- Email: [email protected]
Are we our own impending threat?
FEBRUARY 2002, VOL 75, NO 2
L D tr:c?af A i
Are we our own impending threat?
A
s nursing students, we learned about bacteria, the spread of microbes, skin as a barrier, effects of antimicrobials,and other facets of microbiology. Sitting through nursing classes and listening to foreign words related to infection prevention could be painful because it was difficult to understand specifically how, when, and where the information would be usefid. Words like Staphylococcus aureus, Aspe@lus, Pseudomonas, and Staphylococcus epidermis did not become meaningfil until the importance of ventilation systems, skin preparation, traffic control, housekeeping, and other infection prevention measures were stressed. Even then, the links between infection prevention, nursing practices, and microbiology were not always apparent nor were they associated significantly with safe patient care. RULES MAKE A DIFFERENCE In perioperative settings, standards, guidelines, recommended practices, and other documents from organizations and agencies (eg, AORN, the Joint Commission on Accreditation of Healthcare Organizations,the Centers for Disease Control and Prevention, the Occupational Safety and Health Administration) are followed, and their use makes a difference in patient care. Documents such as these are intended to provide consistency in practices. Even with rules to follow, there are times when behaviors
and rules are conflicting and thus challenges, necessitating the presence of someone to monitor the behavior of others. Some team members understand the purpose and meaning of rules and sincerely believe in their value, yet others question or respond to the rules without considering their intent. Even though most would agree that infection prevention practices (eg, skin preparation, antibiotic delivery, aseptic technique) are critical interventions in perioperative practice, these interventions have been questioned because of time-saving or cost-saving measures or even due to a lack of understanding of their purpose. REAL THREATS Recently, people around the world have been required to question and evaluate the way things are done. In the perioperative setting, we know that microbial spread is an issue that should not be overlooked. Awareness of the threat of microbial spread has increased because biowarfare has challenged our mind-set and made us realize that we no longer can take our safety for granted. The mail has been attacked; what will be n e x t 4 e food we eat, the air we breathe? Time-saving or cost-saving measures are not even considered when dealing with a massive outbreak, yet the same level of threat has been occurring in health care settings for years. Real threats are in our face. Hepatitis C, bloodborne pathogens, vancomycin 264 AORN JOURNAL
resistant enterococcus, and nosocomial infections are common. They are routine agenda items at infection conBRENDA S. 0 ' 1 meetings in QREWRYDAWEs health care settings throughout the country. In spite of attempts to educate and gamer support for programs targeted at monitoring and managing infection control issues, some health care workers still do not wear appropriate protective attire and continue to administer antibiotics inappropriately. Though the efforts to control these threats are ongoing and serious, we are losing ground on important issues that put employees and patients at greater risk. KEY PREVENTION STRATEGIES FORGOTTEN In spite of advances in practice, we might be losing the battle because our energy is being spent trying to develop new strategies instead of implementingexisting strategies. We cannot overlook the value and importance of actions that should be routine in every practice setting, and we cannot be focused so intensely on high levels of prevention that we overlook the value of basic practices. Following the principles of aseptic technique, limiting traffic and closing doors in ORs, wearing masks and gloves correctly, following standard precautions, and
FEBRUARY 2002, VOL 75, NO 2
using antibiotics appropriately are examples of practices that require consistent behaviors by ail team members and control in perioperative settings. Focusing OII simple practices such as these can reduce risk to ourselves and our patients. As our patients' care moves to outpatient and ambulatory settings, we will find that microbial spread and difficulty controlling antibiotic resistance will permeate these settings just as they have permeated inpatient settings. Monitoring by agencies or organizations(eg, the Joint Commission) varies among
settings, and the knowledge of safe practices varies among personnel. The realization that threats in health care exist that are becoming dnmanageable should give all of us a wake-up call. Scary facts were presented at a recent infectious disease conference, but what is even more fiightening is that although prevention strategies are not new, they are not being followed. Now is not the time to lapse into business as usual; rather it is time to reevaluate our own impending threat and revisit infection preven-
tion practices that have served us well for many years. When we are challenged to take a shortcut to save time or money, we should remember that these are not challenges that will disappear. Today, we are responsible for preventing what can be prevented. Tomorrow, it might not be an option. BRENDA S. GREGORY DAWES RN, MSN, CNOR EDITOR Editor's note: Please see page 272 in this Journal for more infomation regarding the infectous disease confemce mention&.
A New, Convenient Way to Pay Membership Dues AORN is pleased to announce the launch of the EZ Pay payment plan for membership dues. This plan allows new and renewing members to pay their dues with a credit card and have the payment spread in equal installments over three consecutive billing cycles. The plan applies to both national dues and
Specialty Assembly dues. A $5 processing fee will be added to the total amount of the dues payment. This feature has been incorporated into the online renewaVapplication form, which can be accessed at http://www.aom.org/_results/mbr-app.asp.It also is being included in membership renewal notices.
Publish an AORN Journal Home Study Program The AORN Journal editor is seeking authors to submit manuscripts that qualify for AORN Journal Home Study Programs. The content must include comprehensive and detailed descriptions of patient care activities, surgical processes, or descriptive patient care information. Content must describe disease processes or surgical procedures, nursing considerations, and patient care. Examples of procedure-specific content include detailed anatomy and physiology; preoperative care and interventions (eg, laboratory work, diagnostic studies); patient and family member teaching; patient-specific (eg, age, diagnosis, specific procedure) needs; preparation for the procedure (eg, scheduling,
equipment and instrumentation needs, patient care needs); intraoperative care and activities, including specific responsibilities of team members; postoperative care; and discharge teaching, expected recovery, and rehabilitation (eg, ofice visits, physical therapy, return to work, reportable symptoms). Author guidelines can be obtained online at http://www.aom.org, or ideas can be discussed with the editor by calling (888) 376-3244 or by sending an e-mail to [email protected]. Home Study Program questions are written by the clinical editor, but suggestions from authors are always welcome. Home Study Programs that have an AORN member as at least one of the authors qualify for the AORN Journal Writers Contest.
266 AORN JOURNAL
L D tr:c?af A i
Are we our own impending threat?
A
s nursing students, we learned about bacteria, the spread of microbes, skin as a barrier, effects of antimicrobials,and other facets of microbiology. Sitting through nursing classes and listening to foreign words related to infection prevention could be painful because it was difficult to understand specifically how, when, and where the information would be usefid. Words like Staphylococcus aureus, Aspe@lus, Pseudomonas, and Staphylococcus epidermis did not become meaningfil until the importance of ventilation systems, skin preparation, traffic control, housekeeping, and other infection prevention measures were stressed. Even then, the links between infection prevention, nursing practices, and microbiology were not always apparent nor were they associated significantly with safe patient care. RULES MAKE A DIFFERENCE In perioperative settings, standards, guidelines, recommended practices, and other documents from organizations and agencies (eg, AORN, the Joint Commission on Accreditation of Healthcare Organizations,the Centers for Disease Control and Prevention, the Occupational Safety and Health Administration) are followed, and their use makes a difference in patient care. Documents such as these are intended to provide consistency in practices. Even with rules to follow, there are times when behaviors
and rules are conflicting and thus challenges, necessitating the presence of someone to monitor the behavior of others. Some team members understand the purpose and meaning of rules and sincerely believe in their value, yet others question or respond to the rules without considering their intent. Even though most would agree that infection prevention practices (eg, skin preparation, antibiotic delivery, aseptic technique) are critical interventions in perioperative practice, these interventions have been questioned because of time-saving or cost-saving measures or even due to a lack of understanding of their purpose. REAL THREATS Recently, people around the world have been required to question and evaluate the way things are done. In the perioperative setting, we know that microbial spread is an issue that should not be overlooked. Awareness of the threat of microbial spread has increased because biowarfare has challenged our mind-set and made us realize that we no longer can take our safety for granted. The mail has been attacked; what will be n e x t 4 e food we eat, the air we breathe? Time-saving or cost-saving measures are not even considered when dealing with a massive outbreak, yet the same level of threat has been occurring in health care settings for years. Real threats are in our face. Hepatitis C, bloodborne pathogens, vancomycin 264 AORN JOURNAL
resistant enterococcus, and nosocomial infections are common. They are routine agenda items at infection conBRENDA S. 0 ' 1 meetings in QREWRYDAWEs health care settings throughout the country. In spite of attempts to educate and gamer support for programs targeted at monitoring and managing infection control issues, some health care workers still do not wear appropriate protective attire and continue to administer antibiotics inappropriately. Though the efforts to control these threats are ongoing and serious, we are losing ground on important issues that put employees and patients at greater risk. KEY PREVENTION STRATEGIES FORGOTTEN In spite of advances in practice, we might be losing the battle because our energy is being spent trying to develop new strategies instead of implementingexisting strategies. We cannot overlook the value and importance of actions that should be routine in every practice setting, and we cannot be focused so intensely on high levels of prevention that we overlook the value of basic practices. Following the principles of aseptic technique, limiting traffic and closing doors in ORs, wearing masks and gloves correctly, following standard precautions, and
FEBRUARY 2002, VOL 75, NO 2
using antibiotics appropriately are examples of practices that require consistent behaviors by ail team members and control in perioperative settings. Focusing OII simple practices such as these can reduce risk to ourselves and our patients. As our patients' care moves to outpatient and ambulatory settings, we will find that microbial spread and difficulty controlling antibiotic resistance will permeate these settings just as they have permeated inpatient settings. Monitoring by agencies or organizations(eg, the Joint Commission) varies among
settings, and the knowledge of safe practices varies among personnel. The realization that threats in health care exist that are becoming dnmanageable should give all of us a wake-up call. Scary facts were presented at a recent infectious disease conference, but what is even more fiightening is that although prevention strategies are not new, they are not being followed. Now is not the time to lapse into business as usual; rather it is time to reevaluate our own impending threat and revisit infection preven-
tion practices that have served us well for many years. When we are challenged to take a shortcut to save time or money, we should remember that these are not challenges that will disappear. Today, we are responsible for preventing what can be prevented. Tomorrow, it might not be an option. BRENDA S. GREGORY DAWES RN, MSN, CNOR EDITOR Editor's note: Please see page 272 in this Journal for more infomation regarding the infectous disease confemce mention&.
A New, Convenient Way to Pay Membership Dues AORN is pleased to announce the launch of the EZ Pay payment plan for membership dues. This plan allows new and renewing members to pay their dues with a credit card and have the payment spread in equal installments over three consecutive billing cycles. The plan applies to both national dues and
Specialty Assembly dues. A $5 processing fee will be added to the total amount of the dues payment. This feature has been incorporated into the online renewaVapplication form, which can be accessed at http://www.aom.org/_results/mbr-app.asp.It also is being included in membership renewal notices.
Publish an AORN Journal Home Study Program The AORN Journal editor is seeking authors to submit manuscripts that qualify for AORN Journal Home Study Programs. The content must include comprehensive and detailed descriptions of patient care activities, surgical processes, or descriptive patient care information. Content must describe disease processes or surgical procedures, nursing considerations, and patient care. Examples of procedure-specific content include detailed anatomy and physiology; preoperative care and interventions (eg, laboratory work, diagnostic studies); patient and family member teaching; patient-specific (eg, age, diagnosis, specific procedure) needs; preparation for the procedure (eg, scheduling,
equipment and instrumentation needs, patient care needs); intraoperative care and activities, including specific responsibilities of team members; postoperative care; and discharge teaching, expected recovery, and rehabilitation (eg, ofice visits, physical therapy, return to work, reportable symptoms). Author guidelines can be obtained online at http://www.aom.org, or ideas can be discussed with the editor by calling (888) 376-3244 or by sending an e-mail to [email protected]. Home Study Program questions are written by the clinical editor, but suggestions from authors are always welcome. Home Study Programs that have an AORN member as at least one of the authors qualify for the AORN Journal Writers Contest.
266 AORN JOURNAL