Infection Control Breaches - NAHC · RBC Limited 2014 • Page 25 • Those breaches that impose a...
Transcript of Infection Control Breaches - NAHC · RBC Limited 2014 • Page 25 • Those breaches that impose a...
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T: (845) 889-8128 • F: (845) 889-4147 • E: [email protected] • www.rbclimited.com
Presented by:
Barbara B. Citarella RN, MS, CHCE
Infection Control Breaches
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• Pioneer ACOs
• ACO Advance Payment Model
• Bundled Payments
• Comprehensive Primary Care
• Advanced Primary Practice Demo
• Community Based Care Transitions Program
Medicare Innovations
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• Value based purchasing for physicians
• Reduce payment for HAIs
• Seamless health care system – a continuum of care and
• A CONTINUUM OF HEALTHCARE ORGANIZATIONS
2015
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• Focus on prevention
• Penalties for HAIs
• Penalties for readmissions
• Cost of extended stays
Affordable Care Act
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• Flu vaccination
• Pneumonia vaccination
• Cancer Screenings
• Hypertension
• Weight
• Smoking
• At Risk Populations
Quality Indicators
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Significant Change in
Types of Providers
Being Used
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• Value driver
• Quality measures- focus on prevention
have to raise the bar for our infection
prevention and surveillance programs
Health Care Reform and Infection Prevention
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Increase in Infection Control Breaches
• Breach, infraction, violation, transgression all denote in some
way the breaking of a rule or law or the upsetting of a normal
and desired state.
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WHO finds hospital breaches worsened MERS
outbreak in UAE
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Paiute Shoshone Tribal Nation
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Smallpox vials, decades old, found in storage
room at NIH campus in Bethesda
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Nevada jury asked to award $2.5B for hepatitis C
outbreak
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The Joint Commission Alerts Health Care
Industry to Prevalence of Unsafe Injection
Practices
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Why The Increase?
Poor skills?
Lack of integrity?
Lack of knowledge?
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Ebola Virus
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Immigration Detention Centers
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• Medicare certified providers are required to adhere to
generally recognized standards of infection control practices
• This memorandum is a summary for the state survey agencies
(SAs) and the accrediting bodies. (AOs)
• They are very specific in regard to tag numbers of the
regulations
CMS 5/30/14 Memorandum
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Subject: Infection Control Breaches Which Warrant
Referral to Public Health Authorities
CMS Memorandum 5/30/14
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• 42 CFR §416.51 for ambulatory surgical centers
• 42 CFR §418.60 for hospices
• 42 CFR§482.42 for hospitals42 CFR §483.65for skilled
nursing facilities and nursing facilities
• 42 CFR §484.12(c) for home health agencies(HHAs)
• 42 CFR §485.635(a)(3)(vi) for critical access hospitals
(CAHs)
Tag Numbers
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Tag Numbers
• 42 CFR §491.9(b)(3)(iii)for rural health clinics (RHCs) and
Federally Qualified Health Centers,
• 42 CFR §494.30 for dialysis facilities
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Tag Numbers
• 42 CFR §491.9(b)(3)(iii)for rural health clinics (RHCs) and
Federally Qualified Health Centers,
• 42 CFR §494.30 for dialysis facilities
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• Those breaches that impose a risk of bloodborne pathogen
transmission including, but not limited to, medication
administration practices.
Breaches Discussed in The Memo
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• Using the same needle for more than one individual
• Using the same syringe, pen, or injection device for more than
one individual
• Re-using a needle/syringe which has already been used to
administrate medication to an individual to subsequently enter
a medication container (vial, bag)
• Using the same lancing/needlestick device for more than one
individual even is the lancet has been changed
Breaches
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Evaluating An Infection Control Breach
• Identification of the breach
• Additional data gathering
• Notify and involve key stakeholders
• Qualitative Assessment Of Breach
• Decision Regarding Patient Notification and Testing
• Communications and Logistical Issues
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Key Stakeholders
• Infection control professionals/experts
• Risk management
• Local and state health departments
• Any affected healthcare providers
• Other local, state and federal regulatory agencies as indicated
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Qualitative Assessment
• Category A- gross error or demonstrated high-risk practice
• Category B- lower likelihood of blood exposure
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Patient Notification Letters
• Send out early in week
• Cognizant of holidays
• Allow for appropriate timing of media notification
• Prepare for a deluge of phone calls
• Have time to effectively manage the situation
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Communication/Logistics
• Develop and carefully plan materials
• Post exposure treatment
• Obtaining consents
• Call centers
• Address legal issues
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Needlestick Safety
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One and Only Campaign
• New York
• New Jersey
• Colorado
• North Carolina
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Understanding The Implications
• Malpractice
• Loss of license
• Agency Closure
• Financial loss
• Imprisonment
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“Chance favors the prepared mind”
- Louis Pasteur
1822-1895
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For information about RBC Limited go to:
www.rbclimited.com
Contact Us:
T: (845) 889-8128
F: (845) 889-4147
48 West Pine Road Staatsburg, NY 12580