HOUSE JOINT MEMORIAL 25

51st legislature - STATE OF NEW MEXICO - first session, 2013

INTRODUCED BY

Elizabeth "Liz" Thomson

FOR THE LEGISLATIVE HEALTH AND HUMAN SERVICES COMMITTEE

A JOINT MEMORIAL

REQUESTING CERTAIN BOARDS OF HEALTH CARE PROFESSIONS TO ADOPT CONTINUING EDUCATION REQUIREMENTS THAT INCLUDE PERIODIC REVIEW OF STANDARD PRECAUTIONS AND SAFE INJECTION PRACTICES AS A CONDITION OF ISSUANCE AND RENEWAL OF LICENSURE OR CERTIFICATION.

     WHEREAS, according to the federal centers for disease control and prevention, the hepatitis C virus is an increasing cause of morbidity and mortality in the United States; and

     WHEREAS, the hepatitis C virus can cause liver damage, liver cancer and even death if untreated, and it is the single leading cause of liver transplantation in the United States; and

     WHEREAS, New Mexico has the highest rate of deaths due to chronic liver disease and cirrhosis in the nation; and

     WHEREAS, the hepatitis C virus is ten times more prevalent than the human immunodeficiency virus in New Mexico, and a 2002 university of New Mexico study of emergency room admissions found that seventeen percent of patients were infected with the hepatitis C virus; and

     WHEREAS, many of the two million seven hundred thousand to three million nine hundred thousand persons in the United States living with the hepatitis C virus are unaware that they are infected and do not receive care and treatment; and

     WHEREAS, fewer than ten percent of those infected with the virus develop acute disease, characterized by the sudden onset of symptoms; and

     WHEREAS, those who do become symptomatic may do so weeks or months after infection; and

     WHEREAS, the centers for disease control and prevention estimates that persons born between 1945 and 1965 comprise three-fourths of all cases of hepatitis C virus infection in the United States, and it has recently recommended one-time testing for these persons without prior ascertainment of risk; and

     WHEREAS, the hepatitis C virus is spread through blood-to-blood contact and not through household or casual contact, and

at room temperature, the virus can survive on surfaces for from sixteen to ninety-six hours; and 

     WHEREAS, in 2008, unsafe injection practices at a small endoscopy center in Las Vegas, Nevada, caused an outbreak in Nevada that potentially exposed over sixty thousand patients to hepatitis C virus; and

     WHEREAS, unsafe injection practices include reuse of syringes for multiple patients or to access shared medications; administration of medication from a single-dose, single-use vial to multiple patients; and failure to use aseptic techniques when preparing and administering injections; and

     WHEREAS, Nevada public health officials estimated that the investigation, response and community testing associated with the 2008 outbreak cost between sixteen million dollars ($16,000,000) and twenty million dollars ($20,000,000); and

     WHEREAS, following the Nevada outbreak, Nevada's health division strongly advised that physicians and other health care providers undergo periodic mandated education in proper infection control procedures; and

     WHEREAS, Nevada currently requires certain categories of health care professionals to attest to their respective professional boards that they have knowledge of and comply with centers for disease control and prevention infection control guidelines, including safe injection practices; and

     WHEREAS, according to the centers for disease control and prevention, many outbreaks occur when health care workers do not adhere to fundamental principles related to safe injection practices, suggesting that those workers fail to understand the potential for their actions to lead to disease transmission; and

     WHEREAS, centers for disease control and prevention experts studying hepatitis C virus outbreaks in non-hospital settings have concluded that many outbreaks go undetected and that those that are discovered represent the "tip of the iceberg"; and

     WHEREAS, centers for disease control and prevention evidence-based guidelines define safe injection practices under "Standard Precautions", and since the publication of these guidelines in 2007, the centers for disease control and prevention is aware of at least nineteen outbreaks associated with single-dose, single-use medication involving bloodborne pathogens and bacterial infections, with a majority of patients requiring hospitalization; and

     WHEREAS, all of these outbreaks arose in outpatient settings; and

     WHEREAS, to prevent the transmission of bloodborne viruses, the centers for disease control and prevention recommends certification and training in infection control principles and practices, including aseptic techniques and safe injection practices; and

     WHEREAS, in addition, the centers for disease control and prevention recommends frequent in-service education and oversight by management of outpatient settings to detect and correct breaches in infection-control practices; and

     WHEREAS, state boards of health care professions are authorized to establish and adopt continuing education requirements for their respective licensees and for persons whom they certify; and

     WHEREAS, the centers for disease control and prevention's guidelines and educational materials on safe injection practices are accessible through the its web site, and, in fact, a new free continuing education and continuing medical education course entitled, "Unsafe Injection Practices: Outbreaks, Incidents and Root Causes", is available through Medscape, an accredited continuing medical education provider;

     NOW, THEREFORE, BE IT RESOLVED BY THE LEGISLATURE OF THE STATE OF NEW MEXICO that the board of optometry, board of nursing, New Mexico board of dental health care, board of pharmacy, New Mexico medical board, board of osteopathic medical examiners, board of podiatry and board of acupuncture and oriental medicine be requested to establish and adopt continuing education requirements for their respective licensees and for persons whom the boards certify, to include periodic review of centers for disease control and prevention guidelines for "Standard Precautions and Safe Injection Practices", no later than July 1, 2013; and

     BE IT FURTHER RESOLVED that those boards be requested to report on continuing education requirements adopted for their respective licensees and for persons whom the boards certify to the legislative health and human services committee no later than July 1, 2013; and

     BE IT FURTHER RESOLVED that copies of this memorial be transmitted to the board of optometry, board of nursing, New Mexico board of dental health care, board of pharmacy, New Mexico medical board, board of osteopathic medical examiners, board of podiatry and board of acupuncture and oriental medicine and to the superintendent of regulation and licensing.

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