After inspectors' recommendations, Truman Veterans Hospital staff to undergo training

Monday, April 19, 2010 | 10:35 p.m. CDT; updated 11:27 p.m. CDT, Monday, April 19, 2010

COLUMBIA — Hundreds of support staff and about 30 medical workers at the Harry S. Truman Memorial Veterans Hospital will undergo training to refresh their skills on protective gear usage and proper sterilization of reusable medical equipment.

The training follows recommendations by the Department of Veteran Affairs Office of Inspector General, which conducted an inspection of the hospital in February.

The inspector general’s routine report established that some hospital staff used shorter sterilization processes in instances where they were supposed to do full sterilization of medical equipment, a practice that potentially exposes patients to germs.

About 300 support staff, which includes cleaners and housekeepers, were also found not to be using personal protective equipment, especially while working in “decontamination” areas, contrary to Veterans Affairs’ policy.

The hospital’s public affairs officer, Stephen Gaither, said Monday that training would be provided to the staff that is mentioned in the report by the end of June.

The hospital director, Sallie Houser-Hanfelder, has concurred with all recommendations of the inspector general and has committed to fully implementing them.

A 12-month review of documentation revealed to the inspectors that staff were using “flash” sterilization while cleaning surgical equipment, a shorter cleaning process that is allowed only in emergency situations, such as a dropped sterilized equipment during an operation.

“Improper reprocessing of reusable medical equipment may transmit pathogens to patients and affect the functionality of the equipment,” according to the report signed by James Floyd, a regional director of Veterans Affairs.

Gaither said 15 nurses and an additional 15 sterilization processing staff will undergo fresh training while 300 support staff workers will be instructed on how to use gowns, gloves, shoe covers and face masks while working at the hospital’s decontamination areas.

The Office of Inspector General made eight recommendations that require immediate corrective action and two “reviews” where no recommendations were made.

This is about the same number of recommendations that the inspector made in the last review report that was published in February 2008.

The report notes that the medical center “had corrected all findings related to health care” from the previous review.

The Office of Inspector General conducts routine inspections on health care facilities for veterans every three years, but it may also move in any time to investigate allegations made by Veteran Affairs employees, patients, members of Congress or any other parties.

The inspections evaluate the quality of medical services extended to veterans and also provide awareness training for employees on potential cases of fraud, waste or abuse of the system.

“We recognize that we have human beings in the organization and cannot achieve perfection," Gaither said. "This is, however, a more favorable report in that there are the same number of recommendations as last time and all the past corrective actions were implemented.”

He said that no patient was exposed to infection from the shorter sterilization processes used by staff.

“If they had been, this would be a much more serious report, and it would have been reported through the Joint Commission Accreditation Program,” said Gaither, referring to the organization that looks into serious patient safety issues.

Among the other recommendations in the report is that all the staff members, who are identified as being at risk of exposure to a harmful atmosphere will also be required to receive an annual respirator testing, training and medical evaluation.

Some staff members will also be required to receive annual environmental hazard training.

The inspector also recommended that staff should improve on their filing of inter-facility transfer documentation, which sometimes are only partially filled.

“They are not bad, they provide good counseling,” said Joe Coslett, an Iraq war veteran who attends post-traumatic stress therapy at the hospital. He echoed sentiments expressed by other patients.

Truman Veterans Hospital is one out of an estimated 1,400 health care sites where an estimated 23.4 million veterans can access their medical care in the U.S. and Puerto Rico.

The hospital serves more than 32,000 veterans per year out of a potential 113,000 vets who live in 44 counties in central Missouri and one county in Western Illinois.

Medical care expenditure budget at the hospital is projected to be $216.3 million this year, down from $221.1 million last year.

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