1. Antibiotic administration. Ms. Goode says ASCs need to make sure the appropriate antibiotics for the procedure being performed, and the patient’s needs are administered at the right time. “Prophylactic antibiotics should be administered within one hour prior to cut time,” she says. “If vancomycin is administered, the antibiotic should be administered within two hours prior to cut time.”
2. Patient preparation. Although much of the work to fight infection control is performed by the ASC, facilities should also look for ways to help patients reduce the risk of incurring an infection. An important component of this is patient and family education on how to prevent, recognize and report signs of infection to their physician, says Ms. Fair says. Also, ASCs should consider which patient surgical skin prep method works best based on the procedure and the patient’s needs. Recent research has suggested the use of chlorhexidine gluconate might decrease the chance of post-op infection. Ms. Goode says ASCs can instruct patients to shower the night before and the morning of surgery with CHG.
“Some facilities, instead of instructing patients to shower, will use skin wipes preoperatively that also contain CHG,” Ms. Fair says.
3. Normothermia. Since patients are at risk of becoming hypothermic during their surgical procedures, maintaining patients’ normothermia should be a critical part of any ASC’s infection control program. Ms. Goode says a patient’s body temperature should be monitored to ensure that the patient does not become hypothermic or hyperthermic during their perioperative stay. This can be achieved in a variety of ways.
“If the procedure is quick, we will use warmed blankets for our patients,” Ms. Goode says. “If it’s a longer surgery, we would use a forced-air unit that blows warm air into an opening in the blanket.”
4. Flash sterilization for instrument inventory. Flash sterilization, a process by which surgical instruments are processed in a shorter amount of time, is coming under increased scrutiny and should therefore be avoided. Ms. Goode says ASCs should ensure their facilities are stocked with enough surgical instruments so instruments never have to be flash sterilized due to insufficient supply. Flash sterilization should only be used in emergency situations.
5. Home- vs. industry-laundered scrubs. In the past, it was believed that surgical scrubs could be washed at staff members’ homes without any increased risk of infections. Ms. Goode says regulatory bodies are now recommending that surgical attire worn in restricted areas, such as the OR, should be laundered by industry facilities that follow recognized industry standards.
“It hasn’t been proven that washing surgical attire at home does or does not reduce the risk of infection, but some studies have suggested the possibility that scrubs might contribute to patient infections,” she says. “AORN has taken a stand recommending that healthcare providers should change into scrubs at the facility and have those scrubs washed by an industry facility.”
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