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40 QUALITY & ACCREDITATION Which 10 US States Have the Most Overworked Nurses? By Mary Rechtoris T here is a shortage of nurses throughout the U.S., with Hawaii boasting the few- est nurses per 1,000 residents. Using U.S. Census Bureau, FBI crime and Kaiser Family Foundation data, Medicare Health Plans compiled a list of states and U.S. regions boasting the highest percentage of overworked nurses. Here are the top 10 based on the number of nurses per 1,000 people: 1. Hawaii: 1.9 2. Utah: 5.7 3. Wisconsin: 5.8 4. Wyoming: 6.0 5. Washington, D.C.: 7.9 6. Washington: 7.9 7. North Carolina: 8.3 8. Oregon: 8.4 9. Nevada: 9.2 10. New Hampshire: 9.2 n 6 Key Findings on Healthcare-Acquired Infections at New Hampshire ASCs By Mary Rechtoris T he New Hampshire Department of Health and Human Services' public health services division released a report detailing the number of healthcare-acquired infections at New Hampshire ASCs in 2016. Here are six key findings: 1. Of licensed New Hampshire ASCs, 96 per- cent complied with HAI mandatory reporting laws. Only one ASC did not comply. 2. Compared to national data, state ASCs reported comparable infection rates for pro- cedures, including breast, hernia and open reduction of fractures. 3. Twelve ASCs reported instances of surgi- cal site infections. Of these, all had similar rates to national data. 4. New Hampshire ASCs had a 99.1 percent adherence rate, regarding ordering surgical IV antibiotic prophylaxis to prevent SSIs. 5. New Hampshire ASCs had a vaccina- tion coverage rate between 53.1 percent and 99.1 percent, compared to the overall state average of 83.3 percent for the 2016 to 2017 influenza season. New Hampshire fared better than the national average vac- cination rate of 76.3 percent. 6. For the 2016 to 2017 influenza season, 14 New Hampshire ASCs had mandatory influenza vaccination polices for healthcare personnel. n Safe Injection Practice Guidelines Remain Challenging for AAAHC-accredited Organizations — 3 Study Insights By Eric Oliver T he Accreditation Associa- tion for Ambulatory Health Care Institute conducted a benchmarking survey finding several ambulatory healthcare fa- cilities failed to meet national safe injection practice guidelines. Here's what you should know: 1. The voluntary benchmarking survey was launched to gain an understanding of compliance with national SIP guidelines. 2. AAAHC collected self-reported responses from 110 AAAHC- accredited ambulatory organi- zations between January 2017 and June 2017. Ninety of those organizations were ASCs or office- based surgery organizations. 3. Concerning ASCs and office- based surgery organizations: • AAAHC found 59 percent of organizations conducted a SIP risk assessment within the last 12 months; 88 percent of those organizations conducted SIP training annually, with 9 percent conducting training at least two times a year. • 91 percent of ASCs had a writ- ten sharp injury prevention program in place, 77 percent used sharps with engineered injury prevention. • 84 percent of organizations performed some sort of proper hand hygiene before adminis- tering an injection. • 68 percent of ASCs stored medication for injections in a designated area away from patient care and away from any potential blood, bodily fluid or contaminated equipment contact. • When obtaining medication from a single-or multi-dose vial, 77 percent of organizations disinfected the rubber septum of the vial with 70 percent alco- hol as well as used both a new sterile needle and syringe. • 77 percent of single-dose medications and 62 percent of prefilled syringes were discard- ed properly. AAAHC Institute Vice President and Senior Director Naomi Kuznets, PhD, said in a release, "Even the highest performing am- bulatory organizations can benefit from ongoing assessment of SIP and other standard practices as policies and requirements evolve over time. The Institute's studies and AAAHC educational resourc- es aim to assist organizations as they address disparities while ensuring patient safety." n

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