Notifying SPD of patient disease
It’s a busy day in the sterile processing department, the racks are full and the workload seems to be never-ending. But this is nothing new; everyone is playing his or her role to keep the department running like a well-oiled machine. And working their butt off, fueling this machine are those working in decontam. It’s a tough job, as we all know too well. It’s hot, you’re on your feet the whole time, oh and it’s dangerous. Dangerous…? Yes, as in all the sharp instruments sticking out every which way waiting for an unsuspecting finger to poke, the hazardous wastes and bodily fluids, and of course the ever-present bloodborne pathogen. But we have nothing to worry about; we are experts, trained to deal with these situations every day. We practice standard precautions, we’re educated, and we have all the personal protective equipment we should need.
Okay, so I have a point here, just bear with me. So the other day I was working in decontam and a nurse had just rolled in some instruments. She notified my co-worker that the patient had HIV and HEP B. She then asked, “should put a sign on it?” I responded by saying “no thank you we practice standard precautions”. My co-working quickly cut me off telling the nurse “don’t listen to him, I’d like to know if I receive any cases with a disease on it.” So once the nurse left I asked my co-worker “why do you want to know what disease a particular case has, we treat everything the same anyways?” She responded, “I just like to know so that I can be extra careful”. I said, “so your not extra careful with every case?” She says, “oh I am but ill just be more careful with this one”. So I let it go and continued to work, all the while thinking about the conversation that had just occurred.
So you may ask yourself, “What’s the big deal, she just likes to know so that she can be extra careful?” Okay so here is the big deal. Every day we gown up and we prepare for the onslaught of work that awaits us, and every day we do our job just as we did the day before. But over time we get comfortable and let our guard down. Now we are getting notified of which cases contain a confirmed disease. Well, this one has got HIV; I better go double glove and put some shoe covers on (wait… your not already wearing them?). Okay so now you’ve developed a bad habit, you have different procedures for different situations. So now back to the conversation with my co-worker. Later that day I asked, “so I understand its nice to know the potential hazards presented to you so that you can better prepare yourself, but what about all the unconfirmed cases that you’ve dealt with today?” She paused for a minute trying to come up with a logical explanation, she couldn’t. At this moment she realized what was wrong with being notified of present diseases. It creates a false sense of assurance or invulnerability.
This is exactly why I cannot stress this enough. Knowing that one particular case contains a bloodborne pathogen is not acceptable. What about patient John Doe who has HIV but has never been tested and is completely oblivious, or patient so and so who has HEP C but never disclosed this during their assessment. These are things we just have no way of knowing, which is why standard precautions (or universal precautions) were developed and implemented. The work we do is important, the work we do is rewarding, but we must never forget that the work we do is hazardous. Never let your guard down, continue to educate yourself as well as others, and always use best practices and strive to be an advocate in your field.