Cdc Expert Commentary - Protect cancer patients from infections

Hello, my name is Alice Guh, and I’m an infectious disease physician and medical officer in the Division of Healthcare Quality Promotion at the Centers for Disease Control and Prevention. I'm pleased to speak with you today as part of the CDC Expert Video Commentary Series on Medscape about a new Infection Control and Prevention Plan for Outpatient Oncology Settings just released by the CDC. As clinicians, we know that patients receiving chemotherapy are at risk for serious infections that may lead to hospitalization, disruptions in chemotherapy schedules, and in some cases, death. Each year more than one million cancer patients receive outpatient chemotherapy, radiation therapy, or both. However, outpatient oncology facilities may vary greatly in their attention to infection prevention. For example, in an oncology clinic in Nebraska, it was discovered that syringes were reused to access bags of saline that were shared among multiple patients. This unsafe practice led to the transmission of hepatitis C virus to at least 99 cancer patients, resulting in one of the largest healthcare- associated outbreaks of its kind. Unfortunately, lapses in basic infection control in oncology clinics have also resulted in a number of outbreaks of bacterial bloodstream infections such as the one that prompted the recent closure of a clinic in Mississippi. Oftentimes, these facilities did not have written infection control policies and procedures for patient protection. CDC has worked with partners to put together a basic infection control and prevention plan that can be used by outpatient oncology facilities to standardize and improve infection prevention practices. CDC's new Basic Infection Control and Prevention Plan for Outpatient Oncology Settings is based on CDC’s evidence-based guidelines as well as relevant guidelines from professional societies and is tailored for quick implementation in outpatient oncology facilities. The key components include the following: A brief review of what constitutes essential infection prevention, such as Standard Precautions and Transmission-based Precautions; References and links to the CDC’s Outpatient Infection Prevention checklist, CDC guidelines and source documents; and lastly, Key policies and procedures needed to meet minimal expectations of patient safety in an outpatient oncology setting. Some of these elements are: Using aseptic technique to access patients’ ports and adhering to safe injection practices when preparing and administering medications, including saline flushes and chemotherapy infusions. Focusing on high-touch surfaces when cleaning patient-care areas, such as patient chairs and IV poles in chemotherapy suites and exam tables in patient exam rooms. Practicing good hand hygiene, respiratory hygiene/cough etiquette, and triaging of patients upon entry to the facility, especially during periods of increased community respiratory virus activity. Oncology facilities that already have an infection control plan in place should use this plan to ensure that their policies and procedures include the essential elements. While this plan may essentially be used exactly “as is,” facilities may also choose to personalize it by adding the facility name and names of specific rooms, inserting titles or positions of designated personnel, and providing more detailed instructions where applicable. All healthcare settings, regardless of the level of care provided, must make infection prevention a priority. We at CDC hope that this plan will help achieve this goal for oncology settings. We urge outpatient oncology providers to use this plan to ensure that cancer patients are receiving the safe care that they expect and deserve. To review the complete Basic Infection Control and Prevention Plan for Outpatient Oncology Settings, follow the link or see the resources on this page. Thank you.