Elective surgeries resumed this week at Mission Hospital in Laguna Beach and Mission Viejo after an extraordinary voluntary eight-day suspension, hospital officials said.
As a precautionary measure, elective surgeries at both campuses were temporarily halted Oct. 9 after three surgical patients contracted an infection whose source couldn’t be identified, Michael Beck, executive officer of the Laguna Beach campus, told the City Council on Tuesday. The resulting halt at the hospital, where 17,000 surgical procedures are done annually, meant the postponement of 275 elective surgeries, a spokeswoman said.
An in-house team of infectious disease specialists first detected the uncommon bacterial infection in three surgical patients in Mission Viejo between May and July, Dr. Chris Bailey said in an interview Wednesday. Among the variables monitored by his team are patient infections, antibiotic use and antibiotic resistance.
In the investigation of nine operating rooms in Mission Viejo and five in Laguna Beach, “we couldn’t find a smoking gun to blame,” said Bailey, who in 20 years with Mission has not previously seen such a widespread closure. Emergency operations continued uninterrupted throughout the suspension.
The patients were treated with antibiotics and recovered. “Keeping patients safe will continue to be our utmost concern and we are taking all actions to ensure a safe environment,” Chief Executive Kenn McFarland he said in a statement released last week to the Laguna Beach hospital advisory committee.
Though investigators could not find a sole cause, administrators focused their efforts on equipment that controls operating room humidity and temperature installed in Mission Viejo and standardizing documentation on the sterilization of surgical instruments at both campuses, said Bailey.
Though the infection was isolated to Mission Viejo, staff work in both campuses and need to have consistent procedures across locations.
Officials of the state Department of Health Services and the Joint Commission, which certifies hospitals for Medicare and Medicaid funding, were informed of the infection cluster and concurred with the focus of the inquiry, Bailey said.
The Joint Commission conducted a survey Oct. 7-8 and issued a preliminary denial of accreditation as a result of an immediate threat to the health or safety of patients or the public, said Katie Louze, a commission spokeswoman in Oakbrook Terrace, Ill. The decision is subject to review and appeal.
A Joint Commission survey would normally be anticipated at Mission Hospital in the six months preceding its expiring accreditation in May, said Mission Hospital spokeswoman Susan Cole.
“The cluster put more scrutiny on other practices,” said Bailey, such as instrument sterilization. Simplifying procedures will make oversight and compliance easier. “That’s the improvement moving forward,” he said.
Whether due to corrective actions or coincidence, no other infections of Enterbacter have surfaced since July, said Bailey, who believes Mission is ready for a return inspection by regulators.
Meanwhile, nurses at St. Joseph’s hospital in Orange, operated by the St. Joseph Hoag Health Alliance that also owns Mission Hospital, publicly called on hospital management to take immediate measures to ensure the health and safety of nurses who may be confronting Ebola patients.
The hospital has failed to enact adequate measures to protect against Ebola, the nurses aid in a statement issued by the California Nurses Assoc., which does not represent St. Joe nurses.
“We believe management should listen to the caregivers and enact these standards now, for the good of RNs, other healthcare workers and the patients in our community,” said the statement by nurse Marlene Tucay, in the medical tele unit of St. Joseph Hospital.
Staff will have been trained in protocols for Ebola set out by the Centers for Disease
Control and Prevention and will start drills next week, Beck told council members.
Because of new protocols, patients may notice extra screening precautions because of the new protocols, Beck said.
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