Archive for: February, 2011

Event related shelf life in the ASC

By: February 28th, 2011 Email This Post Print This Post

Ed. note: The following is an excerpt from a Q&A audio conference titled Infection Prevention Survey Strategies for ASCs: Comply with CMS Conditions for Coverage featuring speakers Dawn Q. McLane RN, MSA, CASC, CNOR  and Libby Chinnes RN, BSN, CIC, IC.

Q: Please discuss the use of event related shelf life related to the ASC.

A: CMS is requiring centers to have a policy based on some recognized standard and therefore AORN’s standard (see below) would assist with this goal. Some centers are using event related policies, but have put a time limit like two years on packaging – even if the package appears intact – because time also plays a role in the sterility of the package.

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Weekly Poll: PAPR use for respiratory protection

By: February 28th, 2011 Email This Post Print This Post

In addition to N95 respirators, OSHA’s Respiratory Protection for Healthcare Workers Training Video covers the use of Powered Air Purifying Respirators (PAPR) by healthcare workers. Do you use PAPRs as part of your respiratory protection plan? Take the OSHA Healthcare Advisor Weekly Poll and let us know.

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Ask the expert: Close encounters with sharps containers

By: February 25th, 2011 Email This Post Print This Post

Q: Are there guidelines for the distance a sharps container should be from where the sharp is used to meet OSHA’s accessibility requirement?

A: OSHA’s Bloodborne Pathogens standard does not give a specific distance for determining compliance for a sharps disposal container location being “as close as feasible to where sharps are used” [(d)(4)(iii)(A)(2)(i)].”

The Agency’s Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens, however, gives some guidance as to how a possible violation would be assessed by an OSHA inspector:

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Don’t step out of the hospital without clean scrubs

By: February 25th, 2011 Email This Post Print This Post

Wearing scrubs outside healthcare facilities may be prohibited if infection prevention organizations have anything to say about it.

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The latest word on sharps containers

By: February 24th, 2011 Email This Post Print This Post

The following is an excerpt from the Complete Guide to Laboratory Safety, Third Edition, by Terry Jo Gile. To purchase this book, click here.

The CDC recommends that sharps containers be mounted on the wall 52-56 inches above the floor at a standing workstation and 38-42 inches above the floor for a seated work station. This height will comfortably accommodate most workers and allow employees to view the entire inlet opening slightly below eye level. This will help employees avoid injury because it will allow them to see any sharps that might be sticking out of the container’s top.

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Dissecting IC challenges for the upcoming year

By: February 24th, 2011 Email This Post Print This Post

Ed. note: The following is an excerpt from the March issue of Briefings on Infection Control. Click here to read more.

Q. What are some of the hot topics or main areas of concentration for infection preventionists (IP), either in your facility or in general, in the upcoming year?

A. Burns: [We are] continuing our efforts to comply with latest recommendations for prevention of device-associated infections [ventilators, urinary catheters, central lines, etc.]. [National Healthcare Safety Network] reporting of central line infections becomes mandatory in January 2011.

Lebo: I am alone in my ambulatory surgery center, so I have my own agenda for goals to attain for the next year:

– Flu vaccine rate increase. We have already exceeded last year, thanks to H1N1 publicity.

– Preop antibiotic dose appropriate for size of patients, according to body mass index. We are consistently 99% with infusing within one hour before surgery.

– Hand hygiene compliance improvement for physicians. This is going to be tough, and I have no real plan to get them to comply.

– Making sure we are Medicare/Medicaid inspection ready.

Chinnes: Some hot topics are: changing the norm so that healthcare-associated infections [HAI] are preventable; expanding surveillance and public reporting/transparency (even into outpatient area); empowerment of consumers; infection preventionist as a coordinator, collaborator (multidisciplinary team effort), engager, and negotiator; resistant organisms; Clostridium difficile; more emphasis on the role of the environment in transmission of infection; antibiotic stewardship; understanding care processes to intervene appropriately; cost-effectiveness.

Burger: We have an improvement team conducting an A3 [Lean SPPI methodology] to improve early identification and decrease transmission of C. difficile.

We have an improvement team working on reducing [surgical site infections (SSI)]. We even hired an OR nurse who strictly works as our OR/IC liaison to identify areas for improvement.

We continue to work on reducing [catheter-associated urinary tract infections], and we would like to make influenza vaccination mandatory for all healthcare workers.

Notes from the field: Why doesn’t that needle have the safety feature engaged?

By: February 24th, 2011 Email This Post Print This Post

When I do a mock OSHA inspection, I always look at the sharps containers. I check to make sure discarded sharps items have not exceeded the fill line. If the sharps container is clear, I can easily see what’s inside. Otherwise, I try to look down into the container.

I look for scalpels that do not have sheaths over the blades, non-retractable lancets, and needles that are non-safety engineered.

On a recent inspection, I knew that the practice I was inspecting was using all safety devices, so what I found was very surprising!

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Emergency nurses offer workplace violence prevention tool

By: February 23rd, 2011 Email This Post Print This Post

Workplace violence is a serious problem in healthcare and the Emergency Nurses Association (ENA) released a toolkit on February 16 to develop a comprehensive plan to manage violent behaviors in the emergency department.

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Hepatitis B outbreak kills six due to unsafe blood glucose monitoring

By: February 23rd, 2011 Email This Post Print This Post

An investigation by the CDC found that a North Carolina assisted-living facility was sharing blood glucose meters and reusable fingerstick devices meant for single patient use.

A Hepatitis B outbreak in October 2010 killed six residents at Glen Care Assisted Living in Mount Olive, NC, because the devices were reused among residents.

The North Carolina Division of Public Health (NCDPH) tested everyone who lived in the facility from January 1 to October 13, 2010, reports the CDC. They found either positive hepatitis B surface antigen and core immunoglobulin or evidence of acute hepatitis six weeks after being admitted.

Killing bacteria will soon be as easy as flipping a switch

By: February 23rd, 2011 Email This Post Print This Post

Staff at Thomas Memorial Hospital in Charleston, WV, are learning how to operate a 3-foot tall portable device with an ultraviolet light bulb that can kill all the infections in a room. When a staff member turns on the Xenex Pulsed Xenon Ultraviolet Disinfection System (PX-UV), the ultraviolet light kills infections by crushing their DNA, reports Charleston Daily Mail.

The disinfection system is effective at killing bacteria on surfaces and staff at the hospital are being trained on how to use it. Once the device is wheeled into the room, sensors let the machine know when the door is closed and people are out of the way before turning on. The hospital is currently using the device in operating rooms.

Thomas Memorial Hospital will not solely rely on PX-UV, but will use it along with its usual cleaning methods. While using the device, the hospital will record its infection rates.

If all goes well, will your facility be purchasing a PX-UV? Let us know in our comment section.

OSHA updates enforcement guidance on PPE

By: February 22nd, 2011 Email This Post Print This Post

As of February 10, OSHA inspectors have new guidance on how and when to cite employers for personal protective equipment (PPE) violations in workplaces.

Enforcement Guidance for Personal Protective Equipment in General Industry now reflects OSHA’s final rule on Employer Payment for Personal Protective Equipment, issued November 2007.The enforcement guide clarifies what type of PPE employers must provide at no cost to workers and when employers are not required to pay for PPE.

Significant changes from the old enforcement guide are:

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Watch out for sneezing elephants: they could transmit tuberculosis!

By: February 21st, 2011 Email This Post Print This Post

In 2009, eight employees at The Elephant Sanctuary in Hohenwald, TN, contracted tuberculosis (TB). The CDC released a report on February 16 saying that elephants were to blame.

Liz, a female Asian elephant at the sanctuary, was diagnosed with TB and thought to have spread the disease. Though three of the eight employees didn’t come in physical contact with Liz, investigators found that the TB bacteria could have been spread when Liz sneezed, or when workers cleaned up the elephant waste , reports The Huffington Post.

The eight employees who tested positive for the disease have been treated and are not sick. And Liz? Liz received treatment and is still alive, according to William Schaffner, MD, the sanctuary’s president and one of the authors of the CDC’s report published in the journal Emerging Infectious Diseases. Schaffner has called for better use of breathing devices at the sanctuary to avoid further instances.

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