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CC News: June 1996

In This Issue

Capital contribution

Renovations, rehab in full swing this summer

Physician remembered as well-liked staffer

Briefs

Biomedical engineering moves to the CC

Nursing honors staff accomplishments

MPW boxes should contain only infectious waste

Clinical Center News, Building 10, Room 1C255, National Institutes of Health, Bethesda, Maryland 20892. (301) 496-2563. Fax: 402-2984. Published monthly for CC employees by the Office of Clinical Center Communications, Colleen Henrichsen, chief. News, articles ideas, calendar events, letters, and photographs are welcome. Deadline for submission is the second Monday of each month.
Editor: Sara Byars sbyars@nih.gov . Staff Writers: Laura Bradbard, Sue Kendall


Capital contribution

The Washington Capitals Hockey Team opened their hearts and their wallets to benefit the NIH Marrow Donor Center when they sponsored a special marrow drive this month at Bethesda's Walter Johnson High School.

On hand for a press conference to announce the event were Jim Schoenfeld, the team's head coach; Tod Button, assistant coach; and Dr. Susan Leitman, chief of the Department of Transfusion Medicine's blood services section and medical director, NIH Marrow Donor Center. Button's father, a scout for the team, was stricken with leukemia last spring and was successfully matched with his sister for a marrow donation.

"I know I speak for my dad, my family, and all those people who care for him when I talk about the importance of the bone marrow drive and the bone marrow program," said Button, "and the importance of giving somebody else, many more people, a chance at a second
life. The same chance that has been given to my father and our family."

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Renovations, rehab in full swing this summer

While planning continues for the CC's new Clinical Research Center, work to improve the existing core is in full swing. "When the new hospital is complete, the old hospital portion of building 10 will still be used for labs and offices," points out Jim Wilson, building services chief. "The infrastructure has to be upgraded and maintained to meet today's demands."

Projects expected to begin this summer include:

  • Installing a new ceiling in the Nutrition Department kitchen. ·Replacing the front entry doors with an 18-foot revolving door. "Right now, the lobby is cold in the winter and hot in the summer," Wilson says. "The new door will help reduce the problem."
  • Putting in new lights and signage in the parking garage.
  • Overhauling the garage structure. "At least three and a half inches of concrete will be blown out with high-pressure water," Wilson says, "to allow replacing rusted steel and pouring a layer of impermeable concrete."
  • Replacing the roof on 10D, the intensive care unit.
  • Installing a new lobby ceiling. "The new ceiling will make it easier to maintain the HVAC system," Wilson says. "Now, the ceiling has to be dismantled before working on the heating, ventilation, and air conditioning."
  • Upgrading patient-care units 2 East and 6 West.
  • Creating better access to Masur Auditorium's stage. "Masur will be closed during July for installation of a lift so that the physically impaired can reach the stage."
Some other major projects in progress include:
  • Overhauling the first-floor escalator. "This should be finished by the end of June."
  • Correcting drainage problems around the building. "A project to stop water leakage around the perimeter of the building was completed earlier this year," Wilson notes, "and during that work we found major flashing problems in the front of the building. We're fixing that now."
  • Construction of the Baxter Cell Processing Lab over the Department of Transfusion Medicine.
  • Elevator upgrades. "These are complete except for elevators in the west tower."
  • Improvements to the air handling systems in the operating rooms. "This project will allow for two of the rooms to be positive or negative air flow rooms, depending on the staff's needs," Wilson says.
  • Bathroom renovations. The prototype outside Masur Auditorium was completed earlier this year. Upgrades include solid-surface countertops and bowls with automatic faucets, automatic heated-air dryers, new floors and toilets, and stainless steel stalls. Twelve bathrooms are slated for the upgrades, including those near Lipsett Amphitheater, behind the police desk on the first floor, and by the B1 and second floor cafeterias.
  • Bird proofing. This sanitation project discourages birds from landing and nesting on building roofs and window sills. The project is nearly two-thirds complete. Summer work will be on the east tower and the A Wing.
The multi-million dollar Clinical Center Essential Maintenance and Safety Program will address the need to systematically improve the 43-year-old building's infrastructure. Work under this umbrella will:
  • Improve the building's air quality. Enhancements to the heating, cooling, and ventilation systems are expected to provide more than 400 percent more fresh air to the building.
  • Open up the building's "lungs" by installing new air-supply ducts at the building's distal ends. This project will claim about three feet at the end of each corridor. Work will be done between 3 and 9 p.m. to minimize disruption.
  • Overhaul the fume hood systems. All fume hoods will be upgraded or replaced to meet current safety standards. Most chemical fume hoods will be converted to air-bypass systems.
  • Continue overall fire safety programs. Automatic sprinklers will be upgraded or installed. Other fire safety components include better fire alarms, barriers, egress, and containment.

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Physician remembered as well-liked staffer

Dr. Alan Van Dervort, former medical staff fellow in the CC Critical Care Medicine Department, was fatally shot in a Gaithersburg parking lot on May 24 and died the following day at Shady Grove Hospital.

A member of NHLBI's pulmonary critical care medicine branch since 1994, Dr. Van Dervort came to NIH in 1987. He studied communication systems employed by cells, research relevant to pulmonary disease in the critically ill patient. NHLBI officials described him as "an excellent physician, well-liked by his co-workers."

Dr. Van Dervort grew up in the Los Angeles area and trained in internal medicine at King's County Hospital/Downstate Medical Center in Brooklyn and later completed a fellowship in critical care medicine at Memorial Sloan Kettering Cancer Hospital in New York City.

During his time at NIH, Dr. Van Dervort developed a reputation as an able, caring, and skilled clinician. His outstanding clinical instincts were appreciated by all those who worked with him. He loved discussing cases, always looking for a better way to do a procedure or solve a problem. He was board certified in internal medicine and critical care medicine.

While working in Critical Care Medicine, Dr. Van Dervort's research focused on developing new therapeutic approaches to treating septic shock. He was among the first to recognize that certain analogs of lipid A, the toxic moiety of endotoxin, could antagonize inflammatory effects of endotoxin and perhaps serve as a new class of agents for treating septic shock. He described lipid A analogs with agonist, antagonist, and mixed agonist-antagonist activity, defining the structure-function relationships of these molecules. This work was part of the foundation that led to the development of an endotoxin antagonist that has entered clinical trials.

Dr. Van Dervort made contributions to our understanding of neutrophil priming, an effect that enhances cytotoxic-responses and may contribute to tissue injury in sepsis. More recently, he studied the role of nitric oxide in regulating inflammation. At NHLBI, Dr. Van Dervort was investigating cGMP-independent nitric oxide signaling pathways involving tyrosine nitrosylation.

Most of all, Dr. Van Dervort's colleagues will remember him for his friendship and his sense of humor. "Big Al," or just "Al," loved basketball, tennis, and life. He frequently played basketball on the 14th floor courts of the Clinical Center and was known as a tough but gracious competitor.
He attended the Washington Bullets Basketball Summer Camp for amateurs and as a season ticket holder frequently went to the Bullets home games with friends and colleagues. He spent weekends playing tennis with his daughter, Alana, or taking her to tennis tournaments.

He is survived by his wife, Annette, his daughter Alana, and his mother, Caprice.
Memorials may go to the Alana Van Dervort Scholarship Fund, c/o Dr. Joel Moss, Building 10, Rm 6D03, MSC 1590, 10 Center Drive, Bethesda, MD 20892-1590.

-by Dr. Robert Danner

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Briefs


New chair named for women scientists

Dr. Margaret Rick, assistant chief of clinical pathology's hematology section, has been named chair of the Clinical Center Women Scientists. Immediate past chair, Dr. Barbara Sonies, Department of Rehabilitation Medicine, will serve as co-chair. "I look forward to receiving advice in the coming year on new directions we should be pursuing to improve the work environment for women," said Dr. John Gallin, CC director, in announcing the appointments.

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Play it safer in summer sun

June is the kickoff for many summer outdoor activities, including the skin cancer awareness program sponsored by the Occupational Medical Service (OMS). This program highlights the risks that excessive exposure to sunlight can pose.
Throughout June, OMS will provide information on skin cancer, including warning signs, risk factors, and advice on how to reduce your risk of developing skin cancer.
OMS also will offer two videotapes on skin cancer recognition, treatment, and prevention. The tapes will be shown in room 6C306 Wednesdays in June at 9 a.m., 10 a.m., 11 a.m., 1 p.m.,
2 p.m., and 3 p.m.

Did you know that:

  • Skin cancer will kill an estimated 6,900 Americans this year. ·NCI recommends sunscreens with a sun protection factor (SPF) of 15 or higher for the best protection.
  • Use of sunscreen products may give a false sense of security. Prolonged exposure to ultraviolet rays may still accelerate the development of melanoma, the most serious form of skin cancer.
  • The safest approach is to limit exposure to the sun, especially between 10 a.m. and 2 p.m.

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Chance on sailboat benefits FOCC

Want to spend the summer sailing? Stop by your R&W store to buy a chance on a 28-foot Pearson sailboat, a sloop valued at $19,000. All proceeds benefit the Friends of the Clinical Center, a program that helps CC patients and families with personal emergency financial assistance while they participate in medical research here. Tickets are $25. Only 400 will be sold, and at press time 300 chances had been purchased. The drawing will be on June 24.

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Quilt--and quilt again--raises money

The Clinical Pathology Department's holiday auction last December netted $2,002 for the Patient Emergency Fund. Additionally, a handmade quilt crafted by Clinical Pathology staffers earned $2,500 for the fund when it was raffled off for the first time in 1994. The winner re-donated the quilt, which raised $637 on its second trip to the raffle box.

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New address for Ober

Ober United Travel Agency, NIH's travel management center, can now be reached by email. The address is oberhq@ix.netcom.com. Requests for travel arrangements, itineary options, questions, comments, kudos, or complaints can be sent to that address. For more information, contact Marie Gillen, the NIH project, at 402-1661 or ag16g@nih.gov.

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Demonstrations prompt reminder to wear IDs

Security measures here will be increased during the World Animal Awareness Week, which begins June 18, according to Jim Sweat, director of the NIH Division of Public Safety. ID cards should be worn be employees on duty in campus and NIH-leased buildings. "There will be an animal rights conference held at the U.S. Air Arena on June 20 and [also] a demonstration outside the area on the same day by Americans for Medical Progress, a pro-research group based in Alexandria," says Sweat.

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Internship grads

Five registered nurses have completed the Neuroscience Nurse Internship Program. They are Terrye L. Hall, Chevalia J. Robinson, Leo J. Fitzpatrick, Alison Y. Pope, and Terree R. Benfield. Program staff include Jody Becker, nurse manager of the neuroscience care program, Critical and Acute Care Patient Services; Kathryn Montgomery, associate CC director for nursing; Dr. Audrey Penn, NINDS deputy director; and Beth Price and Lorena Gaskill, clinical nurse specialists, neuroscience care program, Critical and Acute Care Patient Services.

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Congressional visitors


Members and staff of the House appropriations subcommittee on labor, education, and HHS visited the Clinical Center on May 14 in connection with recent hearings. Rep. John Porter (R-Ill.), who chairs that subcommittee; and Rep. Dan Miller (R-Fla.)

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Biomedical engineering moves to the CC


Assuring the safety and accuracy of clinical equipment is now the responsibility of the CC Materials Management Department. That function had been vested with the Biomedical Engineering and Instrumentation Program in the National Center for Research Resources. Now named the Clinical Engineering Section, the service was transferred to the Clinical Center in January. Roland Corsey, a biomedical engineer, moved from NCRR to head the section. Staff members include biomedical engineers and technicians in both electronics and biomedical engineering.

A comprehensive review of what types and how often equipment should be tested prompted the move, according to Dr. Michele Evans, CC safety officer. CC administrators, safety officials, and biomedical engineers comprised the working group that made the recommendation. "The initial review resulted from more flexible accreditation standards. The Joint Commission on Accreditation of Healthcare Organizations urged hospitals to find ways to ensure that equipment that was most critical to patient care received the priority in all testing," she says.

This reallocation of effort will mean nearly $500,000 in savings a year, mainly due to the elimination of routine testing of non-medical equipment.

The primary function of section staff is to repair medical equipment and to make sure that all clinical equipment is electrically safe and provides correct readings to health-care staff. That equipment includes ECGs, EEGs, infusion pumps, external pacemakers, non-invasive blood pressure machines, pulse oximeters, and electronic thermometers.

Equipment is tested at least annually. "Some pieces are tested more frequently," Corsey points out. "External pacemakers, for example, are tested monthly. We are also testing to see if cellular phones cause any interference with medical equipment."

Section staff no longer provide routine, annual testing for non-clinical equipment, refrigerators in patient rooms and microwave ovens on units, for example. "It's something the Joint Commission no longer requires. We will test the equipment for safety when it is new and apply an identification sticker," Corsey explains. "If the equipment stops working, the patient-care units call us for repair and another safety check."

Another benefit of having biomedical engineering within Materials Management, Corsey points out, is that the department buys most of the supplies and equipment for the Clinical Center. "Medical equipment is our area of expertise. We are able to work with the CC standardization committee when new supplies and equipment are being considered for standardization."

Assuring the safety of electrical equipment used in hospitals became a national issue in the early 1970s, Corsey explains, when consumer advocates asserted that more than 1,000 hospital deaths a year could be attributed to unsafe equipment.

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Nursing honors staff accomplishments


Nursing Department recognized contributions of its department members during ceremonies on May 16.

Mary Haughey was named Nurse of the Year for "exemplary practice skills, patient teaching capabilities, and a commitment to excellence." Haughey has cared for neurology and endocrine patients, as well patients under a new program of care for rheumatic arthritis, dermatomyositis, and lupus. "Within her first months of transferring to the new program, [she] volunteered to take complex patients with muscle weakness and severe pain." She has enhanced education opportunities for her peers by serving as preceptor for new nurses and by developing programs for her unit, service, and the nursing department. Haughey has been staff nurse on 10 East for the last nine months. Her CC career also included five years working with adult endocrinology patients and two years with neurology patients.

Anne Knebel received the Distinguished Nurse Award. She was recognized for leadership in clinical practice, educational activities, and standards development. She coordinated the development and revision of three major standards of practice-noninvasive ventilation support, tracheostomy, and bronchoscopy. Knebel also served as research mentor to three nursing research projects, and developed an important liaison with NINR.

Recipient of the Research Award was Christopher L. Geyer for his work on the protocol, "Clinical Correlates of Post-Lumbar Puncture Headache."

The study sought to identify some of the clinical and psychological variables related to the development of post-lumbar puncture headache. It's one of the most commonly performed procedures among NIAAA protocols and is critical to the understanding of neurotransmitter systems in alcoholism.

Recognized for earning an NIH Director's Award was Jean Harris. It was given in recognition of her exceptional initiative and leadership in coordinating accreditation review in the Clinical Center and for her work with the Workforce Diversity Program.

Merry Danaceau was the CC's nominee for the Maryland Hospital Nurse of the Year Award. A psychiatric clinician, Danaceau works with women's health studies, including perimenopausal depression and mood disorders related to menstruation.

Other award recipients included:

  • Jacques Bolle and Nancy Dianis, Director's Awards.
  • Kelly Cahill, Colleen Carey, Kimberly Maynard, Alexis Mosquera, and Ann Mulqueen, citations for clinical excellence.
  • Diane Aker, Merry Danaceau, Anne Goodwin, and Marie Smyth, citations for leadership excellence.
  • Ana Ferreira, Manjula Patel, and Carl J. Shadrick, citations of excellence in administration and clerical support.
  • Fran Loscalzo and Annette Stine; staff nurses on the mental health alcohol and aging nursing services; and 8 West nursing staff, citations for excellence in team work.
  • Sharon Quint-Kasner, Marilyn Royster, and Rita White, citations for excellence in nursing and patient education.
  • Jody Becker, Laura Cearnal, and nursing staffs of the 9 West/Day Hospital, 11 East, 13 West, and the 13th floor outpatient clinic, service chief awards.

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MPW boxes should contain only infectious waste


Those white boxes with bright orange printing-what are they used for?

They are used for medical pathological waste (MPW), waste contaminated with infectious material or low levels of cytotoxic drugs.

To protect from potential exposure to infectious diseases, MPW is managed differently than regular office trash. It's double bagged in a special MPW box and burned.

Reducing the volume of MPW would help shave disposal costs, which are eight times that of regular office trash, cut the cost of buying MPW boxes, and save Housekeeping and Fabric Care staff time and effort in transporting thousands of MPW boxes each week, NIH environmental protection branch officials note.

How can the volume of MPW be reduced? "Easy," says Gyula Kovach, chief of the environmental protection branch, NIH Division of Safety. "Put only what is really medical pathological waste in the MPW boxes."

Random surveys of the contents have shown some surprises, including soda cans, newspapers, books, research records, and-at least once-a new microscope.

Another way to reduce MPW volume is to decontaminate the material by autoclave or disinfecting process, which will transform the MPW into regular trash.

Because of the warnings and symbols on an MPW box anyone seeing an MPW box must treat the box contents as contaminated.

To avoid misunderstandings:

  • Never discard an empty or damaged MPW box with the regular trash.
  • Never use it for storing or moving non-MPW material.
  • Never put radioactive materials in an MPW box unless the box has been labeled for radioactive material use.
"The Housekeeping and Fabric Care staff are unsung heroes in coping with so many MPW boxes as well as all their other duties," notes Dr. Robert McKinney, director of the NIH division of safety.

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Warren Grant Magnuson Clinical Center (CC)
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Last modified 6/14/96


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