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FEATURE


bara Holder, RN, quality improve- ment, infection control, safety and regulatory officer for Andrews Insti- tute Ambulatory Surgery Center. “During our daily huddles, safety concerns are always discussed first. Our surgical timeout includes a break that encourages employees to speak up about any safety or environ- mental concern. We also have small dry-erase boards hanging in several departments for staff to write on and share their issues and concerns, which are then discussed during the next huddle. Observation and com- munication are key.”


Monitor and Improve


Perform an assessment that assesses your ASC’s specific infection risks. Use this information to build the plan staff and housekeeping service providers should follow when cleaning these spaces to achieve a safe and sanitary environment.”


— Laurie Roderiques, RN, CAIP, CASC Ambulatory Healthcare Strategies


staff, this would include any vendor representatives you invite into your facility. Everyone must know their responsibilities, including what sur- faces they should avoid touching and any rules for bringing outside items, like equipment and briefcases, into these spaces.”


Uncertainty about cleaning prac- tices can raise the risk for infection, Berus says. “Do not miss any oppor- tunity to ensure everything that must be cleaned is done so properly. For example, do your staff know how to clean computer technology, such as keyboards, mice and monitors? What about equipment used by your anes-


thesia providers? Staff may hesitate to clean near these items if medica- tion is sitting out. Your policies should account for any likely scenario staff may encounter.” Do not overlook the importance of proper ventilation, Roderiques says. “Maintain positive air pressure in your OR to keep contaminants out. Closely check temperature and humidity as well. Each area of your facility should have designated safe ranges that are watched closely to help ensure patient safety.” Provide a forum for staff to ask questions and express concerns about cleaning practices, says Bar-


16 ASC FOCUS SEPTEMBER 2019 | ascfocus.org


Accountability and ongoing moni- toring will help ensure staff properly complete their cleaning responsibil- ities, Gatton says. “Our department managers perform daily rounds and document their observations. Monthly facility rounds are performed by our quality improvement manager.” Take the time to develop monitor- ing tools specific to your ASC’s poli- cies and processes, Roderiques says. If an SSI occurs, ASCs should take


an “all-hands-on-deck” approach in response, says Berus. “Assemble a multi-disciplinary team. If the inci- dent can be tied back to something that likely happened in the OR, bring together a scrub technician, nurse, anesthesia provider, surgeon and any other members of your surgical team. Talk through your processes and fig- ure out not only what was done right and wrong, but also the potential opportunities for improvement.” When you identify those oppor- tunities, Berus says, formulate an action plan and implement it. “The plan might concern educating staff or creating a checklist that is reviewed by a manager to better ensure all environmental cleaning processes are followed 100 percent of the time.”


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