1. CMS administrator to step down at the end of February.
Modern Healthcare reports that U.S. Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner has announced her resignation from the agency, to take effect at the end of February. Observers say that, given the history of the position and the current political environment, it may be difficult for President Obama to have a permanent CMS administrator confirmed for the remainder of his time in office. Andy Slavitt, formerly a UnitedHealth Group executive who is now principal deputy administrator, is expected to be named as acting administrator when Ms. Tavenner steps down. Read more…(registration may be required)
Read the farewell letter to CMS staff (PDF)…
2. CDC reports progress in reducing HAIs, but more work needs to be done.
According to a report from the U.S. Centers for Disease Control and Prevention (CDC), significant progress has been made in reducing the incidence of healthcare-associated infections (HAIs), but progress has fallen short of goals. Among the findings of the report:
A 19 percent decrease in surgical site infections related to 10 select procedures tracked between 2008 and 2013
An 8 percent decrease in hospital-onset methicillin-resistant Staphylococcus aureus bacteremia between 2011 and 2013
A 10 percent decrease in hospital-onset Clostridium difficile infections between 2011 and 2013
A 6 percent increase in catheter-associated urinary tract infections between 2009 and 2013 (although data suggest a possible recent decreasing trend)
“More action is needed at every level of public health and health care to improve patient safety and eliminate infections that commonly threaten hospital patients,” the authors write. Read more, with related links…
Read the complete report (PDF)…
3. Non-sterile IV training products administered to patients; FDA urges providers to check labels before use.
The U.S. Food and Drug Administration (FDA) states that some Wallcur simulated intravenous (IV) products have been distributed to healthcare facilities and administered to patients. Such products are not sterile and should not be injected in humans or animals. The agency notes that more than 40 patients have received infusions of the simulated saline products, and many adverse events including fever, chills, tremors and headache have occurred associated with these incidents. Some patients were hospitalized, and one death is associated with the use of these products. However, it is not known if this death is directly related to the use of the product. The agency states that, before administering IV solutions to patients, healthcare providers should carefully check the labels to ensure that the products are not training products. Read more…
4. NIH calls for further research into efficacy and use of opioids for chronic pain.
A position paper released by the National Institutes of Health (NIH) finds little to no evidence for the effectiveness of opioid drugs in the treatment of long-term chronic pain. According to a seven-member panel convened by NIH, many of the studies used to justify the prescription of opioid pain relievers were either poorly conducted or of an insufficient duration. Among the authors’ recommendations:
Further research into multidisciplinary pain interventions, as well as risk identification and mitigation strategies
Electronic health records systems that incorporate decision support for pain management and facilitate export of clinical data to help identify benefits and harms of opioid use
The use of alternative study designs in addition to randomized trials
In the absence of definitive evidence, providers should follow current guidelines from professional societies regarding treatment with opioids
Read more…
Read the complete position paper…
5. Study: Misuse of prescription opioids plateaued or declined from 2011 to 2013.
Data published in the January 15 issue of The New England Journal of Medicine suggest that diversion and abuse of prescription opioid medications may be on the decline. The authors drew data from the Researched Abuse, Diversion, and Addiction-Related Surveillance (RADARS) System to examine trends in the United States regarding misuse of six prescription opioid analgesics: oxycodone, hydrocodone, hydromorphone, fentanyl, morphine, and tramadol. They found that prescriptions for opioid analgesics increased substantially from 2002 through 2010, but then decreased slightly from 2011 through 2013. RADARS System programs reported large increases in the rates of opioid diversion and abuse from 2002 to 2010, but rates flattened or decreased from 2011 through 2013, with the rate of opioid-related deaths rising and falling in a similar pattern. Reported nonmedical use did not change significantly among college students during the study period. Read more…
Read the complete study…
6. Device manufacturer agrees to make detailed trial data available to outside researchers.
The New York Times reports that Johnson & Johnson has agreed to make detailed clinical trial data on its medical devices and diagnostic tests available to outside researchers through a collaboration with Yale University. Some observers have noted that the agreement applies only to products approved for marketing since the beginning of 2014. In addition, because FDA does not require that all medical devices undergo clinical trials before approval, available data on some devices will be limited. Medtronic had previously allowed Yale University to evaluate data on its recombinant human bone morphogenetic protein-2 product, but the paper notes that this new agreement will mark the first time a device manufacturer has made study data available in a systematic way. Read more…
7. California.
The California Medical Association notes that the Medical Board of California has approved an amendment to the state’s administrative law to allow physicians assistants (PAs) to perform surgery without the immediate physical presence of a supervising physician. Under existing law, PAs may assist surgery under the supervision of a physician. Under a regulation that takes effect April 1, 2015, a PA may perform surgical procedures without the physical presence of the supervising physician in the operating room, if the physician is “immediately available” to the PA. Read more…
8. Help build a Safe and Accessible Playground in Las Vegas.
Join the AAOS on Tuesday, March 24, 2015, for the 16th annual Safe and Accessible Playground Build. This year’s project will take place at Palabra Viva Las Vegas church, starting at 8:30 a.m., and concluding with a ribbon-cutting ceremony at 2:30 p.m. Be a playground build sponsor or register as a build day volunteer. No experience is necessary to take part in this fun and rewarding activity!
Learn more and register…