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APIC Chicago is a local Chapter of the Association for Professionals in Infection Control and Epidemiology, Inc. (APIC). APIC is a multi-disciplinary voluntary international organization with over 10,000 members. The purpose of the organization is to influence, support and improve the quality of healthcare through the practice and management of infection control and the application of epidemiology in all healthcare settings.

APIC Chicago has approximately 200 members. Educational meetings are held at least four times per year with an all day conference held in the fall. The annual business meeting is held the first Wednesday in December. Visit the meetings tab to find out more about local, regional and national educational meetings.

If you would like to learn more about the organization, contact any member of the APIC Chicago Board of Directors or visit the membership section tab.

What's New!

Save The Date!

September 11th
6:30-8PM

MRSA in Healthcare Worker with speaker Dr. Weber
Elmhurst Memorial Hospital
200 Berteau Avenue
Elmhurst
Click here to read more

 

September 2008

IL Reporting per NHSN: CLABSI Training (Webcast) Memo and Schedule

Read more here....

August 2008

APIC Issues Infection Prevention Tips For Flood Clean-Up

8 August 2008

On July 31, 2008, the Centers for Medicare and Medicaid Services (CMS) released the final rule on the fiscal year 2009 Inpatient Prospective System (IPPS). The rule is expected to be published in the Federal Register on August 19th.

As a result, we wanted to ensure that APIC Members have information on the agency's decisions related to hospital-acquired conditions (HACs). As you may know, APIC submitted comments to CMS when the rule was proposed and those comments may be found here.

We hope this information is helpful.

Sincerely,

APIC Government Relations Department

CMS Issues Final IPPS Rule for Fiscal Year 2009

CMS has added three of the nine proposed HACs to the existing eight for which the agency will pay the lower DRG amount if the complications was acquired at the hospital and the patient has no other complications or comorbidities. Below are the three conditions being added, and those not being added, along with direct excerpts from the CMS rule on the subject.

Conditions Being Added:

• Manifestations of Poor Glycemic Control

We believe that extreme manifestations of poor glycemic control are reasonably preventable through the application of evidence-based guidelines and sound medical practice while in the hospital setting; specifically, we believe that they are preventable through the use of routine serum glucose measurement and control which are basic elements of good hospital care. We are finalizing manifestations of poor glycemic control as an HAC because we have determined after considering the comments received that these conditions meet the statutory criteria.

• Surgical Site Infections

We are selecting surgical site infections following certain orthopedic procedures. The category of surgical site infection following certain orthopedic surgeries (includes selected procedures that are often elective and that involve the repair, replacement, or fusion of various joints including the shoulder, elbow, and spine) AND bariatric surgery for obesity. These procedures will join mediastinitis following coronary artery bypass graft (CABG), which was selected in the FY 2008 IPPS final rule with comment period, as surgical site infection HACs. We look forward to working with stakeholders to identify additional procedures, such as device procedures, in which surgical site infections can be considered reasonably preventable through the application of evidence-based guidelines.

• Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE)

We agree with commenters that DVT/PE is reasonably preventable in specific subpopulations, and we are therefore selecting DVT/PE following certain orthopedic surgeries, specifically certain hip and knee replacement surgeries, as HACs.

Conditions Not Being Added:

• Delirium

After consideration of the public comments received, we have decided not to select delirium as an HAC in this final rule. We will continue to monitor the evidence-based guidelines surrounding prevention of delirium. If evidence warrants, we may consider proposing delirium as an HAC in the future.

• Ventilator-Associated Pneumonia (VAP)

In light of the public comments that we received, we are not selecting VAP as an HAC. We will work in partnership with the CDC and closely monitor the evolving literature addressing the prevention of VAP through the application of evidence-based guidelines. If evidence warrants, we may consider proposing VAP as an HAC in the future.

• Staphylococcus aureus Septicemia

In light of these public comments, we are not selecting Staphylococcus aureus septicemia as an HAC in this final rule. If evidence warrants, we may consider proposing Staphylococcus aureus septicemia as an HAC in the future. We note that several commenters recognized that Staphylococcus aureus septicemia cases are being addressed through the vascular catheter-associated infection HAC that was selected in the FY 2008 IPPS final rule with comment period.

• Clostridium difficile-Associated Disease (CDAD)

In light of these public comments, we are not selecting CDAD as an HAC in this final rule. However, we continue to receive strong support from consumers and purchasers to include CDAD as an HAC, and we will continue to consult with the CDC regarding the evidence-based prevention guidelines and coding for CDAD. If evidence warrants, we may consider proposing CDAD as an HAC in the future.

• Legionnaires' Disease

In light of these public comments, we are not selecting Legionnaires' Disease as an HAC in this final rule. Although we are not selecting Legionnaires' Disease as an HAC in this final rule, we will continue to consult with the CDC about the evidence-based prevention guidelines. If evidence warrants, we may consider Legionnaires' Disease and other water-borne pathogens suggested by commenters and noted in section II.F.9. of this preamble (Enhancement and Future Issues) as HACs in the future.

• Iatrogenic Pneumothorax

In light of these public comments, we are not selecting iatrogenic pneumothorax as an HAC in this final rule. Although we are not selecting iatrogenic pneumothorax as an HAC in this final rule, we do recognize this as an adverse event that occurs frequently. We will continue to review the development of evidence-based guidelines for the prevention of iatrogenic pneumothorax. If evidence warrants, we may consider iatrogenic pneumothorax as an HAC in the future.

• Methicillin-resistant Staphylococcus aureus (MRSA)

Though we did not propose MRSA as a candidate HAC in the FY 2009 IPPS proposed rule, MRSA can trigger the HAC payment provision. For every infectious condition selected as an HAC, MRSA could be the etiology of that infection. For example, if MRSA were the cause of a vascular catheter-associated infection (one of the eight conditions selected in the FY 2008 IPPS final rule with comment period), the HAC payment provision would apply to that MRSA infection. As we noted in the FY 2008 IPPS final rule with comment period (72 FR 47212), colonization by MRSA is not a reasonably preventable condition according to the current evidence-based guidelines. Therefore, MRSA does not meet the "reasonably preventable" statutory criterion for an HAC.

For additional information, please see the links below:

Click here to view the Final Rule
Click here to view Press Release related to the Final Rule

20 July 08 :: IMPORTANT IDPH REPORTING UPDATE
Re: REPORTING CLABSI per HOSPITAL REPORT CART ACT

From: GALE ELDER
Sent: Friday, July 18, 2008 10:54 AM
Subject: Hospital Report Card Act

The enclosed memorandum and attachments contain very important information regarding Public Act 93-563, the Hospital Report Card Act, and mandated reporting of infection indicators. The Public Act requires that all general acute care hospitals in Illinois submit data using methodology based on a scientifically valid national reporting system. The Department has decided to use the National Health Safety Network (NHSN) of the Centers for Disease Control (CDC) for reporting of central line bloodstream infection (CLABSI) in the MICU, SICU or combined ICU's. At this time, the Department is not requiring reporting from the NICU or PICU. The rationale for using the NHSN reporting system is outlined in Attachment I to the memorandum.

Please read the memo and attachments and insure they are distributed to the appropriate hospital personnel. The Department looks forward to working with you and your organization to continue to provide safe and quality patient care.

If you have any questions concerning this communication, please do not hesitate to contact Mary Driscoll, Chief of the IDPH Division of Patient Safety and Quality, at 312-793-2051 or
mary.driscoll@illinois.gov.

Sincerely,

Damon T. Arnold, M.D., M.P.H.
Director

Gale Elder
IL Dept. of Public Health
Division of Health Policy
Phone: 217-782-6235
Fax: 217-785-4308

gale.elder@illinois.gov

May 9, 2008 :: CMS-ProposeHospAcqConditions2009

April 2008 :: CMS-1390-Proposed Changes to the Hospital Inpatient Prospective Payment Systems and Fiscal Year 2009 (Display Date: 04/14/2008; Publication Date: 04/30/2008)
http://www.cms.hhs.gov/AcuteInpatientPPS/

April 15, 2008 :: IMPORTANT MESSAGE FROM NATIONAL APIC
Dear APIC Member:
A hearing entitled "Healthcare Associated Infections: A Preventable Epidemic" will be held on Wednesday, April 16th at 11:00 a.m. Eastern Time before the U.S. House of Representatives Committee on Government Oversight and Reform.
The committee, chaired by Representative Henry Waxman, will examine the problem of Healthcare Associated Infections (HAIs) and whether the U.S. Department of Health and Human Services (HHS) is providing the leadership necessary to combat this public health threat.

Reade More Here:

Leadership Needed from HHS to Prioritize Prevention Practices and Improve Data on These Infections
Testimony Before the Committee on Oversight and Government Reform, House of Representatives
Health-Care-Associated Infections in Hospitals
Report to the Chairman, Committee on Oversight and Government Reform, House of Representatives

March 14, 2008 :: Amendment to IL Control of Tuberculosis Code (77 Ill. Adm. Code 696) Illinois Register Citation: 32 Ill. Reg. 4010)

The rules previously required the use of the Mantoux tuberculin skin test (TST) as the only test approved for screening for LTBI. The amendment allows the use of a newly developed FDA-approved blood test for the detection of patients with active TB disease or LTBI. Click here to read more

APIC National Convention 2008: Denver Colorado
Register by April 14, 2008 to save on registration fees!
Conference Dates: June 15 – 19
Pre-conferences: June 13 – 14
Exhibition Dates: June 15 – 17
Register Online at www.apic.org

February 2008

MRSA in Illinois: Descriptive Analysis of Hospital Discharge Data 2002-2006 "Increasing reports and growing public concern about MRSA have prompted IDPH to publish the following study depicting the burden of MRSA infections in Illinois hospitals."
http://www.idph.state.il.us/health/infect/MRSA_Data_02-06.pdf

February 15 :: Chicago Tribune article "Staph infections rising in Illinois: 'Urban phenomenon' spreading throughout rural hospitals now” By Judith Graham
www.chicagotribune.com/features/lifestyle/health/chi-mrsa_15feb15,1,1466221.story

October 2007 :: OSHA Annual TB fit test requirement: Lisa Tomlinson, APIC Director of Government Affairs, has confirmed that the requirement for ANNUAL FIT TEST (TB) is enforceable on October 1, 2007 despite much effort to change and prevent this requirement.
>> Read more here

August 2007 :: The Governor signed both HB 192 and SB 233 on 8/20/07. What that means is not clear, since the bills are very different in the approach to controlling MDRO’s. As we learn more about the implementation we will share the information. Click here to read the article in the Chicago Tribune.

July 2007 The IL Hospital Report Card Act became effective March 28, 2007. IHA will establish a website for member questions, and is also offering educational conference calls related to the Hospital Report Card Act. Slides from one of those presentations with a letter from IDPH's Eric Whitaker, MD, MPH.can be accessed here. Read more here

June 2007: "The Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings 2007" (1.39MB, 219 pages) updates and expands the 1996 Guideline for Isolation Precautions in Hospitals. This guideline can be accessed at http://www.cdc.gov/ncidod/dhqp/gl_isolation.html or http://www.cdc.gov/ncidod/dhqp/pdf/guidelines/Isolation2007.pdf.
This document is associated with the Management of Multidrug-Resistant Organism 2006 PDF (233 KB, 74 page) guideline published last year http://www.cdc.gov/ncidod/dhqp/pdf/ar/MDROGuideline2006.pdf.

June 7, 2007: To strengthen the collaboration between IDPH and public health partners in efforts to prevent community-associated methicillin resistant Staphylococcus aureus (CA-MRSA), IDPH has published a memo (6/7/07) that includes many useful CA MRSA references.

The healthcare provider guidelines highlighted in the memo is entitled “Methicillin-Resistant Staphylococcus aureus in Illinois: Guidelines for the Primary Care Provider”. It can be accessed on the web at http://www.idph.state.il.us/health/infect/MRSA_Provider.htm

Special CDC Clinician Communication Update: Interim Guidance for the Use of Facemasks and Respirators in Public Settings During an Influenza Pandemic

May 3, 2007 - Facemasks and Respirators Could Provide Added Value When Used in Combination with Other Preventive Measures

May 8, 2007 - This week, the Illinois House and Senate hear testimony regarding pending bills related to MRSA. During live testimony, view or listen by opening the following links or visiting the Illinois General Assembly webpage http://www.ilga.gov/ and finding "House" on the top blue bar. Click on Audio/Visual.

May 2, 2007 - Chicago Tribune Commentary ‘Keeping patients safe’ by Michael O. Vernon, President, APIC Chicago (Association for Professionals in Infection Control and Epidemiology); Director, Communicable Disease Control, Cook County Department of Public Health. >> Read More

April 30, 2007 - Chicago Tribune 'Super bug' bill targets hospitals: State measure could dictate fight against deadly bacterium’
>> Read More

April 25, 2007 (from current issue of APIC Epdate)

CMS Proposes Changes For Hospital Inpatient Prospective Payment System

The FY08 Inpatient Prospective Payment System Proposed Rule, released on April 13, 2007, contains six proposed conditions of which three are HAI related conditions and three serious preventable events for which CMS will not provide higher payments if the selected condition was not present upon admission. While these changes won't take effect until FY 2009, CMS will finalize its conditions by October 1, 2007. It is noteworthy that use of "Present on Admissions Codes" also take effect on October 1, 2007.

Proposed conditions that will not be covered include HAI related issues: Catheter-associated urinary tract infections; pressure ulcers; Staphylococcus aureus septicema; and "serious preventable events:" object left in surgery; air embolism, and blood incompatibility.

APIC plans to respond to this proposal in collaboration with key stakeholders and will provide its members with access to key comments for their use if they choose to respond from their respective organizations.

http://www.apic.org/EUpdate

April 2007- Recommendations for Surveillance of Clostridium difficile-Associated Disease McDonald LC, et.al. (Ad Hoc Clostridium difficile Surveillance Working Group) ICHE 2007 Feb;28 (2):140-5 An ad hoc C. difficile surveillance working group was formed to develop interim surveillance definitions and recommendations based on existing literature and expert opinion that can help to improve CDAD surveillance and prevention efforts. Tracking of healthcare facility–onset, healthcare facility–associated CDAD is the minimum surveillance required for healthcare settings; tracking of community-onset, healthcare facility–associated CDAD should be performed only in conjunction with tracking of healthcare facility–onset, healthcare facility–associated CDAD. Recommended definitions for surveillance and for calculation of rates are included in the article.

March 2007- In an effort to create a nationwide commitment to the elimination of MRSA transmission, APIC has launched and continues to build a comprehensive program to aid its members in overcoming barriers to the elimination of this deadly organism.

Available now on APIC web site (under Government Advocacy): Guide to the Elimination of Methicillin-Resistant Staphylococcus aureus in Hospital Settings, created by the MRSA Task Force and released on March 14, 2007, provides infection prevention and control professionals with a step-by-step approach to battle MRSA transmission. A range of approaches has been included to make the guide appropriate for any size or type of facility.

Home Government Advocacy Methicillin-Resistant Staphylococcus Aureus (MRSA) >MRSA Initiatives (link to document is found under Guide to the Elimination of Methicillin-Resistant Staphylococcus aureus)

MRSA Legislative Issues

Legislative Mandates for Use of Active Surveillance Cultures to Screen for Methicillin-Resistant Staphylococcus aureus and Vancomycin-Resistant Enterococci: Position Statement From the Joint SHEA and APIC Task Force
An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU

 



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