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December 2008 |
DISASTER PREPAREDNESS
No way to measure whether hospitals are disaster-ready
Though health care facilities invest a great deal of time and money toward disaster preparedness, a recent American Medical Association (AMA) study indicates that, without evidence-based performance measurements, it could be difficult to tell how ready a facility really is.
Published in the AMA’s Disaster Medicine and Public Health Preparedness journal’s December issue (abstracts available free, login required for reprint), Need for Performance Metrics in Hospital Emergency Management concludes there is a need for “universally accepted, evidence-based performance measures.” Such measures could help benchmark how well a facility has prepared for a disaster, and show a progression in its disaster readiness program. Because disasters are so difficult to predict, the study argues, it remains a challenge to determine whether a hospital’s investment in disaster preparedness has affected its ability to effectively respond when disaster strikes. The study’s authors suggest the “application of traditional health care quality paradigms, coupled with novel analytic approaches to develop meaningful performance data in hospital emergency management.”
Read more on this study here.
UNIVERSAL PROTOCOL
Joint Commission releases FAQs, Web site for revised Universal Protocol
The Joint Commission has published a Web site and frequently asked questions document to aid facilities preparing for the revised Universal Protocol.
Going into effect on Jan. 1, 2009, the Revised Universal Protocol Web resources include a link to the current Universal Protocol, implementation expectations, the aforementioned frequently asked questions document, and accreditation applications for various types of facilities. The Joint Commission has also made available Universal Protocol posters, published in both English and Spanish.
Visit The Joint Commission’s Universal Protocol Web page here.
DISINFECTION AND STERILIZATION
New CDC guideline for healthcare disinfection and sterilization released
New evidence-based recommendations on the preferred methods for cleaning, disinfection and sterilization of patient-care medical devices and for cleaning and disinfecting the healthcare environment were released last month by the Centers for Disease Control and Prevention (CDC).
The Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, supercedes the relevant sections contained in the 1985 CDC Guideline for Handwashing and Environmental Control. The new document also reviews cleaning methods to achieve maximum effectiveness from disinfection and sterilization results by first cleaning and removing organic and inorganic materials. Chemical disinfectants for patient-care equipment are also discussed in the document.
- In addition to updated recommendations, new topics addressed in the guideline include:
- Inactivation of antibiotic-resistant bacteria, bioterrorist agents, emerging pathogens, and blood borne pathogens
- Toxicologic, environmental, and occupational concerns associated with disinfection and sterilization practices
- Disinfection of patient-care equipment used in ambulatory settings and home care
- New sterilization processes, such as hydrogen peroxide gas plasma and liquid peracetic acid
- Disinfection of complex medical instruments (e.g., endoscopes).
The new CDC guideline can be accessed by visiting www.cdc.gov/ncidod/dhqp/pdf/guidelines/Disinfection_Nov_2008.pdf.
HEALTHCARE REFORM
Consensus agreement sets out national healthcare priorities
A consensus agreement reporting on a core set of national priorities in health care has been established and publicly released through combined input from representatives of AORN, the American Nurses Association (ANA), the National Quality Forum (NQF) and more than 20 other major national healthcare organizations working as part of a National Priorities Partnership convened by NQF.
The partnership members worked together to create a consensus agreement report, Aligning Our Efforts To Transform America’s Healthcare Goals, designed to set national priorities and goals to achieve a high-performing, healthcare system that delivers quality care to all.
The report outlines priorities and goals that address major challenges in health care, including eliminating harm, eradicating disparities, reducing disease burden and removing waste. The partnership was established to address the absence of national priorities and goals for performance improvement in healthcare, according to a Nov. 14 news release from ANA.
To learn more about the National Priorities Partnership, visit http://www.nationalprioritiespartnership.org/.
INFECTION CONTROL
C. difficile more prevalent than previously estimated
The life threatening Clostridium difficile bacterium that causes diarrhea and more serious intestinal conditions is 6.5 to 20 times greater than previous estimates, according to a new study released Nov. 11 by the Association for Professionals in Infection Control and Epidemiology (APIC).
The National Prevalence Study of Clostridium difficile in U.S. Healthcare Facilities indicates that 13 out of every 1,000 inpatients were infected or colonized with C. difficile. That’s an estimated 7,178 inpatients on any given day in American healthcare institutions with an associated cost of $17.6 to $51.5 million, according to the survey.
Survey results were collected from 12.5% of all medial facilities in the U.S. on one day between May and August 2008. A total of 1,443 patients were identified with C. difficile infection from among 648 participating hospitals. To learn more, visit http://www.apic.org/.
DESIGN AND CONSTRUCTION
Comment period closing for 2010 guidelines for healthcare construction
On Dec. 15 the comment period will close for the public to provide input on the American Institute of Architecture’s Guidelines for Design and Construction of Health Care Facilities.
The guidelines cover minimum program, space, and equipment needs for all clinical and support areas of hospitals, nursing facilities, freestanding psychiatric facilities, outpatient and rehabilitation facilities, and long-term care facilities. The document also includes minimum engineering design criteria for plumbing, medical gas, electrical, and heating, ventilating, and air conditioning systems.
New and revised content in the draft guidelines include new acoustics in health care facilities, new facility requirements for safe patient handling and movement and information technology requirements in general hospitals.
The draft 2010 guideline document is available for review in PDF form and can be accessed, along with instructions for submitting comments, through the Facility Guidelines Institute (FGI) Web site at http://www.fgiguidelines.org/. Comments must be submitted electronically through the FGI Web site no later than Dec. 15, 2008.
INNOVATIONS
Cleveland Clinic doctors pick top 10 medical innovations
Doctors from Cleveland Clinic in Ohio recently named their picks for the 2009 top 10 innovations in medicine, including national health information exchange, and Natural Orifice Transluminal Endoscopic Surgery (NOTES) (see page 13 in this issue to read more about NOTES).
The innovations were chosen by Cleveland Clinic doctors and their consultants as the procedures and products they think could have the most impact on medicine in the coming year.
Their top 10 picks are:
- Use of circulating tumor cell technology
- Warm organ perfusion device
- Diaphragm pacing system
- Multi-spectral imaging systems
- Percutaneous mitral valve regurgitation repair
- New strategies for creating vaccines for avian flu
- Laparoendoscopic single-site surgery (LESS) and NOTES
- Integration of diffuser tensor imaging
- Doppler-guided uterine artery occlusion
- National health information exchange
The top innovations were announced Nov. 12, on the final day of the Medical Innovation Summit hosted by Cleveland Clinic, according to a Cleveland Clinic news release. To read more visit, my.clevelandclinic.org/media_relations/library/2007/885.aspx.
RESEARCH
Surgical study highlights pros and cons of bypass surgery for severe obesity
Severely obese patients who underwent two different gastric bypass techniques had lost up to 31% of the Body Mass Index after four years, with no deaths reported among the 50 study subjects, according to a study published in the November issue of the British Journal of Surgery.
The study was carried out by surgeons at the University Hospital Zurich in Switzerland to compare the two gastric bypass techniques and find out whether varying the length of the small bowel limb during surgery could offer superior weight loss.
As a result of the four-year study, the surgeons now perform proximal gastric bypass as the operation of first choice. The distal gastric bypass technique, with its longer alimentary limb, wasn’t deemed to offer any significant advantages and had a number of drawbacks, according to the surgeons.
Read more news in AORN Management Connections and AORN Connections.