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Selected Category: Outpatient Care

Helping Cancer Patients Prevent Infections this Winter

Categories: Healthcare-associated infections, Outpatient Care, Patients

Alice Guh, M.D, MPH

Alice Guh, M.D, MPH

Author:   Alice Guh, M.D., M.P.H.
Medical Officer, CDC’s Division of Healthcare Quality Promotion

When you are battling cancer, the last thing you want to get is an infection.  This is one of the reasons why I am involved in Preventing Infections in Cancer Patients,  a program focused on providing information, action steps and tools for cancer patients, their families and healthcare providers to reduce the risk of developing potentially life-threatening infections during chemotherapy treatment.

With flu season peaking, I thought it was an appropriate time to answer some questions about how cancer patients can take action to protect themselves against the flu and other serious infections this winter.

Why are cancer patients at greater risk for infection from the flu?

Cancer patients who are receiving chemotherapy are vulnerable to infections when their white blood cell count is low. It’s important for cancer patients to understand how to prevent infections year-round, and especially during flu season.

In the winter months, cancer patients face an additional infection risk: influenza or flu. Like other infections, flu is more likely to cause serious complications in cancer patients because of their   weakened immune systems. These complications can include pneumonia, a disruption to their chemotherapy schedules, hospitalization and death.

What Happens in the Outpatient Clinic Doesn’t Always Stay in the Outpatient Clinic: Lessons from a Regional Outbreak of Adenovirus-associated Epidemic Keratoconjunctivitis (EKC)

Categories: Healthcare-associated infections, Outpatient Care, State HAI Prevention

Andrew Wiese, MPH

Andrew Wiese, MPH

Author – Andrew Wiese, MPH
Applied Epidemiology Fellow
Tennessee Department of Health
CDC, Council of State and Territorial Epidemiologists (CSTE)

This week’s Morbidity and Mortality Weekly Report (MMWR) includes a description of six separate outbreaks of Adenovirus-associated epidemic keratoconjunctivitis (EKC) in four different states. These outbreaks were mainly associated with outpatient eye care.

Last August, as a new CDC/CSTE Applied Epidemiology fellow in the Tennessee Department of Health (TDH), I experienced firsthand an outbreak that was similar to those described in the MMWR. We were contacted by a concerned patient who experienced severe conjunctivitis after receiving care at a local ophthalmology clinic and was aware of similarly affected patients.  I was asked to help lead the investigation.

Communication with the clinic identified gaps related to cohorting of suspected cases, procedures for disinfection of equipment and surfaces, and the policy for the appropriate length of time ill staff should be kept from patient contact.  Our TDH team then guided implementation of appropriate infection control practices to prevent further transmission.  While our investigation identified ninety cases of EKC at the clinic, only a single case from the clinic occurred after the health department’s intervention.

One and Done: Single-Dose/Single-Use Vials Are Meant for One Patient

Categories: Healthcare-associated infections, Injection Safety, Outpatient Care

Michael Bell, MD

Michael Bell, MD

Author: Michael Bell, MD,
Associate Director for Infection Control at CDC′s Division of Healthcare Quality Promotion.

CDC released a report today detailing two outbreaks that occurred when healthcare providers failed to follow basic injection safety elements of Standard Precautions.  These breaches resulted in life-threatening – yet completely preventable – infections in a number of patients receiving injections for pain relief.  How does this happen in today’s advanced medical settings?

In both outbreaks, healthcare providers were splitting single-dose/single-use medication vials meant for one patient into new doses for multiple patients.  There was a lack of awareness that this practice puts patients at risk of infection.  Because injections were prepared with new needles and syringes and, in one of the clinics, in a separate “clean” medication preparation room, providers thought they were being safe.  However, these preservative-free medications are not safe for multi-patient use.  Ultimately, ten patients in these two clinics required hospitalization for treatment of mediastinitis, bacterial meningitis, epidural abscess, septic arthritis, bursitis, and sepsis – all severe infections caused by either Staphylococcus aureus (Staph) or its drug-resistant form MRSA.

New, Simple Tools Help Busy Clinicians Double Check Injection Safety Knowledge, Practices

Categories: Healthcare-associated infections, Injection Safety, Outpatient Care

One & Only Campaign

One & Only Campaign

Author – Joseph Perz, DrPH, MA
Prevention Team Leader for the Division of Healthcare Quality Promotion,
Centers for Disease Control and Prevention

You might be thinking, “Is a knowledge refresher on injection safety really needed?  Providers all know how to give safe injections!”  Sadly, this is not the case.  We at CDC have seen outbreak after outbreak related to providers not following safe injection practice standards as outlined in CDC guidelines.  We also see patient notifications that inform patients that they “may have been exposed – please be tested.”  Failures in basic patient protections that we see include the reuse of syringes or needles; the reuse of single-dose/single-use vials; and mishandling of multi-dose/multi-use vials.  With every outbreak or patient notification event that has occurred over the past 10 years, we have wondered how many other infections and exposures are slipping by, unnoticed. 

The CDC and the Safe Injection Practices Coalition have released a safe injection toolkit geared specifically for busy medical practices.  This free toolkit features a Power Point presentation with recorded audio, convenient for use during staff meetings, in-services, and other educational seminars.  Other pieces include a no-cost Medscape CME activity, a safe injection practices training video, and a number of eye-catching posters to remind staff about the basics of injection safety. 

Protect Cancer Patients from Infections

Categories: Antibiotic use, Healthcare-associated infections, Outpatient Care

Alice Guh, M.D, MPH

Alice Guh, M.D, MPH

Author: Alice Guh,
CDC medical officer and co-lead of Preventing Infections in Cancer Patients initiative

As clinicians, we know that the nearly one million patients who receive outpatient cancer treatment each year are at risk for serious infections that may lead to hospitalization, disruptions in chemotherapy schedules, and in some cases, death. Even so, it appears that outpatient oncology facilities may vary greatly in their attention to infection prevention. As one example – at an oncology clinic in Nebraska, it was discovered that syringes were reused to access bags of saline that were shared among multiple patients. This unsafe practice led to the transmission of hepatitis C virus to at least 99 cancer patients, resulting in one of the largest healthcare-associated outbreaks of its kind.

To help address this problem, CDC is launching a new program called Preventing Infections in Cancer Patients, featuring tools to help both clinicians and patients prevent infections.

As a cornerstone of this new initiative, CDC worked with partners to develop a Basic Infection Control and Prevention Plan for Outpatient Oncology Settings, which can be used by outpatient oncology facilities to standardize – and improve – infection prevention practices.

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