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A Patient Speaks from the Heart

Categories: Healthcare-associated infections, Injection Safety

Karen Morrow

Karen Morrow

Guest Author: Karen Morrow

Like any other tragedy, the first thing to enter a person’s mind is, “This can’t be happening to me.”  It’s exactly what I thought.  I absolutely knew that I was OK…until I read the test results.  I still go back and read them now and can’t believe they are mine.  Writing this now, I am crying.  Even after all this time, it is still just so unbelievable to me.

I was one of the patients notified that I might be at risk for serious disease during the 2008 hepatitis C outbreak in Las Vegas.  Unbelievably, I tested positive for hepatitis C.  I followed the CDC’s recommended course of treatment, which was 48 weeks of both interferon and ribavin.  This regimen itself brought on a plethora of symptoms, some of which were nausea, insomnia, hair loss, exhaustion, muscle aches and pains, diarrhea and constipation.   Throughout the recent criminal trial involving my healthcare provider, I would go and sit in the courtroom every afternoon after work to listen.  I was sick at my stomach and nervous as hell, but I needed to be there.  Words fail me sometimes at the situation in which I find myself.  My whole life I have been a good girl:  absolutely no risky behaviors.  But I am a totally different person today than I was the moment before I received that call from my doctor’s office.

Overcoming Education Gaps and Denial: CDC and SIPC Release New Tools to Help Clinicians Ensure Every Injection is Safe

Categories: Healthcare-associated infections, Injection Safety

The Impacts of Unsafe Medical Injections in the U.S.

The Impacts of Unsafe Medical Injections in the U.S.

Author: Centers for Disease Control and Prevention 

Injection safety is part of the minimum expectation for safe care anywhere healthcare is delivered; yet, CDC has had to investigate outbreak after outbreak of life-threatening infections caused by injection errors.  How can this completely preventable problem continue to go unchecked?  Lack of initial and continued infection control training, denial of the problem, reimbursement pressures, drug shortages, and lack of appreciation for the consequences have all been used as excuses; but in 2012 there is no acceptable excuse for an unsafe injection in the United States. 

Eradicating unsafe practices will take a multifaceted approach, and now is the time for action to ensure that no additional patients are harmed through unsafe injections.  Today, the CDC and the Safe Injection Practices Coalition released new materials to make it easier for clinicians and others working in healthcare to learn and train others about following safe injection practices. 

Two Birds with One Stone:  Bloodborne Pathogen Training + Patient Safety – Enhanced PowerPoint

Healthcare providers or training managers who need to keep staff current on bloodborne pathogens training can now use a new presentation:  “Safe Injection Practices:  Protection Yourself and Your Patients – A Bloodborne Pathogens Training Activity.” This training was created to remind healthcare providers that measures they take to protect themselves from bloodborne pathogens and other exposures also protect patients from healthcare-associated infections.  View the training on the One & Only Campaign’s website.   

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.

“You Could Have Heard a Pin Drop.” Kent Hospital Renews Vigilance on Injection Safety Rules

Categories: Healthcare-associated infections, Injection Safety, State HAI Prevention

Peter Graves MD

Peter Graves MD

Guest Author – Peter Graves, MD
Chairman, Department of Emergency Medicine
Academic Faculty, Kent Hospital Emergency Medicine Residency Program
Kent Hospital
Warwick, RI

One of the great “truisms” of Life is that we often don’t know—what we don’t know. In other words, we can’t imagine the scope of a problem if we are under the assumption that it doesn’t even exist.

No provider goes to the hospital or office with the intent of harming patients. So I was shocked to learn that the Centers for Disease Control and Prevention has tracked over 40 outbreaks of infectious disease caused by unsafe injection practices including hepatitis B (HBV), hepatitis C (HCV) and bacterial infections in the past 10 years in the United States. It is fundamentally unacceptable that these outbreaks were because healthcare providers failed to follow Standard Precautions when preparing an injection. Those lapses in basic infection control include reusing needles and syringes from patient to patient or misusing single-dose and multi-dose vials. This boggles the minds of many practitioners who may feel they are following correct procedures—when in fact they might not be doing so at all.

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. 

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