Here are three tips on maintaining good infection control policies at your surgery center.
1. Make sure pre-owned equipment is in good condition. Making sure pre-owned equipment is in good condition before using it is imperative in preventing infection at your ASC, says Ray Midlam, product manager, certified pre-owned equipment for Olympus America. Be sure to find out if the model is still supported by the OEM, otherwise you may end up with a product with no access to replacement parts. And don't be lulled into complacency by a product sporting a "certified" or "CPO" label. This is an unregulated term with no standards to support it. So ask the supplier what, in fact, their "certified" label means and how the product was repaired.
For example, if the equipment is an endoscope, did it undergo a rigorous refurbishment process with all parts inspected? Were the insertion tube and other worn or damaged parts replaced with OEM parts? If not, buyers beware: A scope that has been altered with third-party parts — even those purporting to be reverse engineered or "OEM-like" — is no longer FDA 510(k) compliant, which means it is no longer validated for reprocessing. Therefore, unless you are purchasing the pre-owned scope from the OEM, make sure to ask the seller for reprocessing validation for any of its modified parts. Also check with your facility's infection control department for any specific instructions relative to modified medical equipment.
2. Never reuse detergents and brushes when disinfecting scopes. No matter what type of enzymatic detergent your ASC uses to soak scopes into, Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, stresses the importance of changing — not reusing — detergents after each use for optimal effectiveness. Just as a household member would refill a sink with new water and new detergent to clean dirty dishes, ASCs should also be mindful of changing water and enzymatic detergent because detergent will break down, Mr. Sweeney says.
"This may be a case of someone not paying attention to the manufacturer's recommendations or trying to save money, but ASCs must not reuse enzymatic detergent with multiple scopes. Detergents absolutely break down and lose integrity after each use," he says. "ASCs will sometimes reuse a brush to clean a scope too, but they have to remember that there are disposable kinds and reusable kinds. If you use a single-use item, you're supposed to use that item just one time."
3. Standardize infection prevention processes. Organizations can standardize skin preparations for all surgeons to increase the effectiveness of the infection control process. "The more things we can standardized in healthcare, particularly with surgeries like orthopedic surgeries, the more we can identify when something doesn't go right because we know how it is supposed to go," says Linda Greene, RN, MPS, CIC, a member of the Association for Professionals in Infection Control and Epidemiology's board and lead author of APIC's Guide to the Elimination of Orthopedic Surgical Site Infections. When there are cases where the patient contracts an infection, have the surgical team gather and examine the case to see what needs to be changed, says Ms. Greene.
You can also enlist patients in this process because even if you follow all medical guidelines, infections may still occur if the patient doesn't follow infection prevention instructions. Giving patients written instructions increases the chance they will complete the infection control measures, such as the preoperative shower, appropriately. Some organizations offer courses for patients before elective surgery to go through all of the infection control and outcome expectations, says Ms. Greene.
1. Make sure pre-owned equipment is in good condition. Making sure pre-owned equipment is in good condition before using it is imperative in preventing infection at your ASC, says Ray Midlam, product manager, certified pre-owned equipment for Olympus America. Be sure to find out if the model is still supported by the OEM, otherwise you may end up with a product with no access to replacement parts. And don't be lulled into complacency by a product sporting a "certified" or "CPO" label. This is an unregulated term with no standards to support it. So ask the supplier what, in fact, their "certified" label means and how the product was repaired.
For example, if the equipment is an endoscope, did it undergo a rigorous refurbishment process with all parts inspected? Were the insertion tube and other worn or damaged parts replaced with OEM parts? If not, buyers beware: A scope that has been altered with third-party parts — even those purporting to be reverse engineered or "OEM-like" — is no longer FDA 510(k) compliant, which means it is no longer validated for reprocessing. Therefore, unless you are purchasing the pre-owned scope from the OEM, make sure to ask the seller for reprocessing validation for any of its modified parts. Also check with your facility's infection control department for any specific instructions relative to modified medical equipment.
2. Never reuse detergents and brushes when disinfecting scopes. No matter what type of enzymatic detergent your ASC uses to soak scopes into, Shaun Sweeney, vice president of sales and marketing for Cygnus Medical, stresses the importance of changing — not reusing — detergents after each use for optimal effectiveness. Just as a household member would refill a sink with new water and new detergent to clean dirty dishes, ASCs should also be mindful of changing water and enzymatic detergent because detergent will break down, Mr. Sweeney says.
"This may be a case of someone not paying attention to the manufacturer's recommendations or trying to save money, but ASCs must not reuse enzymatic detergent with multiple scopes. Detergents absolutely break down and lose integrity after each use," he says. "ASCs will sometimes reuse a brush to clean a scope too, but they have to remember that there are disposable kinds and reusable kinds. If you use a single-use item, you're supposed to use that item just one time."
3. Standardize infection prevention processes. Organizations can standardize skin preparations for all surgeons to increase the effectiveness of the infection control process. "The more things we can standardized in healthcare, particularly with surgeries like orthopedic surgeries, the more we can identify when something doesn't go right because we know how it is supposed to go," says Linda Greene, RN, MPS, CIC, a member of the Association for Professionals in Infection Control and Epidemiology's board and lead author of APIC's Guide to the Elimination of Orthopedic Surgical Site Infections. When there are cases where the patient contracts an infection, have the surgical team gather and examine the case to see what needs to be changed, says Ms. Greene.
You can also enlist patients in this process because even if you follow all medical guidelines, infections may still occur if the patient doesn't follow infection prevention instructions. Giving patients written instructions increases the chance they will complete the infection control measures, such as the preoperative shower, appropriately. Some organizations offer courses for patients before elective surgery to go through all of the infection control and outcome expectations, says Ms. Greene.