1. Consult the experts. Some very specific recommended practices and guidelines for infection control in GI-driven ASCs have been published and are typically available through organization websites or manufacturers’ recommendations. Ms. Rahn suggests consulting the Society of Gastroenterology Nurses and Associates, American Society for Gastrointestinal Endoscopy, CMS regulation sites and AAAHC standards.
“ASCs are obligated to follow the highest professional standards and have thorough knowledge of those standards and regulations,” she says.
2. Implement technology. Various companies produce infection-preventive equipment and tools to assist healthcare professionals. One such tool Endoscopy Center of St. Louis utilizes is Verimetrix, which is a leak tester that measures the moisture content in a scope.
“It also records and tracks patient and scope information,” Ms. Rahn says. “Verimetrix eliminates any human error and also allows for clinicians to be hands-free and perform other tasks.”
3. Use daily documentation, checklists and reminders. At Endoscopy Center of St. Louis, daily checklists contain information on infection control-related responsibilities, such as the procedures for terminally cleaning, along with dates, times and concentrations of solutions for scope reprocessing. The checklists are laminated and posted in view in the scope reprocessing room. Utilizing check lists not only ensures that standards are being followed but also provides the manager with accountability of the staff.
In conjunction with daily checklists, scope reprocessing logs are utilized to record scope numbers, times of day, dates and concentrations for reprocessing solutions. This process is repeated for every scope.
“This is also a means for measuring accountability,” Ms. Rahn says. “These logs can be used as a tracking mechanism should problems arise.”
4. Use one-time disposable reprocessing equipment. Although disposable reprocessing equipment may be an expensive venture, Ms. Rahn says the investment helps the ASC maintain a high level of infection control.
“Our physician-investors realize the value of disposable equipment in regards to safety and efficiency,” she says.
5. Limit the number of people working in the reprocessing room. Ms. Rahn suggests limiting the number of people working in the scope reprocessing room in order to decrease the number of hands that touch the equipment.
“Limiting the number of people working in the reprocessing room to one or two specialists with the sole duty of reprocessing minimizes the risk of errors or damage to scopes due to mishandling,” she says.
6. Provide continuing education for reprocessing specialists. Ms. Rahn says it is extremely important to provide continuing education for specialists working in the scope reprocessing room. Part of this is achieved by regularly discussing new articles and new equipment that is available for scope reprocessing. The center also conducts yearly competency testing and return demonstrations.
“There are few classes [on reprocessing] that SGNA provides which can be taken online,” Ms. Rahn says. “Manufacturers can also provide information and training. Our physician-investors recognize the importance of reprocessing specialists.”
7. Continually evaluate infection control processes. Ms. Rahn says infection control within GI-driven ASCs is an on-going process. For the endoscopy center, that means continuous evaluation of the daily checklists, maintaining staff accountability, continuing education for staff members, particularly reprocessing specialists, and implementing changes when necessary.
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