Small Equipment DisinfectionTAG F<strong>441</strong> COMPLIANCE AIDResident-care devices (e.g., electronic thermometers or glucose monitoring devices)may transmit pathogens if devices contaminated with blood or body fluids are sharedwithout cleaning and disinfecting between uses for different residents.Reducing and/or preventing infections through indirect contact requires thedecontamination (i.e., cleaning, sanitizing, or disinfecting an object to render it safefor handling) of resident equipment, medical devices, and the environment.<strong>Medline</strong> offers three proven solutions for disinfection. All meet CMS/CDC/OSHAguidelines for 1:10 bleach solution (equivalent to 0.5 to 0.6% sodium hypochlorite)for clinical effectiveness. All products below are registered with the EPA.Dispatch ® hospital cleaner towels with bleach save you from mixingyour own 1:10 bleach dilution daily (as OSHA recommends). Anindividually wrapped towel or one from the 60-count soft pack will“wet cover” about 10 square feet for a one-minute count.The 150-count pop-up towel will cover about 18 square feet.CLH69150 Canister, 150/can, 8 can/csCLH69260 Soft Pack 60/pk, 12 pk/csCLH69101 Individually Wrapped 50/bx, 6 bx/csClorox ® , long the standard in one-step disinfecting, produces hospitalgradewipes with a 0.55% sodium hypochlorite disinfectant. Packedin a 70-count pop-up tub, the wipes are heavier and stronger thanmost on the market. Tested for compliance with safety, efficacy, shelflife and label strength standards.CLO35309 Canister 70/can, 6 can/csGluco-Chlor ® is designed specifically for disinfecting glucose metersand other bedside test equipment. 3” x 3” lint free wipes arenon-abrasive and compatible with delicate optical components.Super-Chlor ® wipes use the same 0.525% ClNaO solution in alarger wipe (9” x 9” or 12” x 12”) for larger surfaces.MOIGC110 Gluco-Chlor Wipe 3"x3" 100 pk/bx, 12 bx/csMOIGC110Z Gluco-Chlor Wipe 3"x3" 100 pk/bxMOISC110 Super-Chlor Wipe 9"x9" 100 pk/bx, 8 bx/csMOIGC112 Super-Chlor Wipe 12"x12" 50 pk/bx, 8 bx/cs<strong>Compliance</strong> aid is one phone call away. Order your disinfection wipes from <strong>Medline</strong> today.1-800-MEDLINE or medline.com.<strong>Medline</strong> is a registered trademark of <strong>Medline</strong> Industries, Inc. Dispatch is a registered trademark of Caltech Industries, Inc.Clorox is a registered trademark of The Clorox Company. Gluco-Chlor and Super-Chlor are registered trademarks of Medtrol, Inc.
Focus onInfectionControlUnderstanding the New F-<strong>Tag</strong> <strong>441</strong> RequirementsIf you’re confused about the Centers for Medicare & Medicaid Services(CMS) revised F-<strong>Tag</strong> <strong>441</strong> requirements regarding shared medical devices –particularly glucose meters – you’re not alone.Although every infection preventionist, healthcare worker, administrator andregulatory surveyor certainly would prefer long-term care facilities to providededicated medical equipment for each resident, they also realize this can becost prohibitive. Therefore, CMS and the CDC guidelines allow for thesharing of durable medical equipment – such as glucose meters – as longas it is properly cleaned and disinfected between every patient use.By Lorri A. Downs, RN, BSN, MS, CIC,Vice President of Infection PreventionWhy are the regulatory eyes of CMS looking so closelyat cleaning and disinfection?Healthcare-associated infections are a major concern, andgerms are commonly transmitted from person to person viamedical devices. The new F-<strong>Tag</strong> <strong>441</strong> states: 1“Infections are a significant source of morbidity andmortality for nursing home residents and account for up tohalf of all nursing home resident transfers to hospitals.Infections result in an estimated 150,000 to 200,000hospital admissions per year at an estimated cost of $673million to $2 billion annually. When a nursing home residentis hospitalized with a primary diagnosis of infection, the deathrate can reach as high as 40 percent. It is estimated that anaverage of 1.6 to 3.8 infections per resident occur annuallyin nursing homes.”Reducing and/or preventing infections acquired throughindirect contact with surfaces or medical equipment requiresdecontamination (cleaning, sanitizing or disinfection) prior toexposing a different resident to the particular piece ofmedical equipment.When devices are shared, staff training and education iscrucial to ensure proper infection control. One commonbarrier is lack of clear delegation of equipment cleaning tasks.If the responsibility is left to everyone, often no one ends upperforming the cleaning task. Healthcare workers are busyand simply assume another staff member completed thissimple but critical task.How has F-<strong>Tag</strong> <strong>441</strong> changed?As mentioned earlier, CMS is especially concerned aboutinfection control due to the rising rates of healthcare-acquiredconditions. They have combined all F-<strong>Tag</strong>s related toinfection control (i.e., F-<strong>Tag</strong> <strong>441</strong>, 442, 443, 444 and 445) intoone location under F-<strong>Tag</strong> <strong>441</strong> to make these guidelines moreaccessible. F-<strong>Tag</strong> <strong>441</strong> is now the “one-stop-shop” forinfection control requirements.The revisions to F-<strong>Tag</strong> <strong>441</strong> are based in part on a Centers forDisease Control and Prevention (CDC) report describingseparate outbreaks of hepatitis B virus (HBV) linked to thesharing of blood glucose monitoring equipment at long-termcare facilities in Mississippi, North Carolina and California. 2Investigators suggest that recommendations concerningstandard precautions and the reuse of fingerstick deviceshave not been adhered to or enforced consistently inlong-term care settings. The potential for devices to carrybloodborne pathogens and multidrug resistant bacteria andviruses (if the device is not cleaned between every use) iswell-documented in the CDC report. For a copy of thereport, go to www.cdc.gov/mmwr/preview/mmwrhtml/mm5409a2.htm. Ultimately the safety of your residents andemployees is at the core of most of the rules and regulationssurrounding infection control. Yet it can be challenging tokeep up with all the regulatory changes. Implementingroutine processes will increase your staff’s knowledge andawareness, along with the assurance that clean care really issafer care.How will this regulatory change affect long-term carefacilities?Regulatory inspections will be more frequent, and facilitiesthat are 1.) cited with severe non-compliance with the new