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Study: Role models--not sink access--may be key to handwashing
Lawsuit snowballs against uterus-branding physician
Duke begins to tighten up organ transfusion processes

Patient Safety Monitor Alert, February 25, 2003

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STUDY: ROLE MODELS--NOT SINK ACCESS--MAY BE KEY TO HANDWASHING

If it seems like all your pleas for staff to regularly wash their hands fall on deaf ears, take a look at senior physicians' behavior. Their influence on handwashing behavior is immense, according to a new study conducted by the Centers for Disease Control and Prevention and the Northwestern Memorial Hospital in Chicago.

Most nurses, residents, and medical students in the study washed their hands about half the time after they came in contact with a patient. However, if a senior doctor they were working with did not wash up, only about 10 percent of staff would then wash their own hands.

Access to sinks, on the other hand, may not greatly influence infection control. Researchers observed staff at a Northwestern facility built in 1998, as well as one built in 1999. Though there were more sinks installed at the newer hospital, workers there were actually less likely to wash their hands (only 23 percent of the time). At the older hospital, staff washed 53 percent of the time.

LAWSUIT SNOWBALLS AGAINST UTERUS-BRANDING PHYSICIAN

It doesn't always pay to be creative when marking a surgical site-at least that's what Dr. James M. Guiler has found out. In late January, one of his patients filed a lawsuit accusing him of branding his alma mater's initials on her uterus during her hysterectomy. The patient, Stephanie Means, along with her husband, is seeking an unspecified amount for emotional distress, according to the Chicago Tribune.

Last week, nine more women petitioned Fayet County Circuit Court to join the lawsuit, according to the Associated Press (AP). Both Means and the nine additional women say that videotapes of their surgeries revealed that Guiler used a cauterizing instrument to brand "UK"-for "University of Kentucky"--on their uteri before removing the organs, according to the Louisville, KY Courier-Journal. The group of women includes a nurse who used to work in Guiler's office.

Guiler told morning talk shows that his intention was to differentiate the right side of the uterus from the left, according to the Tribune. "He crossed the line," Vickie Anderson, one of the women, told the AP. "It's chauvinistic, arrogant, and shows a total disrespect for women."

DUKE BEGINS TO TIGHTEN UP ORGAN TRANSFUSION PROCESSES

Most health care professionals by now have heard about the death of Jesica Stantillan. The case, in which Santillan was given a heart and lung transplant with the wrong blood type at Duke University Medical Center, has been widely publicized over the last week. Santillan's body rejected the type A organs (which did not match her type O-positive blood) hours after the surgery. Though she received a second transplant last Thursday with organs that matched her blood type, she died on Saturday.

Now, the hospital has begun to pinpoint causes of the mistake, attributing it to human errors at several different points throughout the organ placement process, according to USA Today. There was no "structured redundancy" in the process, William Fulkerson, vice president and chief executive officer of the hospital, stated in a letter to the United Network for Organ Sharing.

However, the hospital has now implemented a new system with redundancies. As part of the system, at least three surgeons will now match the organ donor's blood type with the recipient's prior to an operation, the paper reported.

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