orm_june-2024 - 8

Surgery center culture must prioritize cleaning, hand hygiene
STERILIZATION & INFECTION PREVENTION
A
mbulatory
surgery
centers
(ASCs) play an increasingly crucial
role in delivering outpatient
surgical care that is efficient, effective,
and-most importantly-safe. As
the ASC sector continues to grow and
evolve, maintaining best practices in
hand hygiene and environmental cleaning
and disinfection is imperative to
protect patients from infections. ASCs
also should strive to cultivate a safety
culture that prizes continuous improvement
and continuous learning, including
education and training focused specifically
on infection prevention.
Hand hygiene
Hand hygiene is the most important
practice for healthcare professionals to
prevent the spread of infection. However,
the World Health Organization
(WHO) estimates hand hygiene compliance
in healthcare is only around 40%
worldwide.
In ASCs, factors contributing to incomplete
or inconsistent practices
include skin irritation, inadequate resources
(sinks, towels, etc), understaffing,
and insufficient training. Time
constraints due to busy work environments,
high patient volumes, and competing
priorities also can interfere with
prioritizing hand hygiene.
Establishing accountability for hand
hygiene requires consistently enforcing
and reinforcing best practices. One
example is washing hands at critical
moments, such as before and after patient
contact, after touching a potentially
contaminated surface, and before
performing invasive procedures. Another
is washing for at least 20 seconds.
Rushing and overlooking areas where
pathogens proliferate-between the fingers,
under the nails-can result in inconsistencies
put patients at unnecessary
risk of harm.
Organizations such as the Centers
for Disease Control and Prevention
(CDC) and the WHO offer resources
to help evaluate and improve existing
8
OR Manager | June 2024
practices. These include guidelines and
checklists specifically for outpatient
settings (see References). Other essentials
for hand hygiene include sufficient
inventory of products; access to
training and education; and regular risk
assessments, monitoring, and auditing.
Fully embracing hand hygiene may
require a culture change. For example,
peers should feel empowered to hold
one another accountable for adhering
to best practices.
Environmental disinfection,
cleaning
Maintaining a clean, hygienic environment
is crucial for minimizing the risk of
healthcare-associated infections. However,
issues such as inconsistent cleaning
schedules, insufficient resources,
knowledge gaps, and lack of oversight
can hamper an ASC's efforts.
Standardized, transparent processes
can help prevent lapses in environmental
cleaning and disinfection practices.
All staff should be clear about
who is responsible for what tasks, how
frequently any given area should be
cleaned, and which products and techniques
are most appropriate for the
job. Regular audits and inspections are
essential to assessing compliance with
cleaning protocols, identifying areas for
improvement, and providing feedback
to staff.
Additionally, healthcare workers responsible
for environmental cleaning
must be trained in effective cleaning and
disinfection methods, including appropriate
dilution, disinfectant application,
and adherence to recommended contact
times. Training should be tailored to the
staff members' specific needs. For instance,
surgical technologists or sterile
processing personnel might require adhering
to specific procedures that do not
apply to those responsible for general
housekeeping, which requires knowledge
of the safety protocols and potential
hazards associated with different
chemicals.
BY ERICA SMITH
Distributors can help ASCs ensure
they have the appropriate equipment
and supplies, and that cleaning agents
or disinfectants are compatible with the
pathogens commonly encountered in
healthcare settings. Compared to hospitals,
ASCs need flexible stocking requirements,
standard inside delivery,
and low minimum order requirements.
A culture of safety
For ASCs, the lack of standardized, ongoing
infection prevention education initiatives
is a major obstacle to sustaining
long-term improvement. ASCs might
also struggle to dedicate resources or
personnel specifically to infection prevention
initiatives. In the absence of an
infection preventionist or department,
responsibility for education and training
may fall by the wayside, leaving staff
members without the necessary knowledge
and skills or a full appreciation for
their role in preventing infections.
Rather, ASCs must not overlook regular
training sessions covering essential
topics such as hand hygiene, sterilization
procedures, and environmental
cleaning and disinfection. However, reinforcing
key concepts requires more than
didactic lectures. Practical, hands-on
training is also essential. Interactive
workshops and simulation-based training
can provide opportunities to practice
hand hygiene techniques, donning and
doffing personal protective equipment
(PPE), and cleaning and disinfection
procedures. Conducted in a controlled
environment, such training facilitates
the kind of practical feedback and technique
reinforcement required to effectively
implement infection prevention
protocols in daily practice.
In addition to incorporating both theoretical
and practical instruction, an
ASC's comprehensive education and
training curricula should be tailored to
the specific needs and roles of staff
members. Online learning platforms,
mobile applications, and virtual reality
simulations can provide flexible, interacwww.ormanager.com
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