Did your healthcare facility cover the spread on H1N1 respiratory protection? If not, your facility is probably scrambling to acquire N95 respirators and figuring out how to fit-test and educate employees on their use.
At the risk of delving into Monday-morning quarterbacking, did you really think the CDC was going to say it was OK to use surgical masks over the more highly-protective N95 respirators in protecting U.S. healthcare workers from H1N1 influenza? Apparently, others thought so, too.
Since the CDC first promoted the use of respirators in its interim guidance during the pandemic preseason in May, there has been controversy about whether H1N1 infectious transmission dynamic were essential droplet or airborne.
Droplet argues well for masks while an airborne dynamic suggests N95 respirators. And many fans lined up on both sides. Of note, the Society for Healthcare Epidemiology of America (SHEA) and the AHA favored masks; for the most part, nurses associations, labor organizations, and the Institute of Medicine (IOM) cheered on N95s. Some experts believed the IOM was better with more recent scientific studies than SHEA when developing their positions.
The ruling on the field, which the CDC revised on October 14, is for "respiratory protection that is at least as protective as a fit-tested disposable N95 respirator for healthcare personnel who are in close contact with patients with suspected or confirmed 2009 H1N1 influenza." Close contact, as defined by the CDC, means "working within 6 feet of the patient or entering into a small enclosed airspace shared with the patient (e.g., average patient room)."
The interim guidance does recognize that respirator shortages may occur and allows for healthcare facilities "to develop a risk assessment by which respirators in clinically short supply can be issued on a priority basis," according to the interim guidance. Also the interim guidance applies to both inpatient and outpatient settings, including home heath and clinical setting within non-healthcare institutions such as schools.
Meanwhile, OSHA was warming up on the sidelines as it issued an announcement—on the same day as the interim guidance—about an upcoming "compliance directive that will closely follow the CDC interim guidance to ensure uniform procedures when conducting inspections."
Within an hour after the news, the HCPro OSHA Compliance hotline started receiving inquiries about the possibility of cutting the fit-testing requirement. The answer, according to OSHA: "Where respirators are required to be used, the OSHA Respiratory Protection standard must be followed, including worker training and fit testing."
That kind of last-minute-reprieve thinking isn’t unusual, even though readers of the OSHA Healthcare Advisor have known about this issue for some time. The problem is that unlike football, pandemic influenza preparation is not a spectator sport. And time has expired for healthcare facilities that thought the CDC was going to produce a comeback win in the last two minutes of the respirator-mask game.
Medical practitioners presented ardent and disparate views to a Vermont state panel reviewing the merits of free medicine samples provided at doctors' offices, the Associated Press reports. Curbing or even eliminating the free samples could be the next stop for Vermont, a state that already holds drug companies accountable for their marketing efforts. The Vermont attorney general's office held the hearing, part of a broader study to be submitted to the state Legislature in December.
In this post on "Valley PR Blog" about industry-specific PR challenges, Debra Stevens, director of marketing and communications for the Phoenix Children's Hospital notes that communicating about pediatric healthcare means telling stories of children with a variety of health conditions. But federal health privacy regulations under HIPAA laws sometimes restricts the ability to tell these stories, Stevens says.
The push by Senate Majority Leader Harry Reid for a public health-insurance option is creating new obstacles for healthcare legislation in the Senate, despite new poll data suggesting a plurality of Americans support the idea. Connecticut independent Sen. Joe Lieberman said that he would vote to block passage of the Senate healthcare bill in its current form, dealing an initial blow to Reid's effort to gather 60 votes. But a Wall Street Journal/NBC News poll suggested the public option is gaining support: 48% of respondents supported the idea; 42% were opposed, and 10% weren't sure. In a September poll, 46% of respondents supported it, 48% opposed it and 6% were undecided.
Senate Majority Leader Harry M. Reid's decision to bring to the chamber's floor a healthcare bill containing a government insurance plan was met with skepticism by moderate Democrats, who said they still do not know whether they could support a public option on a final vote. Democrats expect Reid to attempt to secure commitments from all 60 members of his caucus to allow the Senate to begin debate on the legislation, aimed at lowering healthcare costs, reforming insurance practices, and expanding coverage to about 30 million uninsured Americans.
New York Attorney General Andrew M. Cuomo announced the details of a new national database that would help determine how much insurance companies should reimburse patients who go out of network to see a doctor. Consumers would also be able to check a new Web site to see what an insurer was likely to pay before they went to an out-of-network doctor. The announcement is part of a settlement reached with more than a dozen insurance companies concerning the industry's controversial payment of out-of-network claims.