Unsafe Injection Practices Plaque U.S. Outpatient Facilities

In a post last year I discussed how an Oral Surgeon Investigated for Reusing Needles and Syringes. In a recent article in JAMA titled “Unsafe Injection Practices Plague US Outpatient Facilities, Harm Patients,” Bridget M. Kuehn discusses many problems with injection practices (December 26, 2012,Vol 308, No. 24, pp. 2551-2552).

She describes how hepatitis C virus was contracted by 2 patients who received an epidural injection from a pain management clinic.

“During the visit, they observed the physician who treated both patients withdrawing medication from a multiple-dose vial with a previously used syringe topped with a new needle, a breach of safe injection practices that may have contaminated the vial and exposed subsequent patients to potential blood-borne infections.”

This led to 8,000 patients who were treated at the clinic to be tested and 8 additional cases of hepatis C to be found.

A few large studies have explored the issue of lapses in infection control and have showed that they happen in more than 40% of all surgery clinics.  The article states

“Michael Bell, MD, associate director for infection control in the CDC’s [US Centers for Disease Control and Prevention] division of health care quality promotion, was frank in his assessment of the data, saying US patients deserve better than a “coin toss” chance of being exposed to infection at a surgical center.”

This has prompted the U.S. CDC to launch a one needle, one syringe, one time, equals zero infections campaign. See http://oneandonlycampaign.org/.

The JAMA article mentions that at least 48 cases have occurred in the past decade of outbreaks of infectious diseases due to unsafe injection practices. Pain clinics and outpatient oncology centers were noted as being particularly problematic.

A noted problem to the One and Only Campaign is that some doctors don’t acknowledge that there is a problem. The article mentions how the Center for Medicare & Medicaid Services (CMS) is able to conduct unannounced surveys of a range of organizations providing outpatient care of course this only works if they are beneficiaries of Medicare and Medicaid. It is not clear exactly what can be done for outpatient centers that don’t participate in Medicare and Medicaid.

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