By now, one would think that all health care workers know the importance of washing their hands, yet a recent study found that staff at outpatient care facilities fail to follow recommendations for hand hygiene 37% of the time, and for safe injection practices 33% of the time, even after having policies in place about these infection control issues (Am J Infect Control 2016;44:374-380).
Researchers from the University of New Mexico and the New Mexico Department of Health conducted a cross-sectional study of 15 geographically dispersed outpatient facilities in which medical students assessed infection prevention policies and practices during the summer of 2014. Medical student interviews with outpatient facility staff indicated that 93% of recommended policies were in place across the 15 facilities.
However, when the students observed behaviors, they noted only 63% compliance with recommended hand hygiene practices and 66% compliance with safe injection practices. In 37% of hand hygiene observations, no hand hygiene was performed.
“Despite high levels of report of hand hygiene education and observed supply availability, observations of hand hygiene and aseptic injection technique showed lack of similarly high behavior compliance,” the researchers wrote.
“This project highlights the importance of assessing both the report of recommended infection prevention policies and practices, as well as behavior compliance through observational audits.”
Medical students assessed prevention policies using an outpatient infection prevention checklist developed by the Centers for Disease Control and Prevention that included 14 topic areas, including administrative policies, education and training, occupational health, environment cleaning, hand hygiene and injection safety. In addition to assessing policies via the checklist, the students evaluated injection safety and hand hygiene practices through direct observations. Each student was asked to observe 10 injections and 20 hand hygiene opportunities at their assigned outpatient practice.
Of the 163 injection safety observations, only 66% of the preparations complied with all of the recommended infection prevention steps, which included performing hand hygiene, disinfecting the rubber septum, using a new needle and syringe, properly discarding single-dose vials and dating multidose vials upon opening. During the 330 hand hygiene observations, students reported that hand hygiene supplies were available 100% of the time.
“These findings highlight the need for ongoing quality improvement initiatives regarding infection prevention policies and practices in outpatient settings,” the researchers concluded.
MOST ENTITIES THAT CONTINUE TO FAIL THEIR BUSINESS PLAN… NORMALLY GOES OUT OF BUSINESS OR DECLARES BANKRUPTCY… NOT THE DEA… GIVE US MORE MONEY SO THAT WE CAN CONTINUE TO FAIL.. 45 YRS AND COUNTING !
WASHINGTON — The opioid epidemic is gripping the country, and it is not getting any better.
“What I’m seeing here, unfortunately, is more heroin overdoses,” said Loudoun County Sheriff Mike Chapman. “Looking at the several heroin deaths Loudoun County has had already this year and several last year, it is shocking.”
Especially since Loudoun County, Virginia is considered one of the richest counties in the country.
“But it’s happening,” Chapman said. “It’s happening everywhere. It’s happening in all ages. It doesn’t matter what your income is, it doesn’t matter where you live in the county. This is affecting everybody. And awareness is the key. Making sure everybody knows it out there. And stay away from it because once you try it you’re done, you’re going to be addicted to it.”
Chapman spoke at an event in Leesburg, Virginia on Saturday aimed at addressing law enforcement’s latest efforts in the opioid epidemic. Acting DEA Administrator Chuck Rosenberg joined state and federal law enforcement leaders at a travelling DEA Drug Museum exhibit called “Drugs: Costs & Consequences.”
The event was held in conjunction with National Prescription Drug Take-Back Day. The museum was one more than 5,000 drug drop-off locations across the U.S.
Rosenberg said that last year’s drug take-back day, which was held in September, reaped 742,000 pounds of unwanted and expired drugs — about 10-percent of those drugs were opioids. “Even if that’s true, only 10 percent, that is 74,000 pounds of opioids off the street,” Rosenberg said.
Getting the opioids off the street is huge because opioid abuse leads to heroin abuse, he said.
One part of the solution is arrests, especially the arrests of the drug distributors. Education is another tool being used in this fight.
“We can’t solve this problem alone,” said Karl Colder, a special agent in charge at the DEA’s Washington Division Office.
Colder said law enforcement has to team up with prevention, rehabilitation, treatment and educational professionals to get the message out. They also have to educate the public — particularly parents.
“They have to understand that this is a reality and that they have to talk to their kids about this,” he said. “Our school systems have to be more open about this because the abusers are a lot younger now.”
Unidentified family members reportedly told TMZ that Prince had multiple doctors scoring him prescriptions, including a “personal friend.”
Prince had a problem with Percocet and nearly suffered a fatal overdose six days prior to his death, the celebrity website reported.
His private plane made an unscheduled landing in Moline, Ill., on April 15 after back-to-back concerts in Atlanta — and he was carried off the plane by his bodyguard, a law enforcement source confirmed to The News.
Prince received an emergency “save shot” at the airport for the alleged Percocet overdose, TMZ said.
Authorities are now on the hunt for any doctors who prescribed the “Purple Rain” artist powerful drugs and the circumstances of their care, the website said.
Such an investigation would mirror the forensic work that took place after Michael Jackson’s death. That probe revealed a pattern of doctor shopping on the part of Jackson and a cover-up that led to an involuntary manslaughter conviction for Dr. Conrad Murray.
Prince sought the treatment as he was dealing with chronic hip pain, the station reported.
The local news station also said representatives for the bank now handling Prince’s estate as court-appointed trustee went to great lengths Tuesday to get inside the locked vault at his suburban Minneapolis home.
Bremer Bank hired a St. Paul company to drill through the vault so it could take an inventory of its contents, KSTP reported.
Prince’s longtime sound engineer previously told The News that Prince kept his invaluable stash of recordings in the vault, including a mountain of unreleased music that could lead to posthumous albums.
Meanwhile, Prince’s sister reportedly walked out of a family meeting Thursday amid tensions with two brothers.
Unidentified sources told TMZ that Tyka Nelson, 55, marched out of the meeting after half-brother Alfred Nelson, 62, said he was upset over not being invited to Prince’s private funeral service last Saturday.
After an autopsy, his body was cremated. A couple dozen close friends and relatives gathered for his private funeral at Paisley Park on Saturday.
“There were a lot of tears, and a lot of hugs. But there was also a lot of sharing stories and memories, which created a lot of laughter — which that too would have been what Prince would have wanted,” close family friend Sylvia Amos, 67, told the Daily News.
Prince lived with Amos’ family, including her brother Andre Cymone, as a teen.
“It’s still very unbelievable to me,” she told The News this week, confirming she attended the funeral.
“There were a lot of candles, because as his sister said, he loved candles, and people were free to take the candles with them when it was over,” she said.
Paisley Park staff served Prince’s favorite vegetarian dishes at the service, including a pasta and beans recipe and sliced vegetables with hummus and guacamole, she said.
“We also danced to his music and we were all encouraged to get up and dance,” she said. “The song that closed out the memorial service was ‘Purple Rain,’ and everyone was kind of holding onto someone else, quietly listening with most of us having tears in our eyes.”
In an eerie twist, she said a black silhouette of Prince’s face projected on the walls of his private funeral Saturday included a haunting detail.
The computer projecting the image had its mouse arrow hovering over Prince’s cheek in a position that looked like a single teardrop, she said.
“You couldn’t help but look at it,” Amos said. “It was his nephew who noted that it looked like a teardrop.”
The Maine legislature on Friday overturned Governor Gary LePage’s veto of a bill that would allow pharmacies to sell an opiate-overdose antidote without a prescription
By James King
Apr 29, 2016 at 6:16 PM ET
On Friday, the Maine legislature voted with a two-thirds majority to override the veto made by Governor Paul LePage of a bill that would allow the sale of the opiate-overdose antidote naloxone without a prescription.
LePage was the target of criticism for his veto of the bill as well as comments he made about opiate addicts—after vetoing the bill, LePage said “naloxone does not truly save lives; it merely extends them until the next overdose.” He attempted to defend his comments after an onslaught of criticism with an even more offensive remark.
“There comes a point in time where who is responsible for who,” the controversial governor, who once said drug dealers were flocking to Maine to “impregnate young white girls,” said. “You know a shot of Narcan is $70 and the person who gets it doesn’t have to pay it back.”
“Governor LePage may think a person’s life is worth less than $70, but saving lives is priceless and we are going to continue to advocate for laws that are based in science, compassion and human rights,” said Jerónimo Saldaña, policy manager for the Drug Policy Alliance, in response to the vote on Friday. “Today, the Maine legislature sent a resounding message to Governor LePage and every other elected official in the nation that promoting failed drug war policies will not be tolerated.”
Naloxone is available without a prescription in more than 30 states, but it’s still difficult to obtain in many places—which is shame, since it has a proven capacity to save lives. The drug is a shot, given to someone who’s overdosed, and can keep someone alive for an hour or more until they can get medical assistance. The CDC estimates its reversed more than 26,000 overdoses since 1996.
In September, CVS Pharmacies announced a program to start selling Naloxone in its pharmacies in several states where the drug is legally sold without a prescription. Currently, the pharmacy chain sells Naloxone without a prescription in 22 states, including New Hampshire, which was added to the growing list of states on Thursday.
The opioid epidemic has touched so many families in New Hampshire and across the U.S. and expanding access to naloxone is one important step in our efforts to address it,” Marcia Lee Taylor, President and CEO of the Partnership for Drug-Free Kids, said in a press release on Thursday. “We applaud CVS Health for increasing access to this life-saving drug for patients without a prescription at CVS Pharmacy locations in New Hampshire and in many other states across the country.”
In 2013, there were approximately 24,000 deaths from heroin and prescription opiate overdoses, according to data from the Centers for Disease Control and Prevention. “Heroin use in the United States increased 63 percent from 2002 through 2013. This increase occurred among a broad range of demographics, including men and women, most age groups, and all income levels,” according to a CDC report released in July. The CDC credits the spike to users who started abusing prescription opiates like Oxycontin and Hydrocodone.
Medicare wants to shift away from paying doctors according to number of visits, procedures, hospitalizations, and tests — and toward paying for performance.
This week, Medicare officials unveiled an ambitious plan to do just that. The nearly thousand-page report proposes an opt-in track for doctors called the “merit-based incentive payment system” (MIPS), designed to reward or penalize them based on their performance. The proposal would also pay doctors to try out Medicare’s alternative payment models — non-traditional (and hopefully money-saving) new ways for the public health program to reimburse doctors.
The proposal is the first step toward what could be the biggest update to Medicare in its 50-year history. It’s part of a bigger plan to tie as much as half of doctor payments to patients’ health outcomes by 2019.
Proponents of the proposed “pay-for-performance” system say that Medicare’s traditional “fee-for-service” system is too costly and encourages waste. Under fee-for-service, doctors are paid a flat free for every test or procedure they perform, regardless of whether those services actually improve their patients’ health. As a result, doctors may administer expensive medical tests even when there’s little chance these tests will find a tumor or disease — and taxpayers end up footing the bill.
Medicare wants to save taxpayer dollars by penalizing wasteful doctors, but doctors have been known to fight tooth and nail against what Medicare considers wasteful. Facing criticism last year, Medicare had to abandon its proposal to penalize doctors for ordering routine prostate-cancer exams for their patients. On the one hand, prostate exams have led an estimated one million men to be treated for cancer that would never have bothered them — again, with taxpayers footing the bill. Yet, even the very authors of that study, doctors themselves, opposed Medicare’s proposal.
“[We] are not comfortable rewarding doctors for withholding a test that could help some men,” the two doctors wrote in the New York Times. They added that Medicare should not penalize doctors, but should raise patient deductibles for screenings it deems unnecessary.
The American Medical Association (AMA), the largest and most powerful group of doctors in the nation, has also criticized Medicare, calling its past attempts to implement pay-for-performance “burdensome, meaningless and punitive.” But Wednesday’s proposal got the AMA’s stamp of approval.
“Our initial review suggests that CMS has been listening to physicians’ concerns,” Steven Stack, the association’s president, said in a statement. “It is hard to overstate the significance of these proposed regulations for patients and physicians.”
The second way the proposal tries to save money and promote quality care is through “alternative payment models.” Under one common alternative model — the bundled payment model — Medicare pays doctors for all care in connection with a single “episode” of sickness or, for instance, a single knee replacement procedure. All the doctors in a given region get the same flat fee for a procedure based on the average cost of the procedure in that region. The model encourages pricey health care providers to bring down costs like their more cost-efficient neighbors.
Other models promote doctor innovation. For example, doctors can be part of a health home — “where doctors can help patients understand prevention and wellness,” the Center for Medicare and Medicaid Services explains in a video. “They can try innovative approaches like tele-health or nutrition classes.”
Patrick Conway, CMS’s chief medical officer, emphasized that the new payment system is opt-in, giving doctors “the opportunity to participate in a way that is best for them, their practice, and their patients.” Even so, CMS expects the vast majority of doctors to opt in.
The comment period for the proposal is open for the next two months.
This is a HANDBILL that reportedly was passed out in the Chicago , IL area on April 27th & 28th. As has been routinely reported by Pharmacists/Techs that work for the other major – and not so major – chains. Working conditions vary very little between locations. You ask, if they are unhappy about their work environment… why don’t they find another job… since chains collectively operate 60%-70% of all community pharmacy outlets… it is pretty much senseless to move from one horrible work environment to another.
I have yet to hear from a Pharmacist/Tech that has been able to get off of the “chain treadmill” and find a position with a Independent Pharmacy that they regretted the move.
Some of us believe that … “A Tired Pharmacist/Tech is a Dangerous Pharmacist/Tech…”
Have you ever asked yourself.. if all these Pharmacists/Techs don’t care enough to take care of their own personal health.. do they really care about your health ?
The consumer advocacy group Public Citizen is suing the US Food and Drug Administration (FDA) in federal court over the agency’s practice of redacting information in the curricula vitae (CV) of its advisory committee members.
Public Citizen alleges that the redactions mask information about these outside experts that could reveal potential biases and provide relevant background on their professional qualifications, according to a complaint filed to the US District Court of the District of Columbia on Wednesday.
In its complaint, Public Citizen calls FDA’s practice of redacting the CVs “arbitrary and capricious,” and claims that the agency is failing to proactively disclose the documents under the Freedom of Information Act (FOIA).
Specifically, the group believes that FDA’s reasoning for redacting the CVs does not meet the criteria of any of nine FOIA exemptions for redacting information.
According to Public Citizen, around 90% of the CVs posted to FDA’s website for its advisory committee members contain redactions (Center for Drug Evaluation and Research, 92%; Center for Biologics Evaluation and Research, 86%; Center for Devices and Radiological Health, 98%).
Public Citizen says it first raised the issue to FDA in a letter dated 4 February 2014. Public Citizen says that Sarah Kotler, who was then FDA’s deputy director for the Division of Freedom of Information, responded by saying FDA’s policy is to “categorically redact” certain information in its advisory committee members’ CVs.
Advisory Committee Redactions
FDA maintains around 50 advisory committees, comprised of experts from outside the agency, to weigh in on specific scientific and medical issues. The agency typically convenes an advisory committee meeting when it wants input on a new drug or device, or when it is looking into a specific safety issue for an approved product.
While FDA publishes advisory committee members’ CVs on its website, it frequently redacts information, such as “the dates of degrees conferred, the names of professional colleagues and mentors, the amounts of grants received from private companies, and the names of presentations and unpublished articles.”
According to Dr. Michael Carome, director of Public Citizen’s Health Research Group, who sits on FDA’s Pharmacy Compounding Advisory Committee, the agency redacted his CV despite his request that it be made available without any redaction.
“The agency redacted my military awards and service and the amount of one National Kidney Foundation grant long since closed out,” he said. “The notion that releasing this information would be an invasion of privacy or that it was confidential would be hard to understand anyway – but after I specifically had stated that the CV could be posted in full, it is ridiculous.”
When you turn a MEDICAL PROBLEM over to LAW ENFORCEMENT to take care of … you get a LAW ENFORCEMENT SOLUTION. Which will never solve a medical problem… but.. will guarantee LAW ENFORCEMENT continued EMPLOYMENT.
Action T4 (German: Aktion T4, pronounced [akˈtsi̯oːn teː fiːɐ]) was the postwar designation for a programme of forced euthanasia in wartime Nazi Germany. The name T4 is an abbreviation of Tiergartenstraße 4, a street address of the Chancellery department set up in spring 1940 in the Berlin borough of Tiergarten, which recruited and paid personnel associated with T4. Under the programme German physicians were directed to sign off patients “incurably sick, by critical medical examination” and then administer to them a “mercy death” (German: Gnadentod). In October 1939 Adolf Hitler signed a “euthanasia decree” backdated to 1 September 1939 that authorized ReichsleiterPhilipp Bouhler, the chief of his Chancellery, and Dr. Karl Brandt, Hitler’s personal physician, to carry out the programme of involuntary euthanasia (translated as follows):
Reich Leader Bouhler and Dr. Brandt are entrusted with the responsibility of extending the authority of physicians, designated by name, so that patients who, on the basis of human judgment [menschlichem Ermessen], are considered incurable, can be granted mercy death [Gnadentod] after a definitive diagnosis. — Adolf Hitler