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Regulations and Other Requirements Affecting IC Programs Jan 2012 Regulations, Standards, and Other Requirements Affecting Infection Prevention and Control Programs How to Obtain Regulations, Documents and Resources Centers for Disease Control and Prevention (CDC) Document How to Obtain CDC Infection Control Practices Advisory CDC Infection Control in Healthcare Settings website Committee (HICPAC) Guidelines http://www.cdc.gov/hai/ National Institute for Occupational Safety and Health (NIOSH): Workplace safety and health information (e.g., respirators) National Healthcare Safety System Manual, forms and reports http://www.cdc.gov/niosh/ http://www.cdc.gov/nhsn Centers for Disease Control and Prevention National Healthcare Safety Network MS-A24 1600 Clifton Rd Atlanta, GA 30333 Clinician Outreach and Communication Activity -system through which CDC informs clinicians via weekly e-mail updates of recent changes to information health issues Sign up for the COCA email updates at http://www.bt.cdc.gov/coca HAI Prevention Tool-Kits: includes Policy, C.dif, CLABSI, Environmental cleaning, Long Term Care, MRSA, Norovirus, SSI, and CA-UTI http://www.cdc.gov/HAI/prevent/prevention_tools.html Centers for Medicare and Medicaid Services (CMS) Document How to Obtain CMS regulations: http://www.access.gpo.gov/nara/cfr/waisidx_01/42cf 42 CFR Part 483 – Requirements for States and r483_01.html Long Term Care Facilities (483.65 Infection Control) 7500 Security Boulevard Baltimore, MD 21244-1850 Ph: (877) 267-2323 CMS Regulation: 42 CFR Part 482— Conditions of Participation for Hospitals 42 CFR 482.42 Infection control www.cms.gov http://www.access.gpo.gov/nara/cfr/waisidx_01/42cf r482_01.html www.cms.gov State Operations Manual Appendices (contains links to survey requirements and interpretive guidelines for many healthcare settings) http://www.cms.hhs.gov/manuals/downloads/som10 7_appendicestoc.pdf Survey & Certification Focus on Patient Safety and Quality - Draft Surveyor Worksheets - https://www.cms.gov/Surveycertificationgeninf Regulations, Standards, and Other Requirements Page 2 of 5 Hospitals o/downloads/SCLetter12_01.pdf CMS Regulation: 42 CFR Part 416 Ambulatory Surgery Centers: 42 CFR 416.51 Infection control http://ecfr.gpoaccess.gov/cgi/t/text/textidx?c=ecfr&rgn=div5&view=text&node=42:3.0.1.1.3 &idno=42 State Operations Manual (SOM) Appendix L, Ambulatory Surgical Centers (ASC) Comprehensive Revision - Includes Surveyor Infection Control Worksheet https://www.cms.gov/SurveyCertificationGenIn fo/downloads/SCLetter09_37.pdf Flash Sterilization usage https://www.cms.gov/SurveyCertificationGenIn fo/downloads/SCLetter09_55.pdf California Department of Public Health (CDPH) Document Medical Waste Management How to Obtain Hospital Pollution Prevention Program Medical Waste Management - Nevada http://www.cdph.ca.gov/certlic/medicalwaste/P ages/default.aspx http://www.cdph.ca.gov/certlic/medicalwaste/P ages/HospitalPollutionPrevention.aspx http://ndep.nv.gov/bwm/special.htm Nevada Administrative Code 444.646 and 444.662 Department of Resources and Recycling (CA only) Document How to Obtain Disposal of pharmaceutical waste (multidose, http://www.calrecycle.ca.gov/HomeHazWaste/ etc) Medications/ Disposal of medical sharps in the community Food and Drug Administration (FDA) Document Medwatch FDA’s Medical Reporting Program (problems with drugs, devices, biologics except vaccines, medical foods) You can subscribe to FDA MedWatch email alerts and Safety Alert RSS feeds http://www.calrecycle.ca.gov/HomeHazWaste/ Sharps/ How to Obtain http://www.fda.gov/Safety/MedWatch/default.htm Ph: (800) 332-1088 Vaccine Adverse Event Reporting (VAERS) http://vaers.hhs.gov/index CPG Sec. 300.500 *Reprocessing of Single Use* Devices (CPG 7124-016) http://www.fda.gov/ICECI/ComplianceManuals/Comp liancePolicyGuidanceManual/ucm073887.htm Occupational Safety and Health Administration (OSHA) * Both CA and NV are independent states and must meet or exceed the NIOSH standards. Regulations, Standards, and Other Requirements Page 3 of 5 Document Regulations: Respiratory Protection 29 CFR. 1910.134 Respiratory Protection for TB 29 FR. 1910.139 Bloodborne Pathogens 29 CFR. 1910.1030 Ethylene Oxide 29 CFR. 1910.1047 Formaldehyde 29 CFR. 1910.1048 Hazard Communication 29 CFR. 1910.1200 Occupational Injury and Illness Recording and Reporting (29 CFR 1904) How to Obtain OSHA Home Page: www.osha.gov has links to compliance assistance, laws & regulations, compliance directives, training programs, slide sets, and other topics Compliance Directives: Compliance Directives Directory CPL 2-2.69 Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens (Nov. 27, 2001) CPL 2.106 - Enforcement Procedures and Scheduling for Occupational Exposure to Tuberculosis (Feb. 9, 1996) California specific information: http://www.ca- OSHA Training e tools See Hospital training e tool: http://www.osha.gov/SLTC/etools/hospital/index.html For OSHA regulations and compliance links: http://www.osha.gov/comp-links.html and click on the letter for the desired topic (e.g., click on "B" for bloodborne pathogens standard) osha.com/ http://www.dir.ca.gov/title8/5199.html Nevada specific information: http://dirweb.state.nv.us/OSHA/osha.htm See Nursing Home training e Tool: http://www.osha.gov/SLTC/etools/nursinghome/index. html See OSHA eTools and Electronic Products for Compliance Assistance: http://www.osha.gov/dts/osta/oshasoft/index.html#Po werPoint%20Presentations Disease Specific Recommendations RECOMMENDATIONS FOR THE PREVENTION AND CONTROL OF INFLUENZA CALIFORNIA LONG-TERM CARE FACILITIES Clostridium difficile Infections http://www.cdph.ca.gov/programs/hai/Document s/Influenza-Recommendations-LTCF-v.1211.pdf http://www.cdc.gov/mmwr/pdf/wk/mm61e0306. pdf Professional and Practice Standards APIC/CHICA-Canada Professional and Practice Standards Task Force. APIC/CHICA-Canada infection control and epidemiology: Professional and practice standards. American Journal of Infection Control 2008;36:385-9. Available at: www.apic.org under Guidelines and Standards section. Freidman C et al. Requirements for infrastructure and essential activities of infection control and epidemiology in out-of-hospital settings: A Consensus Panel report. American Journal of Infection Control 1999;27:418-30. Scheckler et al. Requirements for infrastructure and essential activities of infection control Regulations, Standards, and Other Requirements Page 4 of 5 and epidemiology in hospitals: A Consensus Panel report. Am J Infect Control 1998;26:47-60 . Other Standards, Accreditation Organizations and Resources Accreditation Association for Ambulatory Health Care (AAAHC) http://www.aaahc.org Accreditation program and resources for a variety of ambulatory care settings Advisory Committee on Immunization Practices (ACIP) http://www.cdc.gov/vaccines/recs/acip/default.htm Epidemiology and Prevention of Vaccine Preventable Diseases (“the Pink Book”) can be downloaded free of charge at : http://www.cdc.gov/vaccines/pubs/pinkbook/default.htm#download Vaccine Information Statements (VIS): http://www.cdc.gov/vaccines/pubs/vis/default.htm American Academy of Pediatrics (AAP) www.aap.org Report of the Committee on Infectious Diseases (“Red Book”) order from above or 141 Northwest Point Boulevard, Elk Grove Village, IL 60007-1098 American Institute of Architects (AIA) Guidelines for the Design and Construction of Hospitals and Health Care Facilities, 2010 – is available on their website. The 2010 is available for $168, and available in 3 formats. Public comment is open for the 2014 edition. Order from http://www.fgiguidelines.org/2010guidelines.html Association for Advancement of Medical Instrumentation (AAMI) Guidelines for decontamination and sterilization in hospitals and ambulatory care www.aami.org 1110 North Glebe Road, Suite 220, Arlington, VA 22201-4795| 703-525-4890 3M Infection Prevention Division Sterile U website http://3M.com/AttestSterileU online training for sterile processing personnel. Association for Professionals in Infection Control and Epidemiology (APIC) www.apic.org see links to resources 1275 K Street, NW, Suite 1000, Washington, DC 20005-4006 phone:202-789-1890 APIC Sierra – Chapter #44 Serving Northern CA from Turlock to Yreka and Northern Nevada in Reno, Sparks, Carson City, Gardnerville, Minden, Ely, and Elko areas. www.apicsierra.org California APIC Coordinating Council (CACC) Obtain State and local education activities Obtain status of State mandated regulations www.caapic.org Association of Perioperative Registered Nurses (AORN) Standards, recommended practices and guidelines for operating room practice www.aorn.org 2170 S Parker Road, Suite 300, Denver, CO 80231 (800) 755-2676 or (303) 755-6304 Commission on Accreditation of Rehabilitation Facilities Regulations, Standards, and Other Requirements Page 5 of 5 Independent accrediting association for rehabilitation facilities, home health care and substance abuse centers. http://www.carf.org/ Code of Federal Regulations To obtain federal regulations: http://www.firstgov.gov/ State regulations also available through this site Department of Transportation (DOT) Medical Waste Infectious Substance Packaging 49CFR.173.196 173.196 Category A infectious substances Exceptions 49CFR.173.134 Regulated Medical Waste Packaging 49CFR.173.197 To obtain: www.epa.gov The Joint Commission http://www.jointcommission.org/ Sign up for E-newsletters (Ambulatory Care Advisor, BHC Accreditation News, Home Care Bulletin, http://www.jointcommission.org/daily_update/joint_commission_daily_update.aspx, LTC Update, news releases) The jointcommission online is published every Wednesday. Accreditation program and resources for a variety of healthcare settings 2012 Survey Activity Guide http://www.jointcommission.org/assets/1/18/2012_Organization_SAG.pdf National Commission on Correctional Health Care http://ncchc.org Provides Standards for Health Services, Position Statements and Clinical Guidelines State and Local Regulations Obtain from legal department in your organization Medical waste handling and disposal falls under state and local regulations Many available on State Government and State Health Department Websites (too numerous to list here) State and local health departments can be accessed through CDC Website at http://www.cdc.gov/other.htm Information on Safe Needle Disposal for Home Care http://www.safeneedledisposal.org (Interactive map. Nevada map has an error and references Montana regulations); California information is accurate. NOTE: All websites accessed Dec. 31, 2011 Compiled by K. Arias, and updated by Harriette Carr