamination and cross-infection. Remember that proper application of individual infection control practices, procedures, and protocols helps to strengthen other, seemingly unrelated program components. Overlapping preventive measures are used routinely and they work. Sometimes we just do not think of them as being re-enforcements for each other.