Phenelle Segal to Present on ASC Infection Control Practices at GSASC/SCASCA Conference

Phenelle Segal, RN, CIC, FAPIC, founder and president of Infection Control Consulting Services (ICCS), will be presenting at the August Georgia Society of Ambulatory Surgery Centers (GSASC) and South Carolina Ambulatory Surgery Center Association (SCASCA) Joint Semi-Annual Conference and Tradeshow.

This meeting will take place August 15–16, 2019, at the Hilton Head Marriott Resort & Spa in Hilton Head Island, S.C.

Phenelle will be discussing "Controversial Infection Control Practices in Ambulatory Surgery Centers" on August 15 from 8:45 AM – 12:00 PM.

If you will be attending the conference and are interested in arranging a meeting with Phenelle, contact ICCS.

New Jersey Issues New Infection Control Recommendations for LTC

The N.J. Department of Health (DOH) has issued new policy recommendations for infection control at long-term care (LTC) facilities.

They come in response to an adenovirus outbreak last year at a pediatric facility in the state that led to 11 deaths and dozens of cases.

The DOH is recommending all LTC facilities with pediatric and adult ventilator beds have an infection control plan that "allows for separation of sick and well residents — and the staff caring for them — as quickly as possible and monitoring of staff and residents for illness," according to a DOH news release.

One of the most significant recommendations is for these LTC facilities to have an outbreak plan that addresses the following:

• policies for patient and staff notification;

• availability of lab testing;

• protocols to assess visitor wellness;

• protocols to identify/exclude sick staff from the facility; and

• separation of sick and well patients at the outset of an outbreak to prevent spread of illness.

The report also includes recommendations for amending state regulations to require such facilities to:

• implement protocols to ensure parents and guardians of residents are immediately notified when outbreaks occur;

• employ a full-time infection control professional;

• have an agreement in place to consult with an infectious disease specialist during an outbreak; and

• provide all staff with training in the facility's infection control policies — including protocols for identifying employees and visitors showing signs of illness — every six months.

Other recommendations touch on areas including response to outbreak by local health departments, development of a respiratory virus outbreak preparedness checklist and funding for staff dedicated to respiratory virus surveillance.

Since some of the recommendations call for policy changes, the N.J. Senate and Assembly Health committees have introduced legislation to address them. 

Study: Most Antibiotics Prescribed Before Dental Procedures Unnecessary

The results of a new study show that more than 80% of antibiotics prescribed for infection prophylaxis prior to dental procedures are unnecessary.

The retrospective cohort study, published in JAMA Network Open, examined about 168,000 dental visits from 2011-2015 involving about 91,000 patients who received antibiotic prophylaxis. Appropriate antibiotic prophylaxis was defined as "a prescription dispensed before a dental visit with a procedure that manipulated the gingiva or tooth periapex in patients with an appropriate cardiac diagnosis."

Researchers noted that nearly 91% of the visits had manipulation of the gingiva or tooth periapex, but only about 21% of patients had a cardiac condition at the highest risk of adverse outcome from infective endocarditis. They therefore determined that 80.9% of antibiotic prophylaxis prescriptions were "discordant with guidelines."

Their conclusions include the following: "While antibiotic prophylaxis is appropriately prescribed for indicated dental procedures in patients with cardiac conditions, most antibiotic prophylaxis is prescribed to patients in whom guideline-identified risk factors are not present. Although prescribing is slowly improving, the high proportion of antibiotics that were found to be unnecessary in our study is worrisome. Implementing antimicrobial stewardship efforts in dental practices is an opportunity to improve antibiotic prescribing for infection prophylaxis."

The researchers note that dentists prescribe about 10% of all antibiotic prescriptions in the United States and are also the top prescriber of clindamycin in the United States. Furthermore, they note that antibiotics prescribed by dentists for infection prophylaxis have been associated with community-associated C difficile infection.

May 2019 Issue of Infection Prevention & Control Newsletter Published

The May 2019 issue of the ICCS Infection Prevention & Control Newsletter has published.

The issue includes stories on ophthalmology devices, patient privacy curtains, measles, TB, antibiotic stewardship requirement and a New York bill on infection prevention certification.

Access the latest issue of our infection prevention newsletter.

Receive the free ICCS Newsletter by signing up here.

New Guidelines Advise Against Annual TB Testing for Healthcare Personnel

The National Tuberculosis Controllers Association (NTCA), in partnership with the Centers for Disease Control and Prevention (CDC), has released updated recommendations for tuberculosis (TB) screening, testing and treatment of healthcare personnel.

Of note, the updated recommendations advise against annual screening of all healthcare personnel for TB. In an NTCA news release, Dr. Robert Belknap, medical director of the Denver Metro Tuberculosis Clinic, and co-lead of the workgroup that assembled the recommendations states, "The continued routine practice of annual testing has been costly, has resulted in false positive tests for TB infection, and is no longer supported by what we have observed in healthcare settings over time. This movement away from annual testing is long overdue."

As the new recommendations note, "TB rates in the United States have declined substantially; the annual national TB rate in 2017 (2.8 per 100,000 population) represents a 73% decrease from the rate in 1991 (10.4) and a 42% decrease from the rate in 2005. Surveillance data reported to CDC during 1995–2007 revealed that TB incidence rates among healthcare personnel were similar to those in the general population, raising questions about the cost-effectiveness of routine serial occupational testing."

Other recommendations include the following:

• individual baseline (preplacement) risk assessment;

• symptom evaluation and testing of persons without prior TB or latent TB infection (LTBI);

• treatment for healthcare personnel diagnosed with LTBI;

• annual symptom screening for persons with untreated LTBI; and

• annual TB education of all healthcare personnel.

The updated recommendations supplement the existing 2005 guidelines for preventing the transmission of TB in healthcare settings.