atans1

SGH tragedy: “Penny wise, Safety foolish” allegation

In Public Administration on 04/11/2015 at 4:27 am

A regular reader and commenter who describes himself “As someone who has worked in PAP’s health system apparatus and also with the civil service real politicks” gives his take on the sharing of vials. (Btw, here’s his take on why Amos “the Fantastic” was sent to Block 7, Woodbridge.)

Btw, I hope he or she can explain where the huge losses occur in the system: bureaucracy, overstaffing?

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The Hepatitis C outbreak in a Singapore hospital has cast the spotlight on a practice known as multi-dosing, where nurses or doctors inject patients by attaching new needles and syringes to a shared vial of fluid. 

The Singapore General Hospital – the site of the cluster – said the virus could have spread that way, and it has since stopped the practice. 

On Wednesday (Oct 7), the Ministry of Health said that it is “not yet conclusive” that the use of multi-dose vials is the cause of the Hepatitis C infections at SGH*.

(CNA)

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Moral of the story is to have good medical insurance that can cover at least B1 or A-class in govt hospitals. Such “private class” patients are issued their own personal drug vials including multi-use ones — no such thing as sharing of multi-use vials.

The main reason is that C & B2 class are loss-making [CI note: Can explain how the losses come about?], requiring large injections of cash from MOH to cover. Much of the practices in C & B2 wards in govt hospitals e.g. standardised care plans, clinical pathways (equivalent to SOPs & IAs in army) are designed to save money & avoid so-called unnecessary tests / investigations / procedures.

Do you know that even “poor” community hospitals (e.g. Ren Ci, St Luke’s) issue personal multi-use drug vials to their patients — no sharing?!? How come?? Becoz these are considered as private hospitals & they are required by MOH to practice cost-recovery at a minimum, in order to obtain the minimal subsidies from ministry. Hence such hospitals simply issue personal drug vials as (1) to avoid cross-infections which will be hell to recover from as a “poor” community hospital with no ministry backing, and (2) vast majority of such drug vials are priced / cost in the cents or at most $1 or $2 — still easily recovered from individual patients.

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*More from From CNA on 7 October

“Both single-dose and multi-dose injection medication vials are used in our public hospitals. Our public hospitals utilise multi-dose vials where the preparation is specifically formulated for such use, and governed by safety protocols,” MOH said in response to media queries.

“Regardless of whether medication vials are single-dose or multi-dose, their safe use requires healthcare providers to adhere to existing safety protocols for the use of medication vials. Staff education, appropriate training and compliance to the protocols are important in ensuring patient safety.

“As multi-dose vials are potentially at risk of contamination between uses, their safe use requires additional safety and infection prevention and control measures that staff have to comply with, such as opening only one vial of a particular medication at a time in each patient-care area, as recommended by WHO. Failure to comply to safety protocols may cause infection,” the ministry said.

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  1. […] – Thoughts of a Cynical Investor: SGH tragedy: “Penny wise, Safety foolish” allegation […]

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