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Gary Evans writes Hospital Infection Control & Prevention (HIC), Hospital Employee Health (HEH) and contributes to IRB Advisor (IRB). As senior writer at AHC, Evans has written numerous articles on infectious disease threats to both patients and health care workers, including pandemic influenza, MERS and Ebola. He has been honored for excellence in analytical reporting five times by the National Press Club in Washington, DC.
This one has been flying under the radar, but for those of you who may have missed it, CMS is directing its surveyors to alert public health authorities if they see unsafe injection practices during inspections of health care facilities. Does that mean that they weren’t doing it before? Well, a lot of things weren’t happening before.
As originally reported in Hospital Infection Control & Prevention, CMS inspectors had actually visited the Las Vegas endoscopy clinic that was the site of massive hepatitis C exposure incident in 2008, but failed to recognize the reuse of single dose vials and other flagrant infection control breaches.
A recent memo by the Centers for Medicare & Medicaid Services states if State Survey Agencies (SAs) or Accrediting Organizations (AOs) witness the following practices it's time to cite and sound the alarm by calling in public health authorities:
• Using the same needle for more than one individual;
• Using the same (pre-filled/manufactured/insulin or any other) syringe, pen or injection device for more than one individual;
• Re-using a needle or syringe which has already been used to administer medication to an individual to subsequently enter a medication container (e.g., vial, bag), and then using contents from that medication container for another individual;
• Using the same lancing/fingerstick device for more than one individual, even if the lancet is changed.
According to the CMS, SAs should consult with their State’s Healthcare Associated Infections (HAI) Prevention Coordinator or State Epidemiologist on the preferred referral process. Since AOs operate in multiple States, they do not have to confer with State public health officials to set up referral processes, but are expected to refer identified breaches to the appropriate State public health contact identified at: http://www.cdc.gov/HAI/state-based/index.html