Current Challenges in Infection Control & Prevention in Ambulatory Care: Q&A With Beverly Robins of HFAP

Beverly Robins RN, BSN, MBA, is director of accreditation services for the Healthcare Facilities Accreditation Program. Ms. Robins joined HFAP in October. She most recently served as director of nursing ambulatory care at the University of Chicago, and previously served as the Joint Commission's field director of ambulatory care for nearly eight years.


Q: What are the top challenges relating to infection prevention and control facing ambulatory care today?

Beverly Robins: With respect to infection prevention and control, ambulatory care facilities are challenged with having an effective infection prevention and control program. The key is to have knowledgeable individuals responsible for developing and managing, as well as implementing, the infection prevention and control program for the facility.


Qualified personnel must be designated to oversee the infection control and prevention activities of the ambulatory surgery center. Although the designee must have ongoing education about infection prevention and control activities, they are not required to be an infection control nurse. Membership to a professional association such as APIC, the Association for Professionals in Infection Control and Epidemiology, may be a valuable educational resource for this person.


Staff practicing in ambulatory care settings may be able to utilize the resources of a local hospital. In general, hospitals offer a wide array of in-services on various infection prevention and control related topics that may prove to be a valuable and cost-effective resource to ASC staff. However, any information obtained from them must be revised so that it is applicable to the ambulatory setting and services offered by the facility.


Q: Can this ASC staff member participate in these activities even if the ASC is not directly affiliated with the hospital?


BR: ASC staff are advised to contact the infection control nurse at a local hospital to request permission to attend in-services related to infection control and prevention. ASC staff may be allowed to attend in-services sponsored by the hospital, especially if both the hospital and ASC are engaged in a communitywide initiative.

Q: What are some other ways to obtain infection prevention and control training?


BR: ASC staff can purchase an infection control manual that addresses issues that are specific to ambulatory care settings. They can receive education and training via online self-study programs that offer continuing education units and are self-paced. Also, staff  can register to attend seminars and training sessions that are offered nationally or locally.

Q: Why do some ambulatory care facilities struggle with infection prevention and control?


BR: Oftentimes in ASCs, staff wear multiple hats. However, staff designated to oversee the infection control and prevention activities must have sufficient time to review infection control risks within the ASC, prioritize goals relating to infection control, monitor hand hygiene practices, instrument sterilization, equipment cleaning and other associated activities.


ASC staff must be educated about the standards requirements and have sufficient time to review and implement the infection control activities in the ASC. The ultimate responsibility falls back to the governing body — the governing body must allocate appropriate staff resources and allow sufficient time for staff to perform their duties in order to minimize the spread of infection in its ASC.


Q: How do you bring leadership around to support and allocate resources?


BR: The key is to provide the governing body with data that supports the need for additional resources. If the staff can show comparative data for staffing ASCs of their size, they may be in a position to make a compelling case for the additional resources if needed. It is a matter of presenting the requirements that must be performed to the governing body and making a business case for additional resources needed in order to accomplish the work. Lastly, staff can provide evidence that demonstrates how effective infection control and prevention activities improve patient outcomes in their setting.


Learn more about HFAP.

More Articles Featuring HFAP:

CMS Issues Revised '30-Minute Rule' on Administration of Medication

12 Questions to Ask to Ensure an Effective Hand Hygiene Program

Top Healthcare Challenges, Emergency Preparedness & Value of Leadership: Q&A With Joseph Cappiello of HFAP

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