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Selected Category: Healthcare-associated infections

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.

Safe Diabetes Care: Insulin Pens are ONE Person ONLY

Categories: Healthcare-associated infections, Injection Safety

Ann L. Albright, PhD, RD

Ann L. Albright, PhD, RD

Guest Author: Ann L. Albright, PhD, RD
Director, Division of Diabetes Translation,
Centers for Disease Control and Prevention

Diabetes is a chronic condition that is a 24/7 responsibility for everyone who has it. Diligence is necessary to manage diabetes, since its highs and lows can strike while we are otherwise busy with life. It is exciting that there are advances and tools such as the insulin pen to make it easier for people to administer insulin. This is particularly helpful for children, who often must take insulin during the school day, or for those who need to administer insulin while on the go. Diabetes isn’t a convenient disease to live with, no matter what your age.

Along with these tools come great responsibilities, of course, and as health professionals, we can help keep our patients safe. It’s always important to think about how someone uses an insulin pen. The pen can make it easier for people to administer the correct dosage in a timely way, as well as to keep track of only one item, rather than the insulin vial and syringes. But it can also make it easier to share with another individual, without considering the consequences. Teaching people with diabetes to take care of their insulin pen, to use it only for themselves, is essential.

Coming Out of “Deafening Silence” to Fight Sepsis Together

Categories: Healthcare-associated infections, Sepsis

Steven Q. Simpson, MD

Steven Q. Simpson, MD

Guest Author: Steven Q. Simpson, MD
University of Kansas and Sepsis Alliance

What severe sepsis needs is the equivalent of an American Heart Association. An organization that exists to teach the general public, as well as physicians, how to save lives. Thanks, in large part, to the heart association, Americans are well versed in the symptoms of heart attack. Pick up the phone and call your mother (this assumes that your mother is not a doc, which is not a 100% safe assumption, but is more likely to be true than not). Ask her what causes heart attacks. There is a high likelihood that she understands that heart attacks stem from acute occlusion of a coronary artery. She can probably tell you that the symptoms include pain in the chest, jaw, and shoulder and that there are clot busting drugs to help, if you get to the hospital quickly. More than likely, she also recognizes some of the major risk factors, including cholesterol, hypertension, and – one hopes – smoking.

Now ask her about sepsis, and listen to the deafening silence on the other end of the phone line. Severe sepsis is the stealth killer; it kills between 30% and 50% of people who develop it, and it is one of the most common causes of death in the US, although the deaths are often attributed to underlying diseases, such as COPD or cancer. There are no public service announcements about sepsis. One does not find the signs or symptoms in the lay press. Only the occasional nightmare story about a young person in whom the diagnosis of severe sepsis was missed and who died as a result. The sad thing is that this happens much more frequently than the reports in the papers show up. Worse yet, physicians remain, in large part, oblivious to the simple approach to infected patients that would prevent many of the deaths. Worst of all, every family has been touched by severe sepsis in one way or another, but they mostly do not know it, because none of the doctors called it that, only “severe pneumonia,” “kidney infection,” “peritonitis.”

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