Outreach emphasizes infection control basics
Basic infection control practices are being reviewed in light of six cases of hepatitis C that have been linked with a surgery center in Las Vegas that reportedly reused syringes, with new needles, and reused single-dose vials.
"We feel strongly that we need to communicate with all providers and all settings across the country," says CDC investigator Joseph Perz, PhD, who is acting team leader for prevention in the Division of Healthcare Quality Promotion. "This kind of injection safety is the most basic type of infection control during patient care. It has to be met as a very basic expectation."
The New York State Society of Anesthesiologists and the New York State Department of Health are working together on an educational outreach program for anesthesiologists in the state, says Richard A. Beers, MD, professor of anesthesiology at State University of New York Upstate Medical University in Syracuse. In 2007, a cluster of three hepatitis C infections were reported in patients who received anesthesia from the same New York City anesthesiologist.
"Our goal is to ensure, to the best of our ability, that the situation that occurred in Long Island never again occurs and that New York State patients continue to receive the safest care possible," Beers says. "Measures such as these are far more effective than lawsuits that benefit primarily attorneys."
The groups' message emphasizes the following points:
- Needles, cannulae, and syringes are sterile, single-patient-use items. These items are contaminated and potentially infectious after any single patient use. Use occurs when the syringe, needle, or cannula contacts any port of a patient's intravenous infusion line, including the drug or fluid reservoir.
- Medication from a syringe must not be administered to multiple patients even if the needle on the syringe is changed.
- Health care facilities should designate separate areas for preparation and disposal of medications.
- Single-dose vials should not be used to administer medications to multiple patients. Multidose vials should not be stored in the immediate patient treatment/care area.
- A single bag or bottle of intravenous solution or medication should not be used as a common source of for multiple patients. Infusion sets (i.e., intravenous bags, tubing and connectors) should be used for one patient only, and the entire set should be disposed of appropriately after use.
"Many of these practices are common sense and are strictly adhered to by our member anesthesiologists," Beers says. "Some practices are not yet commonly followed; however, they are changes that would eliminate the potential for contamination."
For example, if multidose vials are available in a patient care area, a patient will not be at risk for bloodborne infection exposure from the contents of the vial if a clean syringe, clean needle, and alcohol swab are used to penetrate the stopper each time the vial is accessed. However, one breach in infection control practice, and the contents of the vial may be contaminated, which opens the potential for exposure.
"Not all patient care areas in New York state restrict the use of multidose vials," Beers says. "Furthermore, some medications are not supplied in single-use packaging. Not only do we need to work at changing the availability and use of multidose vials in patient care areas; we may also need to work with the FDA and drug manufacturers to encourage single-dose drug packaging."
In the future, there may be efforts to eliminate multiple-dose vials of medications from clinical practice, says Donald M. Mathews, MD, associate chairman for academic affairs in the Department of Anesthesiology at St. Vincent's Hospital Manhattan in New York City. "I am sure it would increase pharmacy direct and indirect costs and increase the expense of patient care," Mathews says. "If it could prevent this type of problem, however, it might be worth it."
Basic infection control practices are being reviewed in light of six cases of hepatitis C that have been linked with a surgery center in Las Vegas that reportedly reused syringes, with new needles, and reused single-dose vials.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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