---------------------------------------------------------------------------REPORT OF THE MONTH, Volume VII, Number 5 – September-October 2003
- - - - from the North Carolina Statewide Program for Infection Control and Epidemiology
----------------------------------------------------------------------------CONTENTS:
NEWS FEATURES
PUBLIC HEALTH EPIDEMIOLOGIST JOINS SPICE STAFF
REGULATORY/LEGISLATIVE
REVISED NC SANITATION RULES IN EFFECT
QUESTION OF THE MONTH
NORTH CAROLINA ADDS VACCINIA TO COMMUNICABLE DISEASE REPORT
CARD
NEWS AND ANNOUNCEMENTS
- CDC PUBLIC HEALTH GUIDANCE FOR COMMUNITY-LEVEL
PREPAREDNESS AND RESPONSE TO SEVERE ACUTE RESPIRATORY
SYNDROME (SARS)
- ADDITIONS TO SPICE SARS WEB PAGE
- MOLD REMEDIATION IN SCHOOLS AND COMMERCIAL BUILDINGS
- JCAHO INFORMATION ABOUT SAFETY GOALS ON INFECTIONS AND
COMMUNICATION
- BLOODBORNE PATHOGENS STANDARD TOPIC OF NEW SAFETY AND
HEALTH BULLETIN
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
____________________________________________________________________
NEWS FEATURES
PUBLIC HEALTH EPIDEMIOLOGIST JOINS SPICE STAFF
Jennifer MacFarquhar has joined the staff of the SPICE program in the capacity of
Public Health Epidemiologist (PHE) regional coordinator. North Carolina has
designated a portion of federal funds to create positions within hospitals to assist
hospitals with preparedness efforts and to serve as liaisons between hospitals and the
public health sector. North Carolina has contracted with 11 medical facilities to house
Public Health Epidemiologists. Theses facilities have a combined patient service base
of more than 50% of the population within the state and were chosen based on number
of inpatient beds, Emergency Department volume, and geographic location. The PHEs
will monitor infectious diseases and community-acquired infections of special interest,
perform syndromic surveillance, provide an in-hospital link for the public health
community, coordinate and participate in investigations of community-acquired
infections or outbreaks, and participate in special investigative projects related to public
health importance. Jennifer holds a B.S. degree in Nursing with additional coursework
completed towards a MSN/MBA and a MPH. In addition, she holds a Certification in
Infection Control and has practiced in the field of Infection Control since 1997 within the
Duke University Health System and as an independent consultant.
REGULATORY/LEGISLATIVE
REVISED NC SANITATION RULES IN EFFECT
The North Carolina Department of Environment and Natural Resources completed the
revision to Rules Governing the Sanitation of Hospitals, Nursing Homes, Adult Care
Homes and Other Institutions (15A NCAC 18A.1300). The revised rules became
effective June 1, 2003. The rule revisions were made with the assistance of
representatives from industry (long term care and acute care hospitals), Division of
Facility Services, and the Division of Environmental Health. Some of the significant rule
changes or additions are listed below.
Where bedpans are cleaned in patient rooms, minimum bedpan cleaning facilities shall
consist of a toilet room with bedpan lugs or spray arms. Where facilities for cleaning
bedpans are not provided in patient rooms, bedpans shall be taken to a soiled utility
room to be cleaned and disinfected using an EPA registered hospital disinfectant after
each use. Hand sinks shall not be used (as a source of water) for cleaning (rinsing)
bedpans or bedside commodes.
Where disposable bedpans are reused, they shall be labeled with the patient’s name
and date and shall not be used by more than one patient.
Disposable water pitches no longer have an arbitrary time for replacement. The rule
states to mark pitchers with the patient’s name, and they shall be used only by that
patient and shall be disposed of or replaced when visibly soiled.
Feeding syringes which are reused shall be labeled with the patient’s name and date
when opened, shall be disassembled and rinsed after each use, and shall be disposed
of in 24 hours.
Oral suction (Yonkers) catheters which are reused shall be flushed after each use and
shall be disposed of within 24 hours. Feeding syringes and oral suction catheters shall
be stored in clean containers.
Pet therapy and food protection rules are now defined. No live animals shall be allowed
in any room where food is prepared or stored. Live animals shall be allowed in dining
areas if their presence will not result in contamination of food, clean equipment, or
serving utensils such as in the following situations: fish or animals in display tanks or
support animals.
Carpeting has now been approved for use in healthcare institutions. Carpeting shall be
maintained clean, odor free, dry and in good repair.
A complete copy of the NC Sanitation Rules is online at
http://www.deh.enr.state.nc.us/ehs/rules/t15a-18a.13.pdf
QUESTION OF THE MONTH
NORTH CAROLINA ADDS VACCINIA TO COMMUNICABLE DISEASE REPORT
CARD
Q: I saw a sample of the new white NC Communicable Disease Report Card with
vaccinia listed as one of the diseases. Does this mean we need to report every
person who responds to the smallpox vaccination and has a vaccinia pustule?
A.: No, for communicable disease reporting purposes, the reporting of vaccinia
applies only to inadvertent inoculation of vaccinia by a vaccinee with an infectious
pustule coming in contact with another person. In that situation, the other person would
be the one with a reportable disease.
Per Dr. Megan Davies, NC Communicable Disease Section
Note: Monkeypox and SARS were also added to the list of diseases that must be
reported within 24 hours. The new white cards are available for use.
NEWS AND ANNOUNCEMENTS
CDC PUBLIC HEALTH GUIDANCE FOR COMMUNITY-LEVEL PREPAREDNESS
AND RESPONSE TO SEVERE ACUTE RESPIRATORY SYNDROME (SARS)
October 17, 2003. The Centers for Disease Control and Prevention (CDC) posted this
document in draft form to assist local and state public health and healthcare officials in
their preparations for a possible reemergence of SARS during the approaching
respiratory disease season. CDC invites interested public health partners to submit
comments on the draft document to: sars-plan@cdc.gov.
For more information about the SARS Plan, visit CDC's web site at
http://www.cdc.gov/ncidod/sars/ or contact the
Office of Communication at 404-639-3286.
ADDITIONS TO SPICE SARS WEB PAGE
For information on SARS, see the Statewide Program for Infection Control and
Epidemiology (SPICE) web page on SARS. A recent addition is the “UNC Health Care Practice Improvements for Management of SARS,” September 30, 2003.
http://www.unc.edu/depts/spice/SARS.html
MOLD REMEDIATION IN SCHOOLS AND COMMERCIAL BUILDINGS
This document presents guidelines for the remediation/cleanup of mold and moisture
problems in schools and commercial buildings; these guidelines include measures
designed to protect the health of building occupants and remediators. It is available
online at
http://www.epa.gov/iaq/molds/images/moldremediation.pdf
JCAHO INFORMATION ABOUT SAFETY GOALS ON INFECTIONS AND
COMMUNICATION
Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has posted a
new frequently asked questions (FAQ) document that clarifies the safety goal on
infections and adherence to CDC hand hygiene guidelines. These FAQs also add
information on the safety goal, including the new requirements for a JCAHO-approved
minimum list of "do not use" abbreviations, acronyms and symbols; plus at least three
organization-selected "do not use" abbreviations, acronyms or symbols.
http://www.jcaho.org/accredited+organizations/patient+safety/04+npsg/04_faqs.htm
printer-friendly version:
http://www.jcaho.org/accredited+organizations/patient+safety/04+npsg/2004+national+p
atient+safety+goals.pdf
BLOODBORNE PATHOGENS STANDARD TOPIC OF NEW SAFETY AND HEALTH
BULLETIN
OSHA recently published a bulletin reiterating the agency's policy on disposal of
contaminated needles and blood tube holders following blood drawing procedures.
OSHA's bloodborne pathogens standard prohibits the removal of needles from medical
devices and removal of contaminated needles from blood tube holders following a blood
drawing procedure. The safety and health information bulletin details those
requirements and also includes an Evaluation Toolbox that supplies guidance on the
evaluation, selection, and appropriate use of engineering controls. The bulletin also
provides the most recent sharps injury data from the Exposure Prevention Information
Network.
http://www.osha.gov/dts/shib/shib101503.html
COURSES FOR THE INFECTION CONTROL PROFESSIONAL
"Infection Control in Long-Term Care Facilities” will be held in Chapel Hill March 22-24,
2004.
“Infection Control Part I: Clinical Surveillance of Healthcare-Associated Infections” will
be held in Chapel Hill May 3-7, 2004.
“Infection Control Part II: The ICP as an Environmentalist” will be held in Chapel Hill in
the fall of 2004
-----------------------------------------------------------------------------------Contributors to Report of the Month: Karen K. Hoffmann, RN, MS, CIC; William A.
Rutala, PhD, MPH; David J. Weber, MD, MPH; Jennifer MacFarquhar, RN, BSN, CIC;
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 2003 Statewide Program for Infection Control and Epidemiology