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SIGNpost 00690

*SAFE INJECTION GLOBAL NETWORK* SIGNPOST *

Post00690   SCM + VAX + HDR + Abstracts + Waste Award + News   20 March 2013

CONTENTS
1. Supply Chain Management: SCM Newsletter – Information and Communications
Technology Issue
2. New: “Temperature Stability of Vaccines” with updated bubble graphics
3. Human Development Report 2013: The Rise of the South: Human Progress in
a Diverse World
4. Abstract: The silence of the unblown whistle: the nevada hepatitis C
public health crisis
5. Abstract: Parenteral acute viral hepatitis: current diagnosis,
prevention and treatment
6. Abstract: Three years of national hand hygiene campaign in Germany: what
are the key conclusions for clinical practice?
7. Abstract: Waste management in non-hospital emergency units
8. Abstract: Let’s do no harm: Medication errors in nursing: Part 1
9. Abstract: ‘On the same level’: facilitators’ experiences running a drug
user-led safer injecting education campaign
11. Abstract: Association of resident fatigue and distress with
occupational blood and body fluid exposures and motor vehicle incidents
12. Abstract: Skin preparation with alcohol versus alcohol followed by any
antiseptic for preventing bacteraemia or contamination of blood for
transfusion
13. Abstract: Reservoirs and vectors of emerging viruses
14. Abstract: Anaphylaxis in the allergist’s office: Preparing your office
and staff for medical emergencies
15. No Abstract: Management of occupational exposure to HIV and viral
hepatitis
16. No Abstract: Incidence of needlestick and other sharp object injuries
in newly graduated nurses
17. No Abstract: Employee needlestick injuries are prevalent and
preventable
18. India: Lucknow Hospital Recognized for Cutting-Edge Medical Waste Work
19. News
– USA: Contamination Of Drugs Found At Connecticut Hospital Prompts
Nationwide Warning
– Switzerland: Music teacher and self-styled healer ‘infected 16 people
with HIV after using contaminated needles for acupuncture’

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Visit the WHO injection safety website and the SIGN Alliance Secretariat
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Selected updates and breaking news items on the SIGN Moderator Facebook
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Selected updates at: http://twitter.com/#!/signmoderator
__________________________________________________________________
________________________________*_________________________________

1. Supply Chain Management: SCM Newsletter – Information and Communications
Technology Issue
__________________________________________________________________
SCM Newsletter – Information and Communications Technology Issue

From: “Anne Marie Hvid” <anne_marie_hvid@jsi.com> Date: Thu, 28 Feb 2013

The Quarter 4, 2012 issue of the USAID | DELIVER PROJECT’s Supply Chain
Management (SCM) Newsletter focuses on a number of promising mobile supply
chain interventions, which are quickly becoming a preferred approach to
data collection, tracking, and reporting.

Mobile systems such as ILSGateway in Tanzania, the Early Warning System in
Ghana, and cStock in Malawi are being taken to scale in the coming year,
having demonstrated an ability to consistently provide crucial supply
chain data that were previously intermittent, late, or unreliable.

Topics in this edition of the newsletter include supply chain software in
30 countries, linking to the last mile, 10 years of Delivery Team Topping
Up, and the 2012 mHealth Summit.

Read the Quarter 4, 2012 issue of the SCM Newsletter at http://j.mp/Wujd8U

regards

Anne Marie Hvid, PMP
Knowledge Management Advisor
USAID | DELIVER PROJECT
email: ahvid@jsi.com
http://deliver.jsi.com/
__________________________________________________________________
________________________________*_________________________________

2. New: “Temperature Stability of Vaccines” with updated bubble graphics

Crossposted from www.Technet21.org with thanks.
__________________________________________________________________
“Temperature Stability of Vaccines” with updated bubble graphics

Debra Kristensen (PATH/Vaccine Technologies) and Diana Chang Blanc (WHO
Geneva, EPI)

WHO and PATH have jointly updated the popular Temperature Stability of
Vaccines slides that were originally produced by Dr. Julie Milstien for the
TechNet21 2006 consultation.

This updated version includes vaccines that have become available since the
original slide set was created. The slides graphically depict the relative
heat and freeze sensitivities of vaccines, based on stability data coming
from multiple sources.

The “Summary of stability data” document (link on final slide) lists the
references that were used to plot the stability for each vaccine type.
Speaker’s notes are included with background information. We hope that
TechNet21 members will find this resource useful.

VaccineStability-Feb2013-FINAL.pdf [568 Kb]
http://tinyurl.com/StabiilityOfVax
__________________________________________________________________
________________________________*_________________________________

3. Human Development Report 2013: The Rise of the South: Human Progress in
a Diverse World

Crossposted with thanks from the Equity List
http://listserv.paho.org/Archives/equidad.html
Twitter http://twitter.com/eqpaho
__________________________________________________________________
Human Development Report 2013: The Rise of the South: Human Progress in a
Diverse World

“Rise of South” transforming global power balance, Massive poverty
reduction, middle-class expansion from major development gains in Africa,
Asia, Latin America

Mexico City, 14 March 2013—The rise of the South is radically reshaping the
world of the 21st century, with developing nations driving economic growth,
lifting hundreds of millions of people from poverty, and propelling
billions more into a new global middle class…

United Nations Development Programme’s (UNDP) 2013 Human Development
Report

Full report: 2013 Human Development Report [5,793 KB] PDF
http://bit.ly/10MweOd

Summary http://bit.ly/13Vx6Vl

Website: http://bit.ly/Z21yoS

“The rise of the South is unprecedented in its speed and scale,” the 2013
Report says. “…“Never in history have the living conditions and prospects
of so many people changed so dramatically and so fast.”

….This phenomenon goes well beyond the so called BRICs, middle income
countries often represented by Brazil, Russia, India and China, the 2013
Report stresses. The Report shows that more than 40 developing countries
have made greater human development gains in recent decades than would have
been predicted. These achievements, it says, are largely attributable to
sustained investment in education, health care and social programmes, and
open engagement with an increasingly interconnected world…..”

“……Norway, Australia and the United States lead this year’s Human
Development Index (HDI) rankings, the annual United Nations measure of
progress in human well-being, while Niger, the Democratic Republic of the
Congo (DRC) and Mozambique are at the bottom.

The new HDI figures, launched today in Mexico City by the UN Development
Programme (UNDP), combines measures of life expectancy, literacy, school
enrolment and gross domestic product (GDP) per capita. This year 187
countries and territories were measured.

“….National averages hide large variation in human experiences, and wide
disparities remain within countries of both the North and the South,” the
report says.

The report emphasizes the unprecedented growth of developing countries,
which is propelling millions out of poverty and reshaping the global
system.

According to the report, leading economies in the South such as China,
India and Brazil will be the main drivers of economic growth and societal
change for the first time in centuries. This growth, however, is not
limited to these three countries, and the report spotlights more than 40
other countries that have made greater human development gains in recent
decades than what was predicted…..”

Contents:

Overview
Introduction

1. The state of human development
Progress of nations
Social integration
Human security

2. A more global South
Rebalancing: a more global world, a more global South
Impetus from human development
Innovation and entrepreneurship in the South
New forms of cooperation
Sustaining progress in uncertain times

3. Drivers of development transformation
Driver 1: a proactive developmental state
Driver 2: tapping of global markets
Driver 3: determined social policy innovation

4. Sustaining momentum
Policy priorities for developing countries
Modelling demography and education
Impact of the rate of population ageing
The need for ambitious policies
Seizing the moment

5. Governance and partnerships for a new era
A new global view of public goods
Better representation for the South
Global civil society
Towards coherent pluralism
Responsible sovereignty
New institutions, new mechanisms
Conclusions: partners in a new era

Notes and References
Statistics
__________________________________________________________________
________________________________*_________________________________

4. Abstract: The silence of the unblown whistle: the nevada hepatitis C
public health crisis
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592579/

Yale J Biol Med. 2013 Mar;86(1):79-87.

The silence of the unblown whistle: the nevada hepatitis C public health
crisis.

Leary E, Diers D.

Master’s Candidate, Nursing, Management, Policy and Leadership.

In 2008, one of the worst public health crises occurred in the state of
Nevada, where authorities discovered up to 63,000 patients were potentially
exposed to hepatitis C infection, largely due to substandard infection
control and other negligent practices at two endoscopy clinics in Las
Vegas.

In the subsequent grand jury proceedings that followed, it was discovered
that several clinic employees not only participated in these egregious
practices, but doctors, nurses, and other health care professionals
witnessed yet failed to report these incidents, largely due to fears of
whistleblower retaliation.

In response, the Nevada state legislature attempted to strengthen
whistleblower protection laws, but it remains unclear if such laws actually
protect employees who attempt to report patient safety concerns.

As the push for quality patient outcomes becomes more prominent with health
care reform, whistleblower concerns must be effectively addressed to ensure
that health care professionals can report patient safety concerns without
fear of retaliation.

KEYWORDS: Desai, Nevada, hepatitis C, infection control, nurse
anesthetists, nurses, nursing, outbreak, public health, retaliation,
whistleblower, whistleblowing

Free PMC Article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3592579/
__________________________________________________________________
________________________________*_________________________________

5. Abstract: Parenteral acute viral hepatitis: current diagnosis,
prevention and treatment
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23402196

Eksp Klin Gastroenterol. 2012;(6):76-85.

[Parenteral acute viral hepatitis: current diagnosis, prevention and
treatment].

[Article in Russian]

Podymova SD.

Questions of diagnostics, feature of clinic, treatment and preventation of
active virus hepatites with parenteral mechanism of transmission of an
infection (hepatites B, C, D, G) which make up a significant number of all
acute virus hepatites are considered.

A wide circulation, features of modern diagnostics and frequency of
progress of chronic forms define a problem of diagnostics and treatment of
a virus hepatites, as one of important for domestic healthcare.

Data about the importance and features serological markers of viruses of a
hepatites B, C, D, G, are presented and their clinical interpretation is
analyzed. Modern drug therapy is in detail resulted including preparations
of interferon.

The need of specific preventive actions, post-exposure preventive
maintenance and passive immunization is considered.
__________________________________________________________________
________________________________*_________________________________

6. Abstract: Three years of national hand hygiene campaign in Germany: what
are the key conclusions for clinical practice?
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23453170

J Hosp Infect. 2013 Feb;83 Suppl 1:S11-6. doi: 10.1016/S0195-6701(13)
60004-3.

Three years of national hand hygiene campaign in Germany: what are the key
conclusions for clinical practice?

Reichardt C, Königer D, Bunte-Schönberger K, van der Linden P, Mönch N,
Schwab F, Behnke M, Gastmeier P.

Institute of Hygiene and Environmental Medicine, University Medicine
Berlin, Charité, Berlin, Germany. Electronic address:
christiane.reichardt@charite.de.

The World Health Organization (WHO) started the ‘Clean Care is Safer Care’
campaign in 2005. Since then, more than 120 countries have pledged to
improve hand hygiene as a keystone of their national or subnational
healthcare-associated infection prevention programmes. Thirty-eight
countries have implemented national campaigns.

Germany started a national campaign to improve hand hygiene compliance on 1
January 2008. The campaign, ‘AKTION Saubere Hände’, is funded by the German
Ministry of Health and was initiated by the National Reference Centre for
the Surveillance of Nosocomial Infections, the Society for Quality
Management in Health Care and the German Coalition for Patient Safety. The
campaign is designed as a multi-modal campaign based on the WHO
implementation strategy.

Since the end of 2010, more than 700 healthcare institutions have been
actively participating in the campaign, among which are 28 university
hospitals. Voluntarily participating hospitals have to implement the
following measures: active support by hospital administrators of local
campaign implementation, participation in a one-day introductory course,
education of healthcare workers at least once a year, measurement of
alcohol-based hand-rub consumption (AHC) and feedback on resulting data,
implementation of the WHO ‘My Five Moments for Hand Hygiene’ model,
increase in hand-rub availability, participation in national hand hygiene
day at least every two years, and participation in national campaign
network workshops at least once every two years.

Observational studies to measure hand hygiene compliance are optional.
Overall, there has been a significant increase of 11% in hand hygiene
compliance in 62 hospitals that observed compliance before and after
intervention. A total of 129 hospitals provided AHC data for three years
and achieved an overall increase of 30.7%. The availability of alcohol-
based hand rub increased from 86.8% to > 100% in intensive care units and
from 63.6% to 91.3% in non-intensive care units.

Overall, the implementation of a national campaign using the WHO multi-
modal intervention strategy has led to improved hand hygiene compliance and
hand-rub availability in participating settings.

Copyright © 2013 The Healthcare Infection Society. Published by Elsevier
Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

7. Abstract: Waste management in non-hospital emergency units
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23459915

Rev Lat Am Enfermagem. 2013 Feb;21 Spec No:259-66.

Waste management in non-hospital emergency units.

[Article in English, Portuguese]

Pereira MS, Alves SB, Souza AC, Tipple AF, Rezende FR, Rodrigues EG.

Pontifícia Universidade Católica de Goiás, Brazil.

OBJECTIVE: to analyze waste management in urgency and emergency non-
hospital health care service units.

METHOD: Epidemiological cross-sectional study undertaken at three Non-
Hospital Emergency Units. The data were collected using systematic
observation, registered daily in a spreadsheet and checklist, and analyzed
through descriptive statistics.

RESULTS: the generation of waste varied from 0.087 to 0.138 kg per patient
per day. Waste management showed inadequacies in all stages, especially in
the separation stage. Infectious waste was found together with common
waste, preventing recycling, and piercing and cutting objects were mixed
with waste from different groups, increasing the risk of occupational
accidents.

CONCLUSION: the study reveals the lack of an institutional waste management
policy, as demonstrated by the failure of operational stages, involving
problems related to management, physical structure, material and human
resources at the units. This is relevant for health care units, considering
the quality of patient care and its interface with sustainability.

Free full text http://dx.doi.org/10.1590/S0104-11692013000700032
__________________________________________________________________
________________________________*_________________________________

8. Abstract: Let’s do no harm: Medication errors in nursing: Part 1
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23474430

Nurse Educ Pract. 2013 Mar 6. pii: S1471-5953(13)00025-5.

Let’s do no harm: Medication errors in nursing: Part 1.

Leufer T, Cleary-Holdforth J.

School of Nursing and Human Sciences, Dublin City University, Collins Ave,
Glasnevin, Dublin, Ireland. Electronic address: therese.leufer@dcu.ie.

In the current climate of global economic chaos and increasing healthcare
litigation, it is perhaps simultaneously unsurprising and yet perplexing
that patients continue to fall foul of healthcare systems worldwide. Major
incidents in patient care such as serious misdiagnoses, medication errors,
the proliferation of superbugs and malpractice persist leading to injury or
death of patients, emotional trauma to their families and, understandably,
a reduction in the public’s confidence in the healthcare system not to
mention the financial consequences.

Many, if not most or indeed all, of these incidents are preventable and
should not happen. Yet the systems in place within healthcare permit their
occurrence, with worrying regularity, it would appear. The area that this
paper will focus on specifically is that of medication errors. The worrying
trends with regard to medication errors will be presented. Potential
contributing factors will be examined.

The specific aim of this paper is to illuminate the extent and severity of
the problem of medication errors in practice and to explore elements within
the practice setting that can compound the problem. The multi-faceted
nature of the problem will also be considered.

Copyright © 2013 Elsevier Ltd. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

9. Abstract: ‘On the same level’: facilitators’ experiences running a drug
user-led safer injecting education campaign
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23497293

Harm Reduct J. 2013 Mar 6;10(1):4.

‘On the same level’: facilitators’ experiences running a drug user-led
safer injecting education campaign.

Callon C, Charles G, Alexander R, Small W, Kerr T.

BACKGROUND: Unsafe injection practices play a major role in elevated rates
of morbidity and mortality among people who inject drugs (IDU). There is
growing interest in the direct involvement of IDU in interventions that
seek to address unsafe injecting. This study describes a drug user-led
safer injecting education campaign, and explores facilitators’ experiences
delivering educational workshops.

METHODS: We conducted semi-structured qualitative interviews with 8 members
of the Injection Support (IS) Team who developed and facilitated a series
of safer injecting education workshops. Interviews explored facilitator’s
perceptions of the workshops, experiences being a facilitator, and
perspectives on the educational campaign. Interviews were transcribed
verbatim and a thematic analysis was conducted.

RESULTS: IS Team facilitators described how the workshop’s structure and
content enabled effective communication of information about safer
injecting practices, while targeting the unsafe practices of workshop
participants. Facilitators’ identity as IDU enhanced their ability to
relate to workshop participants and communicate educational messages in
language accessible to workshop participants. Facilitators reported gaining
knowledge and skills from their involvement in the campaign, as well as
positive feelings about themselves from the realization that they were
helping people to protect their health. Overall, facilitators felt that
this campaign provided IDU with valuable information, although facilitators
also critiqued the campaign and suggested improvements for future efforts.

CONCLUSIONS: This study demonstrates the feasibility of involving IDU in
educational initiatives targeting unsafe injecting. Findings illustrate how
IDU involvement in prevention activities improves relevance and cultural
appropriateness of interventions while providing individual, social, and
professional benefits to those IDU delivering education.

Free full text http://www.harmreductionjournal.com/content/10/1/4/abstract
__________________________________________________________________
________________________________*_________________________________

10. Abstract: Can needle and syringe programmes and opiate substitution
therapy achieve substantial reductions in hepatitis C virus prevalence?
Model projections for different epidemic settings
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/22564041

Addiction. 2012 Nov;107(11):1984-95.

Can needle and syringe programmes and opiate substitution therapy achieve
substantial reductions in hepatitis C virus prevalence? Model projections
for different epidemic settings.

Vickerman P, Martin N, Turner K, Hickman M.

London School of Hygiene and Tropical Medicine, London, UK.
peter.vickerman@lshtm.ac.uk

AIMS: To investigate the impact of scaling-up opiate substitution therapy
(OST) and high coverage needle and syringe programmes (100%NSP-obtaining
more sterile syringes than you inject) on HCV prevalence among injecting
drug users (IDUs).

DESIGN: Hepatitis C virus HCV transmission modelling using U.K. estimates
for effect of OST and 100%NSP on individual risk of HCV infection.

SETTING: Range of chronic HCV prevalent (20/40/60%) settings with no
OST/100%NSP, and U.K. setting with 50% coverage of both OST and 100%NSP.

PARTICIPANTS: Injecting drug users.

MEASUREMENTS: Decrease in HCV prevalence after 5-20 years due to scale-up
of OST and 100%NSP to 20/40/60% coverage in no OST/100%NSP settings, or
from 50% to 60/70/80% coverage in the U.K. setting.

FINDINGS: For 40% chronic HCV prevalence, scaling-up OST and 100%NSP from
0% to 20% coverage reduces HCV prevalence by 13% after 10 years. This
increases to a 24/33% relative reduction at 40/60% coverage. Marginally
less impact occurs in higher prevalence settings over 10 years, but this
becomes more pronounced over time. In the United Kingdom, without current
coverage levels of OST and 100%NSP the chronic HCV prevalence could be 65%
instead of 40%. However, increasing OST and 100%NSP coverage further is
unlikely to reduce chronic prevalence to less than 30% over 10 years unless
coverage becomes =80%.

CONCLUSIONS: Scaling-up opiate substitution therapy and high coverage
needle and syringe programmes can reduce hepatitis C prevalence among
injecting drug users, but reductions can be modest and require long-term
sustained intervention coverage. In high coverage settings, other
interventions are needed to further decrease hepatitis C prevalence. In low
coverage settings, sustained scale-up of both interventions is needed.

© 2012 The Authors. Addiction © 2012 Society for the Study of Addiction.

Comment in

Commentary on Vickerman et?al. (2012): Reducing hepatitis C virus among
injection drug users through harm reduction programs. [Addiction. 2012]
http://www.ncbi.nlm.nih.gov/pubmed/23039752
__________________________________________________________________
________________________________*_________________________________

11. Abstract: Association of resident fatigue and distress with
occupational blood and body fluid exposures and motor vehicle incidents
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23218084

Mayo Clin Proc. 2012 Dec;87(12):1138-44.

Association of resident fatigue and distress with occupational blood and
body fluid exposures and motor vehicle incidents.

West CP, Tan AD, Shanafelt TD.

Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905,
USA. west.colin@mayo.edu

OBJECTIVE: To evaluate the effect of resident physicians’ distress on their
personal safety.

PARTICIPANTS AND METHODS: We conducted a prospective, longitudinal cohort
study of internal medicine residents at Mayo Clinic in Rochester,
Minnesota. Participants completed surveys quarterly from July 1, 2007,
through July 31, 2011, during their training period. Frequency of self-
reported blood and body fluid (BBF) exposures and motor vehicle incidents
was recorded. Associations of validated measures of quality of life,
burnout, symptoms of depression, fatigue, and sleepiness with a
subsequently reported BBF exposure or motor vehicle incident were
determined using generalized estimating equations for repeated measures.

RESULTS: Data were provided by 340 of 384 eligible residents (88.5%). Of
the 301 participants providing BBF exposure data, 23 (7.6%) reported having
at least 1 BBF exposure during the study period. Motor vehicle incidents
were reported by 168 of 300 respondents (56.0%), including 34 (11.3%)
reporting a motor vehicle crash and 130 (43.3%) reporting a near-miss motor
vehicle crash. Other than the low personal accomplishment domain of
burnout, distress and fatigue at one time point exhibited no statistically
significant associations with BBF exposure in the subsequent 3 months.
However, diminished quality of life, burnout, positive screening for
depression, fatigue, and sleepiness were each associated with statistically
significantly increased odds of reporting a motor vehicle incident in the
subsequent 3 months.

CONCLUSION: Exposures to BBF are relatively uncommon among internal
medicine residents in current training environments. Motor vehicle
incidents, however, remain common. Our results confirm the importance of
fatigue and sleepiness to resident safety concerns. In addition, higher
levels of distress may be contributory factors to motor vehicle crashes and
other related incidents. Interventions designed to address both fatigue and
distress may be needed to optimally promote patient and resident safety.

Copyright © 2012 Mayo Foundation for Medical Education and Research.
Published by Elsevier Inc. All rights reserved.

Comment in: Physicians’ well-being and safety: it’s not all about sleep.
[Mayo Clin Proc. 2012] http://www.ncbi.nlm.nih.gov/pubmed/23218082
__________________________________________________________________
________________________________*_________________________________

12. Abstract: Skin preparation with alcohol versus alcohol followed by any
antiseptic for preventing bacteraemia or contamination of blood for
transfusion
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23440821

Cochrane Database Syst Rev. 2013 Jan 31;1:CD007948.

Skin preparation with alcohol versus alcohol followed by any antiseptic for
preventing bacteraemia or contamination of blood for transfusion.

Webster J, Bell-Syer SE, Foxlee R.

Centre for Clinical Nursing, Royal Brisbane andWomen’s Hospital, Brisbane,
Australia.joan_webster@health.qld.gov.au.

BACKGROUND: Blood for transfusion may become contaminated at any point
between collection and transfusion and may result in bacteraemia (the
presence of bacteria in the blood), severe illness or even death for the
blood recipient. Donor arm skin is one potential source of blood
contamination, so it is usual to cleanse the skin with an antiseptic before
blood donation. One-step and two-step alcohol based antiseptic regimens are
both commonly advocated but there is uncertainty as to which is most
effective.

OBJECTIVES: To assess the effects of cleansing the skin of blood donors
with alcohol in a one-step compared with alcohol in a two-step procedure to
prevent contamination of collected blood or bacteraemia in the recipient.

SEARCH METHODS: For this second update we searched the Cochrane Wounds
Group Specialised Register (searched 20 November 2012); The Cochrane
Central Register of Controlled Trials (CENTRAL) The Cochrane Library 2012,
Issue 11; Ovid MEDLINE (20011 to November Week 2 2012); Ovid MEDLINE (In-
Process & Other Non-Indexed Citations November 20, 2012); Ovid EMBASE (
20011 to 2012 Week 46); and EBSCO CINAHL ( 2008 to 15 November 2012).

SELECTION CRITERIA: All randomised trials (RCTs) comparing alcohol based
donor skin cleansing in a one-step versus a two-step process that includes
alcohol and any other antiseptic for pre-venepuncture skin cleansing were
considered. Quasi randomised trials were to have been considered in the
absence of RCTs.

DATA COLLECTION AND ANALYSIS: Two review authors independently assessed
studies for inclusion.

MAIN RESULTS: No studies (RCTs or quasi RCTs) met the inclusion criteria.

AUTHORS’ CONCLUSIONS: We did not identify any eligible studies for
inclusion in this review. It is therefore unclear whether a two-step,
alcohol followed by antiseptic skin cleansing process prior to blood
donation confers any reduction in the risk of blood contamination or
bacteraemia in blood recipients, or conversely whether a one-step process
increases risk above that associated with a two-step process.

Update of Cochrane Database Syst Rev. 2009;(3):CD007948.
__________________________________________________________________
________________________________*_________________________________

13. Abstract: Reservoirs and vectors of emerging viruses
__________________________________________________________________

http://www.ncbi.nlm.nih.gov/pubmed/23491947

Curr Opin Virol. 2013 Mar 12. pii: S1879-6257(13)00020-5.

Reservoirs and vectors of emerging viruses.

Mackenzie JS, Jeggo M.

Faculty of Health Sciences, Curtin University, Perth, Western Australia,
Australia; Burnet Institute, Melbourne, Australia. Electronic address:
J.Mackenzie@curtin.edu.au.

Wildlife, especially mammals and birds, are hosts to an enormous number of
viruses, most of which we have absolutely no knowledge about even though we
know these viruses circulate readily in their specific niches. More often
than not, these viruses are silent or asymptomatic in their natural hosts.

In some instances, they can infect other species, and in rare cases, this
cross-species transmission might lead to human infection. There are also
instances where we know the reservoir hosts of zoonotic viruses that can
and do infect humans.

Studies of these animal hosts, the reservoirs of the viruses, provide us
with the knowledge of the types of virus circulating in wildlife species,
their incidence, pathogenicity for their host, and in some instances, the
potential for transmission to other hosts.

This paper describes examples of some of the viruses that have been
detected in wildlife, and the reservoir hosts from which they have been
detected. It also briefly explores the spread of arthropod-borne viruses
and their diseases through the movement and establishment of vectors in new
habitats.

Copyright © 2013 Elsevier B.V. All rights reserved.
__________________________________________________________________
________________________________*_________________________________

14. Abstract: Anaphylaxis in the allergist’s office: Preparing your office
and staff for medical emergencies
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23484886

Allergy Asthma Proc. 2013 Mar;34(2):120-31.

Anaphylaxis in the allergist’s office: Preparing your office and staff for
medical emergencies.

Wallace DV.

Department of Medicine, Nova Southeastern University, Davie, Florida, USA.

All allergists who administer subcutaneous immunotherapy (SCIT) experience
anaphylaxis in their offices and must devote proper planning, preparation,
and practice to ensure that all staff members recognize the early signs and
symptoms of anaphylaxis and can respond appropriately.

Educating staff and patients, preparing an anaphylaxis emergency cart,
developing and following selection criteria for SCIT and high-risk
procedures, and customizing an “Action Plan for Anaphylaxis Management”
create the foundation for mounting an adequate response to anaphylaxis.

Strategies to prevent near-fatal and fatal reactions include (1) avoiding,
when possible, the administration of SCIT to patients on beta-blockers; (2)
using a preinjection questionnaire to review changes in the patient’s
medical condition, e.g., episodes of asthma since the previous injection;
(3) using standardized forms and procedures for SCIT; (4) one might also
consider an objective measure of airway function (e.g., peak flow
measurement) for the asthmatic patient before allergy injections; (5)
insisting on a 30-minute waiting time after SCIT; and (6) giving
consideration to prescribing a dual-pack epinephrine autoinjector to all
SCIT patients.

Treatment of anaphylaxis should start with epinephrine administered
intramuscularly at the first sign of anaphylaxis. Oxygen and i.v. fluids
may be needed for moderate-to-severe anaphylaxis or anaphylaxis that is
quickly developing or unresponsive to the first injection of epinephrine.
Emergency medical services should be called for all patients who are
experiencing moderate-to-severe (grade 2 or higher) anaphylaxis, if they
require more than 1 dose of epinephrine and/or i.v. fluids, or if they do
not immediately respond to treatment.
__________________________________________________________________
________________________________*_________________________________

15. No Abstract: Management of occupational exposure to HIV and viral
hepatitis
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23379106

Rev Infirm. 2013 Jan;(187):53-4.

[Management of occupational exposure to HIV and viral hepatitis].

[Article in French]

Chevillotte J.

CHI Poissy Saint-Germain, Saint-Germain-en-Laye, France.
jerome.chevillotte@laposte.net
__________________________________________________________________
________________________________*_________________________________

16. No Abstract: Incidence of needlestick and other sharp object injuries
in newly graduated nurses
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23489737

Am J Infect Control. 2013 Mar 12. pii: S0196-6553(13)00066-7.

Incidence of needlestick and other sharp object injuries in newly graduated
nurses.

Yang YH, Wu SJ, Wang CL, Yang CY, Liou SH, Wu TN.

Department of Occupational Safety and Hygiene, Fooyin University,
Kaohsiung, Taiwan.
__________________________________________________________________
________________________________*_________________________________

17. No Abstract: Employee needlestick injuries are prevalent and
preventable
__________________________________________________________________
http://www.ncbi.nlm.nih.gov/pubmed/23488381

HDA Now. 2012 Fall:8-9.

Employee needlestick injuries are prevalent and preventable.

TDIC Risk Management Staff.
__________________________________________________________________
________________________________*_________________________________

18. India: Lucknow Hospital Recognized for Cutting-Edge Medical Waste Work
__________________________________________________________________
http://tinyurl.com/cc9xgj3 With video

India: Lucknow Hospital Recognized for Cutting-Edge Medical Waste Work
UNDP (05.03.13)

UNDP Press Release

India — The King George’s Medical University (KGMU) received a Special
Recognition Award from UNDP/GEF Global Healthcare Waste Management Project,
Health Care Without Harm and the World Health Organization recognizing the
outstanding work of KGMU medical staff in transforming the hospital over
two and a half years from an institution without any effective waste
management programme into a regional model institution for sound bio-
medical waste management practices.

The award was accepted by Dr. Kirti Srivastava and the Nodal Officers of
the Bio-Medical Waste Management Committee of King George’s Medical
University. It was presented during the national dissemination work of the
UNDP project, funded by the Global Environment Facility, titled ‘Global
Healthcare Waste Management.’ The seven country project supports
initiatives to create model bio-medical waste management programmes in
hospitals and healthcare institutions in seven countries including
Argentina, India, Latvia, Lebanon, Philippines, Senegal and Vietnam.

The Special Recognition Award was presented by Jack Weinberg, Senior Policy
Advisor, UNDP Global Healthcare Waste Management Project and Mrs. Payden,
World Health Organization South East Asia Regional Office.

The Global project singled out KGMU to receive special recognition. “This
project worked with many hospitals and healthcare facilities in seven
countries,” said Jack Weinberg, Senior Advisor to the Global Project Team.
“KGMU and its medical staff stood out for their deep dedication and the
great challenges they overcame to create a state-of-the-art, sustainable
model institution for sound bio-medical waste management practices.”

The project is implemented by UNDP with funding from the Global Environment
Facility. It is supported by the World Health Organization and the
international NGO, Healthcare Without Harm. The Indian component of the
project is executed by the Government of India, Ministry of Environment and
Forests.

According to Dr. Subba Rao, Director, Hazardous Substance Management
Division, Ministry of Environment and Forests, Government of India, “The
Ministry of Environment and Forests applauds the transformation of KGMU’s
hospital into a regional resource centre and model that can support efforts
to implement sound bio-medical waste management practices across northern
India.”

“Good bio-medical waste management practices are necessary to prevent the
spread of infectious diseases and to protect patients, hospital staff and
the community at large,” said Mrs. Payden, Regional Advisor, World Health
Organization, South East Asia Regional Office. “WHO is proud to support
this award to Dr. Kirti and the Nodal Officers.”

A national dissemination workshop of the UNDP- GEF implemented health care
waste management project titled ‘Demonstrating and Promoting Best
Techniques and Practices for Reducing Health Care Waste to Avoid
Environmental Releases of Dioxins and Furans and mercury reduction’ is
being organized by KGMU on 5 March 2013. This workshop was attended by
delegates from UNDP, WHO, MoEF and other organizations.

When project activities started at KGMU in 2010, the hospital had no
systematic bio-medical waste management programme in place. Funds were not
available for adequate waste management supplies. Medical professionals and
the paramedical staff generally considered the handling of infectious waste
to be the responsibility of sweepers and waste handlers who lacked
necessary training and protective equipment. Bags and bins containing
infectious wastes were often not well-controlled and were routinely opened
so that potentially recyclable materials could be removed and later sold.
All waste from the hospital complex was then incinerated or dumped into an
open pit, a situation common at most healthcare facilities across India.

After two and a half years of intensive effort, the situation in the
hospital has been completely transformed and KGMU is now internationally
recognized as a model institution for sound healthcare waste management
practices. Bio-medical wastes are routinely segregated from other wastes at
the point of generation thereby reducing potentially infectious wastes by
more than 80 percent. This waste is then sterilized using a steam
autoclave, permitting safe recycling which produces a revenue stream for
the hospital. Bio-medical waste is no longer incinerated, thereby
minimizing emissions of hazardous air pollutants.

Expressing satisfaction at the award, Chief Guest, Shri J.P. Sharma pointed
to the importance of implementing this model across the state.

The Honourable Vice Chancellor Prof D.K. Gupta “Congratulated the whole
team of bio-medical waste management committee for the commendable work
they have done to transform the waste management system in the
institution.”

The Honourable Vice Chancellor, the Dean of Faculty, the Registrar, the
Medical Superintendents and the administration of KGMU have all been
supportive throughout the implementation of the project,” said Dr. Kirti
Srivastava. “They have agreed to devote necessary funds to continue the
KGMU’s bio-medical waste programme following the end of the project and to
retain the staff and training programs needed to sustain it.”
__________________________________________________________________
________________________________*_________________________________

19. News

– USA: Contamination Of Drugs Found At Connecticut Hospital Prompts
Nationwide Warning
– Switzerland: Music teacher and self-styled healer ‘infected 16 people
with HIV after using contaminated needles for acupuncture’

Selected news items reprinted under the fair use doctrine of international
copyright law: http://www4.law.cornell.edu/uscode/17/107.html
__________________________________________________________________
USA: Contamination Of Drugs Found At Connecticut Hospital Prompts
Nationwide Warning
Associated Press (18.03.13)

WASHINGTON (AP) _ The Food and Drug Administration is warning doctors and
hospital managers about a nationwide recall of all drugs made by a New
Jersey compounding pharmacy because they may be contaminated with mold.

The recalled products from Med Prep Consulting Inc. include dozens of drugs
packaged in infusion bags, plastic syringes and glass vials distributed to
regional hospitals.

The Tinton Falls, N.J.-based company said Saturday that mold was found in
five bags of magnesium sulfate products dispensed to a Connecticut
hospital.

No infections have been reported to date, but the FDA says it is working
with officials in New Jersey and Connecticut to determine the scope of
contamination.

A tainted steroid distributed by an unrelated pharmacy last year has killed
50 people and sickened more than 720 nationwide.

© Copyright 2013 The Associated Press. All Rights Reserved.
__________________________________________________________________
__________________________________________________________________
Switzerland: Music teacher and self-styled healer ‘infected 16 people with
HIV after using contaminated needles for acupuncture’
By Harriet Arkell Snd Allan Hall in Berlin, Daily Mail uk (18.03.13)

A Swiss music teacher charged with infecting 16 people with HIV by
injecting them with needles contaminated by the virus has been arrested
after he refused to go to court.

The 54-year-old man, who is not being named in accordance with Swiss law,
is said to have told his patients, many of them his music students, that he
could ‘heal’ them with acupuncture.

Police stormed his flat in the Swiss capital Bern after he stopped
attending his trial and instead barricaded himself at home.

The self-proclaimed healer’s flat in the capital Bern was surrounded by
police marksmen after he came out brandishing two samurai swords.

He failed to appear at his trial on Thursday citing ‘acute mental and
physical exhaustion’.

Police who visited his home on Friday managed to hit him with pepper spray
in the garden before he ran and barricaded himself inside, issuing repeated
threats.

Swiss police said they subsequently stormed the man’s home and arrested
him. An unidentified woman with him was also arrested.

The man had been free on bail since August. His trial began on March 6, but
he stopped turning up in court on Thursday.

The case came to the attention of the Swiss authorities after an HIV-
positive patient told a Bern hospital in 2004 he had traced his infection
back to acupuncture treatments carried out by the accused.

After two more people were diagnosed with HIV and found to have links to
the man, detectives investigated and charged the man with infecting 16
‘patients’ with HIV-tainted blood between 2001 and 2005.

The court in Bern heard that the man conned his pupils into believing he
was an acupuncture specialist and said he could ‘heal’ them with various
problems.

The court heard that all 16 people injected by the man, who is not HIV-
positive, have contracted the AIDS virus.

One of them told the court he visited the ‘healer’ in a bid to cure his
epilepsy and migraine attacks.

‘I know he gave me the virus because there is no other way I could have
contracted it – not sex, drugs or a blood transfusion,’ the victim said.
Prosecutors say the blood used by the man came from another of his pupils
but he denies the allegation.

The man, who faces life imprisonment if found guilty, has denied the
charges.
__________________________________________________________________
________________________________*_________________________________
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