The end of November is traditionally a time for introspection as we count our blessings at the Thanksgiving table. We're particularly thankful for the sacrifices made by our troops overseas, especially those who are away from their families during the Holidays. With this in mind, National is once again proud to support Operation Iraq-Afghanistan: The Spirit of Christmas by making a donation to help fill over 5,000 Christmas stockings for children with a parent serving in Iraq or Afghanistan. Continuing in this spirit of gratitude, instead of our usual "fun facts" section, this month we bring you a list of reasons to be thankful. The author is unknown, but all of us were humbled as we read down the list.

Many of us are thankful for our good health, at this time of year maintained by watching out for the many sources of bacteria we come across in our daily lives. Recent research from Johns Hopkins Hospital alerted us of a potential bacteria source we'd never considered before - find out the surprising culprit in our article. This month's second article reports on proposed changes to HIPPA's Privacy Rule and their impact on patients and healthcare organizations.

Right after our Thanksgiving break, here at National we traditionally begin to gear up for the Holidays. We've already decorated our Christmas tree and filled every inch of the building with festive trimmings - now we're looking forward to Secret Santa gifts and our annual Christmas luncheon. As you plan for the Holidays, don't forget to call National with your coverage needs!

Stephen Read, President
National Anesthesia Services, Inc. and National Physician Staffing, Inc.

"No matter how good or bad you think your life is, wake up each day and be thankful. Someone somewhere is fighting to survive."

---- Author Unknown

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As some of you know we have been donating to Operation Iraq-Afghanistan "The Spirit of Christmas" since 2007. This year, the organization received good news that there is a downsized presence of US Troops overseas and that last year there was surplus of packages sent to the soldiers on the front lines. This news has given the organization the opportunity to switch their focus to supporting the families here at home.

National was able to contribute a monetary donation to this year's campaign, "Bringing the Spirit of Christmas to the Families of Our Real American Heroes." Our donation will assist the organization in their transition to serving the families and children of the servicemen/women serving on the front lines. The goal of the campaign is to fill over 5,000 Christmas stockings and truly bring "The Spirit of Christmas" to the children.

For a follow up on the success of this year's campaign, be sure to check out the upcoming editions of National News. For more information on the organization Operation Iraq-Afghanistan, please visit http://operationiraq.org/.

Hands-free faucets are more likely to be contaminated with harmful bacteria than manual fixtures, say researchers at Johns Hopkins Hospital in Baltimore.

The researchers discovered Legionella bacteria "between 0 and 3,000 bacterial colony forming units per milliliter of water" growing in half of the cultures taken from 20 automatic faucets, which dispense preset amounts of water when staff place their hands in front of electronic-eye sensors. The bacteria, however, were present in only 15% of cultures taken from 20 standard faucets with separate handles for hot and cold water. Researchers discovered half the amount of bacteria of any kind in the manual faucets compared to the automatic ones.

At a loss to explain the discrepancy, the researchers point to the inability of public utility disinfection treatments to work fully on the automatic faucets' complex valves. Regardless of why bacteria tends to colonize more in newer fixtures, hospital officials replaced the 20 automatic faucets recently installed in Hopkins's patient care areas and opted for 1,080 traditional fixtures in the facility's East Baltimore expansion site currently under construction.

Emily Sydnor, MD, lead investigator of the study and a fellow in infectious diseases at Johns Hopkins, says Legionella bacteria rarely cause illness in healthy people but pose a real risk of infection in hospital patients with weakened immune systems. She was encouraged that the electronic faucets were used up to 110 times each day, because it showed "staff are actually washing their hands so frequently." However, she says automatic faucets "may not be the best option to aid our staff in protecting our patients from potential risk of infection."

The study's take-home message, according to Lisa Maragakis, MD, MPH, director of hospital epidemiology and infection control at Johns Hopkins: Newer isn't always better. She says caregivers should know that "new devices, even faucets, however well intentioned in their make-up and purpose, have the potential for unintended consequences, which is why constant surveillance is needed."

---Daniel Cook
www.outpatientsurgery.net

Patients would have the right to request and receive a record of who accessed and viewed their electronic protected health information in a proposed change to the Health Insurance Portability and Affordability Act's Privacy Rule.

Under HIPAA, healthcare organizations are already required to track access to patient data contained in electronic records, but they're not required to disclose this access information to patients. The proposed rule change, part of the Department of Health and Human Service's implementation of the 2009 HITECH Act, "represents an important step in our continued efforts to promote accountability across the health care system, ensuring that providers properly safeguard health information," says HHS Office of Civil Rights Director Georgina Verdugo in a press release.

The proposal, currently up for public comment, would give patients the right to 2 types of information:

-an "access report," which would tell them who has accessed their protected health information "for purposes of treatment, payment and health care operations" in general, but would not divulge the specific purposes for each person's access; and

-an "accounting of disclosures" that would provide more detailed information about disclosures "most likely to impact the individual," such as disclosures to law enforcement or legal authorities, as well as the purposes of such disclosures.

If the rule takes effect as written, healthcare organizations would have to update the HIPAA privacy notices they give to patients, beginning Jan. 1, 2013, to inform them of these rights and how they can go about requesting access reports, reports Medscape Medical News, quoting an anonymous HHS spokesperson.

"The changes being proposed will impact physicians," says the spokesperson. "We strongly encourage them to read the rule in the Federal Register and give us their feedback during the comment period. We want to hear from small and mid-sized providers on what they expect the impact will be on their practices."

HHS notes that "only a small minority of individuals" tend to exercise their right to an accounting of protected health information disclosures and that healthcare organizations are already required to log all the information that would be contained in an access report, so "there should be minimal, if any, changes to existing information systems." The proposal also shortens the length of time for which providers must account for disclosures from 6 years to 3 years.

---Irene Tsikitas
www.outpatientsurgery.net

General Disclaimer: The materials have been compiled by National Anesthesia Services. Inc. from internal and external sources. However, while we have attempted to provide accurate information in this publication, no representation is made or warranty given as to the completeness or accuracy of the Materials. In particular, you should be aware that the Materials may be incomplete, may contain errors, or may have become out of date. You should therefore verify information obtained from this publication before you take any action upon it.