Dentist Infection Control

Infection Control Consulting Services Blog


Healthcare-Associated Infections Update from Health and Human Services

In 2009, U.S. Health and Human Services (HHS), through the Office of Disease Prevention and Health Promotion (ODPHP), released a plan called the "National Action Plan to Prevent Health Care-Associated Infections: Road Map to Elimination" (HAI Action Plan). The action plan addressed acute care, ambulatory surgery centers, end-stage renal disease facilities and long-term care. In 2013, the HAI Action Plan went through a substantial update, and included a section for increasing influenza vaccination of healthcare personnel.

This week, the ODPHP announced "ambitious new targets for the national acute-care hospital metrics" for the HAI Action Plan. It used 2015 data as a baseline to replace targets that expired in 2013. The goal for these measures is to primarily track HAIs at a national level.

The measures include the following goals:

There are a few other important developments associated with this update:
  • ODPHP eliminated the Surgical Care Improvement Project (SCIP) process measure due to major compliance and widely accepted practice.
  • Antibiotic stewardship is gaining major momentum, with HHS developing an "Agency Priority Goal" for combating antibiotic resistant bacteria. 

Infection Control Consulting Services (ICCS) is a national provider of healthcare infection control consulting services to a wide range of facilities, including hospitals, ambulatory surgery centers, outpatient care facilities, dentists and nursing homes. Services include development of comprehensive, compliant infection prevention programs; infection prevention risk assessment; accreditation and CMS survey preparation; and infection education.


Dental Infection Control Special Report on Pulpotomy, Mycobacteria in Children

Infection Control Consulting Services (ICCS) has published a new special report concerning dental infection prevention and control practices.

The report examines recent outbreaks of Mycobacterium abscessus odontogenic infections in children following pulpotomy procedures ("child root canal").

As the report notes, "... the water that was used during the pulpotomy treatment allowed bacteria growing in the water to be trapped in the tooth when it was capped after the procedure was completed. ... Dental waterlines are a challenge as bacteria grow biofilm which adheres to the plastic tubes and is very difficult to eradicate."

Read the ICCS special report on dental infection control.


Nurse Assist Initiates Recall of IV Flush Syringes Due to Infections

Nurse Assist, a Texas-based medical device manufacturer primarily for hospitals and long-term care facilities, has announced the initiation of a voluntarily recall of all unexpired lots of IV flush syringes due to a potential link to Burkholderia cepacia bloodstream infections.

To date, infections have been reported in four states:

As the U.S. Centers for Disease Control and Prevention (CDC) notes, symptoms of B. cepacia infection vary widely, ranging from no symptoms at all to serious respiratory infections, especially in patients with cystic fibrosis. B. cepacia can also be resistant to many common antibiotics.

The recall applies to flush syringes with 3ml, 5ml and 10 ml fills across four product codes. These lots were distributed between February 16 and September 30 of this year.

To return recalled product for credit, contact Nurse Assist customer service at (800) 649-6800 ext. 10.


Antibiotic Stewardship in Outpatient Settings in the Spotlight Following Release of Letter From CDC

The Centers for Disease Control and Prevention, along with The Pew Charitable Trusts and a dozen national health organizations, have released a letter on the importance of antibiotic stewardship in outpatient settings.

The letter is intended to represent the commitment of these organizations to collaborate on expanding current antibiotic stewardship efforts, fill research gaps around effective interventions for improving prescribing habits and help healthcare professionals and patients use antibiotics appropriately in outpatient settings.

In May, Journal of the American Medical Association released data that showed physicians in private offices and emergency rooms significantly overprescribe antibiotics. The article noted that at least 30% of antibiotics prescribed in U.S. outpatient settings are unnecessary. 

As the letter noted, "... the spread of antibiotic-resistant bacteria has placed the world on the precipice of what public health leaders call a 'post-antibiotic' era in which even simple surgical procedures could be complicated by deadly infections. ... although antibiotics are generally safe, these drugs also carry risks for individual patients. For example, antibiotics can cause adverse events ranging from minor side effects to serious allergic reactions and antibiotic use increases the potential for a patient to develop an infection."

Learn more about antibiotic stewardship in outpatient settings in this Becker's ASC Review column on multidisciplinary ASC antibiotic stewardship program implementation.



New CDC Collaboration Seeks to Prevent Dialysis Bloodstream Infections

The Centers for Disease Control and Prevention (CDC) has announced the launch of a new collaboration aimed at preventing bloodstream infections among hemodialysis patients.

The Making Dialysis Safer For Patients Coalition is comprised of healthcare organizations, patient advocacy organizations, industry partners, and other public health partners spanning the dialysis spectrum.

More than 400,000 people presently rely on hemodialysis care, and they are at risk of developing serious infections. As the CDC notes, the Coalition's goals are to:
  • facilitate implementation and adoption of core interventions through promotion, dissemination, and use of audit tools, checklists, and other infection prevention education resources;
  • increase awareness about the core interventions for dialysis bloodstream infection prevention through educational efforts; and
  • share experiences and findings through collaboration with other Coalition participants.

Dr. Priti Patel, medical director of the Coalition, said, "Dialysis patients are particularly vulnerable to infections. We want to get lifesaving tools into the right hands to make a real impact on patients' lives."


Joint Commission: Infection Control Standard Among the Most Challenging for Ambulatory Care, Hospitals

The Joint Commission standard IC.02.02.01 (The [organization] reduces the risk of infections associated with medical equipment, devices, and supplies.) was one of the top requirements cited most frequently as "not compliant" during surveys and reviews of ambulatory care facilities, hospitals and office-based surgery practices for the first half of 2016, according to Joint Commission Online.

For ambulatory care, this standard was the most challenging requirement, with a 49% non-compliance percentage.

For hospitals, it was the second most challenging, with a 59% non-compliance percentage.

For critical access hospitals, it was tied for the most challenging, with 73% non-compliance percentage.

For office-based surgery practices, it was the second most challenging, with a 53% non-compliance percentage.

Infection Control Consulting Services (ICCS) provides a wide range of infection prevention and control consulting services, including infection control survey preparation and preparation of and assistance with corrective plans of action related to survey deficiencies. If your facility requires assistance with meeting Joint Commission requirements, contact ICCS today!


FDA Recommendation: Stop Using System 83 Plus AERs for Duodenoscope Reprocessing

The U.S. Food & Drug Administration (FDA) recently issued a recommendation advising healthcare facilities no longer use Custom Ultrasonics' System 83 Plus automated endoscope reprocessors (AERs) for reprocessing duodenoscopes.

Contained within this notice to facilities that reprocess duodenoscopes is the following FDA advice: "Identify and transition to alternate methods to reprocess duodenoscopes, such as manual high-level disinfection, alternative AERs, liquid chemical sterilization, or other sterilization methods according to the duodenoscope manufacturers' reprocessing instructions."

Infection Control Consulting Services (ICCS) cautions facilities that may choose manual high-level disinfection (HLD) upon ceasing use of System 83 Plus AERs that every step for reprocessing in this manner must follow manufacturers' instructions for use (IFUs). This includes IFUs available from the scope manufacturer, HLD chemical manufacturer and other items that may be used during reprocessing. In addition, facility written policies must be followed. Guidelines set forth by associations and agencies, including the FDA and Centers for Disease Control and Prevention (CDC), if applicable, should be followed as well.

ICCS finds during on-site visits that facilities performing manual HLD are subject to a higher rates of process failure than facilities conducting automated HLD. Breakdown in processes include, but are not limited to, failure to test the temperature and viability of the chemical(s). Documentation of steps taken as well as monitoring of technician methods for conducting this process is important. At a minimum, annual reprocessing competencies should be conducted. They should occur more frequently if a change in procedure or product is introduced. Change of reprocessing personnel requires a competency as well.

Note: FDA communicated that Custom Ultrasonics' System 83 Plus AERs remain in service for the reprocessing of endoscopes other than duodenoscopes.