Improve ASC Outcomes Through Environmental Hygiene Assemble a multidisciplinary team, follow evidence-based guidelines and use the right tools BY ROBERT KURTZ

R ockford Ambulatory Surgery Center in Rockford, Illinois,

assumes every patient who walks in the door to be potentially infectious. That mentality, says Gina Hartman, RN, CASC, the ASC’s director of perioper- ative services, helps keep staff focused on effectively cleaning any surface that might come into contact with patients. “By ensuring environmental hygiene has been completed, our periopera- tive staff reduce the risk not only for postoperative infections but also con- tagious respiratory diseases,” she says. Proper cleaning and disinfection

that follows recommended practices are critical to the prevention of health- care-associated infections, says Carol Calabrese, RN, senior clinical adviser for infection prevention for Diversey in Fort Mill, South Carolina. “If an ASC promises to provide a safe envi- ronment for patients, then it must work to deliver on that promise,” she says. To identify potential opportunities to strengthen your ASC’s environ- mental hygiene program, assemble a multidisciplinary team to assess your processes, Calabrese says. Include on this team individuals responsible for infection prevention, quality, nursing, anesthesia and environmental ser- vices. “If your facility is cleaned by a building service contractor, include a representative from that company as well,” she advises. During the COVID-19 health crisis, Hartman says, environmental hygiene and cleaning responsibilities have been extended beyond clinical staff. “Beginning in March, our business office staff became an integral part of these processes. We have empowered all members of our team to contribute to cleaning and provide input for ways to improve what we do.”

Enhance your environmental hygiene program by verifying whether your prac- tices align with guidelines from orga- nizations like the Association of peri- Operative Registered Nurses and other evidence-based practices, Calabrese says. “You want to try to ensure that processes are easily understood and the roles and responsibilities of all stake- holders are clearly outlined.” Recent changes to Rockford’s envi- ronmental hygiene program have largely concerned non-clinical areas, with efforts focused on combatting poten- tial risks associated with COVID-19, Hartman says. Among the new pro- cesses: Patients are informed multiple times prior to surgery that facial cov- erings are required for entry into the ASC. Every patient must use hand sanitizer upon entry. The ASC’s wait- ing rooms are cleaned more frequently throughout the day. Visitors are not permitted, except for those accompa- nying pediatric patients.

“The multidisciplinary team can identify the high-touch surfaces in the non-clinical space that now


require more frequent disinfection,” Calabrese says. Hartman expects the pandemic to

result in some permanent changes to her ASC’s processes. “I believe that more frequent disinfection of non-sur- gical areas will remain a standard part of our infection control program.” If you want a successful environ-

mental hygiene program, staff need the right products and tools to complete proper cleaning and disinfection, Cal- abrese says. “You must ensure recom- mended contact times can be achieved, the product used has coverage for the pathogens of concern and time allotted is sufficient to get the job done. Stan- dardization here is key.”

Successful cleaning and disinfec- tion also require validation by a mea- surable process. This, Calabrese says, can be accomplished by leveraging one or more methods, with fluorescent marking and adenosine triphosphate as the most used.

Of utmost importance to maintain- ing a successful program is delivering education and training upon hire and then again at least annually. “Focus on processes, products and why clean- ing and disinfection is so important in ASCs,” Calabrese says. “Competency testing and observation should be incorporated to ensure team members are knowledgeable and following your policies and procedures.”

Hartman hopes that the pandemic

will ultimately lead to improvements in patient safety and outcomes. “I believe, as healthcare professionals, we have a responsibility to learn and discover bet- ter methods for infection prevention and how they can be applied to best serve our patient community.”

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