Lately in work, I brought to the attention of my senior, the "need-to-improve" infection control practice of the anaesthetist in theatre.
To me, placing a sterile bung (cover) at the end of a syringe to stop it from getting contaminated makes sense, infection-control-wise. So that when you administer the medicine to the patient, the possibility of infection risk to the patient is even more minimized compared to when you did not cover the syringe. Although, yes it is clean, but when you put a bung on it while lying on the counter waiting to be used, the possibility of infection is even lessened than when you did not cover it. To me, that was common sense.
Besides, what was the reason that it couldn't be done? If it was an emergency and there was no time, fine. That is acceptable. You gotta have your priorities right. Save the life first and we can worry about infection later. But on an 8-hour procedure, one has the time to cover syringes, surely. So it awfully looks to me like sheer laziness. To me that is not acceptable.
It took my seniours a long while to respond. Then they called the Infection Control Nurse of the Trust. Guess what she told me...
We need to gather more evidence that, "not putting a bung on a syringe", is an infection risk.
And I was dismissed. Ok...... Guess, that infection control nurse when I was a student was wrong....??
This is where you think for yourself....
For me, if I were the patient, I would rather that the doctors cover the syringes with a sterile bung to minimise the risk of infection to me.
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Hehe.. you know blogging is a great way to vent our frustrations when people just won't listen to us.
ReplyDeleteIt makes sense to believe that using bungs as you describe would lessen infection risks, but I might suggest that its possble that the effect of using bungs is so small, that it might not be worth the effort.
For example, in manufacturing it is known that visual inspection is only 95% effective. 5% of defects on average will still be missed by visual inspection. So if you know that a particular defect only occurs 0.2% of the time, adding a twnty minute visual inspection to your manufacturing process is a complete waste of money, because visual inspection can not reduce this defect rate.
This is where it's important to operate with scientific data rather than 'common sense'.
When working for EMC Corporation in Massachusetts, we used to say "A loud mouth without data, is just a loud mouth."
I recommend searching medical journals and the internet to see if someone has done a study along these lines. If you find a study that supports your 'common sense' it would make your argument stronger the next time you present it. Or you may discover for yourself that your 'common sense' assumption is wrong.
You may discover that there truely is no advantage to using bungs, or that the advantage is so small that you are adding needless cost to your process.
I recall for example, discovering that a plastic cutting board will actually hold more bacteria than a hard wood cutting board. This is an example where scientific data contradicts 'common sense'.
Good luck with your search for the truth on this.
The AAGBI (Association of Anaesthetists of Great Britain and Ireland) (http://www.aagbi.org) guidelines says that you have to cap injection ports, including syringes.
ReplyDeleteAAGBI is the GMC recognized body for anaesthetists in the UK. GMC is the licensing body for doctors in the UK. GMC stands for General Medical Council.
Source:
Association of Anaesthetists of Great Britain and Ireland (AAGBI) (2002). Infection Control in Anaesthesia. London: The Association of Anaesthetists of Great Britain and Ireland.