The following article is written by Donna Nucci, RN, CIC, infection prevention consultant.
The top 10 facility infection prevention program component updates I would perform tomorrow if I were the person "trained in infection prevention employed by a facility or available to the facility" (CDC, CMS) are as follows:
1. Download, review and implement the CDC's new guide for ambulatory centers and the corresponding checklist outlining the minimum requirements for ambulatory centers, available here: www.cdc.gov/HAI/pdfs/guidelines/ambulatory-care-checklist-07-2011.pdf (pdf).
2. Review all infection prevention policies to ensure they reflect the newest standards of care and practice within the facility (See: www.aorn.org/PracticeResources/PolicyandProcedureTemplates2ndEdition/ and http://infectionprevention.sgna.org/).
3. Provide competency training in infection control for all staff including physicians and place documentation in credentialing and education files (See: www.aorn.org/PracticeResources/PerioperativeCompetencies/).
4. Standardize all preoperative SSI prevention measures to reflect the best practice of the surgeries performed, utilizing the newest updates provided by surgical organizations AORN and APIC. One such example is found here: www.apic.org/downloads/ortho_guide.pdf (pdf).
5. Provide all staff with specific training at hire and annually concerning safe injection practices. Join the www.oneandonlycampaign.org.
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6. Monitor hand hygiene compliance monthly and provide specific interventions to improve hand hygiene according the World health Organization and the Joint Commission hand hygiene program recommendations, found here: www.who.int/gpsc/5may/en/ and here: www.jointcommission.org/assets/1/18/hh_monograph.pdf (pdf).
7. Facilitate certification for all reprocessing staff. Visit www.iahcsmm.org for surgical instruments and www.sterileprocessing.org/gi.htm for GI scope reprocessing.
8. Standardize all environmental cleaning process based on AORN standards and CDC's Guidelines for Environmental Infection Control in Health-Care Facilities found here: www.cdc.gov/hicpac/pdf/guidelines/eic_in_HCF_03.pdf (pdf)
9. Provide the designated infection control person with formalized training through APIC (See: www.apic.org/AM/Template.cfm?Section=EPI_1012&Template=/CM/HTMLDisplay.cfm&ContentID=18679).
10. Formulate facility Infection prevention risk assessment, infection surveillance program and exposure control plan. Submit to quality and medical advisory boards for review and approval (See: www.osha.gov/Publications/osha3186.pdf (pdf); www.beckersasc.com/asc-accreditation-and-patient-safety/sample-infection-control-risk-assessment.html and www.apic.org/downloads/ortho_guide.pdf (pdf)).
Donna Nucci, RN, CIC, can be reached at dnucciconsulting@yahoo.com or (860) 575- 9837.
Editor's Note: This article originally appeared in Pharm-ASC, a weekly e-mail publication by Sheldon S. Sones, RPh, FASCP, a Newington, Conn.-based consultant, pharmacist and safe medication officer.
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