CBSPD Announces Management Course Dates for 2009

The CBSPD has posted the dates for their Educational meetings for Managers and Supervisors for 2009.

Click on the this link for the PDF

New Research supports the use of the TOSI

An article that appears in AJIC -2/08-Volume 36,number 1. The study was done by Dr. Michelle Alfa,Nancy Olson and Louise Buelow-Smith in Winnipeg,Manitoba, Canada states" our data supports the value of users evaluating the cleaning efficacy of Washer Disinfectors by...TOSI testing...Washser Disinfectors that do not provide adequate cleaning as determine by these tests should be taken out of service until they are fixed or replaced..."

To read the complete article Click here.

Mystery solved: How bleach kills germs

Research out of the University of Michigan have just figured out how the cleaner does its dirty work.

It seems that hypochlorous acid, the active ingredient in bleach, attacks proteins in bacteria, causing them to clump up much like an egg that has been boiled, a team at the University of Michigan reported in the journal Cell on 11/14/08.

To read the complete story Click here.

Hospitals use more antibiotics despite concerns

Reuters has reported that experts worry bacteria will become resistant to existing drugs.

To read the complete story Click here.

Class 6 White Paper now on line

STERIS Corporation has issued a free white paper to explain the emulating ink technology and capabilities of the first Class 6 steam sterilization chemical indicators cleared for use in US healthcare facilities. Download the paper here.

Doorknobs and TV remotes are germ hotbeds

The AP is reporting that The University of Virginia has released a report that common areas with in a house harbor germs; some germs stay up to two days. To read the complete article. Please Click on this link.

C.difficile strikes again

The Toronto paper The Globe and Mail has reported that " Aging hospitals breed deadly outbreaks" . The paper reported that an outbreak of C.difficile at an Ontario hospital between May 2006 and December 2007 killed 91 patients. For the complete story click on this link.

Unreported Changes to Sterilization Wraps Draw FDA Warning

The FDA Daily email update Vol. 5, No. 181;Tuesday, Sept. 16, 2008 reported the following.

Unreported Changes to Sterilization Wraps Draw FDA Warning
Kimberly-Clark Healthcare failed to obtain marketing clearance before selling 12 models of previously approved sterilization wraps that the FDA considers new products because significant changes were made, according to a warning letter. The FDA says the devices are adulterated and misbranded because the company failed to provide adequate justification for not submitting 510(k)s or PMAs for the updated line. The company claimed the changes made between 1991–1995 were not significant enough to require new 510(k)s.
The GMP Letter

NIOSH brochure offers tips for reducing occupational stress in hospitals

A new brochure from the National Institute for Occupational Safety and Health examines potential causes and health effects of occupational stress in hospitals, and suggests work practices that can help reduce it. A combination of organizational change and stress management “is often the most successful approach for reducing stress at work,” the authors note.

New Web Page on Understanding Chemical Indicators

3M Health Care has announced the addition of a new Web site (to its suite of free, objective educational tools offered through 3M Attest Sterile U Online.
Focused on the topic of steam sterilization load and pack control monitoring devices, the new website provides clear answers and facts on the differences and implications of using Biological Indicators, Class 5 Integrating Indicators, and Class 6 Emulating Indicators for monitoring. It also contains guidance on how and when to use the various steam sterilization load and pack control monitoring devices, and offers in depth details on standards and guidelines from various industry associations. To access the site visit click on link.

U.S. News Best Hospitals for 2008 are posted

The 2008 "Best Hospitals" rankings are out.

For more, click here

The Honor Roll link

Listings by specialty

Where does your hospital rank ?

Printed copy will be on the Newsstands July 14,2008.

Residents Alerted to Improperly Washed Surgical Tools

Ann Work a reported for the Times Record News in Witchita Falls, Texas has reported that a Health Care System had to inform over 1,800 patients that the instruments used in their surgeries might not have been cleaned properly . The possible source of the concern " the detergent dispenser" . Just another reason why medical facilities should be testing their medical automatic washers.

Clink on the link to read the complete story.

Duke Settles Hydraulic Fluid Case

As reported on6/24/2008 in MDSI daily updates.

Duke settles hydraulic fluid case; New lawsuits filed against Cardinal, Steris, and Duke University Health System (Durham, NC) settled claims by patients who in 2004 were operated on at Durham Regional Hospital (Durham, NC) and Duke Health Raleigh Hospital (Raleigh, NC) using surgical instruments mistakenly cleaned with used hydraulic fluid. Details of the settlement were not disclosed. Following the settlement, an additional lawsuit with 67 plaintiffs was filed in Durham County Superior Court against distributor Cardinal Health (Dublin, OH) and Steris Corp (Mentor, OH), which made the sterilization washers used in the hospitals to clean surgical equipment, as well as the detergent and other products used in the process. Cardinal Health employees, several of whom were also named as defendents, allegedly should have been able to tell that the barrels that originally held detergent had been used for another purpose, and should not have returned them to the company for resale.

How do you wipe something clean?

The actual process of decontamination a surface is the same for both cleaning and disinfection. Due to the effect of biofilms, surface wiping is needed to assist in the removal of surface contamination. Wiping should never be carried out in a circular motion as this causes the wipe in its dirtiest state to be passed over an area which has just been cleaned. This point needs to be reinforced with operators, as a circular wiping pattern is the most comfortable and convenient but not the best practice.

The correct technique is to wipe, towards you, in straight horizontal lines, each time overlapping the previous one by 10-25%. A contaminated wipe should not be passed over an area that has just been wiped, unless it is folded and refolded to provide a clean surface. Usually quarterly folds are recommended but must be validated with each operator concerned, as a quarterly fold can lead to confusion as to which surfaces of the wipe have been used. In this case wipes folded in half should be used. Surface wiping should be carried out from top to bottom, from back to front, and from cleanest to dirtiest. The wipe itself should be constructed from a low particulate material.

The source of this information is Cleaning of Isolators - A Vital Part of a Contamination Control Program By: Karen Rossington; April 2004.

When to Use Alcohol as a Disinfectant

It has been known for many years that alcohol is an effective disinfectant;studies have shown that it is a better disinfectant when it is neither too weak nor too concentrated.Disinfectant efficacy is optimal at concentrations between 50% and 80%. Many institutions use 70% alcohol blends as standard.

To read more click on this link.

Joint Commission releases 2009 patient safety goals

The Joint Commission released the 2009 National Patient Safety Goals and related requirements for its accreditation programs.

To review the complete document click on this link.

JCAHO 2009 Patient Safety Goals

More Knee and Hip Surgery Cases

Central Service departments are going to be doing more knee and hip type surgries in the future according to a report out of The University of Michigan. The number of baby boomers who are opting for knee replacement surgery earlier in life is growing at an exponential rate, says J. David Blaha, M.D., an orthopaedic surgeon at the University of Michigan Health System. Only a few years ago, between 300,000 and 350,000 knee replacement surgeries were being done. Today, that number has risen to a staggering 500,000 and going up each year.

To read more on this story just click on the link.

http://www.newswise.com/articles/view/541310/?sc=rsmn

New Type of Latex Glove Cleared

On April 23, 2008, the Food and Drug Administration (FDA) cleared for marketing the Yulex Patient Examination Glove. This is the first medical device made from guayule latex, a new form of natural rubber latex.

For more information on this please click on this FDA link.

C. difficile exacts heavy toll at Ontario hospital

Canada : HPN has reported a story out of Toronto that a deadly outbreak of a highly contagious superbug at an Ontario hospital claimed the lives of one-third of the patients afflicted with the disease, a far greater toll than previously believed. Joseph Brant Memorial Hospital in Burlington announced yesterday that 91 of the 177 patients diagnosed with Clostridium difficile, commonly known as C. difficile, over a 20-month period ending last December died in the institution. It blamed the disease for 62 of the deaths.

Please click on this link for detailed information.

Reprocessing Industry Group Applauds GAO Report Findings

"Medical device reprocessing, as the GAO again confirms, is stringently regulated by the Food and Drug Administration (FDA),” Vukelich says. “Twice in eight years GAO has looked at the practice of reprocessing ‘single-use’ devices (SUDs) and found no evidence of increased risk to patients.”

To read the complete story pleae click on the link.

How is Your Hospital doing these days ?

Have you ever wanted to compare hospitals and their care? Now you have a way. The comparisons are posted on a special web site.

The site was launched in 2004 as part of the federal Medicare Prescription Drug, Improvement and Modernization Act of 2003. The U.S. Department of Health & Human Services has created its "Hospital Compare" Web site: www.hospitalcompare.hhs.gov.

Click on these two links to read more about this process and compare your hospital.

Link 1


Link 2

What's Right in Health Care: 365 Stories of Purpose, Worthwhile Work, and Making a Difference.

A new book has been published dealing with 365 Healthcare stories that have made a difference. Go to this link to read more about this new book. The link is

http://thenewsherald.com/stories/012008/loc_20080120005.shtml

OSHA Offers a New Resource for Medical Facilities

In the fall of 2007 OSHA released a Web site that provides step-by-step guidance, along with the requirements and educational resources managers need to ensure occupational safety.Please click on the link below for this tool and more information.

http://www.osha.gov/dcsp/compliance_assistance/quickstarts/health_care/index_hc.html

Fingernails and Infection

Outpatient Surgery E-Weekly (2/5/08) has reported about a study that is published in the January issue of the Journal Infection Control and Hospital Epidemiology that found that although antibiotic gels help increase hand hygiene, they failed to reduce infection rates in two ICUs over a two-year period.

"Hand hygiene may be important, but it's only one ingredient in the overall recipe for preventing infection," says Mark Rupp, MD, professor of infectious diseases at the University of Nebraska Medical Center, medical director of the school's Department of Healthcare Epideminology and the study's principal author.

Exactly why the infection rates did not decrease when hand hygiene compliance increased is unknown, says Dr. Rupp. One theory has to do with fingernail length. They found more, and varied, microbes when the nurses had fingernails more than two millimeters long, wore rings or lacked access to hand gels. According to Dr. Rupp, fingernails are too long for healthcare if you can see them over the skin of your fingers when looking at your palm.

To read more on this topic please go to the link below.

http://www.journals.uchicago.edu/doi/abs/10.1086/524333

FDA Public Health Notification: Unretrieved Device Fragments

Issued: January 15, 2008

Dear Healthcare Practitioner:

This is to advise you of serious adverse events associated with unretrieved device fragments (UDFs) and provide recommendations to mitigate these events. A UDF is a fragment of a medical device that has separated unintentionally and remains in the patient after a procedure. Patients may not be aware that this has occurred. The Center for Devices and Radiological Health (CDRH) receives nearly 1000 adverse event reports each year related to UDFs. These have included more than 200 different medical devices and numerous medical specialties.

To read the complete report please go to this link :

http://www.fda.gov/cdrh/safety/011508-udf.html

Avoiding Hazards from Using Cleaners and Disinfectants on Electronic Medical Equipment

FDA, CDC, EPA and OSHA have issued a Public Health Notification on how to avoid hazards when using liquid cleaners and disinfectants on electronic medical equipment. The Notification covers a wide range of equipment, including infusion pumps, ventilators, analgesia pumps, computer workstations and monitoring equipment.

This action was prompted by reports of fires and other equipment damage, as well as burns to healthcare workers, when these types of liquids were used inappropriately on equipment that has unsealed electrical circuits. In many cases, healthcare workers routinely sprayed the equipment with disinfectants or wrapped the housings with disinfectant-soaked towels, causing damage to the circuitry.

The Notification provides a number of recommendations to reduce the risk. Here are some of the highlights:

• Protect equipment from contamination during use, which can help avoid the need for disinfection.

• If equipment becomes contaminated, remove it from use and be sure it's serviced before returning it to use.

• Clean equipment surfaces according to the instructions from both the equipment manufacturer and the chemical manufacturer.


Additional Information:

FDA MedWatch Safety Alert. Cleaners and Disinfectants: Hazards of Excess Use on Electronic Medical Equipment. November 1, 2007.

http://www.fda.gov/medwatch/safety/2007/safety07.htm#Cleaners

Ireland Issues Guideline on Device Reprocessing

Ireland Issues Guideline on Device Reprocessing

Ireland’s Health Service Executive has released a practice guideline on decontamination of reusable invasive medical devices (RIMDs).

The new code of practice sets standards and best practices for facilities operating within Ireland’s public health system.

“Decontamination facilities should be designed, constructed, maintained and controlled to provide effective segregation of clean and dirty activities and to provide an environment that minimizes contamination of clean and disinfected RIMD,” the guideline says.

The seven-part guideline includes sections on recommended practices for central decontamination units, endoscopy units and dental services, as well as an audit prototype for evaluating decontamination procedures.

The guideline, “Code of Practice for Decontamination of Reusable Invasive Medical Devices,” can be viewed at:

www.hse.ie/en/Publications/HSEPublicationsNew/AcuteHospitalReportsGuidelines/#d.en.8696.