Results are in from the first round of government inspections of infection control practices at ASCs and the news is not good: About two-thirds of the 68 surgery centers surveyed had at least 1 documented lapse in infection control, and 18% had lapses in 3 or more of the 5 categories assessed by surveyors from the Centers for Medicare and Medicaid Services and the Centers for Disease Control and Prevention.
Improper hand hygiene, gloving, injection safety and equipment reprocessing were among the "suboptimal" practices discovered during the pilot round of infection control surveys conducted in 2008, according to findings presented at the International Conference on Healthcare-Associated Infections.
The improper reuse of single-use devices appears to have been a recurring problem unearthed during the surveys, which were conducted in Maryland, North Carolina and Oklahoma from June to October 2008. The findings, broken down in Table 1, show facilities were cited for using single-dose medication vials, spring-loaded lancing penlets for blood glucose monitoring and other single-use devices, such as bite blocks, for multiple patients. Other examples of lapses were failure to wash hands after contact with body fluids and failure to properly clean OR surfaces after procedures.
The researchers, led by Melissa Schaefer, MD, of the CDC's Division of Healthcare Quality Promotion, found no statistically significant association between infection control lapses and the volume of procedures performed at an ASC or a particular facility type. Based on the findings, they conclude that "adherence to infection control in this sample of ASCs was suboptimal."
Recently, CMS collaborated with the CDC to pilot a new audit tool to assess adherence to infection control as part of the inspection process. The first round of CMS/CDC surveys examined in this study has since been expanded nationwide with funding from the 2009 federal economic stimulus package. The researchers encourage ASCs to review the audit tool surveyors are using and consult with evidence-based guidelines and requirements to ensure they're complying with proper infection control practices.
OSM has guidance on how to ace your CMS infection control survey here and here.
Irene Tsikitas
Table 1 courtesy of "Multi-State Infection Control Assessment of Ambulatory Surgical Centers, 2008" by Schaefer, et al.
