A couple of weeks back I posted about the Office of Human Research Protections' shutting down a highly effective infection control program. In the NY Times, Jane Brody discusses the program further. Here's the list of the five things the hospitals used to combat hospital-acquired infections:
When inserting a central venous catheter, doctors should do the following:1. Wash their hands with soap.
2. Clean the patient's skin with chlorhexidine antiseptic.
3. Put sterile drapes over the entire patient.
4. Wear a sterile mask, hat, gown and gloves.
5. Put a sterile dressing over the catheter site.
Here's what you can do to halt OHRP's idiocy:
The federal Office for Human Research Protections recently ruled that because this quality-control program constituted research on human subjects, every participating hospital must first get approval from its institutional review board. That ruling did not halt the use of checklists in the Michigan hospitals where they had become part of routine care. But it did stop the collection of data based on the lists, which Dr. Gawande described as "the driving force behind the effectiveness of the program," until each hospital's institutional review board approved it.
These boards meet monthly, bimonthly or quarterly. Sam Watson, executive director of the Michigan Hospital Association's Keystone Center for Patient Safety and Quality, a sponsor of the Michigan checklist program, said the need for their approval could seriously delay the use of checklists for other aspects of medical care, like preventing hospital-acquired urinary infections -- something his center has been working on with Dr. Saint.
Dr. Gawande suggested that consumers write to their members of Congress and the Department of Health and Human Services, asking that the ruling be reversed. Dr. Pronovost suggested that consumers let Congress know that checklist programs "could have a profound impact on their health," ask local hospitals whether they are using checklists to reduce infections, and write to state hospital associations asking for a statewide effort to reduce infections.
I'm writing my letters; please consider writing some letters too.
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Actually, the mask and hat are not sterile and never have been, even the ones we surgeons wear in the operating room. They are clean and disposable, but not sterile. Don't believe me? Hang out in the O.R. sometime.
Sorry, the surgeon in me just couldn't let something like that pass.
Orac,
true. It's better than nothing though...
Orac,
true. It's better than nothing though...
Posted by: Mike the Mad Biologist | January 25, 2008 1:37 PM
Ya, it seems to me that any precautions would be appreciated, especially if you are the one being subjected to the possibility of leaving the hospital in worse shape than when you came in.
Dave Briggs :~)
There's a happy update on this: http://www.baltimoresun.com/news/health/bal-checklist0219,0,5206065.sto…
Should have been a "duh" decision from the beginning, but it's nice to see they eventually got it right.
Ya, it seems to me that any precautions would be appreciated, especially if you are the one being subjected to the possibility of leaving the hospital in worse shape than when you came in