Beth LaBouyer, RN, CNOR, executive director of California Ambulatory Surgery Association, and Debbie Mack, RN, CNOR, CASC, immediate past president of CASA and vice president of operations at Chicago-based National Surgical Hospitals, discuss six practices California ASCs can adopt right now to strengthen their infection control programs.
1. Attend the annual infection control seminar. Even before the actual conditions for coverage and the requirements for infection control were posted in 2009, CASA knew infection control requirements were coming down the pipeline. So in 2008, the association started holding a 1.5-day infection control training seminar, open to all CASA members and ASC professionals. The association renews its recommended infection control plan annually and presents this information during the seminar, utilizing the CMS infection control worksheet as well as a risk assessment tool. At the end of the seminar, the state association prints certificates of training to each participant.
"During this seminar, we talk about the essential components of an infection control program. The topics include the cleaning/sterilization process, pharmaceutical and medical waste management, handling multiple drug-resistant organisms, safe medication practices, investigating and reporting surgical cite infections and how to effectively administer all of these programs," Ms. LaBouyer says.
2. Consult the CASA website. Ms. LaBouyer says the association has an extensive website with multiple links that California ASCs can consult in order to retrieve more information and up-to-date news on infection control. External resources on the CASA website include the Centers for Disease Control and Prevention, Association of PeriOperative Registered Nurses and Association of Professionals in Infection Control and Epidemiology.
The CASA website, in addition to its external links and resources, also provides California ASCs with sample policies and procedures. "We have some sample policies and procedures posted on our website, such as a sample infection control admission policy, infection control logs, infection control surveillance forms and so on," Ms. LaBouyer says. "Some of these samples are donated through ASCs who offer up their forms as examples, and some are derived through AORN recommendations."
3. Conduct infection control training with janitorial staff. Although some ASCs may provide infection control training and confirmation of competency to the nursing staff, Ms. Mack says ASCs should adopt focused infection control training and increase accountability for janitorial staff as well.
"ASCs should also focus on educating the housekeeping staff, whether they are employed or contracted, on infection control so that they are competent. To increase accountability, they should also be provided with an ASC cleaning checklist, provided during the annual infection control seminar, to ensure that all the areas of an ASC are cleaned thoroughly," she says.
4. Implement a buddy system as part of your ASC's hand hygiene surveillance. One best practice shared by California ASCs is a "buddy system," which can be implemented as part of an ASC's hand hygiene program. Essentially, staff members are paired up with another colleague, and each person is responsible for keeping the other partner accountable to excellent hand hygiene compliance.
"Some California ASCs have adopted a buddy system where basically if I'm going to work with another staff member, we agree with each other that we will help one another comply 100 percent to hand-washing guidelines," Ms. Mack says. "It's hard to constantly remember to wash hands, especially if you get wrapped up in patient care. You may go to check a patient's blood pressure, get called right away to another patient and forget to wash your hands."
5. Incorporate safe injection practice into the orientation program. During its annual infection control seminar, CASA has also introduced a safe injection practices to be incorporated into California ASCs' orientation programs for new employees. "Safe injection practices were added to our orientation and annual infection control review because we want to make sure we are doing our best to prevent infections for the safety of our patients," Ms. Mack says.
6. Participate in the CASA forums. Another offering CASA provides to California ASCs is the ability to share information and questions about infection control among other area facilities. Ms. Mack says California ASCs can participate in our in-person forums through CASA regional meetings and also online forums through the members-only section of the CASA website. The forums give California ASCs a way to seek suggestions, advice and best practices from other ASCs if they encounter a particularly tough infection control-related challenge or unfavorable CMS survey.
"Through our regional meetings and web-based forums, we're able to collect all the different questions and issues California ASCs have faced in the past in regards to infection control, so if any ASC has a question, they can seek answers from this forum," Ms. Mack says. "For example, there was a regional ASC that had a hole in their OR table pad. This notice put it on other ASCs radar to check and make sure their own OR table pads have no holes so they could be properly decontaminated."
"Creating a culture where everyone is involved in the infection control process is the key to success. CASA's goal is to provide our members with information, resources and staff availability to help them achieve this goal," says Ms. LaBouyer.
Learn more about California Ambulatory Surgery Association.
1. Attend the annual infection control seminar. Even before the actual conditions for coverage and the requirements for infection control were posted in 2009, CASA knew infection control requirements were coming down the pipeline. So in 2008, the association started holding a 1.5-day infection control training seminar, open to all CASA members and ASC professionals. The association renews its recommended infection control plan annually and presents this information during the seminar, utilizing the CMS infection control worksheet as well as a risk assessment tool. At the end of the seminar, the state association prints certificates of training to each participant.
"During this seminar, we talk about the essential components of an infection control program. The topics include the cleaning/sterilization process, pharmaceutical and medical waste management, handling multiple drug-resistant organisms, safe medication practices, investigating and reporting surgical cite infections and how to effectively administer all of these programs," Ms. LaBouyer says.
2. Consult the CASA website. Ms. LaBouyer says the association has an extensive website with multiple links that California ASCs can consult in order to retrieve more information and up-to-date news on infection control. External resources on the CASA website include the Centers for Disease Control and Prevention, Association of PeriOperative Registered Nurses and Association of Professionals in Infection Control and Epidemiology.
The CASA website, in addition to its external links and resources, also provides California ASCs with sample policies and procedures. "We have some sample policies and procedures posted on our website, such as a sample infection control admission policy, infection control logs, infection control surveillance forms and so on," Ms. LaBouyer says. "Some of these samples are donated through ASCs who offer up their forms as examples, and some are derived through AORN recommendations."
3. Conduct infection control training with janitorial staff. Although some ASCs may provide infection control training and confirmation of competency to the nursing staff, Ms. Mack says ASCs should adopt focused infection control training and increase accountability for janitorial staff as well.
"ASCs should also focus on educating the housekeeping staff, whether they are employed or contracted, on infection control so that they are competent. To increase accountability, they should also be provided with an ASC cleaning checklist, provided during the annual infection control seminar, to ensure that all the areas of an ASC are cleaned thoroughly," she says.
4. Implement a buddy system as part of your ASC's hand hygiene surveillance. One best practice shared by California ASCs is a "buddy system," which can be implemented as part of an ASC's hand hygiene program. Essentially, staff members are paired up with another colleague, and each person is responsible for keeping the other partner accountable to excellent hand hygiene compliance.
"Some California ASCs have adopted a buddy system where basically if I'm going to work with another staff member, we agree with each other that we will help one another comply 100 percent to hand-washing guidelines," Ms. Mack says. "It's hard to constantly remember to wash hands, especially if you get wrapped up in patient care. You may go to check a patient's blood pressure, get called right away to another patient and forget to wash your hands."
5. Incorporate safe injection practice into the orientation program. During its annual infection control seminar, CASA has also introduced a safe injection practices to be incorporated into California ASCs' orientation programs for new employees. "Safe injection practices were added to our orientation and annual infection control review because we want to make sure we are doing our best to prevent infections for the safety of our patients," Ms. Mack says.
6. Participate in the CASA forums. Another offering CASA provides to California ASCs is the ability to share information and questions about infection control among other area facilities. Ms. Mack says California ASCs can participate in our in-person forums through CASA regional meetings and also online forums through the members-only section of the CASA website. The forums give California ASCs a way to seek suggestions, advice and best practices from other ASCs if they encounter a particularly tough infection control-related challenge or unfavorable CMS survey.
"Through our regional meetings and web-based forums, we're able to collect all the different questions and issues California ASCs have faced in the past in regards to infection control, so if any ASC has a question, they can seek answers from this forum," Ms. Mack says. "For example, there was a regional ASC that had a hole in their OR table pad. This notice put it on other ASCs radar to check and make sure their own OR table pads have no holes so they could be properly decontaminated."
"Creating a culture where everyone is involved in the infection control process is the key to success. CASA's goal is to provide our members with information, resources and staff availability to help them achieve this goal," says Ms. LaBouyer.
Learn more about California Ambulatory Surgery Association.
