THE LOWDOWN
Spring 2022

An Educational Resource for Long-Term Care

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​​​​​​​Welcome to the spring edition of The Lowdown. Spring is a time of warmer temperatures, more daylight, and increased activity. It is also a good time to review and improve practices that may seem routine but are important. This issue of the Lowdown is focused on practices to keep you and your residents safe to enjoy the springtime. Happy reading! 

Sharps Safety 

Safe Injection Practices
Safe injection practices prevent transmission of infectious diseases due to inappropriate handling of injectable medication. Transmission can occur between one resident and another resident, or between a resident and staff during preparation and injection of medications. Unsafe injection practices put you at risk of disease transmission, such as bacterial infections like MRSA or bloodborne pathogens like hepatitis C or HIV. Because of this risk, safe injection practices are a formal element of Standard Precautions.1

Led by the Centers for Disease Control and Prevention (CDC) Safe Injection Practices Coalition, the One & Only Campaign is a public health effort to eliminate unsafe medical injections. The campaign provides many tools and resources on injection safety.2

Injection Safety Guidelines from the One & Only Campaign3
  • Follow proper infection control practices and maintain aseptic technique during the preparation and administration of injected medications (e.g., perform hand hygiene). 
  • Never administer medications from the same syringe to more than one resident/patient, even if the needle is changed. 
  • Never enter a vial with a used syringe or needle. 
  • Do not use medications packaged as single-dose or single-use for more than one patient/resident. 
  • Do not use bags of intravenous solution as a common source of supply for more than one patient/resident. 
  • Limit the use of multidose vials and dedicate them to a single patient/resident whenever possible. 
  • Always use face masks when injecting material or inserting a catheter into the epidural or subdural space.

​Sharps Disposal Containers

Used sharps should be disposed of immediately into a sharps container approved by the U.S. Food and Drug Administration (FDA). These containers have been evaluated for safety and effectiveness to help reduce the risk of injury and infections from sharps. FDA-cleared sharps disposal containers are made from puncture-resistant plastic with leak-resistant sides and bottom and a tight-fitting, puncture-resistant lid. These containers are labeled to warn of hazardous waste and marked with a line to indicate when the container should be considered full. 

When the container is considered full, it needs to be closed and properly disposed.4,5
For more information, please visit: 

​Is Legionella Lurking in Your Water?

Legionnaires’ disease is a serious, sometimes lethal pneumonia. This disease was named for an outbreak of severe pneumonia among attendees at an American Legion convention in Philadelphia in 1976. 

The Pennsylvania Department of Health reports one of the highest annual incidence rates by state. Numerous healthcare facilities have reported outbreaks of healthcareacquired Legionnaires’ disease, with transmission consistently linked to the hot water distribution system. Preventing healthcare-acquired Legionnaires’ disease depends on identifying possible sources where Legionella pneumophila growth 
could occur and implementing control measures 

Health departments and public agencies have issued guidelines to prevent outbreaks, including proactive culturing for Legionella in the hot water distribution system before any cases of healthcare-acquired Legionnaires’ disease are discovered—an evidence-based strategy. 

Short-term approaches to terminate an outbreak include superheating and flushing or hyperchlorination in the hot water distribution system. Long-term systemic water treatment with copper-silver ionization, chlorine dioxide, or monochloramine has also been effective in controlling Legionella.6

The Centers for Medicare & Medicaid Services (CMS) issued a policy memorandum in June 2017 for healthcare facilities to raise awareness about ways to prevent Legionella infections.6

CMS expects Medicare-certified healthcare facilities to develop and adhere to policies and procedures that reduce the risk of growth and spread of Legionella and other opportunistic pathogens in building water systems. 

CMS surveyors will review policies, procedures, and reports to verify that facilities comply with the new requirements to protect the health and safety of their patients.6

For more information, visit http://patientsafety.pa.gov/ADVISORIES/Pages/201709_Legionella.aspx.

Unite for Safety: Clean Your Hands 

May 5 is World Hand Hygiene Day! World Health Organization (WHO) has stated the objective of this year’s campaign is to recognize that people at all levels should work together to influence the culture/climate through clean hands knowledge and behaviors, to meet the common goal of safety and quality in the healthcare organization.7

When the culture of a healthcare facility values and practices hand hygiene, residents, staff, and visitors feel protected. Hand hygiene is the most important measure you can use to prevent the spread of infection! Many studies show that improved hand hygiene reduces infection rates. Everyone should focus on the importance of hand hygiene to protect others and save lives. Be a good role model: Perform hand hygiene and reinforce the importance of hand hygiene with everyone. Staff, physicians, patients, family members, and visitors should perform hand hygiene.8

References
  1. Centers for Disease Control and Prevention. Injection Safety. CDC website. https://www.cdc.gov/injectionsafety/index.html. Updated May 2, 2012. Accessed February 23, 2022.
  2. Centers for Disease Control and Prevention. One & Only Campaign. CDC website. https://www.cdc.gov/injectionsafety/one-and-only.html. Updated December 3, 2019. Accessed February 22, 2022.
  3. Centers for Disease Control and Prevention. Injection Safety Guidelines Pocket Guide. CDC website. https://www.cdc.gov/injectionsafety/PDF/Injection-Safe- ty-Guidelines-P.pdf. Updated August 23, 2019. Accessed February 23, 2022.
  4. Food and Drug Administration. Sharps Disposal Containers. FDA website. https:// www.fda.gov/medical-devices/safely-using-sharps-needles-and-syringes-home- work-and-travel/sharps-disposal-containers. Updated April 28, 2021. Accessed February 22, 2022.
  5. Centers for Disease Control and Prevention. Selecting, Evaluating and Using Sharps Disposal Containers. CDC website. https://www.cdc.gov/niosh/docs/97- 111/. Updated June 6, 2014. Accessed February 22, 2022.
  6. Roberts T, Stout J. Legionella: Could This Potentially Deadly Bacteria Be Lurking in Your Facility’s Water Distribution System? Pa Patient Saf Advis. 2017;14(3). http://patientsafety.pa.gov/ADVISORIES/Pages/201709_Legionella.aspx
  7. World Health Organization. World Hand Hygiene Day 2022. WHO website. https:// www.who.int/news-room/events/detail/2022/05/05/default-calendar/world- hand-hygiene-day-2022-unite-for-safety-clean-your-hands! Published February 2, 2022. Accessed February 22, 2022.
  8. World Health Organization. Your 5 Moments for Hand Hygiene. WHO website. https://cdn.who.int/media/docs/default-source/integrated-health-services-(ihs)/ infection-prevention-and-control/your-5-moments-for-hand-hygiene-poster.pdf. Published April 23, 2009. Accessed February 23, 2022.