Our most recent Infection Control webinars had some excellent questions from the audience. Click on the link to see the answers provided by Cathy Montgomery and Robert Morgan to these questions....

1. What are your suggestions for training "after- hours" cleaning crews?
2. Are the multi-dose medications allowable on the anesthesia cart? Is this considered a direct patient contact area?
3. Does the autoclave have to show pressure for documenting? We have an older autoclave that does not document pressure.
4. What type of things should an implant log include? What about spinal cord stimulators?
5. Do we have to lock-up non-controlled drugs when we leave the OR? Drugs like antibiotics, decadron or neostigmine?
6. And others!

Teva has placed their propofol manufacturing on hold. This has further complicated services for ASCs using this product. Alerts have been set up to encourage providers to report any resale of stocked products and increased attention is being given to using these single dose vials for multiple patients. Regardless of the supply issue single use vials of this drug can not be used for more than one patient. I realize that centers are trying to make do with the limited supply of Propofol but CMS, Joint Commission and AAAHC do not allow single use drugs to be used by multiple patients even in the face of a shortage.

I have had a significate number of requests concerning the, "locking" of the anesthesia carts. Because of incidents like the one in Colorado recently where a surgical technician took the drug Fentanyl off the anesthesia cart, injecting into her leg and then replacing the contaminated needle filled with saline. Also, the inappropriate use of Propofol in the death of Michael Jackson has pushed the emphasis and focus on drug security to the forefront of everyones mind. It is required that medication not be accessable by unauthorized individuals. Whether it is the family at the bedside, the housekeeper, vendor or staff. It doesn't matter if it is morphine or eye drops. All drugs must be secured when they are not under direct supervision. This includes the anesthesia cart between cases.

Hand hygiene is a simple cost effective way to reduce transmission of disease and prevent infections in the healthcare arena. Unfortunately, compliance is an issue that plagues healthcare even in today's market place. With MDRO's, MRSA and VRE on the increase we need to do everything in our arsenal to prevent the spread of these types of diseases. Implimentation of hand hygiene tools has become the standard in many healthcare facilities to monitor compliance with hand washing. A Pennsylvania hospital has taken the next step to ensure compliance by using corrective action with its employees. I think if your employment is jeopardized by not washing your hands then that should be enough motivation to participate and wash your hands. (please click link to read full article from Philly.com)