Could White Coats Be Obsolete?

A new infection control recommendation could make white coats obsolete according to Newswise.com. 

In a move to reduce health care associated infections, certain attire for health care professionals, including the traditional white coat, could become a thing of the past.

“White coats, neckties, and wrist watches can become contaminated and may potentially serve as vehicles to carry germs from one patient to another,” said Mark Rupp, M.D., chief of the division of infectious diseases at the University of Nebraska Medical Center and one of the authors of recommendations issued by the Society for Healthcare Epidemiology of America (SHEA), one of the world’s top infection control organizations.

“However, it is unknown whether white coats and neck ties play any real role in transmission of infection,” said Dr. Rupp, who is a past president of SHEA. “Until better data are available, hospitals and doctor’s offices should first concentrate on well-known ways to prevent transmission of infection -- like hand hygiene, environmental cleaning, and careful attention to insertion and care of invasive devices like vascular catheters.”

Read the entire article here.

5 CMS Updates for ASCs in 2014

Below are 5 recent legislative and legal updates impacting the ambulatory surgery center industry on the national and state level. 

1. January 1, 2014 marked the beginning of the 2014 Medicare N1 codes. There are 210 new procedures given N1 status by Medicare, most of which were separately paid in previous years. The new regulation applies to the ASC, not the physician, and only for Medicare covered patients. Learn more about the new N1 codes here.

2. The Centers for Medicare and Medicaid Services proposed expanding emergency preparedness requirements at the end of last year. Providers, including ASCs, would be required to: 

  • Develop an emergency plan using an all-hazards approach focusing on capacities and capabilities;
  • Develop and implement policies and procedures based on the risk assessment and emergency plan;
  • Develop and maintain a communication plan complying with federal and state law to coordinate across healthcare providers and with state, local and public health departments and emergency systems;
  • Develop and maintain training and testing programs.

3. The CMS Final Payment Rule includes new quality reporting requirements for cataract surgery. The new requirements include reporting improvement in the patient's visual function within 90 days following cataract surgery, which is a patient reported outcome measure. According to the report, several stakeholders have met with members of Congress to raise issue with the new measure and the potential for unfair penalization under the current rule.

4. In January, MedPAC made the final recommendation for pay rates in 2015, recommending ASCs get no pay raise next year. MedPAC recommended increasing hospital inpatient and outpatient prospective payment systems by 3.25 percent. However, MedPAC also suggested reducing or eliminating the differences between hospital outpatient departments and physician offices for some procedures.

5. It was announced earlier this year that CMS delayed data collection for three new quality measures that were finalized for inclusion in the Ambulatory Surgical Center Quality Reporting Program until April 1. ASCs still need to report data from this year, but instead of reporting for all 12 months only patient encounters from April 1 to Dec. 31 should be included. 

For more information and a complete list of updates please visit Becker's ASC Review.

 

Stethoscopes Hold More Germs Than Doctors’ Hands, Study Says

While doctors and other medical professionals tend to put a great deal of emphasis on cleanliness and hand washing, a new study indicates that the number one tool that a doctors uses to interact with patients – a stethoscope – may actually hold more germs than his or her hands.

Surprisingly, the new report says that a typical stethoscope is generally cleaned less than once a month – if it gets cleaned at all.

The University of Geneva research team who conducted the study found that stethoscopes often hold just as much bacteria as the palms of doctors’ hands with only the tips of the fingers holding more.

To read the entire article visit Liberty Voice.

You can also view this segment from Fox News' Sunday House Call for more information.

How to Clean a Stethoscope

  1. Remove the ear tips from the stethoscope.
  2. Mix together a cup of one-fifth antibacterial soap and four-fifths water. Put the ear tips into this solution and allow them to sit for five minutes.
  3. Remove the ear tips and rinse them off. Allow time for them to dry.
  4. Wipe all areas of the stethoscope with 70 percent isopropyl alcohol wipes.
  5. Put the ear tips back on the stethoscope when they are completely dry.

Read more at eHow.com.

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Patient Safety Awareness Week March 2-8

Patient safety is an issue that all medical professionals need to address. Anesthesia is no different than anyone else. Malpractice attorneys just cannot wait for an anesthesia provider to make a mistake. According to attorneys Meyers, Evans and Associates, the most common causes of anesthesia error during surgery are:

1. Overdose or under dose of anesthesia

2. Delayed delivery of anesthesia

3. Failure to avoid an allergic reaction if it could have reasonably been prevented.

4. Drug interactions complications

5. Failure to properly administer oxygen during surgery

6. Failure to properly monitor the patient

7. Use of defective medical equipment during sedation

So now ask yourself, are you performing inadequate anesthesia? Are you doing your best to provide the safest anesthesia for your patients? Can you say that any of the above items you have been guilty of doing?

As an anesthesia clinician I think there are several other items that could be added to the above list.

1. Labeling of syringes: There are numerous occasions at numerous facilities where I will see that medications are not being labeled, dated or initialed. It is so easy to place a label on a syringe.

2. Poor hand hygiene: The use of gloves is not only a safety issue for the patient but it is also to protect you as a clinician. So many times gloves are not even used. When gloves are used then they are used improperly.

Think….after you intubate a patient do you immediately remove your gloves or do you grab the circuit, bag, or any other part of the anesthesia machine with gloves that have been contaminated with patient secretions? How many times have you reached for your pen or now the computer key board with dirty gloves on? Then do you foam or wash your hands when you take your gloves off? Do you foam or wash your hands in between patient contact?

3. IV ports:  IV tubing….where has it been? Draped over the end of the stretcher or on the floor while rolling the patient to the OR? Have no idea what has occurred with the IV tubing if the patient has come from the medical floor from within the hospital. This is why it is important to clean the IV ports prior to injecting medications. Those IV ports are exposed to everything.

Patient safety should not be an occasional thought. It should be at the forefront of each anesthetic that we administer from the pre-operative evaluation all the way through to patient’s discharge from PACU.

We must help to remind each other of the safety issues we face every day for our patients.

Remember, a lot of times we are the “gate keeper” for our patients to ensure their surgical experience is not only optimal but of the highest quality and safety.