1. Infection Prevention Update
Marie Kassai, RN, BSN, MPH, CIC, FAPIC

2. Objectives Upon completion, the participants will be able to:
State the new CMS and APIC Infection Prevention Issues
Surgical Attire
Housekeeping
Reconstituting medications for OR
Initiate HIV Testing on Source Patient
State the issues related to Legionella

3. Surgical Attire
APIC and CMS emphasized complete covering of hair and ears
ACS – 10/2016 Skull cap can be worn “when close to the totality of hair is covered by it and only a limited amount of hair on the nape of the neck or a modest sideburn remains.
Survey Procedures That operating room attire is suitable for the kind of surgical case performed, must wear only clean surgical attire, that surgical attire is designed for maximum skin and hair coverage

4. Surgical Attire
The following agencies have adopted the requirement for full head covering:
CDC – HICPAC Guidelines
OSHA – Blood Borne Pathogens
WHO – Guidelines for Safe Surgery – 2009
AST – Association of Surgical technologists – 2007
AORN – 2015 – Guidelines for Perioperative Practice
Current recommendation – Wear surgical attire for procedures, such as endoscopy and pain management.

5. Legionella ASC need to be aware of the issue per CMS
No requirements to do water survey
Know the possible sources of legionella
Water fountains
Ice Machines
Water Heaters
Water Storage Tanks
Eyewash Stations
Hot Tubs
Decorative Fountains
This Photo by Unknown Author is licensed under CC BY-SA
This Photo by Unknown Author is licensed under CC BY

6. ANSI Requirements for Eye Wash Stations
Read the document carefully to evaluated where the eye wash is needed.
Need MIXER Valves in order to maintain water from 60 to 100 degrees
Device must be tested weekly and documented
Temperature must also be documented.

7. HIV Testing
SOURCE PATIENT MAY NOW BE TESTED FOR HIV POST STAFF EXPOSURE
This Photo by Unknown Author is licensed under CC BY-SA

8. Housekeeping Products Used – Who checks? Who Trains the Housekeepers ?
Competency – Who ensures Competency ?
Things to check
Mixing of solution
Labeling of bottles
Utilization of mops and water
Annual Training – who does it ?
This Photo by Unknown Author is licensed under CC BY-NC-ND

9. Endoscopy Wear surgical attire
Document end of case until the beginning of cleaning
Scan scope with magnifying light prior to processing
Check cleaning with Channel Check or other product – Risk Assessment
Transport in plastic container which is marked, cleaned and marked again

10. NEW Information Two Dose Hepatitis B Vaccine – Heplisav-B
Flu Vaccine – Plan for vaccinations – Most using Quad
New Information – Measles – Now reports of fatal consequences
Sterile Cystoscope – with Endosheath – Follow IFU for use and cleaning
New Respiratory Device - CircuitGuard - States it is disposable – question is when and after how many patients