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| Outbreak Sparks VA Contamination Probe |
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Veterans Affairs officials say 17 veterans who were treated at separate VA facilities where endoscopic equipment wasn't properly disinfected between cases have tested positive for infectious diseases, including one case of HIV, 5 of hepatitis B and 11 of hepatitis C.
The U.S. Department of Veterans Affairs has not confirmed a connection between the improperly prepared equipment and the infected patients, but the agency is conducting epidemiological investigations to determine "the possibility of such a relationship."
Over the past several months, the VA has sent letters to more than 10,000 patients of its Miami, Murfreesboro, Tenn., and Augusta, Ga., facilities that urged them to undergo testing for HIV and hepatitis as a precautionary measure. The patients who have tested positive had undergone colonoscopies and other procedures at the Tennessee and Georgia facilities. No infections have been reported from Miami.
Officials say that as of March 14, the equipment processing errors that led to these incidents have been corrected at VA facilities nationwide. The agency is continuing to reach out to veterans who may have been exposed before the corrections were made.
Irene Tsikitas |
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| Minced Cartilage Encourages New Growth in Knee |
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Orthopedic surgeons at 40 North American surgical facilities are conducting clinical trials on a new method of regrowing damaged cartilage in the knee to treat osteoarthritis.
The new procedure, known as the cartilage autograft implantation system (CAIS), is a variation on the current autologous chondrocyte implantation method, which uses whole pieces of the patient's own cartilage. In CAIS, healthy cartilage is collected from the joint and grated, then applied to a bioabsorbable scaffold and implanted in the knee during a single surgery.
One benefit of the new procedure is that a small amount of minced cartilage cells combined with the scaffold can cover an area larger than an intact autograft of cartilage. Because less cartilage needs to be harvested, the procedure is less expensive, less traumatic and requires little planning ahead of time, as compared to donor allografts and other methods of cartilage regeneration, says Brian Cole, MD, MBA, a professor of orthopedics, anatomy and biology at Rush University Medical Center in Chicago and head of its Cartilage Restoration Center.
The clinical trials follow a 2006 study that determined the procedure's safety, says Dr. Cole. Research sites across the country are currently seeking patients to participate in upcoming trials to compare the process with the previously accepted method of microfracturing bone to enact cartilage growth, the results of which are generally weaker than a patient's original cartilage.
Kent Steinriede |
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| Massachusetts Releases Hospital Safety Report |
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In a newly revised accounting of the state's hospital-specific adverse events, Massachusetts acute care hospitals reported 62 serious safety violations related to surgical care in 2008, according to a state Department of Public Health report.
The report, based on the National Quality Forum's categorization of serious reportable events, includes surgical-related errors (SREs) such as wrong-site, wrong-patient and wrong-procedure surgeries, foreign objects left in patients and the immediate post-op death of ASA Class I patients.
Out of 338 reported SREs across all patient care categories, the 32 incidents of retained foreign objects and 24 wrong-site surgeries trailed only patient falls (224) as the most frequently occurring errors. Additionally, 5 wrong-procedure errors and 1 wrong-patient surgery were documented.
DPH officials note that the state's hospitals have always been required to submit patient safety data, but 2008 was the first year in which they used a reporting system based on NQF standards. This initial reporting year will serve as a baseline to assess future error reporting, they say, and cannot be used to judge the quality of care at specific hospitals.
"This is a very important step we are taking for patient safety in Massachusetts," says DPH Commissioner John Auerbach. "This new reporting system - and the data collected - will provide a roadmap for hospitals, healthcare providers and public health professionals to follow as we work together to prevent many of these errors in the future."
Daniel Cook |
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| News & Notes |
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Tip of the week "Staying current on myriad insurance contracts can be a nightmare, especially for larger facilities," writes Sara Rapuano, MBA, OCS, COE, of the Wills Eye Institute in Philadelphia. So she created a one-page quick reference guide using a Microsoft Excel spreadsheet and "obnoxiously colored" paper. The spreadsheet lists the insurance companies the facility has contracts with, the facility's provider ID numbers at each, referral and pre-authorization requirements and other important details. The page is laminated for durability, but she reminds users to update and reprint it whenever the information changes.
Glove changes recommended The risk of surgical glove perforation grows with each minute gloves are worn, according to a European study published in the journal Infection Control & Hospital Epidemiology. Researchers found that the rate of microperforation in surgical gloves increased from 15 percent after up to 90 minutes of wear to 18 percent after 91 to 150 minutes, and to 24 percent after more than 150 minutes. The authors conclude that surgeons, first assistants and OR nurses should change gloves after 90 minutes of surgery.
Poor phaco cleaning Most surgical facilities don't use the recommended 120cc of water per port to flush phaco handpieces, according to researchers who surveyed 40 surgical facilities and visited 43 sites and presented their findings at the American Society of Cataract and Refractive Surgery's annual meeting last week. They reported that 79 percent of centers reviewed used 10cc to 100cc per flush. Improper cleaning and sterilization are common, and easily avoided, causes of toxic anterior segment syndrome (TASS), they note.
Pinnacle III expands services Pinnacle Central Billing Office, a division of management consulting firm Pinnacle III, has expanded its ASC coding, billing and collections division to include physician billing, and has changed its name to Specialty Billing Solutions.
Patient safety study A survey of patient safety among Medicare beneficiaries at U.S. hospitals shows that 913,215 adverse events were reported between 2005 and 2007, a figure which totals to 2.3 percent of the 38 million Medicare hospitalizations during that time or one event every 1.7 minutes, says healthcare ratings organization HealthGrades. For its sixth annual "Patient Safety in American Hospitals" study, the group polled 5,000 non-federal hospitals on 15 indicators of patient safety. The events included 97,755 patient deaths and cost healthcare facilities over $6.9 billion, and the survey showed increasing incidences of decubitus ulcer, sepsis and deep vein thrombosis. |
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