全科医生蔑视感控，停职三月！
检索/翻译：曹峥峥、庾芝霞 校对/审核：黄宇琨
作者：Clare Dyer
一名全科医生不顾护士投诉，重复使用一次性使用器具，并让诊所护士在疫苗 "冷链 "事件中对病人撒谎，已被英国医学注册处暂停执业资格3个月。
Sikandir Arshad将他用来提取病人宫内节育环的设备简单冲洗过后，用它从另一个病人身上取出节育环。当被护士质疑时，他告诉护士，反正身体的那个部位也不是无菌的，所以没有必要使用无菌器械。
还有一次，Arshad对一名护士说，他要用抽屉里的镊子而不是无菌包来取出病人的节育环。他还曾在小手术中重复使用一次性海绵夹取出节育环和电疗设备。
Arshad在第二位护士向他讲述感染风险后，仍然对多名患者采取这些做法。有一次，他甚至把一副沾满干血的海绵夹放在抽屉里。
2017年，这家位于斯塔福德郡的诊所发现，存放疫苗的冰箱温度高于规定的限值。在通知可能受影响的患者及其家属时，Arshad告诉诊所护士，"冷链事件 "是由于运输过程中的错误引起的，虽然他知道事实并非如此。
后来，在一位病人投诉这件事后，Arshad在给英国国家医疗服务系统的手写信草稿中写道，他的一位护士向病人转述了这一虚假说法。尽管Arshad知道该护士并没有转述。他还在与英格兰公共卫生局会面之前，询问该护士，是否可以重写冰箱记录表。
Arshad承认了医学委员会对他的所有指控，包括他的不诚实。他的行为没有对病人造成实际伤害，但他将病人暴露在感染的风险之中。他告诉医疗从业者法庭，事发过后，他学习了许多课程来弥补错误，提高技能，同时也对感染控制有了更好的理解。
他在一份证人陈述中写道："我承认我在2016年和2017年期间的对感染控制标准的理解是无效，糟糕且不足的。"
他向批评他重复使用仪器的两名护士道歉，这两名护士最终都从诊所辞职。他们后来被转到护士和助产士委员会，不过该委员会没有对他们采取任何行动。
GMC的律师要求对其进行停职制裁。Arshad的律师在听证会上说，他的当事人承认他的执业资格确实出了问题，他应该被停职，但 "担心 "法庭可能会考虑撤销他的医师执业资格。
主持法庭的劳拉-保罗说： "很明显，Arshad博士的不诚实是个非常严重的错误。但是事情发生的时候，他的两个合作伙伴退休了，他是诊所唯一的医生。这种情况下，他的压力太大了。”
保罗说，根据他的许多同事的证词，这种不当行为 "不符合他的性格"。因为他现在在一个条件更好的环境中工作，没有人对他提出过新的投诉。
保罗说，Arshad对他的错误有很深刻的认识。为了解决他的临床失误，他接受了指导，并进行了重要的持续的职业发展（CPD）培训。而且在事件发生后，他没有受到诊所条件的限制，继续工作。基于这些事实，法庭表示感到很满意，并且认为，Arshad医生今后应获得行医的机会。
她说，“三个月的停职，表明了Arshad博士不当行为的严重性，同时也能对他、行业内的专业人士以及广大公众起到警醒的作用。"
原文：
GP who flouted infection control standards is suspended for three months
Clare Dyer
The BMJ
A general practitioner who reused single use implements despite nurses’ complaints and who told a practice nurse to lie to a patient about a vaccine “cold chain” incident has been suspended from the UK medical register for three months.
Sikandir Arshad rinsed the equipment that he had used to extract a patient’s contraceptive coil and then used it to remove a coil from another patient. When challenged by a nurse, he told her that that part of the body was not sterile anyway, so there was no need for sterile instruments.
On another occasion Arshad said to a nurse that he could use forceps from a drawer rather than a sterile pack to extract a patient’s coil. He also reused single use sponge holders when removing coils and cauterisation equipment in minor operations. Arshad continued these practices with multiple patients after a second nurse had spoken to him about infection risk. On one occasion, he stored a pair of sponge holders that were covered in dried blood in a drawer.
In 2017 the practice in Staffordshire found that the fridges that stored its vaccines had been exposed to temperatures above recommended limits. But in notifying potentially affected patients and their families, Arshad at first told a practice nurse to claim that the “cold chain incident” had been caused by a transportation error, when he knew that it had not.
Later, in a draft handwritten letter to NHS England after a patient complained about this incident, he wrote that one of his nurses had relayed this false claim to a patient, when he knew that she had not. He also asked the nurse, ahead of a meeting with Public Health England, if the fridge record sheets could be rewritten.
Arshad admitted all of the General Medical Council’s allegations against him, including the charge of dishonesty. No patient harm had resulted from his actions, but he admitted exposing patients to infection risk. He had since come to a better understanding of infection control while taking numerous courses to remedy his errors and improve his skills, he told the medical practitioners tribunal.
“I accept that my infection control standards during 2016 and 2017 had lapsed and were poor and inadequate,” he wrote in a witness statement.
He apologised to the two nurses who had criticised his reuse of instruments, both of whom ultimately resigned from the practice. They were later referred to the Nursing and Midwifery Council, though it took no action against them.
Counsel for the GMC asked for a sanction of suspension. Arshad’s counsel told the hearing that his client accepted that his fitness to practise was impaired and that he merited a suspension but was “fearful” that the tribunal might be considering erasure.
Laura Paul, chairing the tribunal, said that “while it is clear that Dr Arshad’s dishonesty was serious,” this took place “in an extremely pressured environment,” where he was the sole practitioner after the retirement of his two partners.
The misconduct was “out of character,” according to numerous testimonials from his colleagues, she said. He now worked in a more supportive environment, and no new complaints had been raised against him since.
He had shown insight, “engaged with mentoring and undertaken significant [continuing professional development] to address his clinical failings,” and had continued to work without practice restrictions since the events, she said. Given these facts, the tribunal was “satisfied that Dr Arshad should be given the opportunity to practise medicine in the future.”
A three month suspension, she said, “reflects the gravity of Dr Arshad’s misconduct and will send out a clear signal to him, the profession, and the wider public.”
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