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Helpful MCN Healthcare Resources
CDC Issues Health Advisory Regarding the U.S. Multi-State Measles Outbreak, December 2014-January 2015
The U.S. Centers for Disease Control and Prevention (CDC) has issued a Health Advisory regarding the multi-state outbreak of measles associated with travel to Disneyland Resort Theme Parks (which includes Disneyland and Disney California Adventure). The purpose of this HAN Advisory is to notify public health departments and healthcare facilities about this measles outbreak and to provide guidance to healthcare providers.
According to the CDC, the current multi-state outbreak underscores the ongoing risk of importation of measles, the need for high measles vaccine coverage, and the importance of a prompt and appropriate public health response to measles cases and outbreaks. Because of the success of the measles vaccine program, most young physicians have never seen a case of measles and may not take a detailed history of travel or potential exposure and initially may not consider the diagnosis in a clinically compatible case. Therefore the CDC is making the following recommendations for Health Care Providers:
- Ensure all patients are up to date on MMR vaccine and other vaccines.
o Note: Children 1 through 12 years of age may receive MMRV vaccine for protection against measles, mumps,
rubella, and varicella.
- For those who travel abroad, CDC recommends that all U.S. residents older than 6 months be protected from measles and receive MMR vaccine, if needed, prior to departure.
o Infants 6 through 11 months old should receive 1 dose of MMR vaccine before departure.
Note: Infants who receive a dose of MMR vaccine before their first birthday should receive 2 more doses of MMR vaccine, the first of which should be administered when the child is 12 through 15 months of age and the second at least 28 days later.
o Children 12 months of age or older should have documentation of 2 doses of MMR vaccine (separated by at least
o Teenagers and adults without evidence of measles immunity should have documentation of two (2) appropriately
spaced doses of MMR vaccine.
Note: One of the following is considered evidence of measles immunity for international travelers: 1) birth before 1957, 2) documented administration of 2 doses of live measles virus vaccine (MMR, MMRV, or measles vaccines), 3) laboratory (serologic) proof of immunity or laboratory confirmation of disease.
- Consider measles as a diagnosis in anyone with a febrile rash illness and clinically compatible symptoms (cough, coryza, and/or conjunctivitis) who has recently traveled abroad or who has had contact with someone with a febrile rash illness.
- Immunocompromised patients may not exhibit rash or may exhibit an atypical rash. The incubation period for measles from exposure to fever is usually about 10 days (range, 7 to 12 days) and from exposure to rash onset is usually 14 days (range, 7 to 21 days).
- Isolate suspect measles case-patients and immediately report cases to local health departments to ensure a prompt public health response.
- Obtain specimens for testing, including viral specimens for confirmation and genotyping. Contact the local health department for assistance with submitting specimens for testing.
The Health Advisory, link below, includes additional resources and information for health care professionals.
The US Centers for Disease Control and Prevention (CDC) is reporting that more than a third of reproductive-aged women enrolled in Medicaid, and more than a quarter of those with private insurance, filled a prescription for an opioid pain medication each year during 2008-2012. "These statistics are alarming because of the fact that taking opioid medications early in pregnancy can cause birth defects and serious problems for the infant and the mother, and many women of reproductive age are taking these medicines and may not know they are pregnant and therefore may be unknowingly exposing their unborn child. "
According to the CDC it is critical for health care professionals to take a thorough health assessment before prescribing these medicines to women of reproductive age.
The CDC researchers analyzed 2008-2012 data from two large health insurance claims data sets: one of women aged 15-44 years with private insurance and another of women in the same age group enrolled in Medicaid. They found that on average, 39 percent of Medicaid-enrolled women filled an opioid prescription from an outpatient pharmacy each year compared to 28 percent of women with private health insurance.
Previous studies of opioid use in pregnancy suggest these medications might increase the risk of neural tube defects, congenital heart defects and gastroschisis. There is also a risk of neonatal abstinence syndrome (NAS) from exposure to medications such as opioids in pregnancy. NAS is when a newborn experiences symptoms of withdrawal from medications or drugs taken by a mother during pregnancy.
The CDC's National Center on Birth Defects and Developmental Disabilities is working to provide better information to women and their health care providers about medication use during pregnancy through its Treating for Two: Safer Medication Use in Pregnancy initiative. Follow the link below for additional information.
Review of Joint Commission New and Revised Elements of Performance for Diagnostic Imaging Services, Effective July 1, 2015 â€“ Part Four
This is the fourth in a series of StayAlert! Notices' reviewing The Joint Commission's (TJC) recently released new and revised elements of performance (EPs) for their Diagnostic Imaging Services requirements. The changes are applicable to accredited hospitals, critical access hospitals and ambulatory health care facilities that provide diagnostic imaging services and are effective July 1, 2015.
TJC has added elements of performance to Human Resources Standard.01.05.03 for hospitals and critical access hospitals. This standard requires organizations to ensure that staff participate in ongoing education and training. New EP's for this standard require that:
- The organization verifies and documents that ongoing training and education for technologists who perform diagnostic computed tomography (CT) examinations includes the following:
o Radiation dose optimization techniques and tools for pediatric and adult patients addressed in the Image Gently® and Image Wisely® campaigns.
o Safe procedures for operating each type of CT equipment the technologist will use.
- The organization verifies and documents that technologists who perform magnetic resonance imaging (MRI) examinations participate in ongoing education that includes annual training on safe MRI practices in the MRI environment, including:
o Patient screening criteria that address ferromagnetic items, electrically conductive items, medical implants and
devices, and risk for Nephrogenic Systemic Fibrosis (NSF).
o Techniques to avoid thermal injuries including proper patient and equipment positioning.
o MR safe or MR conditional equipment and supplies.
o MRI safety response procedures for patients who require urgent or emergent medical care.
o MRI system emergency shutdown procedures, such as MRI system quench and cryogen safety procedures.
o Patient hearing protection.
o Management of patients with claustrophobia, anxiety, or emotional distress.
Included with today's notice are example policies that reflect these changes.
Featured Policy Library Manuals
MCN’s Utilities and Equipment Management Policy and procedure Manual is a reference guide that is compliant with Joint Commission, NIAHO and CIHQ standards and CMS regulations. MCN provides easy-to-use policies and procedures that are field tested and proven - you need only to customize them to your healthcare organization. Policies and procedures include Utility Systems Management Plan, Alternative Equipment Maintenance Program, Clinical Alarms, Emergency Power and much more!Read more »
MCN Healthcare’s Administrative Manual for Critical Access Hospitals is specifically designed to assist critical access hospitals meet CMS, TJC and NIAHO standards for CAHs. This manual provides over 275 ready-to-implement policies, procedures and forms in an easy-to-customize Word format, and is designed to demonstrate compliance with CAH regulations. Transplant Safety polices are also included in this manual.Read more »
MCN's NEW Ambulatory Surgical Center/Outpatient Surgery Department Policy and Procedure Manual is cross referenced to TJC standards, AAAHC standards and CMS regulations. Policies and procedures meet AORN and CDC recommendations and guidelines. This comprehensive reference guide has over 290 policies and procedures that are ready to customize to your organization. See also the Administrative Manual for Ambulatory Care Facilities and the Ambulatory Services EOC Manual.Read more »