Recently, a story was in the news about an 82-year old Italian woman who died of Legionnaires disease believed to be contracted from the water at her dentist's office. In the US, the CDC and ADA have issued guidance about water quality in dental practices to prevent transmission. The story served as a reminder about exposure to Legionella.

After the complimentary webinar about Clostridium difficile, we received a request for a list of products that are successfully used by ASCs to deal with spores.
Answer: The EPA website was searched and a list of products that are registered with the EPA that will destroy Clostridium difficile spores was not found. The results from an internet search for disinfectant products that are EPA registered in the U.S to destroy C. difficile spores are as follows:

• Dispatch (Clorox Company) EPA Reg. No. 56392-7
• Clorox Germicidal Wipes EPA Reg. No. 67619-12
• Virasept (Ecolab) EPA Reg. No. 1677-226

1. Do you need to know how to find information about isolation procedures? How about basic infection control precautions?
This is the link to the CDC 2007 Guidelines for Isolation Precautions Preventing Transmission of Infectious Agents in health Care Facilities.
http://www.cdc.gov/hicpac/pdf/isolation/Isolation2007.pdf
This document has information about standard precaution and transmission based precaution implementation in a variety of health care settings. There is a lot of information about the rationale for the precautions.

2. Have you wondered what precautions are necessary for a specific disease or a particular pathogens? Look no further, Appendix A to the 2007 Guidelines for Isolation Precautions has what you are looking for.
http://www.cdc.gov/hicpac/2007IP/2007ip_appendA.html


3. Do you need to find the OSHA Blood borne Pathogen Standard? Look here: http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051

4. Where are the US Public Health Service Guidelines mentioned in the Blood borne Pathogen standard?
They can be found here:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5011a1.htm
and here...
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5409a1.htm

If you need a resource for information before the next newsletter, please contact me: mary@excellentiagroup.com

You may have seen the recent presentation by the "Today Show" regarding dirty surgical instruments. If not, see link below. The program highlighted the potentially devastating consequences of retained soil on surgical instruments which had been through the sterilization process. Since this program aired, it would not be surprising if consumers voiced questions to a facility about the effectiveness of their sterilization. Hopefully you are prepared to answer consumer's questions.

The persons who clean, decontaminate, sterilize, and high level disinfect devices are the un-sung heroes of infection prevention. Staff training, effective policies and procedures, and QA/PI monitoring of your sterilization processes can't be overemphasized.

Remember the outbreak of hepatitis C following a series of outpatient colonoscopies performed in Nevada? Well it appears that yet another chapter has been written! The CDC as you recall linked the cases to unsafe injection practices that occurred during the administration of propofol.

More than 80 lawsuits had been filed against Teva Pharmaceutical Industries, the manufacturer of the propofol that was used during these cases. It seems the company was accused of deliberately manufacturing only their more profitable 20 ml and 50 ml vials rather than their smaller 10 ml vial of propofol. This perhaps caused physicians at the clinic to re-use the vials for more than one patient, thus exposing them to hepatitis C. Teva Pharmaceutical Industries case has now settled and they will pay more than $250 million to more than 40 of the lawsuits. Our industry continues to experience shortages and we still are asked the possibility of using single dose vials for multiple patients. Our advice remains to follow protocol and use single dose vials only for one patient.

Excellentia Advisory Group will be presenting our 2nd Annual Infection Prevention Strategies for ASC's and Perioperative Settings. This event will be:

• September 27 - 28, 2012
• St. Louis, MO
• 8:00am to 5:00pm each day
• 14 Contact Hours of Continuing Education
• BONUS for buying now; you get last year's 2-day seminar on DVD set for free! This normally sells for $960.00
• Discount for 2nd or more persons to attend
• Ambulatory Surgery Center & surgical setting focused presentations.
• Specific information that you can apply to your ASC
• Wonderful opportunity to gain the training material that you need to train your entire staff
• A seminar designed to build-upon last year's 2-day seminar
• All speakers will be CIC's or have Advanced Education in Infection Prevention