CMS Infection Control Changes; Up-dates from Excellentia Advisory Group
Important News Updates to CMS Infection Control Audits March 5, 2010

in this issue

From the Desk of Robert Morgan, MSN

Questions & Answers from recent webinars

PROPOFOL shortage continues!!!

Locking Anesthesia Carts

Wash Your Hands Or Lose Your Job!


 

From the Desk of Robert Morgan, MSN
Robert Morgan in conf room

NEED TO KNOW UPDATES and TIPS:

  • Blood Pressure Cuffs
  • Blood pressure cuffs that are nylon or material that does not absorb moisture may be cleaned with an EPA approved disinfectant between patient uses.
  • Air Exchanges
  • Air exchanges in an endo processing room needs to be between 6 to 12 exchanges per hour. Because of the higher and potentially toxic fumes the processing room is usually higher than the endo suite. (According to the AIA) The endo suite is 6 exchanges per hour with 2 of outside air according to the AIA 2001 standards. Bronchoscopy is 12 per hour with 2 of outside air.
  • Single-Use Items
  • Re-using single use items is a touchy gamble. You are thinking because it does not get introduced into the sterile field, it shouldn't matter. However, it is best not to because it may come in contact with bio burden that may or may not be clean completely.




Greetings ASC Administrator or Directors!

If you have been attending our Infection Control webinars, you will find this newsletter issue an important addendum to the information that you have already received from us regarding CMS Infection Control Changes and upcoming audits.
Please check out our Q&A section. This is where we will continue to post the questions from our ongoing Infection Control webinars. I am sure at least some of these same scenarios could be pertinent to YOUR facility!!


  • Questions & Answers from recent webinars
  • 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!

    Click for full Q&A's...
  • PROPOFOL shortage continues!!!
  • 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.

    Click for ASHP Bulletin on Propofol....
  • Locking Anesthesia Carts
  • 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.

  • Wash Your Hands Or Lose Your Job!
  • 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)

    One Hospital's simple measure to defeat infections....
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