CDC, WHO Update Resources on Zika Virus

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On the heels of the World Health Organization (WHO) declaring the spread of the Zika virus an international emergency Feb. 1, both WHO and the Centers for Disease Control and Prevention (CDC) have compiled resources and information on the virus for physicians and patients.

Zika is a disease caused by a virus that is acquired through the bite of an infected Aedes species mosquito. The most common symptoms of the disease are fever, rash, joint pain and conjunctivitis, per the CDC. Symptoms can last anywhere from a few days to a week. A severe reaction that would require hospitalization is at this point uncommon, the CDC states on its website.

The first confirmed case of the virus was in May 2015 in Brazil, and the CDC has issued warnings to travelers of that region, as well as countries where the virus is present. The CDC reports that more than 30 cases have been confirmed in the United States in returning travelers.

According to the Dallas County Health and Human Services, the CDC confirmed Feb. 2 the first case in the U.S. of the Zika virus being acquired through “sexual transmission.”

“The patient was infected with the virus after having sexual contact with an ill individual who returned from a country where Zika virus is present,” the statement read.

For resources, visit the CDC’s or the WHO’s dedicated sections on the Zika virus.

Credit: The Joint Commission

OSHA Extends Comment Period on Revised Safety and Health Program Management Guidelines

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The Occupational Safety and Health Administration (OSHA) announced the deadline for submitting public comments on the revised Safety and Health Program Management Guidelines has been extended through February 22, 2016.

The draft guidelines aim to give employers and workers a sound, flexible framework for addressing safety and health issues in the workplace. Revisions include:

  • A proactive approach to finding and fixing hazards prior to incidents
  • Improved safety and health spanning all types of workplaces
  • Help for small- and medium-sized businesses to effectively protect their workers
  • Increased worker involvement
  • Better communication and coordination on multi-employer worksites

The guidelines are advisory only and do not create any new legal obligations or alter existing obligations created by OSHA standards or regulations. Comments can be submitted here.

USP Publishes Standard on Handling Hazardous Drugs in Healthcare Settings

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On February 1, 2016, The United States Pharmacopeial Convention (USP) published an important new standard as part of a suite of healthcare quality standards included in the United States PharmacopeiaNational Formulary (USPNF).

The new general chapter, <800> Hazardous Drugs – Handling in Healthcare Settings, has been developed to help protect personnel and patients, and reduce the risk of residual exposure in healthcare settings.  The standard applies to all healthcare personnel (i.e., physicians, nurses, veterinarians, pharmacists and technicians) and all healthcare facilities where hazardous drugs are handled or manipulated, including their storage and distribution — with a goal of preventing and/or limiting exposure.

“Healthcare workers are on the frontline of protecting patients and consumers from the risks of hazardous drugs but are also themselves at risk,” noted Jaap Venema, Ph.D., executive vice-president and chief science officer of USP. “Each year, approximately 8 million healthcare workers in the US are potentially exposed to hazardous drugs.  Practitioners are frequently unaware of the scope of the risk or the measures that should be taken to reduce such risk.  The new standard defines processes intended to minimize exposure to hazardous drugs in healthcare settings, thereby protecting healthcare workers as well as patients.”

The standard was developed by the USP Compounding Expert Committee with input from an expert panel of medical and industry experts who provided guidance in best practices, alternative techniques, engineering controls, and other elements needed when handling hazardous drugs in healthcare settings. The standard builds upon several previous publications, including the NIOSH Alert – Preventing Occupational Exposure to Antineoplastic and Other Hazardous Drugs in Health Care SettingsASHP Guidelines on Handling Hazardous Drugs; the Oncology Nursing Society (ONS) Safe Handling of Hazardous Drugs; and OSHA Guidelines.

The USP Compounding Expert Committee recognized that it may take healthcare facilities additional time to comply with the new standard and therefore approved an extended official implementation date of July 1, 2018. With the extended date, healthcare facilities have more than two years to conform to the new requirements.

For more information on the chapter see Frequently Asked Questions. General Chapter <800> was published on February 1, 2016 in the First Supplement to USP 39–NF 34. General Chapter <800> was published in the First Supplement to USP 39–NF 34, and is available for purchase through a subscription to the USP Compounding Compendium or USP-NF.

Joint Commission Publishes New FAQ on Individual Quality Control Plans (IQCP)

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The Joint Commission has published a new FAQ on Individual Quality Control Plans (IQCP) under the Laboratory Accreditation Program.


Individual Quality Control Plan (IQCP) Requirement

Q. Is IQCP (Individualized Quality Control Plan) required for Joint Commission Accredited Laboratories?

A. No.  The development of laboratory-specific quality control plans using the risk assessment process of IQCP is optional.  Laboratories have the following options for all quality control except for those methods classified as Pathology and Cytology. (Some individual states apply additional restrictions.)

  1. Perform the type and frequency of quality control equal to or more stringent than that required by CLIA regulations.  Quality control type and frequency may not be less stringent than the manufacturer’s recommendations.
  2. Develop a laboratory-specific Quality Control Plan using the risk assessment process of IQCP.  The type and frequency of the quality control may not be less stringent than the manufacturer’s recommendations.

The new FAQ is available on The Joint Commission website.

The new Joint Commission requirements for IQCP Option for Clinical Laboratories became effective January 1, 2016.

CDC Looks at Alcohol Use and Pregnancy

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Alcohol use during pregnancy can cause fetal alcohol spectrum disorders (FASDs), which are physical, behavioral, and intellectual disabilities that last a lifetime. More than 3 million US women are at risk of exposing their developing baby to alcohol because they are drinking, having sex, and not using birth control to prevent pregnancy.

About half of all US pregnancies are unplanned and, even if planned, most women do not know they are pregnant until they are 4-6 weeks into the pregnancy. This means a woman might be drinking and exposing her developing baby to alcohol without knowing it. Alcohol screening and counseling helps people who are drinking too much to drink less. It is recommended that women who are pregnant or might be pregnant not drink alcohol at all. FASDs do not occur if a developing baby is not exposed to alcohol before birth.

Read more in the February 2016 edition of CDC Vital Signs.

Joint Commission Addresses Prevention of Unintended Retained Foreign Objects (URFOs)

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In the January 2016 issue of Quick Safety, published January 26, 2016, The Joint Commission addresses strategies for preventing unintended retained foreign objects (URFOs).

The Joint Commission indicates that URFOs remain a challenge for accredited organizations, and identifies that URFOs were the most frequent sentinel event reported to its sentinel event database during 2015 (115 reported) and 2014 (112 reported). This is an increase from 2013 (102 reported), when URFOs dipped to the third most frequently reported sentinel event. URFOs were also the most frequently reported sentinel event in both 2012 and 2011. URFOs were first added to The Joint Commission’s Sentinel Event Policy in 2005.

See Joint Commission Updates Sentinel Event Statistics Through Q3 2015, URFOs Top List

To prevent URFOs, The Joint Commission recommends organizations address count process, team communication and interaction in the OR, tools and methods used during a procedure, physical environment, radiology, and reporting of the discovery of a URFO. Additional details are provided for each recommendation.

Previously, in October 2013, The Joint Commission addressed the prevention of URFOs in Sentinel Event Alert #51: Preventing Unintended Retained Foreign Objects.

More recently, in early January 2016, the Association of periOperative Registered Nurses (AORN) updated its Guideline for Prevention of Retained Surgical Items. The updated AORN guideline provides guidance to perioperative team members for prevention of retained surgical items (RSIs) in patients undergoing operative and other invasive procedures. Guidance is provided for implementing a consistent multidisciplinary approach to preventing RSIs, improving team communication, limiting distractions, standardizing protocols for surgical counts, preventing retention of device fragments, reconciling count discrepancies, and using adjunct technologies to supplement manual count procedures. The revised AORN guidelines were effective January 15, 2016.

See AORN Updates Guideline for Prevention of Retained Surgical Items

Free NPSF Webscast 2/25/2016: Evaluation of Perioperative Medication Errors and Adverse Drug Events

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This complimentary National Patient Safety Foundation (NPSF) Professional Learning Series (PLS) webcast provides a foundation for understanding concepts around medication errors (MEs) and adverse drug events (ADEs), including challenges around data acquisition, use and implementation of solutions. The focus is on identifying, evaluating and classifying types of perioperative medication errors and adverse drug events as well as solutions that may have the potential to prevent them.  Understanding and evaluating perioperative MEs and ADEs is a critical step in designing and implementing targeted, measurable and cost-effective solutions.

Learning Objectives

  • To define and explain the terms medication error and adverse drug event.
  • To identify, evaluate, and classify types of medication errors and adverse drug events in the operating room.
  • To evaluate and compare various methods for obtaining data on medication errors and adverse drug events.
  • To identify and classify solutions that may have the potential to prevent perioperative medication errors and adverse drug events.

Featured Speaker

Karen C. Nanji, MD, MPH
Anesthesiologist, Massachusetts General Hospital
Assistant Professor of Anesthesia, Harvard Medical School

For more information visit the National Patient Safety Foundation (NPSF) website.

AHRQ Publishes Case Studies on Patient Safety Quality Indicators

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The Agency for Healthcare Research and Quality (AHRQ) Quality Indicators™ (QIs) are measures that organizations can apply to inpatient hospital data to assess and improve health care quality, identify areas that need further study and investigation, and track changes over time. The AHRQ QI modules represent aspects such as Prevention, Inpatient, Patient Safety, and Pediatric quality of care. AHRQ provides free software to enable use of the QIs.

AHRQ recently published case studies of organizations that have used the QIs to improve patient safety.

The case studies are available on the AHRQ website. You can learn more about the QI program here.

Source: Agency for Healthcare Research and Quality

SAMHSA Releases Updated Opioid Overdose Prevention Toolkit

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The Substance Abuse and Mental Health Services Administration (SAMHSA) today published an updated version of its Opioid Overdose Prevention Toolkit.

The Toolkit is designed to equip healthcare providers, communities and local governments with material to develop practices and policies to help prevent opioid-related overdoses and deaths, and addresses issues for healthcare providers, first responders, treatment providers, and those recovering from opioid overdose.

The updated Toolkit is available as a single document, or as individual sections:

  1. Facts for Community Members
  2. Essentials for First Responders
  3. Safety Advice for Patients
  4. Information for Prescribers
  5. Resources for Overdose Survivors and Family Members

AORN Updates Guideline for Prevention of Retained Surgical Items

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The Association of periOperative Registered Nurses (AORN) has updated its Guideline for Prevention of Retained Surgical Items. The revised guidelines, effective January 15, 2016, replace the 2010 Recommended Practices for Prevention of Retained Surgical Items.

According to AORN, the recommendations in the updated guideline are intended to be achievable and represent what is believed to be an optimal level of practice. Policies and procedures will reflect variations in practice settings and/or clinical situations that determine the degree to which the guideline can be implemented. AORN recognizes the many diverse settings in which perioperative nurses practice; therefore, the guideline is adaptable to all areas where operative or other invasive procedures may be performed.

The updated guideline provides guidance to perioperative team members for prevention of retained surgical items (RSIs) in patients undergoing operative and other invasive procedures. Guidance is provided for implementing a consistent multidisciplinary approach to preventing RSIs, improving team communication, limiting distractions, standardizing protocols for surgical counts, preventing retention of device fragments, reconciling count discrepancies, and using adjunct technologies to supplement manual count procedures.

RSIs are considered a sentinel event in perioperative care. This rare but serious preventable error can result in patient harm, including re-operation, readmission or increased length of hospital stay, physical harm, emotional harm, and death.

The updated AORN Guideline for Prevention of Retained Surgical Items is available here.