A new era dawned for the land of the rising sun when a team of three Japanese health care workers traveled to the University for a month-long training program in infection control.
The International Health Care Worker Safety Center at the University Health System organized the program, which started in 1998. The program seeks to gather support for various research projects and help modernize Japanese hospitals.
The team from Japan consisted of one physician and two nurses who participated in a basic infection control course.
They also took part in a clinical skills laboratory and learned how to use the Exposure Prevention Information Network system for tracking needle sticks and blood exposure.
Tim Redden, IHCWSC senior director of Corporate and Foundation Relations, says he saw the need for the program while on a visit to Japan in 1994.
"There are substantial gaps in the way they practice their health care worker safety in Japan," Redden says, comparing Japanese to U.S. safety standards.
Certain aspects of traditional Japanese medicine make it difficult for doctors in Japan to accept modern infection control techniques.
This can be attributed to the importance of trust placed between Japanese doctors and patients.
For example, many Japanese physicians avoid using gloves when examining patients. If the doctor puts gloves on, some patients think there is something wrong with them as individuals, Redden says.
Such oversights place Japanese health care personnel at great risk for contracting infections such as hepatitis and HIV. Redden estimates 30 to 40 percent of orthopedic surgeons in Japan are infected with hepatitis B or C. Additionally, the rate of infection for hospital patients in Japan is 20 percent, compared with only 5 percent in the United States.
Standards and guidelines
The visiting team of health care workers want to improve infection rates in Japan. "I'm very happy to see a good model of infection control," says Satoru Itoyama, a clinical fellow specializing in infectious and pulmonary disease at the University of Tokyo Hospital.
Aiko Ko, an instructor from the Japanese Nursing Association and Yaoko Takono, an infection control nurse from Keio University Hospital, formed the rest of the team.
Ko and Takono are two of approximately 20 full-time nurses in Japan specifically trained in infection control.
"There is no professional infection control program for practitioners in Japan," Ko says, explaining why few Japanese nurses become specialized in this area of health care.
IHCWSC Director Janine Jagger says the training program allows Japanese medical professionals to learn ways to train such individuals.
"Part of what we're doing here is to show them what training materials we have and what guidelines the different professional associations have," Jagger says, referring to laws set forth by the U.S. Occupational Safety and Health Administration.
OSHA regulates standards of health care worker safety and requires all hospitals to keep records on occupational injuries, such as needle sticks and infections. But without a Japanese counterpart to OSHA, Japanese hospitals are left without specific guidelines for protecting health care workers.
Sponsorship
The IHCWSC isn't alone in its effort to reach out to Japan - four companies that market health care products also have joined the effort to improve infection control in Japanese hospitals. Johnson & Johnson Medical, Kimberly Clark, Nippon Becton Dickinson and Terumo all have pledged to donate at least $75,000 to IHCWSC to fund research projects related to infection control.
Part of the funds support researchers at the University and at Tokyo University, who are working together to show that certain medical safety equipment will decrease hospital infection rates and protect health care workers.
"Normally, these companies would be killing each other for market share, but the Ministry of Health in Japan controls the market," Redden said, explaining that hospitals in Japan don't receive government reimbursements for medical safety equipment.
The four companies hope the research will convince Japanese authorities that safety equipment is important to have in hospitals and eventually will create a demand for their products.
"It's a very challenging issue, but we want to try," Becton Dickinson spokeswoman Yumiko Hosomi said.
Redden said there are benefits to working with the companies - Becton Dickinson and Johnson & Johnson already have rewarded valuable research professorships to University faculty. "We have established great credibility with these companies," he said. "We should be able to go to them again and again with good research ideas and have them sponsor."
Over the next two years, two more teams of Japanese health care workers will participate in the infection control program. "It's a good thing for the University to have a leadership role in this type of activity," Redden said.
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