Question

After surveillance detected a Hepatitis C outbreak from a private physician's use of contaminated multi-use medication vials, the New York City Department of Health and Mental Hygiene was able to intervene because:

		local health departments regulate the practice of medicine in their communities.
		The physician's infection control practices posed an imminent risk to health making his practice a public health nuisance and health departments have the power to order that nuisance conditions be abated.
		The New York State Office of Professional Medical Conduct was busy with other matters and told the City's health department to deal with it.
		The health department could do nothing but alert the physician to the problem and hope that he took steps to improve his infection control techniques.

Answer 1

Hepatitis C Virus (HCV) is transmitted primarily through percutaneous (parenteral) exposure that can result from needle-stick injuries or contamination of multiple-dose mediaction vials, injection-drug use, primarily reuse of syringes and inadequate infection control in health care settings. Sometimes, HCV transmission occurs among HIV-positive persons, as a result of sexual contact with an HCV-infected partner, among persons who acquired non-professionally applied tattoos and among infants born to HCV infected mothers.

In May 2001, The New York City Department of Health and Mental hygiene was informed of a cluster of 4 patients managed at an outpatient gastroenterology centre who developed acute hepatitis C virus (HCV) infection. An investigation recognized a total of 12 clinic-associated hepatitis C virus transmissions and the outbreak and was find to unsafe handling of multidose anesthetic vials and possible re-use of contaminated needles. This report represent the types of outbreaks that pursue to occur despite safe injection guidelines.

Health care-associated infections (HAI) are considered an undesirable outcome, and as some are preventable, they are considered an indicator of the quality of patient care, an adverse event and a patient safety issue. Nurses can lower the risk for infection and colonization using evidence-based aseptic work practices that decrease the entry of exogenous or endogenous organisms via invasive medical devices.