CMS working on emergency preparedness rule

CMS working on emergency preparedness rule

The Centers for Medicare & Medicaid Services (CMS) confirmed at the American Society for Healthcare Engineering’s (ASHE) annual conference last week that it is working on emergency management requirements for hospitals. Rather than include the emergency management chapter of the 2012 edition of NFPA 99, of which it recently adopted portions, CMS is preparing its own rule.

CMS Representative Kristin Shifflett, who was part of a panel discussion on health care facility codes and standards at the conference, did not provide a time frame for when the new rule would be released.

Minimizing OR traffic may help to lower surgical-site infection rates, study shows

Operating room (OR) staff at Peace Arch Hospital in White Rock, British Columbia, launched a series of strategies to reduce traffic in and out of the OR. The hospital says its efforts may have led to a decrease in surgical-site infections, and it presented results of its study at the American College of Surgeons National Surgical Quality Improvement Program annual conference earlier this week.

The team a conducted a two-day observational study in which nursing students tracked the number of and reason for door openings during surgery. Reasons for entering or leaving the OR included: retrieving charts, instruments or equipment, and taking a break. The nurses counted between 42 and 70 door openings per operation, with operations lasting an average of 75 minutes. The team then counted ways to reduce door openings, including stopping all traffic in and out of the OR between total joint capsule opening and closure, communication by phone and placing a sign on the OR door to remind staff to minimize traffic and to log the reason they are entering during an operation.

Audits taken every six months indicated a significant reduction in OR traffic, from between 42 and 70 door openings to 3.2 door openings per case. The study’s authors say the strategies may have contributed to a decrease in orthopedic surgical-site infections from 2.8 to 2.1 percent.

Joint Commission creates compliance checklist for new imaging room standards

The Joint Commission recently shared data from survey reports on the most common noncompliant areas related to new and revised diagnostic imaging room standards. Now the organization has released a compliance checklist so that hospitals can perform self-assessments and prepare for on-site surveys.

The free downloadable checklist provides:

• Yes/No columns to check off compliance
• Comment section to add site-specific notes for each requirement
• Sign-offs for individuals to confirm compliance

AHA recommends changes to FDA draft on compounding facility guidance

The American Hospital Association (AHA) urged the Food and Drug Administration (FDA) to revise its draft compounding guidance to allow hospital and health system pharmacies to continue to distribute compounded drug products to other health care facilities in the same system.

The AHA “strongly recommends that the FDA remove the arbitrary one-mile radius limitation and replace it with an alternative approach that would support the existing hospital and health system care delivery model and also put into place widely vetted, evidence-based limits on anticipatory compounding in hospitals and health systems to ensure safe, high-quality patient care,” wrote Ashley Thompson, AHA senior vice president for public policy analysis and development. 

Joint Commission officers address solutions to health care workplace violence

A new Viewpoint in the Journal of the American Medical Association focuses on solutions to workplace violence in health care settings.

In “Workplace Violence in Health Care: A Critical Issue With a Promising Solution,” the authors discuss the extent and characteristics of workplace violence in health care-relevant government regulations, the responsibility of health care leaders in addressing workplace violence, a model program for violence prevention in health care settings, and a comprehensive environmental risk analysis.

The authors write in the article’s conclusion that, “a workplace violence prevention program should be a required component of the patient safety system of all health care organizations.”

The article was written by Ron Wyatt, M.D., MHA, and Kim Anderson-Drevs, Ph.D., R.N., from the Joint Commission Office of Quality and Patient Safety, as well as Lynn M. Van Male, Ph.D., from the Workplace Violence Prevention Program with the Veterans Health Administration. 

CDC awards $60 million to help states and territories battle Zika

The Centers for Disease Control and Prevention (CDC) will begin making awards totaling nearly $60 million to states, cities and territories to support efforts to protect Americans from the Zika virus disease and adverse health outcomes that can result from Zika infection.

The Obama administration has requested $1.9 billion that public health experts identified as necessary to combat Zika, but the budget has not been approved by Congress. The CDC states that while its funding is an important tool to help communities prepare for and respond to infectious diseases like the Zika virus, additional support will be needed to further expand mosquito control capabilities and develop a Zika vaccine and diagnostics.

Traditional hand-hygiene audits overstate performance overall, study says

A study published in the Journal of Hospital Medicine details covert observation of hand-hygiene compliance. The purpose of the study was to determine if overt auditing of hand-hygiene compliance results in the Hawthorne effect, which refers to study subjects altering their behavior when they know they are being observed.

The study authors found that there was a 19 percent decrease in hand-hygiene compliance when compared to the auditor’s results and a 40 percent decrease for nurses.

“Our study suggests that traditional hand-hygiene audits not only overstate hand-hygiene performance overall, but can lead to inaccurate inferences about performance by professional groupings due to relative differences in the Hawthorne effect. We suggest that future improvement efforts will rely on more accurate HH [hand-hygiene] monitoring systems and strong attending physician leadership to set an example for trainees,” the study’s authors write.