Maintaining infection control compliance in ASCs — Key strategies

Infection control is a major priority for any healthcare facility. In 2013, the CDC reported substantial reductions for nearly all healthcare-acquired infections. Between 2008 and 2013, the CDC found a 46 percent decrease in Central Line-Associated Blood Stream Infections. Despite the progress, the CDC did not reach its national goals, and more action is needed from all healthcare facilities to reduce HAIs.

While all healthcare facilities face obstacles in infection control, ASCs encounter a different set of challenges when combating HAIs.   

"It is not like in a hospital setting where you have a dedicated person tied to infection control," says Shoney Lewis RN, MSN-HCSM, clinical director of Conroe Surgery Center in Texas. "In an ASC, the ASC infection control nurse is also in charge of patient care."

Although ASCs may not have a full-time  on-staff nurse leader or physician leader dedicated to heading infection prevention, ASCs can implement certain protocols to ensure its employees are complying with infection control standards. Employees at Mrs..Lewis's facilities occasionally  struggle with complying with moments 1 and 5 of the five moments the World Health Organization outlines in its hand hygiene protocol.

The five moments include:

1. Before patient contact
2. Before aseptic task
3. After body fluid exposure risk
4. After patient contact
5. After contact with patient surroundings. 

"People are unaware of how big of a role hand washing plays in infection control," says Mrs. Lewis. "It needs to become part of the norm. Our goal is to make employees more aware."

Rather than just the casual reminder to wash your hands, Conroe Surgery Center's employees participate in annual educational tools such as an online class that addresses the significance of hand hygiene and other infection control measures. Additionally, the center randomly assesses employees throughout the year to ensure the staff is regularly washing their hands.

Tactics surgery center administrators can use to engage their staff include:

1. Hold an in-service day about infection control and hand washing. Provide education on when to wash hands and proper technique. During the in-service, shine a glow bar on the staff members' hands to show contaminated areas employees can't see with the naked eye. Staff will be encouraged to practice good hand hygiene if they can see the impact.

2. Monitor random staff members weekly, or even one day a month, to watch staff during their daily routine. The monitor person can count how many times staff members are non-compliant with hand washing. Attaching numbers to the problem shows staff how big the problem really is and provides a benchmark for improvement.

3. Hang posters around the surgery center addressing proper hand washing techniques and encouraging patients to remind their providers to wash their hands. Patients will speak up if they're empowered and notice a physician or nurse missed a washing.

The Conroe Surgery Center recently partnered with United Surgical Partners International. Through the partnership, Mrs. Lewis learned new tools for infection control compliance.

"Infection control is really about peaking employees' interest," says Mrs. Lewis. "With the new tools, I can get creative and really engage our staff."

In the United States, HAIs are a leading cause of death, with nearly one in every 20 hospitalized patients contracting HAIs, according to Health.gov. Presently, there is a lack of national data about the number of HAIs originating in ASCs. However, ASCs will continue to evolve and perform more complex procedures, and infection control awareness is gaining traction in the ASC field.  

More articles on quality & infection control:
Harrison Medical Center honored for patient safety: 3 highlights
University of Colorado Health nurse read 800 medical records, subsequently fired — 5 insights
Integrated Health Network sees quality improvements in 1st year of ACO with UnitedHealthcare: 5 things to know

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