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WASHINGTON, D.C. -- Hospitals striving to increase handwashing compliance among their healthcare workers will soon receive good news from the Centers for Medicare and Medicaid Services (CMS). A CMS regulation prohibiting the placement of alcohol-based hand sanitizers in exit corridors is due to be lifted, according to a letter from CMS to the Association for Professionals in Infection Control and Epidemiology (APIC).
You have requested that CMS take action to ensure that alcohol-based hand rubs can be conveniently accessed in healthcare facilities, the CMS letter stated. We agree that alcohol-based hand rubs are a useful and effective infection control tool, and that convenient access to alcohol-based hand rubs is an important factor in encouraging their use.
The letter further explained that CMS officials have prepared an interim final rule with comment period to address this issue. The rule is now under review in the Department of Health and Human Services (HHS) and is scheduled for publication in the Federal Register on Dec. 23, 2004. Based on this scheduled publication date, the effective date of the rule will be Feb. 23, 2005. The letter goes on to mention, however, that until the revised regulation is published, the current regulation does remain in effect.
In a Sept. 22, 2004, letter to CMS, APIC had urged the agency to revoke its policy, in light of recent studies proving that alcohol-based hand products (formerly considered to be a fire hazard) could indeed safely be installed in exit corridors.
As an organization of professionals dedicated to preventing and controlling healthcare-associated infections, we consider these wall-mounted dispensers absolutely critical for assuring improved access and compliance with recommended hand hygiene practices, the APIC letter stated.
In October 2002, the Centers for Disease Control and Prevention (CDC) issued recommendations stating that alcohol-based hand rubs may be a better option than traditional handwashing with plain soap and water. However, the outdated CMS policy made ensuring optimal access to these products a particular challenge.
We are hopeful that CMS will choose to play an active and collaborative role in markedly improving healthcare by updating this policy to assure consistency with recommendations from CDC. Failure to take immediate action may significantly jeopardize patient safety in hospitals nationwide, the APIC letter continued.
The news from CMS comes at a pivotal time when facilities are gearing up their efforts toward flu prevention. This is an important step in the right direction and at the right time when every opportunity to make hand hygiene easier matters, said APIC member Judene Bartley, MS, MPH, CIC, who played a key role in the overall effort to demonstrate the safety of these products and to change federal policy to ensure their ready access.
Bartley also serves as liaison to the American Society for Healthcare Engineering, which commissioned the study that provided the necessary data to support the Life Safety Code changes, and subsequently worked to modify the code. We are thrilled that CMS understands the critical nature of this issue and that the agency is moving forward to change this policy based on solid data, said Bartley. She noted that the efforts of many brought this about, beginning with the AHA- and CDC-sponsored stakeholders meeting in July 2003 that brought clinicians and fire safety professionals together to determine how they could effect this important change.
In the meantime, infection control professionals should continue to contact their local jurisdiction if their facility is cited for having dispensers in corridors. States vary in their approach, but CMS has been recommending that if facilities are cited for this deficiency, they should request a temporary waiver from enforcement action in their plan of correction.