Becker's ASC Review

49 Quality & Accreditation I nfection control is a major priority for any healthcare facility. In 2013, the CDC reported substantial reductions for nearly all health- care-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 health- care facilities to reduce HAIs. While all healthcare facilities face obstacles in in- fection 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 imple- ment certain protocols to ensure its employees are complying with infection control standards. Em- ployees at Ms. Lewis's facilities occasionally strug- gle with complying with moments one and five of the five moments the World Health Organization outlines in its hand hygiene protocol. e five moments include: 1. Before patient contact 2. Before aseptic task 3. Aer body fluid exposure risk 4. Aer patient contact 5. Aer 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 mea- sures. 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. e 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 pro- vides a benchmark for improvement. 3. Hang posters around the surgery center address- ing proper hand washing techniques and encourag- ing 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. e Conroe Surgery Center recently partnered with United Surgical Partners International. rough the partnership, Ms. Lewis learned new tools for infection control compliance. "Infection control is really about peaking employ- ees' interest," says Ms. 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 pa- tients 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 aware- ness is gaining traction in the ASC field. n 5 Key Notes on Hand Hygiene in Outpatient Settings: CDC Report By Laura Dyrda Maintaining Infection Control Compliance in ASCs — Key Strategies By Mary Rechtoris T he CDC released a new report titled "Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care," which in- cluded key recommendations for hand hygiene in the outpatient setting. Here are key takeaways from the report on hand hygiene: 1. Both the CDC and World Health Organization recommend using alco- hol-based hand rubs as the primary hand hygiene mode in healthcare set- tings because ABHR can protect against an array of pathogens and there is increased compliance when compared with water and soap hand washing. 2. Hand hygiene should be performed before contact with the patient and before performing an aseptic task, such as inserting the IV or preparing an injection. 3. Hand hygiene should occur aer contact with patients or objects in the immediate vicinity of the patient as well as aer contact with blood or bodily fluids. Hand hygiene should also occur aer removing personal protective equipment. 4. When moving hands from a contaminated body-site to clean body site, providers should practice hand hygiene during patient care. 5. Providers should use soap and water to clean their hands when their hands are visibly dirty or aer caring for patients with Clostridium dif- ficile or norovirus. n "People are unaware of how big a role hand washing plays in infection control. It needs to become part of the norm. Our goal is to make employees more aware." — Shoney Lewis, RN, Conroe Surgery Center in Texas

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