Ebola, Zika, and the Flu: CMS and CDC Want Action on Emerging Infections

This member-only article appears in the May issue of Patient Safety Monitor Journal.

BY A.J. Plunkett

Between antibiotics losing their effectiveness, people refusing to vaccinate, and constant lapses in infection control, the threat of disease should be on the top of every physician’s and nurse’s mind. And not just because CMS and the CDC are taking notice—although they are.

The CDC issued a bulletin urging hospitals and other healthcare facilities to remain prepared for infectious disease outbreaks.

“The ongoing outbreak of Ebola virus disease (EVD) in the Democratic Republic of Congo (DRC) serves as a reminder for U.S. healthcare facilities to review their infection prevention and control processes to safely identify and manage patients with communicable infections,” states the CDC.

Meanwhile, CMS has issued a new memo highlighting concerns over potential outbreaks of infections like Ebola, the Zika virus, or influenza.

CDC recommends action
The CDC’s Clinician Outreach and Communication Activity bulletin comes on the heels of a CMS revision to interpretive guidelines for surveyors implementing the 2017 Conditions of Participation (CoP) on emergency preparedness.

The revision, among other things, emphasizes that healthcare organizations must consider emerging infectious diseases (EID) such as Ebola and influenza when assessing all possible hazards for which the facility must prepare.

Include EID threats as a separate line item for your hazard vulnerability assessment (HVA), which is required by both CMS and The Joint Commission, recommends Steven MacArthur, a former hospital safety officer and now a senior consultant with The Greeley Company in Danvers, Massachusetts. That will highlight your efforts for surveyors.

In a blog post on Inside the Joint Commission partner HCPro’s “Mac’s Safety Space,” MacArthur says integrating the EID threats into infection control sections of your HVA might mask evidence of your attention to these threats. If so, you might be pressed into breaking out those integrated items later, and it will be easier to just keep them separate.

CDC recommendations
The CDC bulletin outlines a number of recommended actions, including planning for initial triage of potential patients or patients under investigation (PUI). It writes:
“Here are the steps that facilities should implement as a routine part of triage to quickly identify, isolate, and inform public health authorities about patients who may have communicable infections:
Ask about and document international travel histories at initial triage. This information can alert healthcare personnel to the possibility of communicable infections, such as viral hemorrhagic fevers or emerging respiratory viruses, and other health conditions, such as malaria, that need specific treatment.
Identify patients who have fever and other signs and symptoms of infection and might warrant isolation pending further evaluation.
Post contact information in easily visible locations for infection control personnel and the local public health jurisdiction for reporting of communicable diseases.”
The bulletin also says facilities already should have “established plans for how PUIs or EVD patients are to be managed and referred,” and includes several online resources.

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