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NEWS FEATURES
REGULATORY/LEGISLATIVE
QUESTION OF THE MONTH
NEWS AND ANNOUNCEMENTS
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
NEWS FEATURES
An Easy Method to Disinfect Patient Privacy Curtains
Controlling the spread of antibiotic resistant gram-positive microbes is an increasing challenge for trauma units, especially burn centers. The authors state that for these immunocompromised populations, prevention is more dependent on appropriate environmental disinfection and good contact control procedures than on antibiotic eradication of the microbe. Previous studies have demonstrated that while gram-negative organisms generally survive for only a short time when dry on various surfaces, gram-positive microbes can survive for long periods. The purpose of this study was to identify a user-friendly, safe, inexpensive means of disinfecting spot contamination on fabrics that remain in patient or clinic rooms as different patients are moved in and out. Several types of disinfectants (phenolics, quaternary ammonium compounds, iodophors, 10% bleach, isopropanol and 3% hydrogen peroxide) were assessed. From these disinfectants, 3% hydrogen peroxide was chosen to be tested. Systematic laboratory testing was done by pipetting 30 antibiotic-resistant and sensitive staphylococci and enterococci onto 4 common hospital fabrics: cotton (clothing), terry cloth (towels), cotton polyester blend (scrub suits) and polyester (curtains). Without disinfection, bacteria survived for many hours to several days. After a single spraying until wet with 3% hydrogen peroxide and a 10-minute drying time, all bacteria on all fabrics were dead in 5 to 120 minutes. Further, on-site testing used contact culture plates on curtains in patients' rooms. Curtain edges where hands were used most often to move the curtain demonstrated a mixture of gram-positive and gram-negative bacteria (median 22 bacteria/24 cm2). After these areas were sprayed with 3% hydrogen peroxide, no bacteria were found. The authors concluded that spraying with 3% hydrogen peroxide is a safe and cost-effective means of spot disinfecting fabrics in patients' rooms. The outcome of this simple procedure may reduce the spread of potentially antibiotic-resistant bacteria.
Neely AN, Maley MP. 3% Hydrogen peroxide for the gram-positive disinfection of fabrics. J Burn Care Rehabil 1999;20:471-477.
REGULATORY/LEGISLATIVE
ALERT, ALERT! OSHA's New Recordkeeping Regulation Revision Effective January 1
The Occupational Health and Safety Administration (OSHA) revision of the 1904 recordkeeping regulation went into effect on January 1, 2002. Although OSHA is not enforcing the new rule for 120 days, giving inspectors time for education and implementation, it is expected that healthcare facilities will be in compliance and will be able to demonstrate compliance for that entire period from January 1.
The old 1904 recordkeeping rule required recording of needlesticks and other exposure incidents on the OSHA 200 log form only if there was a seroconversion or the injury required medical treatment. Medical treatment included the administration of post-exposure prophylaxis or vaccination.
A revision to the recordkeeping rule was published January 19, 2001, and now requires all work-related injuries from needlesticks and cuts, lacerations, punctures and scratches from sharp objects contaminated with another person's blood or OPIM (other potentially infectious materials) to be recorded. Employers may use the OSHA 300, 301, and 300A or equivalent forms to meet the sharps injury log requirement, if the employer additionally records the type and brand of the device on the form. To protect the employee's privacy, the employee's name may not be entered on OSHA 300 (e.g., employers must keep a separate confidential list of the case numbers and employee names so they can update the cases or provide them if asked by the OSHA surveyors). If the employee develops a bloodborne disease the entry must be updated and recorded as an illness. The records (log) of sharps injuries must be maintained in a way that segregates sharps injuries from other types of work-related injuries and illnesses, or allows sharps injuries to be easily separated.
The North Carolina Division of Occupational Health and Safety (OSH) adopted the 1904 recordkeeping revision. In its current format the NC Work's Compensation Form 19 is not equivalent to the OSHA 301 form. The 301 form is the individual incident report record of a work-related illness or injury. OSHNC is in discussion with the Industrial Commission about modifying Form 19. In the interim, employers may complete form 301 or their own "equivalent" form.
Finally, there is form 300A, a summary of work-related injuries and illnesses. This form is the one employers are to post every year. The new rule requires a three-month posting - February 1 to April 30. The summary must be certified by the highest ranking administrator on site as to its accuracy.
OSHA Injury and Illness web site - all you need to know about the new rule
The rule
29 CFR PART 1904 -- Occupational Injury and Illness Recording and Reporting Requirements
http://www.osha-slc.gov/OshStd_toc/OSHA_Std_toc_1904.html
in html format
http://www.osha-slc.gov/recordkeeping/1904_record_report.pdf in pdf format
The forms
http://www.osha-slc.gov/recordkeeping/RKforms.html
Compliance document
Recordkeeping Policies and Procedures Manual CPL 2-0.131
http://www.osha-slc.gov/OshDoc/Directive_data/CPL_2-0_131.html
Slide presentations
http://www.osha-slc.gov/recordkeeping/RKpresentations.html
NC Occupational Safety and Health Division
http://www.dol.state.nc.us/osha/osh.htm
QUESTION OF THE MONTH
Fish Tanks in Hospitals
Q: What is an appropriate policy regarding fish tanks in hospitals?
A: The CDC "Draft Guideline for Environmental Infection Control in Healthcare Facilities, 2001" recommends that facilities avoid placing fish tanks in patient care areas (Category 1B).
At UNC Hospitals fish tanks are allowed in certain areas, such as Recreation Therapy, with the following strict precautions. 1) They are inaccessible to patients (e.g., enclosed area with observation window, freestanding tank with solid, affixed top). 2) They are not managed by health care workers but by a contracted service provider. 3) Patient may participate in feeding the fish but must wash his/her hands before and after the feeding and must be supervised by a Recreation Therapist during the activity.
NEWS AND ANNOUNCEMENTS
NC-APIC spring educational program will be March 22, 2002, at Durham Regional Hospital. Brochures will be mailed in February. For more information, contact Karen Ferree <kferree@lmh.cc>.
World TB Day is March 24. This annual event commemorates the date when Robert Koch announced his discovery of the TB bacillus. The Centers for Disease Control and Prevention (CDC) strongly encourages you to develop specific state or local activities and/or special messages to take advantage of the press interest that World TB Day will stimulate. Several resources are currently available on the internet to assist you in planning your materials and messages for World TB Day.
World TB Day posters at
http://www.cdc.gov/nchstp/tb/worldtb2001/poster.htm
"TB Elimination: Now Is the Time!" brochures at
http://www.cdc.gov/nchstp/tb/pubs/dtbeoth.htm
Stop TB (and World Health Organization) at
http://www.stoptb.org/world.tb.day/WTBD_2002/documents.htm
"FDA-Cleared Sterilants and High Level Disinfectants With General Claims for Processing Reusable Medical and Dental Devices" was updated January 30, 2002. It is online at http://www.fda.gov/cdrh/ode/germlab.html
General Recommendations on Immunization Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the American Academy of Family Physicians (AAFP) was published in the February 8, 2002, edition of the MMWR Recommendations and Reports and is now available in Adobe Acrobat format on the Internet. http://www.cdc.gov/mmwr/PDF/rr/rr5102.pdf
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
"Infection Control in Long-Term Care Facilities" will be held April 15-16, 2002 at The Friday Center in Chapel Hill. Registration information is available online
"Infection Control Part I: Clinical Surveillance of Healthcare-Associated Infections" will be held May 6-10, 2002 at the Holiday Inn in Chapel Hill.
Contributors to Report of the Month: Karen K. Hoffmann, RN, MS, CIC; William A. Rutala, PhD, MPH; David J. Weber, MD, 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 2002 North Carolina Statewide Program for Infection Control and Epidemiology
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