DWELL TIME Be sure surfaces remain wet with the germicide for as long as the label indicates.If you want to give your center's infection prevention efforts an immediate boost, focus your attention on these 5 areas, which continue to be trouble spots for a surprisingly high number of surgical facilities I visit.
1. Unsafe injection practices. You should dedicate multi-dose vials to a single patient whenever possible, yet I continue to see staff draw up medication at the point of use, put the vial back in the anesthesia cart and use it for the next patient. Or I see multi-dose vials of irrigation medication for orthopedic procedures left with the needle and syringe in the diaphragm for many procedures (treat irrigation vials the same as injectables). As a rule: If a multi-dose injectable medication vial enters an immediate patient treatment area such as the operating and procedure rooms, anesthesia and procedure carts, and patient rooms or bays, it should be dedicated for single-patient use only.
This is not to say you can't use multi-dose vials for more than one patient. If you do, keep and access the vials in a dedicated medication preparation area (the nurses station or outside the procedure room) away from immediate patient treatment areas. This is to prevent not only the risk of entering the vial with the same needle and syringe used during the procedure, but also the inadvertent contamination of the vial through direct or indirect contact with potentially contaminated surfaces or equipment. The key word to remember is access. If you access the multi-dose vials in the room where surgery is taking place or some other immediate patient treatment area, dedicate the vial to that patient. If you draw up the medication outside the immediate patient care area, you can use the vial for more than 1 patient, provided the anesthesia provider labels it appropriately according to CMS requirements.
