Archive for: July, 2010
There have been a number of questions regarding the time frame for spiking IV bags prior to administration. Libby Chinnes and Dawn McLane, our experts in the “Infection Prevention Survey Strategies for ASCs: Comply with CMS’ Conditions for Coverage,” webcast, answered that question, explaining that the guidelines according to U.S. Pharmacy standards is that IVs should not be spiked more than one hour before administration.
But they also note that the APIC position paper on safe injection practices identifies this as a controversial and unresolved issue.
To clear things up from a regulatory standpoint, I asked The Joint Commission for their perspective. This was their response:
Do you know the answer to these OSHA-related healthcare questions?
True or False
1. Only skin tests are acceptable for occupational screening for TB.
No matter the size, your healthcare facility should look to the risk assessment to drive your safety policies and procedures. That advice is the feature topic in the August issue of Medical Environment Update. The article covers:
- Where to begin with risk assessments
- Parameters to consider
- The importance of documenting your assessment
- Determining hazard severity
- Job Function Risk Assessment Sample Form (Download it and other risk assessment documents from the OSHA Healthcare Advisor Tools page.)
Here is an excerpt from that article and a look at what else is covered in the August issue.
Our sister blog, “Mac’s Safety Space,” is primarily a resource for hospital safety professionals looking for guidance on compliance issues revolving around safety and security.
But quite often the information on that blog delves into infection control and worker safety issues, as blogger Steve MacArthur is prone to discuss a variety of environment of care issues.
Q: Our medical practice has fewer than 10 workers. Aren’t there some OSHA standards that we would not have to follow because of our size?
A: The fewer-than-10-employee rule has nothing to do with whether an OSHA hazards standard applies to a workplace.
Imagine getting your annual flu shot only to find no needles and syringes in sight. This is a feasible scenario according to a new study published in Nature Medicine.
The study evaluates new technology involving a patch in which small microneedles dissolve into the skin for successful influenza vaccination without the inherent dangers of needles. These tiny patches would also allow for self-administration, which would allow for more productive large-scale immunization during pandemics.
A report published in the July issue of Gastronenterology sheds some light on an outbreak of hepatitis B and C in New York City in 2006.
The report linked six cases of hepatitis B and six more cases of hepatitis C to one outpatient endoscopy center, along with an additional case of hepatitis C at a separate clinic, to one healthcare worker — a contract anesthesiologist who practiced at both facilities.
Q: How often do you need a chest x-ray if you test positive to TB? A staff physician believes he needs to have one every 4-5 years unless he becomes symptomatic. What is the recommendation?
A: CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 provides advice and in this case recommends against repeat x-rays.
The guideline document on p. 30 says that healthcare workers:
“…with a baseline positive or newly positive TST or BAMT result should receive one chest radiograph to exclude a diagnosis of TB disease….After this baseline chest radiograph is performed and the result is documented, repeat radiographs are not needed unless symptoms or signs of TB disease develop or a clinician recommends a repeat chest radiograph.”
In place of serial testing, healthcare workers with positive test results should receive a symptom screening. The frequency of the screening should be determined by the risk classification of the healthcare facility, the guidelines add.
State health department regulations for TB prevention in healthcare facilities may differ from federal guidelines, so it is best to check that your state follows CDC recommendations.
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The blog post, “Hospital slapped for with workplace violence citation,” drew lots of visits and good comments showing keen interest in the topic. OSHA currently does not have a workplace violence prevention standard, relying instead on enforcement through the General Duty clause of the OSH Act. Should OSHA promulgate a workplace violence prevention standard or are current enforcement measures adequate? Record you opinion in the poll below.
Q: What is your recommendation for dealing with medical records contaminated with dried blood?
A: First, determine whether there is a work practice shortcoming that is causing medical records to become contaminated with blood and then address it through training.
While it is not OSHA specific, the blog post by Steve MacArthur, safety consultant for The Greeley Company, on the HCPro Hospital Safety Center offers good advice on protecting patients through tamper-resistant electrical receptacles.
Since it is short an to the point, we offer the post here in its entirety.
Should children be safer at home than they are in our facilities?Read the rest of this entry »