Hospital Sterilization: How Problems Slip Through

The hospital says in this case, it wasn’t following the manufacturer’s specific guidelines for this specialized endoscope. “Endoscopes are particularly complex and difficult to clean because they’ve got very long, very narrow channels,” said infection prevention and control expert Dr. Mary Vearncombe. “It’s very difficult to make sure that those channels are flushed and disinfected properly in between uses, just because their diameter is so very narrow.” Dr. Armstong said the late discovery highlights a need to regularly review whether the team in charge of cleaning endoscopesis doing it properly. Common procedure He says the issue is analogous to the deadly E. coli contamination of the water supply in Walkerton, Ont. in 2000. In that case,procedures were in place to ensure safe drinking water, but checks weren’t done to ensure the processes were followed. “One knows what needs to be done to produce a safe water supply, but if the appropriate checks are put into place but they are not monitored and verified, then it’s possible to assume that everything’sOK and the processes are being followed without actually documenting that its actually done on a daily basis or a weekly basis,” said Armstrong,a McMaster University associate professor and consultant gastroenterologist at Hamilton Health Sciences. Every year, about 1.6 million endoscopic procedures are performed in Canada, a figure representing about five per cent of the population. Despite how common the procedure has become, hospitalstend totrack incidents of improper endoscope cleaning that result in patient harm on an ad-hoc basis, says Armstrong.

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Waits are excessive for digestive checkups

The association’s study of 5,500 patient visits to nearly 200 Canadian gastroenterologists shows that 70 per cent of patients referred by family doctors wait more than two months to see a gastroenterologist and have a diagnostic test, while 50 per cent wait more than four months and 20 per cent wait more than 10 months. Continued Below Among these patients, more than one-third have alarm symptoms, which may indicate serious underlying disease such as cancer. Even patients classified as urgent are waiting two to five times longer than best practice targets recommend. Dr. Desmond Leddin, the association president and an associate professor of medicine at Dalhousie University in Halifax, calls the situation “unacceptable.” “We are able to see patients in a time frame that expert review would suggest is only appropriate 20 per cent of the time. There really is a severe problem in terms of wait times for gastroenterology and consultations.” Based on the results of the study, Leddin has asked Prime Minister Paul Martin to incorporate gastroenterology as a priority into the federal government’s program to reduce waiting times. “Patients are suffering while they’re on wait lists,” Leddin says. “And we quite frankly don’t understand why the first ministers and the federal government have identified five areas as a priority for wait time management but gastroenterology is not on that list.” Those five key areas are: cancer treatment, cardiac care, diagnostic imaging, joint replacements and sight restoration. A simple cash infusion to bolster human and technical resources will not remedy the current wait list situation, Leddin says. “Canadian gastroenterologists will need to work hand-in-hand with federal and provincial governments … and move toward the improved use of these resources. “We hope that by 2008 patients with digestive symptoms should not have to wait more than eight weeks to see a gastroenterologist.” With files from The Medical Post.

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