Again contaminated surgical cutlery in Hesse

Again contaminated surgical cutlery discovered in Hesse. Klinikum Kassel confirms hygienic deficiencies of surgical tools

03.02.2011

Contaminated surgical instruments seem to be a far-reaching problem in Hessian hospitals. After more severe deficiencies had already occurred at the end of last year at Klinikum Fulda, contaminated surgical tools were also discovered at Klinikum Kassel.

At the beginning of January, it became known that at the Klinikum Fulda in September 2010, problems with blood remains and rust in the surgical instruments had occurred and since then contamination of the surgical instruments has been repeatedly detected. Since then, the hospital has been supplied with sterile surgical tools by other hospitals. However, impurities were also detected during the inspection of the surgical cutlery delivered from the Klinikum Kassel.

Operations are canceled due to the contaminated surgical instruments
The Fulda hospital informed the responsible regional council due to the contaminated surgical instruments, whereupon employees of the supervisory authority and the responsible health department checked the sterile instruments at the Kasseler Klinikum on Tuesday. The inspections revealed evidence of further deposits on surgical instruments, the authorities said. The central sterilization of the Klinikum Kassel, in which the surgical instruments are cleaned, was closed the same day. All urgently required interventions have been postponed and currently only emergency operations take place in Kassel. This will be the „emergency“ very strictly defined, explained the hospital managing director Gerhard M. Sontheimer opposite the newspaper „Hessian / Lower Saxon general“ (HNA). However, it should be ensured that emergency patients undergo treatment (...) „count on perfect cutlery“ can, Sontheimer continues. The required sterile surgical cutlery will be lent from other clinics or corresponding disposable cutlery will be used, said Klinikum Kassel. Despite the contamination, there was never any danger to patients in Kassel, Sontheimer explained.

Central sterilization at Klinikum Kassel closed
With the closure of the central sterilization Kassel Hospital was practically paralyzed, stressed the hospital's managing director. Therefore, from Thursday onwards, cleaning of the surgical instruments will be based on a 24-hour operation in the sterilization in Bad Arolsen. In addition, the external service provider Orgamed is now to take over part of the cleaning of the surgical cutlery. All the cutlery used so far will not be used any further, emphasized Sontheimer. The contaminated surgical instruments had been sent back to the manufacturers Aesculap and Karl Storz Endoskopie, so they can examine exactly where the problems were and ensure proper sterilization, the statement of the clinic manager. In addition, the sterilization system, which actually „very well maintained“ be checked again. Probably until Friday only emergency operations can be carried out in the hospital. However, it is difficult to determine how long the state of emergency in Kassel will actually last. „We want every patient operated on by us to be sure that we use impeccable instruments“, emphasized the clinic manager.

Hygiene shortcomings due to the increased requirements?
Therefore, the instruments are only used again, „if the manufacturer has certified the removal of the deposits and their safety“, explained Sontheimer. All in all, about 30,000 individual instruments have to be checked by the manufacturers, but at present, the instruments from the Fulda hospital are still under review here, which must also be checked for hygienic safety, emphasized Sontheimer. According to the experts, the increasingly frequent hygiene deficiencies in surgical cutlery are also due to the constantly increasing technical requirements for the proper preparation and cleaning of the instruments in the central sterilization stations. The minimally invasive instruments with cavities of a few millimeters in diameter used today, as well as electronic and optical components, make cleaning much more difficult, according to the hygienists. As a result, contamination of the surgical instruments, which, in addition to possible health consequences during use, generally brings about considerable restrictions on the operation of the surgical equipment in the clinics, are recurrent. For example, due to the restrictions in Kassel currently accounts for about 65 operations daily, said the hospital's CEO.

Reports of contaminated surgical instruments are worrying
Overall, the number of reports of contaminated surgical instruments in Hesse has reached alarming proportions. The Hessian hospitals can therefore assume that the pressure from the state supervisory authorities will increase significantly, as emphasized by the Hessian social minister Stefan Grüttner (CDU). In addition to the already planned for this year introduction of a hygiene regulation, which „Among other things, regulations on the hygiene structure in hospitals, regulations for the supervisory authorities and measures for quality assurance include“ will be, be it „It is urgently necessary that the responsible authorities (...) again specifically investigate the inpatient hospitals in Hesse on the occasion of the events in Kassel and Fulda“, emphasized Grüttner. Also, an increased training of hygiene professionals in care and technology as well as specialized doctors is mandatory. „Therefore, we will (...) develop new offers for training and further education in the field of hygiene for doctors, nurses and technical staff in the hospitals“, explained the CDU politician.

Hospital infections due to poor hygiene
Again and again there are lapses in the recent compliance with the hygiene regulations in German hospitals. According to the health authorities, the number of infections of patients during a hospital stay due to so-called hospital germs is significantly higher in this country than in many of our neighboring European countries (for example the Netherlands). The impurities of surgical instruments play a not insignificant role. In the case of direct contact with open wounds, the risk of infection due to harmful germs is particularly high. In hospitals, in particular, the multi-drug resistant agents (MRSA), which are resistant to treatment with all common antibiotics, represent a serious problem. The lack of compliance with hygiene regulations in particular by the clinic staff has led to a significantly increased occurrence of MRSA here , (Fp)

Also read:
Contaminated surgical instruments at the Fulda Hospital
Every tenth hospital treatment hurts
Risk of infection in the hospital
Sick by hospital germs
Resistant bacteria in German hospitals

Picture: Martin Büdenbender