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Download Electronic Medical Records Minimizing Litigation Risks in the ER

This report examines three major EMR-related issues and suggests countermeasures to protect patients and minimize liability exposures.

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SORCE for Healthcare

CNA is proud to offer our School of Risk Control Excellence (SORCE®), world-class training to help healthcare institutions control their risk and manage their exposures.

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Published Monday, April 9, 2018

Healthcare-associated infections (HAIs) represent a serious threat to patient safety in all types of clinical settings. According to the Centers for Disease Control and Prevention, 722,000 HAIs occur annually in acute care hospitals alone, resulting in approximately 75,000 deaths.1 The annual rate exceeds 1 million HAIs when factoring in other settings across the U.S. healthcare system.2 Stemming the tide of HAIs requires in-service education of front-line staff on sources of infection, common pathogens and their prevention through universal infection control precautions.

Sources of HAIs
HAIs develop when bacteria, viruses, fungi or other pathogens invade the blood and/or tissues of patients while they are receiving treatment for other medical conditions. HAIs are commonly associated with:

  • Surgical procedures
  • Prolonged and/or inappropriate use of medical devices
  • Heavy antibiotic dosing
  • Unsafe injection practices
  • Immunocompromised and/or other chronic underlying conditions
  • Contact with infected carriers
  • Substandard environmental hygiene and/or waste disposal
  • Insufficient infection control precautions

Common types of HAIs
HAIs that are especially frequent in clinical settings include:

  • Catheter-associated urinary tract infections due to incorrect placement, maintenance or use of indwelling catheters.
  • Central line-associated bloodstream infections due to incorrect placement and/or maintenance of intravascular catheters.
  • Clostridium difficile (C. Diff) infections due to antibiotic overuse and the destruction of healthy intestinal bacteria.
  • Methicillin-resistant Staphylococcus aureus (MRSA) bacteremia due to patient/resident contact with contaminated surfaces, medical devices or infected healthcare personnel, resulting in pathogens entering the bloodstream.
  • Surgical site infections due to contaminated medical implants and/or poor sterilization techniques during surgery.
  • Ventilator-associated pneumonia due to cross-contamination via an endotracheal tube.

Precautions against the spread of HAIs
The goal of universal precautions training is to minimize the risk of clinical cross-contamination of dangerous, hard-to-treat pathogens. Annual training sessions should reinforce these universal biosafety practices by highlighting:

  • Hand hygiene before and after contact with patients/residents, bodily fluids and soiled materials; after removing gloves and using the restroom; and whenever hands are visibly soiled. (Hand hygiene guidance also should be offered to patients/residents and family members via signage and live demonstrations of washing techniques.)
  • Protective equipment (i.e., gloves, gowns, masks, eyewear) whenever there is a reasonable chance of contact with blood, bodily fluids, secretions or excretions, or with any items contaminated by these fluids.
  • Respiratory etiquette, e.g., properly covering the mouth and nose when coughing or sneezing and requiring individuals with a communicable disease to wear a surgical mask.
  • Safe injection practices when handling needles and sharps to prevent transmission of bloodborne pathogens and other occupational needle-stick injuries.
  • Proper disposal of medical waste to ensure that infectious materials are appropriately separated, labeled, stored and transported.

Training aids for HAIs
In addition to universal precautions training, in-service education should focus on the prevention and management of common HAIs. For training purposes, these targeted CDC resources are available:

Documentation should be maintained for all infection control training or certification sessions, including dates, names of attendees and proficiency testing results, and copies of certificates earned should be kept on file. By ensuring that staff members are trained in the infection surveillance practices outlined here, healthcare organizations can make significant strides in reducing the rate of HAIs.

1 Centers for Disease Control and Prevention, HAI Data and Statistics.
2 Agency for Health Care Research and Quality, Health Care-Associated Infections.

Insurance for Healthcare Captive Insurers and Self-Insurers

With more than 50 years of experience in the healthcare industry, CNA is a trusted leader and top underwriter of healthcare insurance products and services for a wide spectrum of organizations.

As a healthcare organization that desires or has chosen to self-insure or form a captive insurance company, you may enjoy more flexibility and control of your insurance program and its costs. Yet, there are reasons to seek the support of a recognized insurance carrier that can complement and enhance your program. The changing healthcare market has also created a need for insurance programs to assist with tailored third-party liability partners. These programs can align quality of care initiatives, enhance expense savings, ensure regulatory compliance and permit more control when managing liability.

CNA has helped hundreds of healthcare captive insurers and self-insurers such as yours. We listen and work closely with you to structure and administer an alternative liability insurance program tailored to meet your complex business needs. Our programs are designed to fulfill your unique fronting and risk transfer requirements and expand your coverage capacity. We offer two forms of fronting structures — reinsurance programs and matching deductible programs — that can be adapted to satisfy your professional and general liability coverage requirements. We structure the programs utilizing our admitted and non-admitted insurance companies to allow maximum flexibility, minimize costs, and provide the most underwriting and claims administration control.

With an A rating for financial strength from the major rating organizations, CNA is a solid source upon which to rely.


Learn more about our broad portfolio of insurance solutions specialized to meet the needs of your business.

CNA offers a broad portfolio of insurance solutions — from general liability to property to professional and management liability and more — specialized to meet the needs of your business.


Explore our services designed to help you manage your claims, understand your exposures, address potential losses and maintain business continuity.

CNA offers an array of services designed to help you manage your claims, understand your exposures, address potential losses and maintain business continuity.

Small Business Insurance Fundamentals

Learn more about how to identify the insurance and services you need to safeguard your small business.

For your small business, having the right kind of insurance is critical to success. Are you looking to learn more about the kinds of insurance coverage you need before you contact your local independent agent or broker? We've developed some helpful resources and tools to get you started.

What kind of insurance do I need?
Identifying the right coverages that address your risk exposures and your greatest challenges is important. To help determine your business insurance needs, use this checklist to help guide your discussion with your independent insurance agent.

Why use an independent agent?
Dedicated to offering the broadest selection of policies and coverage to best meet their customers' needs, independent agents represent multiple product lines from more than one carrier. CNA is proud to support the Independent Insurance Agents & Brokers of America and their Young Agents Committee. Find a local independent agent for you.


What is risk control?
For small businesses, preventing and controlling risk can be just as important as being properly covered. CNA Risk Control offers a wide range of services focusing on management accountability, cost drivers and business solutions to help you improve your bottom-line profit.

How can I prepare for an emergency?
Learn how to safeguard your small business, your employees and your family in the event of an emergency by visiting Resources to Manage & Reduce Risk for online tools and resources from CNA's own business continuity planners and government organizations.

How can I better prepare for my policy renewal?
Your independent insurance agent is your best resource to ensure your small business has the proper insurance coverage as it changes and grows year over year. Review this list of 10 items to prepare for your conversation about how your business and its insurance needs have changed since your policy was issued.


Small Business Owners Policy (BOP)

Small Business Owners Policy (BOP)

Commercial Auto

Directors & Officers (D&O)

Employment Practices Liability (EPL)

Equipment Breakdown


Medical & Scientific Equipment

Healthcare Professional Liability


Workers’ Compensation

LItigation Counsel

California Medical Provider Network (MPN)

CNA Claim Services

Outcomes Based Network and CNA Selected Providers

Get Informed. Get Prepared. Get PrepWise.

CNA Risk Control Services

Special Investigations Unit (SIU)

Texas Healthcare Network (HCN)

Workers' Compensation Medical Provider Networks

Need more information about managing your business risks?


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