While ASCs continually have much lower infection rates than hospitals, there are still some common lapses, especially in hand hygiene, safe injection practices and environmental cleaning.
"We are still having breaches" in infection control, Lee Anne Blackwell, RN, vice president of clinical services for Practice Partners in Healthcare, said during a presentation at the Becker's 14th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine June 9 in Chicago.
To keep patients safe — and remain compliant with CMS' Conditions for Coverage — ASCs must have a documented proof that they implemented nationally recognized infection control guidelines, and the infection control program must be overseen by a trained professional.
According to Ms. Blackwell, an ASC's infection control plan should contain the following 10 elements:
1. A purpose statement specifying the plan is based on guidelines from leading authorities in infection control like the CDC, the Association for Professionals in Infection Control and Epidemiology, the Society for Healthcare Epidemiology of America and others.
2. Identification of the infection control plan, responsibility, support and oversight by organization management
3. An authority statement of who is in charge of the infection control plan — the medical executive committee or governing body needs to approve a registered nurse to serve as the infection control nurse preventionist and have his or her authority documented in the personnel file.
4. Clear goals that stem from the ASC's mission, vision and values; enough flexibility to change in response to unexpected outbreaks or issues like Ebola or Zika; and a focus on strategies for reducing infection risks.
5. A defined scope, meaning the plan identifies the who (population to be served), what (indicators or metrics to be measured) and how (how the metrics will be monitored).
6. Investigation and surveillance protocols that ensure both a consistent process to retrieve infection information and a consistent process for infection surveillance. "We still have work here to do," Ms. Blackwell said.
7. Reporting processes, both internally, to the ASC's quality committee and governing body, and externally, to the CDC's National Healthcare Safety Network — which is now mandatory — and other public health authorities.
8. Identified risks. Some questions to consider for infection control risk assessment include what types of patients are served by the ASC, what are the most common diagnoses, what types of patients increase liability for the ASC and what patients are at increased risk for infection. Once the risks are identified, prioritize them and establish goals and objectives to prevent them. "Reach out to target resources," Ms. Blackwell said, such as the CDC or the Occupational Safety and Health Administration.
9. Identified strategies to mitigate risks. "Surveyors are spending a lot of time on monitoring protocols," like hand hygiene or sterilization practices, Ms. Blackwell said. For example, surveyors want clear documentation that tools' instructions for use are being followed.
10. An education plan for infection control staff, employees, medical staff, vendors, guests and patients.
