A government-private partnership is breathing new life into the One & Only Campaign, as Indianapolis-based Eli Lilly and Co. is working with the Centers for Disease Control and Prevention to expand its injection safety program.
The company is providing funding and staff as part of the Safe Injection Practices Coalition (SIPC), a partnership of healthcare-related organizations, patient advocacy organizations, industry partners, and the CDC and other public health partners.
Since 2001, the CDC has conducted some 50 investigations into viral hepatitis and bacterial outbreaks associated with unsafe injection practices. Overall, more than 150,000 patients have been notified that they might have been exposed to hepatitis and HIV due to unsafe injection practices, says Joseph Perz, DrPH, a health care epidemiologist and team leader in the prevention and response branch at the CDC’s division of healthcare quality promotion.
As part of the new partnership, SIPC will create tools for physician training as well as safe injection messages for YouTube and other social media, Perz says.
The new partnership is something the coalition’s other partners welcome, says Lynn Reede, CRNA, DNP, MBA, senior director, professional practice at the American Association of Nurse Anesthetists in Park Ridge, IL. The AANA is one of 14 organizations supporting the campaign.
"Sequestration was challenging for the CDC as resources were limited," Reede says. "So finding an industry partner who can support this very important effort is of great value."
From Lilly’s perspective, the partnership gives its scientists and experts the opportunity to work with the most respected source of authority on safe injection practices, says Jeff Prewett, senior hospital accounts manager with Lilly USA.
"In addition, the CDC gains a valuable partner within the healthcare community to promote and create awareness around safe injection practices," he says.
The next phase of the campaign will focus on educating providers about safe injection practices and underscoring their personal responsibility to follow them, Perz says.
"A lot of what we talk about is infection control and injection practice 101," he says.
Indeed, the flagrant disregard of basic aseptic practices has been a recurrent theme throughout the outbreaks, suggesting the need for a back to the basics approach.
The CDC will also increase public awareness that safe injection practices cannot be taken for granted. With the three-year partnership with Lilly, the CDC will expand the One & Only Campaign in these ways:
• Spread the message to individual and group-owned physician practices;
• Offer health care providers new and enhanced training and communication materials, including electronic continuing medical education, to address new safety issues;
• Reaching new audiences by improving the SIPC website and social media platforms and sharing resource toolkits; and
• Obtaining more support from new and existing SIPC partners.
U.S. not immune to Third World problems
The CDC first became interested in this issue when supporting the World Health Organization’s Safe Injection Global Network, Perz notes.
"Those needs are as great as ever," he says. "What we’ve learned in the last 10 years is that the U.S. is not immune to this problem, and some of the factors that might lead to things like reusing a syringe in the developing world can happen here as health care providers face similar pressures to cut corners."
One example is the 2008 Las Vegas outbreak in two endoscopy clinics, where providers reused syringes and vials to save pennies per patient, Perz says.
"In recent years there have been issues that result in short supplies of medications," he adds.
The drug shortages led to some unsafe practices, such as providers using single-dose medications for multiple patients to stretch their supplies, Reede explains.
One example is propofol, an intravenously administered anesthetic agent. When a chief manufacturer stopped making the drug in 2010, severe shortages followed. Some health care providers were tempted to double dip from the vials, but this is an inherently unsafe practice unless done in optimal conditions.
"Pharmacies have sterile rooms where they are able to safely compound or repackage medicines," Reede says. "Single dose vials, purchased syringes and repackaging — though more expensive — are important for safe injection practices."
The One & Only Campaign will continue to educate providers that they cannot cut corners, Perz emphasizes.
"There are safe ways to stretch supply, and there are unsafe ways to stretch supply," Perz says. "Protecting patients from bloodborne pathogens is a basic responsibility for anyone providing healthcare in the U.S. and worldwide."