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4 ways ASCs balance strict infection control, limited resources
AMBULATORY SURGERY CENTERS
BY CHRISTY NEWLAND
educed costs, faster recovery,
and other advantages can make
outpatient surgical procedures
more convenient for providers and patients
alike. Ambulatory surgery centers
(ASCs) are incredibly safe, but a lot of
work goes into infection control. Crosstrained
staff often wear many hats, and
limited budgets may not leave room
for dedicated infection preventionists.
Smaller facilities may struggle with limited
space and resources, while larger
facilities may face challenges in ensuring
consistency across all areas.
Stringent infection control processes
are increasingly vital as more procedures
shift to outpatient settings. Here
are four recommendations for ensuring
adherence to best practices despite limited
staff and resources.
R
Individualize infection prevention
Whether in a hospital or outpatient surgery
setting, the most effective infection
control policy is tailored to the circumstances,
patient populations, and workflow
of a specific facility. Characteristics
more common among ASCs, such as
smaller staff and a tendency to specialize
in same-day procedures for generally
healthier populations, may lead
these facilities to prioritize essential
measures in high-risk areas, particularly
the OR. Strict adherence to sterile techniques
is crucial to maintain sterility
and prevent contamination during surgical
procedures. Adherence to environmental
guidelines and proper cleaning
procedures are also essential.
Patients also can be vulnerable to
infections before or after a procedure.
To mitigate risks associated with open
wounds or weakened immune systems,
the consensus in both inpatient and
outpatient settings is a bigger focus on
proper hand hygiene, use of antiseptics,
and monitoring for signs of infection
in critical preoperative and postoperative
areas. Ensuring clean, sanitized
recovery rooms also is important to reduce
the risk of infection-particularly
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respiratory infection-during the postanesthesia
period.
Any area where surgical instruments
are handled also should be prioritized.
For an onsite sterile processing department,
essentials include regular training,
evidence-based techniques, and
routine audits. Implementing proper
storage protocols, conducting regular
inventory checks, and cleaning regularly
help mitigate risks associated with improper
storage of sterile supplies.
Technology can help by automating
and enhancing data collection, monitoring,
and reporting. A recent article
in Infection Control Today details how
decision-support tools can use the
electronic health record (EHR) to provide
electronic " nudges " or hard stops
to guide clinicians away from choices
that might increase infection risk. And
with machine learning, EHR data can
help identify patients at highest risk of
healthcare-associated infections (HAIs).
Make the most of what you have
For ASCs facing financial and/or size
constraints, effective infection control
might require redirecting funds and
staff. A thorough review of budget allocations
can reveal opportunities to
not only reallocate resources, but also
maximize the use of existing capacity
and eliminate waste by streamlining
processes. Integrating infection control
responsibilities into daily routines can
make a significant difference. For example,
incorporating infection control
checks into pre-surgery checklists can
help ensure consistency and standardization.
Cross-training
in infection prevention
for all clinical roles can help fully leverage
the expertise of a smaller team.
Formal education programs are often
divided into competency-based training
modules covering specific subjects,
such as appropriate use of personal
protective equipment (PPE). Periodic
refresher courses help ensure staff remain
up-to-date with the latest guideWeek
1: Introduction to infection prevention
* Overview of infection control principles
* Importance of hand hygiene
* Basic PPE usage
Week 2: Advanced infection control techniques
* Sterilization and disinfection methods
* Environmental cleaning protocols
* Handling and disposal of medical waste
Week 3: Practical sessions and simulations
* Hands-on practice of sterilization techniques
* Simulation excercises for infection control
scenarios
Week 4: Competency assessment, feedback
* Competency-based assessments
* Individual feedback sessions
* Review and reinforcement of key concepts
Leverage external resources
Outside resources can be particularly
valuable for training and educating staff.
Partnerships with professional organizations,
such the Association for Professionals
in Infection Control and Epidemiology
(APIC), can provide access to a
variety of training materials and certification
programs.
One prominent resource available to
ASCs is STRIVE (States Targeting Reduction
in Infections via Engagement),
a comprehensive curriculum developed
by infection control experts under the
leadership of the Health Research &
Educational Trust (HRET) and available
through the Centers for Disease Control
and Prevention (CDC). STRIVE offers
a range of infection control modules
that can be useful for new employees
as well as periodic training for existing
staff, including any dedicated infection
preventionists as well as leadership
and even non-clinical roles. Examples
include HAI prevention (including a specific
module on catheter-associated
urinary tract infections); Methicillin-Resistant
Staphylococcus aureus prevention;
and engaging with patients and
families.
ASCs might also explore outside
OR Manager | Mar/Apr 2025 7
lines and protocols. Here is an example
of an infection control training plan:
http://www.ormanager.com
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