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States Ease Licensing and Credentialing; Use Caution
Many states have lifted some restrictions on clinician licensing in response to the COVID-19 pandemic, allowing hospitals to call on more available professionals to handle the increased patient load. Although the relaxed rules are welcomed in the face of the crisis, peer review and compliance leaders should proceed with some caution.
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Pandemic Quality Reporting Eased, But Consider Benefits of Sending Data
Hospital quality leaders already strained by the COVID-19 pandemic welcomed the decision to delay reporting deadlines for the Merit-Based Incentive Payment System and not require reporting or use data from the initial pandemic period for Medicare quality reporting and value-based purchasing programs for future payment years. However, there are important issues to consider as hospitals move forward and regroup in the post-pandemic months.
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Pain Management in the Emergency Department: Opioids and Alternative Pain Management Therapies
Opioid therapy can be an effective form of pain management in the ED for acute painful conditions. The risk of addiction and abuse should be considered in every case. Alternatives to opioid therapy include systemic agents, such as acetaminophen, NSAIDs, lidocaine, alpha agonists, anticonvulsants, ketamine, corticosteroids, and local and regional anesthesia.
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Trauma in Pregnancy: A Comprehensive Overview
The authors provide a concise, comprehensive overview of the unique anatomic and physiologic features of pregnancy, as well as modifications and considerations important for the management of the pregnant trauma patient.
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OSHA Allows ‘Enforcement Discretion’ During COVID-19
Responding to respirator shortages during the outbreak of novel coronavirus, the Occupational Safety and Health Administration has issued a memorandum allowing “enforcement discretion” by compliance officers citing the Respiratory Protection standard (29 CFR § 1910.134).
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CDC Defines ‘Low-Risk’ Occupational Exposures to Coronavirus
The CDC recently issued guidelines allowing healthcare personnel (HCP) to continue working if they incur only “low-risk” exposures to patients with COVID-19. With some reported cases of large numbers of HCP furloughed after exposures, the CDC is moving to preserve the workforce in situations where HCP are exposed to infected patients through minor breaks in protocol or personal protective equipment.
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CDC Guidance for Use of Facemasks During Crisis
The CDC’s recommendation for optimizing the supply of facemasks include “contingency” and “crisis” capacity. These are steps hospitals can take if they are no longer at “conventional” capacity, when standard measures remain in effect. The CDC defines contingency capacity as practices that may be used temporarily during periods of expected facemask shortages. Crisis capacity may call for stopgap measures “that are not commensurate with U.S. standards of care."
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Crossing the Fine Line Between Fear and Courage
A truism that has been observed in various forms is the only time one can show courage is when one acts in the face of fear. This is what healthcare workers responding to the coronavirus pandemic are essentially doing, one expert says.
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CDC Guidelines for Reuse of N95 Respirators
With reuse of N95 respirators in effect at many hospitals, the CDC has issued recommendations that begin with the caveat “there is no way of determining the maximum possible number of safe reuses for an N95 respirator as a generic number to be applied in all cases.”
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Spring of Fear: ED Staff Face Surging Coronavirus
Emergency physicians and other frontline clinicians are trying to hold the line against an accelerating coronavirus pandemic in the United States, even as they fear for their own safety and that of their families and colleagues. A shortage of personal protective equipment — particularly N95 respirators — ratcheted up the anxiety, as did the accumulating media reports of healthcare worker deaths, illness, and home quarantine.