Addressing the syringe
On
behalf of the millions of patients who receive injections for anesthesia, pain
management, and other health reasons each year, the American Association of
Nurse Anesthetists applauds the efforts of the Centers for Disease Control, Nevada
State Department of Health, lawmakers, and the media to finally expose and
correct the frightening infection control problem caused by contaminated
syringes, needles, and medication vials that was brought into the light by the
recent hepatitis C outbreak in Nevada. As the professional association
representing more than 37,000 nurse anesthetists who administer 30 million
anesthetics each year, the association looks forward to working closely with
these organizations and other healthcare organizations and societies to ensure
patient safety across the nation.
It
is important for the public to know that most healthcare professionals have
their patients’ best interests — rather than the bottom line — at heart, and to
that end adhere to accepted infection control standards and guidelines when
injecting anesthetic drugs or medications.
Unfortunately,
and for reasons yet to be determined, there are still some healthcare
professionals, including nurse anesthetists and physician anesthesiologists,
who put their patients in harm’s way through poor infection control practices
when applying this most basic of medical skills.
As
has been reported in the media, this issue goes beyond provider specialty,
title, and credentials. In anesthesia alone, there have been several
high-profile cases of improper use of needles, syringes, and medication vials
over the last six months that put many patients at risk:
•
In October 2007, Dr. Kamal Tiwari,
an anesthesiologist, was accused of reusing syringes on an unspecified number of
patients at a surgery center in Bloomington, Ind. At least two tested positive for hepatitis C.
•
In November 2007, reports surfaced out of Long Island, N.Y., that
anesthesiologist Harvey Finkelstein, MD, was under investigation by the New
York State Department of Health for allegedly reusing syringes to draw up
medicine from multi-dose vials and exposing thousands of patients to
blood-borne pathogen infection.
•
In February 2008, Nevada health officials closed an endoscopy center in Las
Vegas after six patients were diagnosed with hepatitis C. The outbreak was traced back to nurse
anesthetists allegedly reusing syringes to draw up medicine from single-use
vials, thereby contaminating the vials which were then used for multiple
patients.
•
Also in February 2008, Dr. Scott Young, an anesthesiologist working at a
gastrointestinal clinic in Las Vegas, was observed by Nevada health inspectors
reusing syringes and potentially contaminated vials of medication on multiple
patients. According to the investigation
report, “The anesthesiologist was asked what the process was when he went from
a used Propofol vial to a new patient. The anesthesiologist stated that he would
change the needle and reuse the same syringe.”
Simply
stated, reusing needles and syringes, and using medication vials in an unsafe
and inappropriate manner, is inexcusable and cannot be tolerated. If there are any gray areas with regard to
proper usage of needles, syringes and medication vials, then those gray areas
must be identified and made black and white.
The association is committed to working with the Centers for Disease
Control and other groups to put an end to such needless, tragic situations as
those in Nevada, New York, and Indiana.
It
is disappointing that some of our physician colleagues have weighed in on the
Nevada situation involving nurse anesthetists by suggesting on websites and
talk shows that doctors never reuse syringes or improperly use medication vials
and that only nurses and other healthcare providers do. While the evidence in
state health department reports and the media clearly indicates that reuse of
syringes and improper use of vials are not uncommon practices among
anesthesiologists, the association believes the focus of our efforts should be
on fixing the problem rather than fixing blame.
If
we are to solve this problem and regain the public trust, then denial and
finger pointing need to stop and healthcare professionals must work together
for the public good.
Patients
should never have to fear that the injection they received for the purpose of
supporting their health or promoting their healing might actually make them
sicker due to a dirty needle or syringe or a tainted vial of medication. The association will work tirelessly with the
Centers for Disease Control and other interested organizations to achieve this
outcome.
Wanda Wilson is president of the American
Association of Nurse Anesthetists. She is from Park Ridge, Ill.