Healthcare providers, including ambulatory surgery centers, are coming under increased pressures to maintain a high level of infection prevention and control. In order to achieve this, ASCs must ensure physicians and staff members comprehensively know and understand infection control best practices, protocols and policies. Joan Blanchard, MSS, BSN, RN, CNOR, CIC, who serves as the Association of periOperative Registered Nurses' liaison to the CDC Healthcare Infection Control Practices Advisory Committee, shares six common misconceptions about infection control.
1. I do not need to wash my hands after removing my gloves. One common misconception Ms. Blanchard often runs across is the notion healthcare professionals do not need to use proper hand hygiene after wearing surgical gloves. According to Ms. Blanchard, there is an 18 percent failure rate for surgical gloves to keep hands uncontaminated. Gloves may have pin holes that are not readily observable.
"There is no way a manufacturer can test every pair of surgical gloves," Ms. Blanchard says. "That's why it is absolutely critical for healthcare professionals to wash their hands even after removing their gloves."
2. It's okay to dry a skin prep antiseptic off with a towel before it dries. Ms. Blanchard says it is essential ASCs follow manufacturer's guidelines on how long to wait before wiping away skin prep antiseptic from a patient's skin surface.
"If the manufacturer's guidelines says to let the antiseptic dry for 10 minutes, it should be left to dry on the skin for 10 minutes," Ms. Blanchard says. "There is a misconception that antiseptic kills pathogens immediately, but some antiseptics require time to completely or nearly completely kill as many skin pathogens as possible."
3. I do not have to wear a surgical mask or tie the surgical mask strings. Not wearing a surgical mask or failing to securely tie the surgical mask is a danger not only to the patient but to the healthcare professional as well.
"When you are tying the mask on securely, there is a better chance of protecting yourself and the patient is at a lower risk of experiencing an infection," Ms. Blanchard says. "OSHA requires any time you are working with a bloodborne pathogen or the possibility of a bloodborne pathogen splash that you wear a mask in surgery."
4. I am bald, therefore I do not need to wear surgical head gear. Ms. Blanchard says even healthcare professionals with no hair on their heads should still wear protective surgical caps during surgery. Not doing so can still be hazardous to patients, she says.
"It varies from individual to individuals, but everyone sheds skin particles from every part of their body every day," Ms. Blanchard says. "So your head constantly shedding is a huge reason to wear surgical head caps. It's simply a quality and infection prevention issue."
5. I can flash sterilize my instruments for ophthalmology cases. Ophthalmology staff should put their surgical instruments through an entire sterilization cycle, rather than resorting to rinsing instruments in sterile water and flashing for the next case.
"It's not sufficient enough [for eye instruments] to be flash sterilized," Ms. Blanchard says. "Those instruments must be cleaned very thoroughly, decontaminated and undergo a full sterilization cycle. If possible, flash sterilization should be avoided."
6. I can flash instruments between cases. ASCs should never resort to or make a habit of flashing surgical instruments between cases, unless it is absolutely necessary. Instead, ASCs should ensure every case — from open to close — is ready with a full set of instruments that underwent full sterilization.
"There are two distinct levels of care when comparing full sterilization to flash sterilization," Ms. Blanchard says. "Fully sterilized instrumentation should be used for every case. ASCs should not start morning cases with a sterile instrument set and then use flashed instrument sets for every following case."
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1. I do not need to wash my hands after removing my gloves. One common misconception Ms. Blanchard often runs across is the notion healthcare professionals do not need to use proper hand hygiene after wearing surgical gloves. According to Ms. Blanchard, there is an 18 percent failure rate for surgical gloves to keep hands uncontaminated. Gloves may have pin holes that are not readily observable.
"There is no way a manufacturer can test every pair of surgical gloves," Ms. Blanchard says. "That's why it is absolutely critical for healthcare professionals to wash their hands even after removing their gloves."
2. It's okay to dry a skin prep antiseptic off with a towel before it dries. Ms. Blanchard says it is essential ASCs follow manufacturer's guidelines on how long to wait before wiping away skin prep antiseptic from a patient's skin surface.
"If the manufacturer's guidelines says to let the antiseptic dry for 10 minutes, it should be left to dry on the skin for 10 minutes," Ms. Blanchard says. "There is a misconception that antiseptic kills pathogens immediately, but some antiseptics require time to completely or nearly completely kill as many skin pathogens as possible."
3. I do not have to wear a surgical mask or tie the surgical mask strings. Not wearing a surgical mask or failing to securely tie the surgical mask is a danger not only to the patient but to the healthcare professional as well.
"When you are tying the mask on securely, there is a better chance of protecting yourself and the patient is at a lower risk of experiencing an infection," Ms. Blanchard says. "OSHA requires any time you are working with a bloodborne pathogen or the possibility of a bloodborne pathogen splash that you wear a mask in surgery."
4. I am bald, therefore I do not need to wear surgical head gear. Ms. Blanchard says even healthcare professionals with no hair on their heads should still wear protective surgical caps during surgery. Not doing so can still be hazardous to patients, she says.
"It varies from individual to individuals, but everyone sheds skin particles from every part of their body every day," Ms. Blanchard says. "So your head constantly shedding is a huge reason to wear surgical head caps. It's simply a quality and infection prevention issue."
5. I can flash sterilize my instruments for ophthalmology cases. Ophthalmology staff should put their surgical instruments through an entire sterilization cycle, rather than resorting to rinsing instruments in sterile water and flashing for the next case.
"It's not sufficient enough [for eye instruments] to be flash sterilized," Ms. Blanchard says. "Those instruments must be cleaned very thoroughly, decontaminated and undergo a full sterilization cycle. If possible, flash sterilization should be avoided."
6. I can flash instruments between cases. ASCs should never resort to or make a habit of flashing surgical instruments between cases, unless it is absolutely necessary. Instead, ASCs should ensure every case — from open to close — is ready with a full set of instruments that underwent full sterilization.
"There are two distinct levels of care when comparing full sterilization to flash sterilization," Ms. Blanchard says. "Fully sterilized instrumentation should be used for every case. ASCs should not start morning cases with a sterile instrument set and then use flashed instrument sets for every following case."
Learn more about AORN.
