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From the Desk of Robert Morgan, MSN
Nosocomial infections represent the fourth leading
cause of death in the United States with more than
90,000 incidents among 2 million patients with an
annual cost of over $6 billion dollars, ($3000 per
patient). With that said, it is estimated, with the
initiation of an Infection Control Program using a
quality assessment approach that the mortality and
morbidity rate could be brought down significantly with
very little cost.
As the Infection Preventionist Director, I have had the
opportunity to visit many Ambulatory Surgery Centers.
The one practice I would like to discuss at this time is
the use of a bag of IV fluids, like Normal Saline to draw
up flushes for saline locks.
This practice is dangerous and could lead to a
systemic infection. Acinetobacter baumannii is
frequently found in the health care environment, and
commonly colonizes irrigation solutions and
intravenous solutions. It has been an
organism inherently resistant to multiple antibiotics
and therefore places your patients at greater risk. As
the Infection Preventionist Director I encourage all of
you not to use this practice. In the long run it does not
save money. A bag of Normal Saline costs about
$0.77 while a 10 ml bottle of saline for injection costs
about $.037. This would increase your cost for
pharmaceuticals by about $174.80 per year while
reducing your risk of causing an infection. Which
would you rather do?
Medical Device Tracking
The medical device tracking regulation is published in
Title 21 Code of Federal Regulations (CFR) Part 821.
This regulation was design to follow implantable
devices as it is related to recalls of these devices not
for infections. Because of that and the requirements
spelled out by Joint Commission's National Patient
Safety Goals and the Centers for Medicare and
Medicaid on implant tracking has led many to be
concern on which ones to track. Although Joint
Commission says to track all implants the FDA says
something entirely different. Here's a list of items the
FDA says we, as healthcare providers, do not
have to track anymore. These devices that were
subject to tracking orders issued by the agency in
February 1998 have received subsequent orders
releasing them from mandatory tracking requirements
for recalls:
- Intraocular Lenses
- Vascular graft prosthesis of less than 6
millimeters
- Vascular graft prosthesis of 6 millimeters and
greater
- Interarticular disc prosthesis (interpositional
implant)
- Annuloplasty ring
- Tracheal prosthesis
- Arterial stents (used in coronary or peripheral
arteries)
- Penile inflatable implant
- Silicone inflatable breast prosthesis
- Testicular prosthesis, silicone gel-filled
- Silicone gel-filled chin prosthesis
- Silicone gel-filled angel chik reflux valve
- Infusion pumps
- Electromechanical infusion pumps
- Dura mater
The FDA feels these items do not need to be track for
recalls any longer. However, and this really depending
on your surveyor, on whether you are Joint
Commission accredited or AAAHC accredited,
whether or not you must follow all implants for 12
months for infection follow up.
Click for FDA Device Tracking Guidance
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Greetings ASC Administrator or Directors!
Did you know that 68% of ASC's surveyed for Infection
Control have citations of some type? This trend
appears to continue, even after much discussion.
Cleaning in general represents the majority of
citations- equipment. environment, and hands. A word
to the wise, make sure your staff and providers are
aware of this trend. Although surveys have now been
going on for a full year, the dedication of time and to
resources towards the onsite activities does not
appear to be diminishing.
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| STERIS |
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The STERIS Corporation has announced it has
reached an agreement with the FDA regarding the
System 1 sterilization system. It includes an
agreement for the transition and rebate program to
current System 1 customers in the United States and
the decree is still subject to the approval of the U.S.
District Court in the Northern District of Ohio. This
agreement, in general, resolves the complaint of the
FDA allegations from May of 2008 which prohibited the
sale of any liquid chemical sterilization or disinfection
products specially the ones that do not have FDA
clearance. This will formalize STERIS'S rebate
program and allow the continued support of
customers with System 1 equipment. STERIS, under
the transition plan, will be offering a rebate program.
U.S. customers who have purchased System 1
processors from STERIS have the option to have a pro-
rated cash rebate or can trade-in there equipment
towards purchase of new capital equipment and/or
consumable products. There is a condition to
participation in this program, The System 1 units must
be returned.
- What kind of training does House Keeping need to
have?
- If we want to do "Home Laundry" who endorses
that?
- If our ET tubes have an expiration date on them are
they not any good if the expiration date has passed?
- Where can my Alcohol Hand Sanitizer Dispensers
go?
- We would like to store sterile items on wire racks
with clean items. Where is it appropriate to store
sterile items?
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Click for Steris News Release... |
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| CMS Revises IC Survey Form |
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CMS Modifies Surveyor Worksheet
March of this year CMS revised the ASC Infection
Control Surveyor Worksheet. This new format will be
used by all surveyors effective 4/12/10. While there are
no changes to content, the purpose of this is to make
the overall process more efficient. Surveyors are being
instructed to submit their reports within 10 working
days of your review. While you likely will see multiple
surveyors at your location completing individual forms,
they have been instructed to consolidate the
information and submit only one completed form to
CMS.
Click for Revised IC Worksheet Policy
Announcement
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Click for Revised IC Worksheet |
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| WARNING : DANGER |
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There is a fungus among us! A new Deadly Airborne
Fungus has been identified in Oregon. According to
scientists from Duke University Medical Center, the
fungus, which has caused several deaths in Oregon,
will soon move into the adjoining states like California,
Idaho and Nevada. Originally, this fungus outbreak
was seen in Canada in 1999 but has spread into
Washington state and Oregon.
Typically this fungus, Cryptococcus gattii, is seen in
patient with HIV-infections or transplant recipients but
this is not the case in Oregon. This virus is
troublesome threatening healthy people with a
mortality rate of approximately 25 percent in the United
States and an 8.7 percent in Canada and British
Columbia. The course of the disease is more
complicated with the C. gattii than with the more
common fungus of Cryptococcus neoformans.
Beware of this strain! It is very virulent especially when
it infects humans it also affects animals. Symptoms of
C. gattii can be delayed from two the several months
after the initial exposure. These include a cough which
could last for weeks, SHARP chest pain, Shortness of
breath, a headache which is similar to a meningitis
headache, fever, nocturnal sweats, and weight loss.
Animals may have a runny nose, trouble breathing,
nervous system problems and raised bumps under
the animal's skin.
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Read on... |
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