What does it mean to make "meaningful use" of an electronic health record? The federal government began answering that question last week by unveiling specific plans for its EHR incentive program.

According to the Department of Health and Human Services' proposal, which topped 500 pages, physicians and hospitals may qualify for Medicare and Medicaid reimbursement incentives if they meet certain specific criteria for "meaningful use" of EHRs, such as:

Bacteria that are exposed to non-lethal amounts of quaternary ammonium disinfectants (quats) can develop a resistance to the disinfectant as well as to an antibiotic, even when the bacteria have never been exposed to the antibiotic, according to a group of Irish researchers.

"Residue from incorrectly diluted disinfectants left on hospital surfaces could promote the growth of antibiotic-resistant bacteria," says Gerard Fleming, PhD, director of the marine microbiology laboratory at the National University of Ireland in Galway, in a press report. Dr. Fleming and colleagues published the results of their study in the January issue of the journal Microbiology.

The scientists studied the effect of a quat biocide on Pseudomonas aeruginosa, a frequent cause of hospital-acquired pneumonia, urinary tract infection and bacteremia in patients with weak immune systems. They found that when P. aeruginosa was exposed to increasing amounts of benzalkonium chloride, the bacteria mutated to become resistant to the biocide and the antibiotic ciprofloxacin. Besides hospital cleaning products, benzalkonium chloride is found in non-alcohol hand sanitizers, cosmetics and personal hygiene products.

Mixing up the types of disinfectants used in hospitals may be a way of deterring resistance to biocides and antibiotics, said Dr. Fleming. "We need to investigate the effects of using more than one type of disinfectant on promoting antibiotic-resistant strains."

Kent Steinriede

Endoscopy patients who suffer from obstructive sleep apnea are not at increased risk for anesthesia-related complications while under conscious sedation, according to a study published in the December issue of the journal Gastrointestinal Endoscopy.

Researchers at Yale University's department of medicine and division of gastroenterology in New Haven, Conn., used the Berlin Questionnaire to gauge the OSA risk of 233 patients who underwent routine upper endoscopy and colonoscopy procedures. The assessment tool asks patients OSA symptom-related questions such as: Has your weight changed? Do you snore? Are you tired after sleeping? Have you ever fallen asleep while driving? Do you have high blood pressure?

The researchers, led by Vijay S. Khiani, MD, discovered that approximately one-third of the patients they studied were at high risk of OSA, but they also found that the difference in the rate of transient hypoxia (a pulse oximetry measurement less than 92%) between high- and low-risk patients was insignificant (10% versus 7%, respectively).

Based on those findings, the researchers say most endoscopy patients, even if they haven't been screened for OSA, can undergo conscious sedation for routine endoscopic procedures with standard monitoring practices.

Daniel Cook

You can get great deals in the used equipment market, but buying demo and refurbished vital signs monitors, tables, sterilizers and microscopes isn't for everyone. Tell us how you feel about buying pre-owned capital equipment in this week's InstaPoll. We'll report the results in this space next week.

Last week we asked for your views on whether your anesthesia providers could save you money by helping to reduce supply costs and waste at your facility. Of the 50 responses we received in the holiday-shortened week, 62% said they agreed and 38% said they disagreed.

Dan O'Connor