Implementing proper infection control practices is crucial for any ambulatory surgical center.
The people who work at such a facility must take every precaution possible to ensure the health of those who are treated there. By following a few basic steps, ambulatory surgical workers can keep their environment safe for everyone involved.
Following the Latest Industry Regulations and Guidelines
When starting a program to implement infection control, one of the most important steps to remember is that industry regulations and guidelines must be followed. Workers must be updated on any policy changes at a facility and in the industry. Strict compliance to regulations should be expected of every worker at a facility, and this expectation should be made clear to every staff member.
Currently, several guidelines have been put in place by the Centers for Disease Control. All healthcare facilities, including ASCs, must create and make their workers aware of codes of conduct regarding infection prevention. Every surgery site must have an antiseptic available, and the antiseptic agent must offer antimicrobial activity that is broad-spectrum, fast-acting, and persistent.
Before every procedure, all of the members of a surgical team must properly wash their forearms and the other areas of their arms. The day prior to their arrival at a surgical facility, patients must be instructed to take an antiseptic shower. Before any procedure at such a facility, a patient should be given an antimicrobial prophylaxis. All hair removal that is necessary for a procedure should be done immediately prior to that procedure.
The Centers for Medicare and Medicaid Services enforces compliance of its conditions in order to provide coverage of ASCs. CMS has been doing this since 2009. Of the CMS conditions currently in place, one of the most important is that facilities establish and enforce written policies that serve to prevent communicable infections.
Another important CMS condition is that contact must be maintained with a person who has been properly trained in the prevention of infection. According to CMS guidelines, ASCs should have access to a team of infection prevention consultants, or they should have at least one trained and licensed person available to work with the staff members. While certification is not a requirement (except when state laws mandate it), utilizing consultants who can provide documentation of certification is in the best interest of an ASC, its workers, surgeons, and especially, its patients.
Preventing Infection Begins With Staff Members
The first step in maintaining an effective infection control program is to start with the individuals who work at a facility. The health of employees, along with proper hand hygiene, is critical. Hand rub solutions that are alcohol-based are the preference among current health regulatory agencies. This is likely because such a solution is generally less irritating to hands than other types of solutions. An alcohol-based solution is also believed to be the most efficient option.
Ultimately, workers will be more inclined to consistently utilize hand rub solutions that are less irritating and more efficient. Such solutions should be made available throughout a facility, and staff members should use these solutions at the start of every day, as well as any other time they should be used.
Risk awareness and prevention should also be explained and enforced. ASC workers should change their gloves regularly, and they should be made aware of the risk involved with wearing artificial nails or jewelry during any procedure (bacteria underneath a ring can lead to the growth of gram-negative bacteria, which may cause a variety of infections).
One practice that must be forbidden is using single-use vials on multiple patients. This is a major area of concern for CMS, and workers must follow the proper protocols regarding medical vials, infusions, and injections.
Knowing the Particular Environment and Patient Population
A facility should be well aware of its particular environment, so that it may create an infection control program that matches the particular circumstances. Housekeeping and other outside staff should be regularly checked for program compliance. Circumstances that could contribute to an unsafe environment should be avoided. The facility should monitor the frequency of air changes, the negative and positive air pressure gradients, and the humidity and temperature levels.
An ASC should also monitor its patient population. Protocols must be established to minimize the risk of infection entering and spreading within an ASC. Patients must always be instructed to take an antiseptic shower on the day prior to surgery. However, the assumption should be made that not all patients will follow this instruction, and a chlorhexidine rub should be administered on-site on the day that a surgery is scheduled.
Following industry regulations and guidelines for infection prevention is vital for an ASC. Every facility should have a proper infection prevention program in place. When such a program is established and enforced, a broad range of harmful infections may be prevented.
This article about ASC best practices was provided by Sports and Spine Orthopaedics, a fully staffed ASC and sports medicine facility in Los Angeles with board certified surgeons. They have been helping patients with minimally invasive surgery procedures in the Los Angeles area for nearly 10 years and can also be found on twitter and facebook.
