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Safe Injection Practices: Establishing the Habit in Residency

Categories: Healthcare-associated infections, Injection Safety

Aaron Rich Ducoffe, MD

Aaron Rich Ducoffe, MD

Guest Author: Aaron R. Ducoffe, MD
US Department of Health and Human Services

In my first few weeks as a Health Policy and Quality Fellow, I immediately became intrigued with the CDC’s One & Only Campaign and its applicability to my former and upcoming planned specialties.

I have learned in residency that a physician’s best and worst habits develop during training. Therefore, even in the midst of a chaotic hospital day, it is crucial that I maintain a mental checklist for every procedure, especially injections.

A frequent encounter concerns the lidocaine vial. Last year, I performed countless lidocaine injections in the ER for suturing wounds and hematoma blocks for fracture reduction. If the vial was multi-use, I always ensured it was stored appropriately – out of the ER bays in a safe, clean area, avoiding the ever-present improperly stored “leftover” vial. Continuing down the checklist, I always utilized sterile needles and syringes as well as proper aseptic technique for both drawing and injecting the lidocaine. These practices[PDF – 1.35 MB] are not only important for subcutaneous injections, but even more so for intra-articular aspirations and injections, vascular access, and at the depths of other interventional procedures often requiring a sterile IR suite, such as spinal injections.

Not Worth the Risk: Failing to Implement Basic Safe Injection Techniques

Categories: Healthcare-associated infections, Injection Safety

Andrew Engel, MD

Andrew Engel, MD

Guest Author: Andrew Engel, MD
International Spine Intervention Society

The International Spine Intervention Society supports the Centers for Disease Control and Prevention’s safe injection practices. As a strong proponent of using evidence-based medicine and safe injection practices, the International Spine Intervention Society agrees with the message espoused by CDC’s new Key Standards for Pain Clinics [PDF – 1.35 MB] poster.  Unfortunately, there continue to be rare (although much too frequent) infections during interventional spine procedures that are directly linked to failures of implementing basic safe injection techniques. Fortunately, the evidence is clear that by simply following safe injection practices physicians can reduce the likelihood of their patients developing infections.

While many providers express concern that they are not adequately reimbursed for providing a new single dose vial for every patient, the emotional and economic consequences in the event of an infection or possibly an outbreak clearly make "One and Only" practice the practical choice. Breaches in sterile technique, including the reuse of single dose vials, can facilitate a single infection turning into an outbreak.

Some will reflect on their years in practice, saying that they have not adhered to one or more of the standards of care and have never seen an infection as a result.  While these physicians should consider themselves lucky, sporadic transmission of blood borne pathogens may not be recognized as having resulted from unsafe injections.  Given the severity of the potential complications, a single preventable infection, let alone an outbreak, is one too many.  It’s not worth the risk.

For more information about patient safety and interventional spine procedures, check out the International Spine Intervention Society’s FactFinder series at https://www.spinalinjection.org/fact-finders.php.

35 U.S. hospitals designated as Ebola treatment centers

Categories: Healthcare-associated infections

Ebola: U.S. Hospital Readiness as of Dec. 2014

Ebola: U.S. Hospital Readiness as of Dec. 2014

CDC trains and assesses Ebola hospital readiness in collaborative effort

An increasing number of U.S. hospitals are now equipped to treat patients with Ebola, giving nationwide health system Ebola readiness efforts a boost. According to the Centers for Disease Control and Prevention (CDC), state health officials have identified and designated 35 hospitals with Ebola treatment centers, with more expected in the coming weeks.

Hospitals with Ebola treatment centers have been designated by state health officials to serve as treatment facilities for Ebola patients based on a collaborative decision with local health authorities and the hospital administration.

Ebola treatment centers are staffed, equipped and have been assessed to have current capabilities, training and resources to provide the complex treatment necessary to care for a person with Ebola while minimizing risk to health care workers.

“We continue our efforts to strengthen domestic preparedness and hospital readiness. I am pleased to announce that 35 hospitals have been designated by state health officials as Ebola treatment centers that are prepared, trained, and ready to provide care for a patient with Ebola,” said Health and Human Services Secretary Sylvia M. Burwell.

Antimicrobial Stewardship – a concept we must all embrace

Categories: Antibiotic use, Antimicrobial Resistance

Jennie L. Mayfield, BSN, MPH, CIC

Jennie L. Mayfield, BSN, MPH, CIC

Guest Author: Jennie L. Mayfield, BSN, MPH, CIC
2014 President,
Association for Professionals in Infection Control and Epidemiology (APIC)

A retrospective study from The University of Texas College of Pharmacy published in the October issue of the American Journal of Infection Control (AJIC), found that C. difficile infections (CDI) nearly doubled from 2001 to 2010 in U.S. hospitals.

Researchers analyzed 10 years of data from the U.S. National Hospital Discharge Surveys (NHDS) and found that from 2001 to 2010, rates of CDI among hospitalized adults rose from 4.5 to 8.2 CDI discharges per 1,000 total adult hospital discharges.

Antibiotic resistance: Know your ABC’s

Categories: Antibiotic use, Antimicrobial Resistance

Crystal Heishman MSN, RN, CIC, ONC

Crystal Heishman MSN, RN, CIC, ONC

Guest Author: Crystal Heishman MSN, RN, CIC, ONC
Infection preventionist at the University of Louisville Hospital

As healthcare providers and patients, we have long heard the warnings about the dangers and eminent threat of antibiotic resistance. Bacteria have continually adapted to antibiotics, becoming increasingly resistant to many of the medications used to treat them. Resistance is now a global issue that must be addressed comprehensively and quickly.

The Association for Professionals in Infection Control and Epidemiology (APIC) is raising awareness and focusing attention on antibiotic resistance during Get Smart About Antibiotics Week. The centerpiece of this outreach is a new “ABC’s of Antibiotics [PDF – 714 KB]” infographic poster for patients and families that illustrates when antibiotics work and when they don’t.

A = Ask if antibiotics are appropriate; B = Bacteria – antibiotics only kill bacteria and won’t work to treat viruses; and C = Complete the course of your medicines – even if you feel better before you finish them.

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