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Anesthetic Use

The Center for Medicare & Medicaid Services released an Interpretive Guideline on Anesthetic Use for Hospital Procedures. This guideline restricts injection of intravenous sedatives for procedures (including emergency intubation) to “qualified” practitioners, a definition that does not include critical care and emergency medicine nurses. The Critical Care Society Collaborative (CCSC) was concerned about this wording, as the intensivist may be the only qualified individual in the hospital at night. As such, he/she cannot delay intubation to wait for another practitioner and cannot effectively monitor sedation while preparing to perform the procedure. The Critical Care Societies Collaborative sent a letter in August 2010 to the Centers for Medicare & Medicaid Services (CMS) to express concern about guidelines governing anesthesia service. The Collaborative is urging CMS to clarify these guidelines, as they have been broadly interpreted to include administration of sedatives for procedures such as emergent intubation for mechanical ventilation.

HAI Awards

In 2011 the CCSC and the U.S. Department of Health and Human Services (HHS) launched a national awards program to motivate the healthcare community to achieve wide-scale reduction of healthcare-associated infections. Criteria is tied to national standards as outlined in the HHS Action Plan to Prevent Healthcare-Associated Infections.  The initial year of the program saw a tremendous response from the critical care community and awards will be distributed at each of the four societies annual clinical meetings. The first awards were presented in May of 2011 by Don Wright, M.D., M.P.H., Deputy Assistant Secretary for Health for Healthcare Quality, U.S. Department of Health and Human Services as shown below.  In addition to the presentations, selected award winners shared their strategy for success in this important area. The program concluded in 2013 and details regarding award recipients can be found here.

Patient Consent

Patient Consent in Quality Improvement Projects. The CCSC along with the National Association for Medical Directors of Respiratory Care and the Society of Hospital Medicine, worked together to urge the Office of Human Research Protections (OHRP) to reconsider a ruling that Michigan hospitals should have received patient consent when instituting an “ICU checklist” that had already been proven to reduce catheter infections. OHRP eventually agreed with the Collaborative’s view, and HHS went on to support, and even highlight, the check list as an effective tool for preventing these infections.