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While the 39 federal class action lawsuits filed this year are based primarily on nonprofit hospital billing and collection practices, questions about the tax-exempt status of nonprofit hospitals have been litigated in local and state courts in recent years. Pennsylvania was a hotbed for such litigation a few years ago but now is relatively quiet.
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If infectious disease specialists used a color-coded alert system, the color would be on yellow, for elevated. And its edging up to orange. While the threat of severe acute respiratory syndrome (SARS) has subsided, public health experts are becoming increasingly concerned about the potential for pandemic influenza coming from a highly pathogenic avian influenza strain in Asia.
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The battle over annual fit-testing isnt over yet. The U.S. Occupational Health and Safety Administration (OSHA) rule became effective on July 1, but two weeks later, the House appropriations committee approved an amendment that would prohibit OSHA from spending funds to enforce annual fit-testing.
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It took eight months for the supervisor in the hospitals pharmacy to realize that she and most of her co-workers had a persistent cough. That revelation began an employee health investigation, with employee health nurse Janet Abernathy, RN, COHN-S, on the trail of an indoor air culprit.
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Once a year, hospitals roll out the influenza campaign and try to immunize as many health care workers as possible. But therein lies a problem. Once a year may not be enough.
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An analysis of health care workers who cared for avian influenza patients in 1997 revealed that eight exposed health care workers became antibody-positive, demonstrating human-to-human transmission. One developed mild respiratory symptoms, and the rest were asymptomatic.
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All patients who present to a health care setting with fever and respiratory symptoms should be managed according to recommendations for respiratory hygiene and cough etiquette and questioned regarding their recent travel history.
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If youre looking for a silver lining to requirement for annual respirator fit-testing, look to California. That trendsetting state has begun discussions on an airborne biologic hazards standard.
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The death of a Virginia nurse who ignored her symptoms of tuberculosis for months and continued to work serves as a cautionary reminder for hospitals and health care workers: TB remains a risk in many states. Untreated infection can lead to a TB outbreak and even death. And health care workers who go to work sick may be endangering their patients.
