Nursing organization adopts 2004 platforms
The American Organization of Nurse Executives (AONE) in Washington, DC, a subsidiary of the American Hospital Association, has unveiled its policy platforms. The major policies are
- Foreign Nurse Recruitment
AONE supports the lawful entry of nurses from foreign countries to work in the United States and its territories provided they meet all federal qualifications for entry and practice.
It is incumbent upon institutions that recruit foreign nurses to foster an environment that is culturally sensitive and supportive as these nurses are assimilated into the American health care system.
- Mandatory Overtime
It is the view of AONE that mandatory overtime is the staffing vehicle of last resort, limited to crisis situations that would put patients in danger of not receiving the basic requirements of the safe care that they require.
- Mandated Staffing
AONE does not support mandated nurse-staffing ratios. Mandatory nurse staffing ratios will only serve to increase stress on a health care system that is overburdened by an escalating national and international shortage of registered professional nurses and has the potential to create a greater risk to public safety.
The AONE policy statement can be found on its web site (www.hospitalconnect.com).
OSHA and CDC establish hand hygiene policies
To improve hand hygiene among health care workers, the Centers for Disease Control and Prevention (CDC) recommends the use of alcohol-based hand sanitizers. Health care workers only need to use traditional soap and water if their hands are visibly soiled, according to the CDC.
The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogen Standard adds a caveat, however. OSHA requires employees to wash their hands with soap and water if they have had "occupational exposure to blood or other potentially infectious materials."
"OSHA interprets this to mean that when an employee is removing gloves and has had contact, meaning occupational exposure to blood or other potentially infectious materials [OPIM], hands must be washed with an appropriate soap and running water," wrote Richard E. Fairfax, director of the Directorate of Enforcement Programs, in an interpretation letter. "If a sink is not readily accessible (e.g., in the field) for instances where there has been occupational exposure, hands may be decontaminated with a hand cleanser or towelette, but must be washed with soap and running water as soon as feasible. If there has been no occupational exposure to blood or OPIM, antiseptic hand cleansers may be used as an appropriate hand-washing practice," he added.
Gloves are not impervious, according to an OSHA industrial hygienist. Even if no contamination is visible after removing the gloves, soap and water still should be used, Fairfax stated.
CMS tightens claims processing requirements
The Centers for Medicare & Medicaid Services (CMS) has produced an educational article explaining the changes to the Health Insurance Portability and Accountability Act (HIPAA) claims processing requirements that will take effect July 6, 2004. The changes affect all health care providers who bill Medicare Fiscal Intermediaries. Medicare now will require certain data elements that are not needed for payment of Medicare claims but are required by HIPAA. Data that Medicare previously allowed, but is not permitted by HIPAA, will result in claims rejection. Also, data that Medicare now edits only for syntax will be edited for content and will result in claims rejections if data are not valid.
Examples of changes that can result in claims rejections after July 6 include:
- For all home health claims, all line items must contain a date or dates of service for each revenue code or it will be rejected.
- Any claims that are not inpatient claims containing covered days (QTY Segment) will be rejected.
To view the article and for links to more technical documents related to the change, go to the CMS web site (www.cms.hhs.gov/medlearn/matters/mmarticles/2004/MM3031.pdf).