Infection control remains a big problem at VA hospitals

The Department of Veterans Affairs doesn't do a good enough job of assuring that reusable medical equipment, such as surgical tools or wheelchairs, are cleaned and sterilized, the Government Accounting Office says in a report released Tuesday.

Media reports of infections being spread by improperly cleaned equipment prompted the GAO to investigate both the VA's policies and its oversight of VA medical centers nationwide. Their findings: While the VA does have good policies in place, it doesn't do enough to ensure staff are properly trained in cleaning and disinfection procedures. For example, a year after the VA set itself a requirement to create device-specific disinfection training, only 50 percent of VA health systems had done so, the GAO reports.

In some cases, individual VA hospital officials indicated they were confused about how to craft the training. In some cases, hospitals followed manufacturer's instructions to the letter, while in others, they translated those guidelines into more plain language to make it easier for staff to understand.

In response, VA officials say they're putting online a database of training modules created by manufacturers for 1,000 pieces of reusable equipment. And Robert Petzel, the VA's undersecretary for health, told a Congressional committee this week that the department has created a certification process to ensure technicians are absorbing the training.

The GAO also rapped the VA for not tracking how well staff are complying with cleaning and disinfection procedures. VA officials responded that they're stepping up their unannounced site visits--specifically to check for equipment processing--from one to three times per year.

The GAO also found problems with how VA hospitals order and inventory their expendable, or single-use, equipment. The big problem: A lack of a strong, well-documented inventory process. In one case, this resulted in an employee improperly ordering the wrong equipment for a dialysis unit, which exposed patients to possible cross-contamination.

To learn more:
- read the Miami Herald article
- go through the GAO report (.pdf)

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