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NEWS
FEATURES
COURSES FOR THE
INFECTION CONTROL PROFESSIONAL
Chemical indicator tapes are used in conjunction with biological indicators to monitor the sterilization process. They are convenient, inexpensive and indicate that the item has been exposed to the sterilization process. In general, chemical indicator tape is used on every item sterilized in a healthcare facility.
We are reporting a significant health hazard associated with the use of two commonly used sterilization process indicators: 3M ethylene oxide indicator tape and Sterrad indicator tape. The 3M tape changes from yellow (unprocessed) to red (processed), while the Sterrad product changes from red (unprocessed) to yellow (processed). Both products are a similar size and have dashed left-to-right diagonal lines imbedded in the tape. Recently, a North Carolina hospital that uses both an ethylene oxide sterilizer and a Sterrad plasma sterilizer experienced confusion over whether an endoscope was processed (i.e., sterilized) because the two indicator tapes use diametrically opposite colors to indicator whether processing has occurred. Operating room personnel incorrectly assessed the Sterrad indicator tape that showed a red diagonal line as having been sterilized by ethylene oxide when in fact the item had been labeled prior to expected processing in a Sterrad unit. Misinterpretation of the meaning of the indicator tape color led to the use of a nonsterile endoscope in a surgical procedure that potentially could have resulted in cross-transmission of nosocomial pathogens.
We believe that confusion of whether an item has been processed is likely to be widespread and indicates an important health problem as potentially contaminated (i.e., nonprocessed) equipment could be used resulting in cross-transmission of nosocomial pathogens. We have communicated these findings to 3M and Advanced Sterilization Products (Sterrad) and hope they will develop a standard color change to indicate processing of medical equipment or other means to indicate the proper use of the tape.
REGULATORY/LEGISLATIVE
OSHA released the draft text of an ergonomics standard in February 1999 and has a plan for completing a formal proposal by September 1999. As per OSHA procedures, this document will undergo several revisions before it is published as a formal proposal. The draft defines the criteria for what constitutes a workplace muscleskeletal disorder and requires employers to follow specific steps, including training and medical management, if a hazard is discovered or an injury is reported.
The Working Draft of a Proposed Ergonomics Program Standard can be found at the OSHA web site www.osha-slc.gov/SLTC/ergonomics/ergoreg.html
FDA Approves Lyme Disease Vaccine
The US Food and Drug Administration (FDA) has approved the world's first vaccine against Lyme Disease. Lymerix by SmithKline Beecham is a three-shot series taken over one year for people who have occupational or recreational exposure to tick infested areas.
OSHA Announces Plans to Combat Needlestick Injuries
The Occupational Safety and Health Administration (OSHA) is moving to reduce the number of injuries healthcare workers get from needles and other sharp medical objects that potentially carry bloodborne illnesses such as AIDS and hepatitis. An estimated 590,000 needlestick injuries occur each year.
Secretary of Labor Alexis M. Herman said OSHA's action stems in part from a report issued in May 1999 summarizing nearly 400 comments from healthcare facilities, workers and others who responded to the agency's request for information last fall. At that time OSHA asked for ideas and recommendations on ways to better protect workers from contaminated needles or other sharp objects.
OSHA is pursuing a three-pronged approach to help minimize the risk of occupational exposure to bloodborne diseases due to needlestick injuries.
First, the agency already proposed a requirement in the revised Recordkeeping Rule that all injuries resulting from contaminated needles and sharps be recorded on OSHA logs used by employers to record injuries and illnesses. Final action in the rulemaking, which will be based on OSHA's evaluation of the public rulemaking record, is scheduled for this fall.
Second, OSHA will revise the bloodborne pathogens compliance directive later this year to reflect the newer and safer technologies now available. The directive is used by OSHA's compliance officers to enforce the agency's bloodborne pathogens standard.
Third, the agency will take steps to amend the bloodborne pathogens standard by placing needlestick and sharps injuries on its regulatory agenda this fall.
The full report is available online at
the OSHA web site
www.osha-slc.gov/html/ndlreport052099.html
New Blood Screening Test
The Federal Drug Administration has approved a new blood screening test aimed at hepatitis C virus and HIV. The new genetic tests are capable of detecting small amounts of virus before the body even mounts an antibody response. The "nucleic acid testing" (NAT) will be performed nationwide at blood banks.
QUESTION OF THE MONTH
Q: It is just not clear how to disinfect some items between patient uses. How should vaginal probes be reprocessed?
A: Vaginal ultrasound probes have contact with mucous membranes. We recommend these probes should be high-level disinfected by soaking for a minimum of 20 minutes in a 2 percent glutaraldehyde (or other high-level disinfectant) solution between patient uses. Then rinse well to remove all the glutaraldehyde. Additionally, a new condom is used to cover the probe for each patient.
NEWS AND ANNOUNCEMENTSThe "Guideline for Prevention of Surgical Site Infection, 1999" was published in The American Journal of Infection Control in April 1999. It is available online at www.cdc.gov/ncidod/hip
"Bioterrorism Readiness Plan: A Template for Healthcare Facilities" is available free online at www.apic.org and at www.cdc.gov/ncidod/hip/Bio/bio.htm
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
"Infection Control Part II: The ICP as an Environmentalist" will be held September 27-October 1, 1999 at the Holiday Inn in Chapel Hill.
"Infection Control in Home Health and Hospice" will be held October 11, 1999 at The Friday Center in Chapel Hill.
Contributors to Report of the
Month: Karen K. Hoffmann, RN, MS, CIC; William A. Rutala, PhD, MPH,
Eva P.
Clontz, MEd.
To subscribe to the Report of the Month, send email to spice@unc.edu
Report of the Month is also available on the home page of the Statewide Program for Infection Control and Epidemiology at http://www.unc.edu/depts/spice/
The Statewide Program for Infection Control and Epidemiology (SPICE) is funded by the General Assembly of North Carolina to serve the State. SPICE is not a regulatory agency but provides education and consultation to North Carolina healthcare facilities.
Copyright 1999 North Carolina Statewide Program for Infection Control and Epidemiology
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