Immunization against influenza should be a mandatory condition for employment at every healthcare facility nationwide, says the Association for Professionals in Infection Control and Epidemiology.

According to the organization, which issued a position paper on the subject last week, annual immunization rates among healthcare employees are not rising enough to prevent the transmission of healthcare-acquired influenza.

"We took a firmer stance on this issue because it is clear that voluntary efforts are not working," says Linda R. Greene, RN, MPS, CIC, director of infection prevention for the Rochester (N.Y.) General Health System and a member of APIC's board of directors. "Several studies now demonstrate that influenza vaccination of healthcare personnel reduces patient mortality. As infection preventionists, we have an ethical responsibility to protect those individuals entrusted to our care."

Unless such vaccination is medically contraindicated, it should be part of a facility's comprehensive strategy, says APIC, along with the recommendations put forth by the Centers for Disease Control and Prevention's Healthcare Infection Control Practices Advisory Committee and its Advisory Committee on Immunization Practices for healthcare providers.

David Bernard

The California Medical Association and the California Academy of Eye Physicians and Surgeons have filed a lawsuit to stop recently enacted regulations that let optometrists treat glaucoma patients without physician supervision.

The lawsuit claims that the training optometrists undergo for certification to treat glaucoma patients is inadequate because it doesn't require them to treat real patients under physician supervision before accepting their own glaucoma patients. Previous regulations required an optometrist to treat 50 patients under supervision for 2 years.

James Hinsdale, MD, the president of the medical association called the new regulations "the equivalent of handing out drivers' licenses to people who have read a driving manual and attended a class but have never driven a car."

The California Optometric Association, which applauded the regulations, which took effect last month, and countered that the physicians are suing to protect the "economic interests" of California's 3,000 ophthalmologists against the state's 7,000 optometrists. Forty-nine states let optometrists treat glaucoma in some form, according to the association.

Kent Steinriede

Despite suffering 2 retained-object incidents in the past year, Rhode Island Hospital's perioperative services show no current deficiencies, say CMS inspectors.

The Providence hospital's recent review by federal investigators was prompted by the accidental leaving of a drill bit in a patient's head following an August 2010 neurosurgery. At that time, an inspection of the hospital's ORs by the state department of health and CMS revealed that the facility was not "actively ensuring" the surgical staff followed existing surgical-count policy. No X-ray was taken and the surgical count was documented as being correct at the procedure's conclusion, the investigation found. As a result, the state levied a $300,000 fine and required hospital leadership to develop a correction plan.

Compounding the issue was the hospital's announcement, around the time the investigation's findings were issued, that a pair of surgical forceps were left in a patient following a July procedure

"There is a troubling pattern of disregard for established policies that are designed to protect patient safety and prevent medical errors in Rhode Island Hospital's operating rooms," state Director of Health David R. Gifford, MD, MPH, said at the time. "When reports from staff about problems in the operating rooms are not adequately addressed, employees are less likely to speak up and report potential problems or concerns."

Hospital spokeswoman Gail Carvelli did not provide an update on the forceps incident during the recent communication, but did emphasize that CMS inspectors found no surgical issues to highlight in their latest report.

After the drill-bit incident, the hospital reportedly made improvements to its pre- and post-op protocols and launched a website dedicated to sharing its commitment to patient safety with the public.

Daniel Cook

Whether it's laid out poorly or showing signs of wear and tear, an outdated operating room can be a real drain on your efficiency and your team's mood. In this week's InstaPoll, we want to know how old your ORs are. Check back next week for the results.

Last week we asked if your patients can go online to conduct their pre-operative screenings. According to a report in our February issue, a growing number of websites are available to help you streamline the pre-admission process.

About 1 in 5 (21%) of the 78 respondents who took our poll say they use one of those pre-op screening websites. Another 3% say they created a screening form patients can download from their own website. More than three-fourths (76%) say their facilities' forms don't get filled out until patients arrive on the day of surgery .

Dan O'Connor