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Transcript of Injection Safety: Updates from Michigan and the U.S. October 9, 2015 Emily Goerge, MPH, MSN, RN,...
![Page 1: Injection Safety: Updates from Michigan and the U.S. October 9, 2015 Emily Goerge, MPH, MSN, RN, CIC.](https://reader036.fdocuments.in/reader036/viewer/2022062805/5697bfba1a28abf838ca0248/html5/thumbnails/1.jpg)
Injection Safety: Updates from Michigan and the U.S.
October 9, 2015Emily Goerge, MPH, MSN, RN, CIC
![Page 2: Injection Safety: Updates from Michigan and the U.S. October 9, 2015 Emily Goerge, MPH, MSN, RN, CIC.](https://reader036.fdocuments.in/reader036/viewer/2022062805/5697bfba1a28abf838ca0248/html5/thumbnails/2.jpg)
Objectives
• Discuss examples of unsafe injection practices that can lead to healthcare-associated transmission of pathogens
• Describe available training materials to educate
staff
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Protecting patients from disease, one injection at a
time
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Safe Injection Practices Are Every Provider’s Responsibility
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ImmunizationsIVs
Insulin Injections
Pain Management InjectionsBlood Glucose Monitoring
DOCTOR OFFICE
The ED
Acute Care
Ambulatory Surgery Center
Infusion CenterLTC Facility
Ambulance
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Principles of Injection Safety
▫Guiding principle: One needle, one syringe, one time
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Principles of injection safety▫Single-Dose Vials
To be used for only ONE patient▫ IV Bags
Not to be used as a common source▫Multi-dose Vials
Use a new, sterile needle and syringe each time enter the vial
▫Fingerstick devices and insulin pens Never to be shared
▫Glucometers If must be shared, ensure cleaned according to
manufacturers instructions prior to each use
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Why injections?
•Unsafe practices put patients and healthcare workers at risk▫Infectious and non-infectious events
•The adverse events are PREVENTABLE•Can happen in a variety of settings
▫Acute care, long-term care, ambulatory care
•Just takes one mistake…•…or it may involve many unsafe practices
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Injection Safety Outbreaks• Between 2008 and 2013 there have been 38
healthcare-associated outbreaks of hepatitis B or C:▫385 patients acquired HBV or HCV▫Over 100,000 persons were notified of being at risk▫94% of these outbreaks occurred in outpatient
settings
• These outbreaks likely represent only the ‘tip of the iceberg’:▫Asymptomatic carriage▫Most cases undiagnosed
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Reporting
•Report possible outbreaks•Report cases (of viral hepatitis)•Importance of case reporting and follow-
up▫Control the spread of disease▫Exploring risk factors for specific disease
We encourage all LHDs to follow-up on cases of acute and chronic HCV; especially in priority populations
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What is Michigan doing?▫2013 Survey -- ASCs
99%
2%
Medications from Single-Dose or Single-Use vials should not be
used for more than one patient.
True False
2% 2%
97%
How often do you use medica-tions from a Single-Dose vial for more than one patient?
Always Usually Sometimes RarelyNever
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What is Michigan doing?
21.2%
74.2%
4.5%
Fingerstick or lancing devices can be used on more than one pa-
tient as long as the lancet is changed and the device is prop-erly cleaned and disinfected be-
tween patients.
True False Not Sure
6.2% 1.2%1.5%
2.3%
88.8%
How often do you use fingerstick or lancing devices for more than one pa-tient (including when you change the
lancet between patients)?
Always Usually Sometimes Rarely Never
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What is Michigan doing?• 2014 Survey – LTC Facilities
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What is Michigan doing?▫Injection Safety website
www.michigan.gov/injectionsafety Modules
Most 10 minutes or less in length Address topics such as:
o Injection Prep and Admin, o 3 Simple Rules for Diabetes Care, o Drug Diversion
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www.michigan.gov/injectionsafety
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What is Michigan doing?▫Member of One and Only Campaign
www.oneandonlycampaign.org Monthly conference calls
Healthcare facilities are also welcome to join the One and Only Campaign
www.oneandonlycampaign.org/content/one-only-campaign-members
▫Drug Diversion MI NADDI Chapter
www.naddi.org/aws/NADDI/pt/sp/home_page
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What about on a national level?•One and Only Campaign
▫Drug Diversion
http://www.oneandonlycampaign.org/content/risks-healthcare-associated-infections-drug-diversion
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U.S. Outbreaks Associated With Drug Diversion by Healthcare Providers, 1983-2013
www.cdc.gov/injectionsafety/drugdiversion
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▫Oncology and pain clinic patients
▫FAQ document for healthcare providers
▫Healthcare Provider brochure
http://www.oneandonlycampaign.org/
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•Video
http://www.oneandonlycampaign.org/content/audio-video
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Recent updates•From the One and Only Campaign
▫FDA label on multidose insulin pens http://
www.fda.gov/Drugs/DrugSafety/ucm435271.htm
▫WHO – worldwide use of smart syringe http://www.who.int/mediacentre/news/release
s/2015/injection-safety/en/
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Recent Updates
•From CDC▫September 11, 2015 CDC issued Health
Advisory alerting facilities to review procedures for cleaning, disinfecting and sterilizing reusable medical devices Include glucometers http://emergency.cdc.gov/han/han00382.asp
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Other important tools▫CDC has toolkit to assist with patient
notification http://www.cdc.gov/injectionsafety/pntoolkit/index.html
▫Investigation guide http://
www.cdc.gov/hepatitis/outbreaks/healthcareinvestigationguide.htm
▫CDC’s Sharps Safety for Healthcare Workers webpage: http://www.cdc.gov/sharpssafety/?s_cid=dhqp_019 Workbook Teaching Tools
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Things to consider in your facility
•How well do you know your healthcare workers’ injection safety knowledge and practice?▫What about in your outpatient areas and
clinics?
•How are your controlled substances monitored?
•Do you perform any chart review on viral hepatitis patients that seroconvert or have acute disease?
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What can ICPs do?• Survey your healthcare workers to determine areas of need
• Educate staff
• Encourage staff to intervene/report unsafe injection practices
• Perform chart review on new viral hepatitis cases
• Report potential HAIs to local/state health departments (even if only one case!)
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Take Home Points
•Always perform safe injection practices•Be aware of possibility of drug diversion
in facility•Investigate suspicious cases; acute cases
to rule out HAI transmission•Report possible outbreaks to LHD, State
HD
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Thank You!
Emily Goerge, MPH, MSN, RN, CICViral Hepatitis Nurse [email protected]
**NEW** [email protected]/hepatitiswww.michigan.gov/injectionsafety