The May 2019 issue of the ICCS Infection Prevention & Control Newsletter has published.
The issue includes stories on ophthalmology devices, patient privacy curtains, measles, TB, antibiotic stewardship requirement and a New York bill on infection prevention certification.
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The National Tuberculosis Controllers Association (NTCA), in partnership with the Centers for Disease Control and Prevention (CDC), has released updated recommendations for tuberculosis (TB) screening, testing and treatment of healthcare personnel.
Of note, the updated recommendations advise against annual screening of all healthcare personnel for TB. In an NTCA news release, Dr. Robert Belknap, medical director of the Denver Metro Tuberculosis Clinic, and co-lead of the workgroup that assembled the recommendations states, "The continued routine practice of annual testing has been costly, has resulted in false positive tests for TB infection, and is no longer supported by what we have observed in healthcare settings over time. This movement away from annual testing is long overdue."
As the new recommendations note, "TB rates in the United States have declined substantially; the annual national TB rate in 2017 (2.8 per 100,000 population) represents a 73% decrease from the rate in 1991 (10.4) and a 42% decrease from the rate in 2005. Surveillance data reported to CDC during 1995–2007 revealed that TB incidence rates among healthcare personnel were similar to those in the general population, raising questions about the cost-effectiveness of routine serial occupational testing."
Other recommendations include the following:
individual baseline (preplacement) risk assessment;
symptom evaluation and testing of persons without prior TB or latent TB infection (LTBI);
treatment for healthcare personnel diagnosed with LTBI;
annual symptom screening for persons with untreated LTBI; and
annual TB education of all healthcare personnel.
The updated recommendations supplement the existing 2005 guidelines for preventing the transmission of TB in healthcare settings.
The Joint Commission is calling attention to infection risks associated with several ophthalmology devices.
In a Quick Safety article, The Joint Commission notes that its survey data indicates there is "either a lack of awareness of the requirements or misinterpretation of manufacturer’s instructions — combined with lack of staff training and leadership oversight — related to the disinfection of ophthalmology devices."
The result: multiple immediate health and safety threat declarations.
Lack of reprocessing compliance has been observed with tonometers, YAG laser lens and eye specula. Such devices are used in clinics, procedure rooms, urgent care centers, emergency departments and other areas.
The Joint Commission notes that tonometers are particularly problematic because "disinfectants can dissolve the glue that holds the hollow tip together, causing the tip to swell and crack."
In the article, The Joint Commission shares several safety actions organizations should consider. These include reviewing cleaning and disinfection instructions, using U.S. Food and Drug Administration (FDA)-approved high-level disinfectants and ensuring manufacturer instructions for use are accessible and followed.
The results of a new study show that glucocorticoid use significantly increased the risk for infection for patients with rheumatoid arthritis (RA) undergoing joint replacement surgery.
The retrospective cohort study, which was published in Annals of Internal Medicine, examined claims data on nearly 11,000 surgeries — specifically primary or revision hip or knee joint replacement surgery in adults with RA — performed over a nearly 10-year period.
Researchers from the University of Pennsylvania Hospital found that while the risks for hospitalized infection, prosthetic joint infection and readmission following arthroplasty were similar across biologics, glucocorticoid use — particularly when dosages exceeded 10 mg/d — nearly doubled risk for adverse outcomes.
As a news release on the study noted, "According to the researchers, these findings suggest that limiting glucocorticoid use should be a focus of perioperative management."
Lawmakers in New York have sponsored a bill that, if passed, would require infection preventionists to be certified in infection prevention and control if they want to practice in New York hospitals, according to a news release from the Association for Professionals in Infection Control and Epidemiology (APIC).
The bill stipulates that infection preventionists in a general hospital would be required to meet one of the following:
Pass an exam from a nationally accredited infection prevention and epidemiology accrediting organization and hold and maintain certification in infection prevention and control.
Provide evidence of employment as an infection preventionist for one year or more within four years of the bill's passage.
Be a student or intern performing the functions of an infection preventionist (within the scope of the student's or intern's training) while serving under direct supervision of appropriately licensed or certified healthcare professional.
If an infection preventionist fails to meet at least one of these requirements, the individual would have three years from the date of hire to obtain an infection preventionist credential.
The bill, A. 3705/S. 5186, is sponsored by Assemblywoman Aileen Gunther (D) and Senator Jen Metzger (D). Gunther previously held an infection control position at Catskill Regional Medical Center. In the release, she is quoted as saying, "I am proud to lead an effort that will enhance patient safety in New York hospitals by ensuring that infection preventionists have appropriate credentials. I hope other states follow this example."
The bill includes a clause to account for hospitals that are unable to contract with an individual(s) who meets the requirements.