Infection control champions: 4 ASCs with a 0% infection rate
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Ashton Center for Day Surgery (Hoffman Estates, Ill.). The surgery center, which is managed by Oak Brook Medical Management, had 15 months of zero infections reported. According to Nicole Hanga, RN, infection preventionist at Oak Brook Medical Management, the ASC follows evidence-based practice and established guidelines from recognized authorities.
"But if you want to highlight a difference it's that we are nearly fanatical about infection control," she says. "A phrase we frequently hear from new nurses and surgeons is 'Well, we don't do that at the hospital.' Our answer is 'Correct. That's why we do better than hospitals.'"
The 15,000-square-foot multispecialty ASC is accredited by the Joint Commission and features five operating rooms, with more than 40 physicians. The center was opened in 2008. It offers surgical services in numerous specialties, including gastroenterology, gynecology, ophthalmology, orthopedics, pain management, plastic surgery and podiatry.
Bellin Orthopedic Surgery Center (Green Bay, Wis.). The surgery center had an infection rate of 0.04 percent in 2013 and 0 percent in 2014, year-to-date. The infection control policies at the ASC reflect the standards of CMS, Accreditation Association of Ambulatory Health Care, Centers for Disease Control and Prevention and Association of periOperative Registered Nurses, according to Amanda Sosnosky, interim administrator.
"We do several monthly audits in all care settings and we continue to talk about what we find. We hold daily huddles and track all trends," says Ms. Sosnosky. Staff members do not always know who is doing the audit, so it is a blinded review, she adds.
Opened in March 2010, the facility is a joint venture between Orthopedic & Sports Medicine Specialists of Green Bay and Bellin Health. It offers a wide array of services including rotator cuff repair, carpal tunnel release, ACL repairs and fracture repairs. It was one of the 2012/2013 National APEX Quality Award winners.
Hawthorn Surgery Center (Vernon Hills, Ill.). Hawthorn Surgery Center, a Surgical Care Affiliates facility, has had a 0 percent infection rate since October 2013. Angela Thompson, RN, is the center's director of nursing and infection control nurse. Ms. Thompson oversees all infection control protocols and implementation of new policies. Post-operative infections are monitored monthly through physician queries in regards to all patients seen the prior month. "It is our feeling that maintenance of a low percent infection rate is attributed to the proper sterilization of instruments, correct prophylactic antibiotic timing, cleanliness of the facility, enforcing strict hand hygiene practices, the pre-screening process and finally, feedback from our post-op infection control queries," says Ms. Thompson.
Hawthorn Surgery Center also pre-screens all patients for MRSA and VRE. Patients with active cases of either are not admitted to the surgery center. "There are times where infected cases of unknown pathology are brought to the center for irrigation and debridement," says Ms. Thompson. Those cases are placed at the end of the day with no other cases to follow in that OR suite to ensure ample time for terminal cleaning of the OR after the procedure.
In March, the surgery center moved to a new building, twice the size of its old facility. The layout of the new facility is completely different, resulting in altered flow. "We had to do a lot of preparation and planning to update our infection control policies and we had to do it quickly," says administrator Julie Bell. "We had a Joint Commission survey within three weeks after we moved." The survey went smoothly and the center continues to maintain its low infection rate.
"One of the selling points for having surgery in an ASC is the low infection rate," says Ms. Bell. "We make sure we are adhering to all policies to ensure we are working toward that goal."
Oak Brook (Ill.) Surgical Centre. The surgery center reported 18 months of zero infections. The center is managed by Oak Brook Medical Management, and according to Infection Preventionist Nicole Hanga, RN, one approach to maintaining a 0 percent infection rate is constant education, keeping the staff up to date with the latest developments and evidence-based practice as well as sharing the knowledge with everyone who comes through the centers.
Other approaches to maintaining the 0 percent infection rate are "cultivating a culture of infection prevention, making every staff member and physician into an IC champion and constant monitoring and enforcing of the policies," says Ms. Hanga. "There are many more, but I think an 'all of the above' policy works best. Yes, it costs a little more — time, money, and headaches — but we believe it's worth it."
Opened in 1977, the surgery center is accredited by the Joint Commission and includes five operating rooms. More than 100 physicians provide care at the 15,000-square-foot facility in a number of specialties, such as gastroenterology, general surgery, gynecology, neurology, ophthalmology, orthopedics, pain management, plastic surgery, podiatry and urology.
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