"Cost becomes a huge barrier. If It's cheaper to have a multi-dose vial versus a single dose vial and throwing unused medication away, that's a hard thing in this culture of being green and saving and trying to do more with less," she said. "Larger facilities are funded and have resources to help with these efforts, but when care moves out to these alternative care settings, that's where perhaps there aren't infection preventionists and there may be care providers who may not be aware of these issues, that's where some of our bigger challenges happen."
Perz said that enforcement is becoming a more important component. "We've heard from people with the Centers for Medicare & Medicaid Services and the Joint Commission as to how they are more carefully reviewing infection practices as part of infection control and basic safety assessments when facilities are inspected," he said. "However, not all healthcare facilities in the U.S. are subject to that kind of review and oversight. So it's important to rely on educational outreach to get the message out."
The coalition makes numerous recommendations, including efforts to conduct better education of providers, develop medical tools that use "safety-by-design" concepts that make impossible or difficult to use the device unsafely, and evaluate safer practices and safety signals.