RE: Re: Hot Pack Covers and oximeters

[Guest guest]

Hi Steve,

The agency's stand on pulse oximetry was so, for lack of anything better

this morning, ridiculous, that I started doing a general search on it.

First of all, even the FDA considers it " non-invasive " and all I could find

regarding pulse oximetry and Medicare is that they stopped paying for it as

a stand alone treatment.

This is another case of " show me the regulations " because I have never heard

nor can find in a search, that what they are saying is true.

For those having trouble with TJC or any other regulatory body, remember the

reviewers are as human as everyone else and prone to errors. The guidelines

they get are many times very open to interpretation. On top of that, you

have a national push to reduce nosocomial infections and medical errors.

The reality is unless you do everything under sterile conditions, the

infections will keep happening and no hospital or facility can afford to do

everything under sterile conditions. The best we can do is reduce the risk

as much as possible and the only way to do that is through evidence.

The most constructive way to respond may be to do your own study with your

infection control department and see if contamination occurs. If it does

then, like gait belts, departments will have to launder hot pack covers

after each use

M.Howell, P.T., M.P.T.

IPTA Payment Specialist

Meridian, Idaho

thowell@...

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From: PTManager [mailto:PTManager ] On Behalf

Of Steve Passmore

Sent: Friday, June 22, 2012 9:33 PM

To: PTManager

Subject: RE: Re: Hot Pack Covers

Not to sound sarcastic. but maybe JCAHO needs to start and Evidenced Based

Approach. Coming up with rules with no data is just contrary to

conventional practice and common sense. It's one thing to suspect and

investigate (or even a temporary rule) but this practice has been in effect

since loooooong ago and has never been called into question. Next step is

wearing protective suit to even touch a patient (yes I suspect someone is

writing a rule on that one now).

On a separate issue, I just purchased a pulse oximeter so I could have the

option to check the O2 level with some fatigued patients on a home health

eval/re-check. I was told by the Home Health Agency that I could not record

this in the medical record without a physician order. Medicare considers

this an " invasive procedure " even though I was using the finger clip method.

We have an order for vitals and I thought this would be covered in that

section. I realize this is not something that is needed often in a typical

population but I was surprised with the classification. Has anyone else had

this as an issue? Would I jeopardize payment by recording this?

Steve Passmore PT, MS (soon to be DPT)

Healthy Recruiting Tools

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From: PTManager <mailto:PTManager%40yahoogroups.com>

[mailto:PTManager <mailto:PTManager%40yahoogroups.com> ] On

Behalf

Of Effie_Elliott@... <mailto:Effie_Elliott%40Bayhealth.org>

Sent: Friday, June 22, 2012 1:16 PM

To: PTManager <mailto:PTManager%40yahoogroups.com>

Subject: Re: Hot Pack Covers

Kirk -

I just came across your post about hot pack covers in PT Manager.

Ironically, we just had an internal mock JC tracer survey, and were told

by a survey team member from Infection Prevention that we could not re-use

our hot pack covers and that having 6 - 8 layers of toweling between the

hot pack and the patient did not prevent " germs " from seeping through to

come in contact with the patient's skin!

We are hard put to come up with a solution. I have been a PT for a

looooooooooooong time and have never known of a patient becoming infected

from a hot pack treatment appropriately applied.

The question also came up about how and when are the hot pack covers

laundered.

Let me know if you have come up with any creative solutions, or if there

is anyone who has recently gone through a JC survey and experienced a

challenge to the hot pack covers!

Thanks,

Effie

Effie Elliott, PT, DPT

Director, Rehabilitation Services

Bayhealth Medical Center

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