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Digital Issues

Was Anesthesiologist's Firing Racially Motivated?

A Florida anesthesiologist who accused his employer and supervisors of discrimination and retaliation was fired because he abandoned his job, not because he was black, a federal court has ruled.

Dwain A. Hamilton, MD, sued Sheridan Healthcare and 2 of his supervisors at the company after he was fired in July 2012, but the U.S. District Court for the Southern District of Florida dismissed the case this week, citing a lack of evidence that the dismissal was racially motivated.

After numerous serious complaints about his performance and his tardiness as head anesthesiologist on the night shift at Memorial Regional Hospital in Hollywood, Fla., Dr. Hamilton was transferred in late April 2012 to the day shift and told that his future performance would be monitored. He then requested and was given more than 3 weeks off before the switch was to take place.

Before returning, he requested and was granted FMLA leave for another month, ending on June 21. But on June 19, his wife told the hospital that he wouldn't be able to return until June 25. He eventually agreed to return to work on July 2, but didn't show up for work either that day or the next, and was terminated on July 3.

Dr. Hamilton's claim that the actions were racially motivated relied on two statements allegedly made by the supervisors. At the meeting where he was told that he was being moved to the day shift, one said, "I don't have confidence that you can be the face of the department at night." On another occasion, 2 or 3 years earlier, "somebody said," according to Dr. Hamilton, that the other supervisor had said, "the Obamas are coming in," referring to Dr. Hamilton and his paired CRNA, a black woman.

The court wasn't swayed. The first statement might have been interpreted in any number of ways, it said. The second lacked any apparent connection to the actions that took place years later. Instead, said the court, it was clear that Dr. Hamilton had been fired because he abandoned his job, and that abandonment is a legitimate, non-discriminatory reason for discharge.

Calls to Dr. Hamilton and his attorney requesting comment were not returned.

Jim Burger

UV Light Lowers HAIs

Robots that shoot ultraviolet light onto room surfaces reduce rates of hospital-acquired infections caused by multidrug-resistant organisms or Clostridium difficile, according to a study published in the American Journal of Infection Control.

Ultraviolet disinfection (UVD) technology employs mercury bulb devices or pulsed xenon bulbs, the latter of which the researchers began using in May 2011 at a 643-bed New York hospital, with infection prevention, environmental services and performance management teams monitoring the results weekly.

The more than 11,000 uses of UVD between July 2011 and April 2013 resulted in a 20% decrease in overall hospital-acquired infections related to multidrug-resistant organisms, including Clostridium difficile. These results were obtained despite the researchers missing nearly a quarter of the opportunities to employ the technology.

Adult inpatient rooms at the hospital are routinely cleaned with sodium hypochlorite 0.55% disinfectants and pediatric rooms are cleaned with a quaternary ammonium compound. During the study period, UVD was added to the regimen.

Study lead author Janet P. Haas, PhD, RN, director of infection prevention and control at Westchester Medical Center in Valhalla, N.Y., says that because UVD enhances cleaning elsewhere, it could plausibly do the same in ORs. However, she warns the clinical evidence for using UVD in the operating room is less compelling, and more research is needed fully asses the utility of applying the technology in surgical care areas.

Daniel Cook

October 28th E-WEEKLY

New Block Technique Improves Total Knee Outcomes

A nerve block technique that uses the adductor canal of the mid-thigh, rather than the area near the femoral nerve, helps total knee patients recover faster and with less opioid consumption, a recent study suggests.

The study, which was carried out at Virginia Mason Medical Center in Seattle, involved 80 total knee replacement patients. The authors write that patients who had a 0.2% ropivacaine solution infused through a catheter (as opposed to a sham catheter) in the adductor canal reported less pain and showed no temporary weakness in their legs, allowing them to walk sooner and farther.

The technique "appears to improve safety and clinical outcomes, and reduces the length of time needed for hospitalization," says David Auyong, MD, one of the research team members. "All patients now get this nerve block at Virginia Mason as part of our standard work for knee replacement surgery."

Jim Burger

InstaPoll: How Often Do You Follow AORN's Recommended Practices?

AORN's recommendations are broad statements intended to guide policy and procedure development in specific perioperative health care environments. Each recommended practice document consists of recommendations based on the highest level of available evidence. Tell us in this week's InstaPoll how often you follow the association's recommended practices, then check back next week for the results.

Long sleeve or bare arms when you prep a patient's skin? The 577 respondents to last week's poll were pretty evenly divided. Since 1994, AORN's recommended practices have stated that you should wear long-sleeved attire when applying the prep. The sleeves help to contain skin squames shed from bare arms, says the organization. The results:

Should you wear a long-sleeved jacket when prepping patients' skin?

  • No, the sleeve could contaminate the area you're prepping: 45%
  • Yes, skin squames shed from bare arms may increase the patient's risk for an SSI: 55%

Dan O'Connor

News & Notes

  • Sterrad indicators in short supply Production issues have created a "critical shortage" of Sterrad Cyclesure 24 biological indicators, according to Advanced Sterilization Products, the manufacturer of Sterrad low-temperature sterilizers. While the quality of the indicators have not been affected, the company will not be able to meet the full demand for them until August, says the FDA, which recommends prioritizing their use and utilizing another low-temperature method until then.
  • Double glove for anesthesia Anesthesiology residents who wore double gloves during induction and intubation on a dummy patient were significantly less likely to contaminate the patient and the patient's environment, a recent study has found. The lips and mouth of the mannequin were coated with a fluorescent gel, unbeknownst to the participants. Residents with double gloves were told to remove the outer set immediately after intubation. An ultraviolet light showed that the residents with single gloves contaminated about 4 times as many sites as those with double gloves.
  • Dancing doc doing great Six months ago a video of her dancing to Beyonce in the operating room with a surgical team before undergoing a double mastectomy went viral. Now, Deborah Cohen, MD, is cancer-free. "I'm really just on the healing path and trying to absorb everything I've gone through over the past 6 months," the obstetrician and gynecologist at the University of California San Francisco told a local news outlet. "When you are able to keep fear in perspective, there is a lot of room left for joy."