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Safe Injection Practices - PowerPoint PPT Presentation


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Safe Injection Practices. SITUATION. Confirmed patient-to-patient transmission of blood borne & other pathogens in US healthcare facilities Transmission have been linked to unsafe injection practices. BACKGROUND. Past Decade, US

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Presentation Transcript
slide2

SITUATION

  • Confirmed patient-to-patient transmission of blood borne

& other pathogens in US healthcare

facilities

  • Transmission have been linked to unsafe injection practices
slide3

BACKGROUND

Past Decade, US

  • > 35 reported outbreaks of viral hepatitis among patients
    • > 250 confirmed cases since 2008
  • Outbreaks linked to unsafe injection practices
  • > 90,0000 patient notifications re: potential exposures to blood borne pathogens
slide4

BACKGROUND

Mar 2012

  • Orthopedic clinic-DE
  • 7 patients / 5 same procedure date
  • All admitted to hospital for Rx of septic arthritis or bursitis
    • 6 pts. and 1 HCW had MSSA w/ indistinguishable PFGE type
  • Reuse of single-dose vials of bupivacaine for multiple patients

Apr 2012

  • Outpatient Pain Management clinic – AZ
  • 3 patients / same procedure date
    • 1 Pt. developed MRSA mediastinitis & bacteremia
  • 2 Epidural steroid injections / 1 stellate ganglion block
    • Contrast medium drawn up in procedure room
    • Change in vial size due to drug shortages
slide5

ASSESSMENT

  • Unsafe injection practices place patients at risk
    • Use of single-dose vials for multiple patients
    • Contamination of multi-use vials & containers via reuse of needles/syringes
  • Other related consequences include:
    • Negative media
    • Malpractice suits
    • Disciplinary action by licensing boards
slide6

ASSESSMENT

  • Variable practices exist and may differ between health care facilities / settings
  • Healthcare facilities MUST develop processes to
    • Assure policies/protocols set clear expectations
    • Assess existing practices
    • Evaluate existing products
    • Educate and train staff on safe injection practices
slide7

RECOMMENDATIONS

Assure policies/protocols set clear expectations

slide8

RECOMMENDATIONS

Assess Existing Practices

  • TIPS
  • Include all settings where injections may be administered
  • Targeted audits/mock surveys
  • Annual IP Program Review
slide9

RECOMMENDATIONS

Evaluate Existing Products

  • TIPS
  • Work closely with Pharmacy
  • Targeted audits/mock surveys
  • Single dose vials whenever possible
  • If not possible, review alternatives
    • Use multi-dose vial as single-dose vial
    • Can Pharmacy support drawing doses in controlled setting (e.g. in pharmacy under laminar hood)?
slide10

RECOMMENDATIONS

Educate and train staff on safe injection practices

http://www.cdc.gov/injectionsafety/1anOnly.html

slide11

References

  • CDC -The One & Only Campaign - Injection Safety
  • HICPAC. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. June 2007
  • Sue Dill Calloway. Safe Injection Practices Presentation. 2012
  • MMWR. Invasive Staphylococcus aureus Infections Associated with Pain Injections and Reuse of Single-Dose Vials — Arizona and Delaware, 2012. July 13, 2012 / 61(27);501-504