WILTIMS #302: Soap and SOAP

Today's theme works so well that I'm hoping it was actually a super subtle joke by our administration. We learned about infection control and patient progress notes - or as I would call them, soap and SOAP. For the latter, I'm not yelling; it's an acronym for the four sections that typically make up a progress note - Subjective, Objective, Assessment and Plan.

Regarding soap, we had an infection control lecture and "lab" that were brutally boring in the same way learning about empathy is - each is a vitally important aspect of patient care that is emphasized so strenuously and so often that it is quickly taken for granted. It must be so hard for the instructors to teach us. We're obviously an intelligent bunch. And when you break out the PowerPoint slides to teach us how to wash our hands, a task we've been able to handle albeit less expertly since preschool, we roll our eyes and sigh. But every study ever done on physicians and med students shows that we simply don't wash our hands properly or often enough. There's got to be a better way of reinforcing this because, though I may groan a bit when told not to forget the fingernails, I still try to take the message to heart. I worry that some of my classmates may actually have tuned out the more important message about saving lives and the negative impact health care workers can have on their patients.

Moving on to SOAP... a patient note is a fascinating document that's seems more art than science. The goal is to communicate all of the pertinent information about the patient's current problem and past history as efficiently as possible while still being easily understood.

There are many types of patient notes that vary by the stage of the patient's stay as well as the specialty doing the evaluation. There are admitting notes and daily notes and discharge notes. There are post-op notes and post-delivery notes and consult notes. Each follows the same general theme but, depending on the situation, different aspects of the patient's condition and treatment require highlighting or elaboration. The biggest variable is actually the resident or attending physician's personal preferences. We must quickly learn what the person overseeing us finds important or irrelevant when we begin writing notes on their/our patients.

TIL: One of the main benefits of washing your hands rather than using an alcohol-based sanitizer, is that sanitizers are ineffective against spores. By and large, this isn't a big deal as few common disease-causing bacteria have a spore form and the ones that due are rarely found in the hospital environment. The exception is C diff. This nasty bug causes a dangerous antibiotic associated diarrhea that is a rising cause of hospital infections and deaths.