Category Archives: Policy, engineering and educational efforts

Steve Langan, director of HONOReform, shares the latest policy, engineering and educational efforts to advance injection safety.

Hepatitis C and preventive measures by Dr Mudasir Firdosi

June 1, 2015

Evelyn McKnight and Lauren Lollini

We would like to thank Dr. Mudasir Firdosi for helping to highlight Hepatitis C as a truly global issue. This is re-printed from a post which appeared in mid-May.

Kashmir valley is witnessing another disaster in the form of Hepatitis C epidemic. In some villages in Kokernag area, the number of cases is around 40% of the total population. In spite of media pressure, and demand from local population, authorities are still contemplating curbing the further spread of this infection. Similar scenario exists in other districts of the valley like Shopian, Kupwara, and Srinagar.

Hepatitis C is not transmitted by routine personal contact and there needs to be an actual transfer of the virus via blood, blood products and body fluids, from one person to another. From the sociodemographic profile of the rural population, one can easily exclude intravenous drug abuse or sexual contact as the cause of the current epidemic in majority of cases.
read more »

Methodist Monday – Preparing nurses to advocate for their patients

April 13, 2015

Evelyn McKnight and Lauren Lollini

Nursing school faculty at the NE Methodist College stress patient advocacy in their curriculum

Nursing school faculty at the NE Methodist College stress patient advocacy in their curriculum

The American Association of Colleges of Nursing emphasizes that an essential component of baccalaureate nursing education is to prepare the graduate to advocate for individuals, families, groups, communities, populations, the profession of nursing, and changes in the health care system (AACN, 2008). The challenge for nurse educators is how to define advocacy, not just as a word but a greater concept, and how to engage students in advocacy.

Patient lived experiences are a great way for students to understand how their actions in their own practice affect their patient at the time of care and in the future. The focus of nursing education is to prepare students to understand their patient’s problem and provide action steps to correct the problem. The use of personal stories helps the students to visualize and truly understand how their interventions and rationale can affect their patients in years to come.

Reading the book, A Never Event, has made a huge impact on our nursing students. Reading about an incident that happened so close to home allows the students to take accountability and ownership for these profound issues in our health system. The shocking events that occurred call the students to become advocates for quality and safety improvement for our patients. They identify with the stories and the characters and become empowered for change.

Evelyn McKnight’s presence in the classroom helps students to see a person who has a passion for the cause of patient safety.  Evelyn is able to clearly articulate her mission for safe care for every person and she empowers students to see themselves as advocates for her cause as well.  She puts the concept of patient safety right onto the shoulders of the students as future competent health care providers.  I think students comprehend their responsibility for safe patient care in a whole new light after listening to Evelyn McKnight. After hearing her story and learning about all the ways she is impacting health care policy, students see that every person can make a difference in the world.

Evelyn’s contribution to a new book, The Truth About Big Medicine, compliments her personal story in A Never Event and expands on the issues of health policy in America. Evelyn gives a face and story to health policy, helping individuals better understand the importance of health policy awareness, advocacy, and activism. We look forward to including The Truth About Big Medicine in our nursing curriculum at Nebraska Methodist College.

Cathy Barnes, MSN, RN, Katie Doty, MSN, RN, Casey Frost, MSN, RN, Jodi Jenson-Bassett, MSN, RN, Carissa Nielsen, MSN, RN, and Echo Perlman MSN, RN are nursing faculty at the Nebraska Methodist College and the authors of this blog.


American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Retrieved from

Celebrating the Success of the Partnership for Patients

March 30, 2015

Evelyn McKnight and Lauren Lollini

PfP Boxed logo-1 Recently, Partnership for Patients (PfP) issued a report on its achievements. You will recall from a previous post that the PfP is a very large national quality improvement learning collaborative with two aims: to improve safety in acute care hospitals and to improve coordination of care at discharge to prevent readmissions. The PfP is a public-private partnership that seeks national change by setting clear aims, aligning and engaging multiple Federal partners and programs, aligning and engaging multiple private partners and payers, and establishing a national learning network available to all healthcare providers and facilities.

I participated as a patient advocate in the work of the PfP. My fellow patient advocates and I were invited to give input in every meeting, every phone call, every critical decision. The patient advocates imbued passion for safety into the conversation. This passion set the tone for co-operation and action among the members of the campaign. Several times I was part of a discussion which bogged down in, what seemed to me, a standoff between two camps: those who believed that a proposed policy would save lives and thus should be adopted, and those who believed that the policy was too difficult and/or costly for hospitals to execute. A patient advocate took to the airwaves, and gave her personal story of the harm that she suffered because the policy was not in place. The tone immediately changed from “this is too difficult/costly to achieve” to “we must do whatever we can to keep patients safe.” Within minutes the team moved forward, working co-operatively for patient safety. I believe the patient’s voice was a major contribution to the overall success of the campaign.

The Partnership for Patients and its over 3,700 participating hospitals were focused on making hospital care safer, more reliable, and less costly through the achievement of two goals:

  1. Making Care Safer. By the end of 2014, preventable hospital-acquired conditions would decrease by 40% compared to 2010.
  2. Improving Care Transitions. By the end of 2014, preventable complications during a transition from one care setting to another would be decreased so that all hospital readmissions would be reduced by 20% compared to 2010.

As part of the PfP campaign, baseline measures were collected on nine hospital-acquired conditions (e.g., adverse drug events, pressure ulcers and surgical site infections) in 2010. At the end of the initial engagement period of the PfP, a cumulative total of 1.3 million fewer hospital-acquired conditions (HACs) were experienced by hospital patients over the 3 years (2011, 2012, 2013) relative to the number of HACs that would have occurred if rates had remained steady at the 2010 level. It is estimated that approximately 50,000 fewer patients died in the hospital as a result of the reduction in HACs, and approximately $12 billion in health care costs were saved from 2010 to 2013.

It was so gratifying to be part of this effort that keeps the patient at the center of health care quality improvement. The momentum that was created through the PfP is exciting, and I look forward to the continuation of the patient safety movement that is driven by the patient voice.

Saluting the Healthcare Professionals at Madigan Army Medical Center

March 23, 2015

Evelyn McKnight and Lauren Lollini

Tom & Evelyn McKnight recently presented at Madigan Army Medical Center

Tom & Evelyn McKnight recently presented at Madigan Army Medical Center

We were so honored recently to be asked to give several presentations to healthcare providers at Madigan Army Medical Center near Tacoma, Washington.

I have always been in awe of the brave men and women in military service. The commitment and sacrifice that they make is beyond measure. To volunteer to serve our country, often in dangerous circumstances and far away from loved ones, is incredible. They have my deepest admiration.

So it was great respect that we gave presentations on patient safety to healthcare personnel. And our respect was well deserved. The healthcare providers asked thoughtful questions about patient safety and shared their own, impressive efforts in insuring that soldiers receive safe, quality healthcare.

Here is a 3 minute video tribute to Madigan. Madigan Army Medical Center, we salute you!

59 Children Injected with a Single Needle

March 16, 2015

Evelyn McKnight and Lauren Lollini

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

Lauren Lollini is a patient safety advocate who has been integral in changing laws to keep patients safe as well as a member of the Drug Diversion Prevention Committee.

On March 3rd, the India Times reported an incident where 59 children were injected with the same syringe and needle while being administered an antibiotic. This not only highlights the many issues surrounding the state-run hospitals there, but also illustrates the point we, at HONOReform, have been helping to bring to light.

read more »

Injection Safety is a Global Priority

March 9, 2015

Evelyn McKnight and Lauren Lollini

The Safe Injection Global Network is launching a new campaign

The Safe Injection Global Network (SIGN) is launching a new campaign

Steve Langan and Evelyn McKnight recently attended meetings of the Safe Injection Global Network, sponsored by the World Health Organization, in Geneva, Switzerland. Following is their report.

How thrilling to be part of a global effort to advance injection safety! It was a rewarding moment when we entered the doors of the World Health Organization in Geneva, Switzerland last month to participate in meetings of the Safe Injection Global Network.

We joined dedicated advocates of many countries, all working to eradicate reuse of syringes and needles, misuse of medication vials and unnecessary injections. Although we differed in language, culture and homeland, we were united in our passion to prevent disease transmission through unsafe injections everywhere – from India to Egypt, Uganda to the United States, and everywhere in between.

Representatives from Nepal, Brazil, Pakistan and the United Kingdom said to us, “We’ve seen and admired the website of the One and Only Campaign. We’d like something like it in our country.” We were proud to share some highlights of the One and Only Campaign with the assembly, and we are eager to work with SIGN to bring it to all countries.

Here is a 2 minute video that shares some of the highlights of the new SIGN Campaign. We will share here further developments as the campaign unfolds!

Building community for safe injections!

February 23, 2015

Evelyn McKnight and Lauren Lollini

HONOReform is a proud member of the Safe Injection Practices Coalition. Led by the Centers for Disease Control and Prevention, the SIPC developed and distributes the award-winning One and Only Campaign materials (“One Needle, One Syringe, Only One Time”). The One & Only Campaign is a public health campaign to raise awareness among patients and healthcare providers about safe injection practices. There are many, many resources designed for healthcare providers –  posters, videos, brochures, checklists, continuing education opportunities and guidance for infection prevention specific to injection safety. There are resources tailored for specific situations such as dentistry and diabetes care.

 While we applaud the efforts of our colleagues and stand beside them, we also must note that materials designed for patients seem, at this stage, inadequate. Currently, this is the core document developed by SIPC to be used specifically for outreach to patients: Patient Brochure. read more »

Making Lemonade: One CRNA’s Story of Addiction and Recovery

February 16, 2015

Evelyn McKnight and Lauren Lollini

Anita Bertrand, CRNA, was the featured speaker at this year's AANA annual meeting

Anita Bertrand, CRNA, was the featured speaker at this year’s AANA annual meeting

In healthcare, it’s all about saving lives, right? But what happens when it’s about saving the lives of those who are usually the ones caring for the patients? In the case of the American Association of Nurse Anesthetists, it is truly about saving lives as well as caring for their peers. Thanks to their health and wellness series, they are bringing awareness through education as well as teaching their members to look past themselves while gaining a better care for all. Thanks to their peer assistance program, it is much easier for nurse anesthetists to help one another. read more »

2014 was a very good year for HONOReform!

February 9, 2015

Evelyn McKnight and Lauren Lollini

HONOReform is the only national advocay organization dedicated to protecting patients through safeguarding the medical injection process.

HONOReform is the only national advocay organization dedicated to protecting patients through safeguarding the medical injection process.

Once a year, we take some time from our daily work to reflect on what we accomplished throughout the year and set s ome goals for the upcoming year. We are so grateful to you, our fellow advocates, for your steadfast support of injection safety. Below is HONOReform’s End of Year Report, 2014.

Our Mission and Vision

HONOReform is the only national advocacy organization dedicated to protecting patients through safeguarding the medical injection process “from manufacturing to disposal.” Our vision is a nation in which health care providers always follow fundamental injection safety practices that are designed to protect all patients each nd every time they receive an injection.

HONOReform International Debut

HONOReform representatives, including Evelyn and Tom McKnight, traveled to India in September. Our aim was to visit cities and villages and observe healthcare delivery. We visited hospitals and clinics, and we had the opportunity to meet with local patient advocates. Along with our industry partners, we presented to public health leaders, national government officials and a representative of the World Health Organization. Our goal going forward is to help form an injection safety coalition in India.

Presentations and Media

Led by co-founder and president Evelyn McKnight, who continues to present her story on the ongoing need to always use safe injection practices, HONOReform presented at 30 events attended by nearly 3500 people. HONOReform was featured in national media over 25 times in 2014, and we helped lead the much-quoted April 17 USA Today article titled “Doctors, medical staff put patients at risk.”

Updated HONOReform website

Evelyn and HONOReform are active on social media, particularly twitter (#HONOReform). On our streamlined website, click on “JOIN THE CONVERSATION” to receive up-to-the-minute information from HONOReform (on Twitter and Facebook). Also, be sure to check out and subscribe to the HONOReform blog, “Survivor Stories,” edited by Evelyn and Lauren Lollini. To submit an idea for our blog or an article, contact Steve Langan at 402.659.6343 or


Sadly, some healthcare providers in the United States continue to reuse and misuse medical equipment, including syringes. Additional focus areas this year included reuse and misuse of single- and multi-dose vials of medication and responding to increasing reports of drug diversion among healthcare workers. Through the HONOResponse program, active in five states in 2014, HONOReform is poised to help patients and communities immediately following a patient notification or confirmed outbreak.

The SIPC and the Campaign

HONOReform is a proud member of the Safe Injection Practices Coalition (SIPC), which provides support for the One and Only Campaign ( The SIPC continues to develop and distribute new materials, and we continue to raise awareness among healthcare providers and patients about the absolute need for safe injection practices. In 2014, HONOReform discussed with SIPC colleagues a need to emphasize and extend the patient voice. As always, please contact HONOReform and allow us to help you access the materials that will be most useful to you and your institution—if you are a healthcare worker—or your family—if you are a patient.

Support for State Legislation

HONOReform is particularly proud of our many partners in New Hampshire, who pushed for the landmark “Medical Technician Registry” and “Drug Free Workplace” bills, which were signed in to law in June. HONOReform was also active in working toward legislation in North Dakota—where an injection safety proclamation was established. HONOReform is dedicated to advocating for injection safety legislation at the state level.

Our Academic Partners

HONOReform appreciated the many opportunities this year to meet, in person and online, with students from local and area universities and colleges, as they studied the consequences of unsafe injections. We welcome the opportunity to share the HONOReform story and highlight the need to always emphasize injection safety. Our academic partners include University of Nebraska-Omaha, Midland University, Methodist Nursing College, the College of St Mary, St. Louis University and Southeast Community College—among others.

HONOReform Year End Appeal

We are grateful to our many donors for the ongoing support of our mission. Contributions to our annual appeal for donations, response to a request from founder Evelyn McKnight, were especially helpful. Contributions to HONOReform come in a variety of forms. Thank you for helping us to continue to safeguard the medical injection process in the United States.

Our Goals for 2015

We have designated 2015 the HONOReform “Year of Community.” We encourage HONOReform patient advocates and family advocates, our many partner organizations, and the extended national injection safety network to join us. We encourage you to join HONOReform social media and help us extend the conversation and our reach!