On tips for managers to improve infection control in the ambulatory setting
With Mickie Parsons, RN, MSN, CNOR
Perioperative Nursing Consultant
On tips for managers to improve infection control in the ambulatory setting
With Mickie Parsons, RN, MSN, CNOR
Perioperative Nursing Consultant
This month in AORN Management Connections we talk to Mickie Parsons, RN, MSN, CNOR. She is a perioperative nursing consultant who has been working with ambulatory facilities to update and implement their infection control programs in order to meet the Centers for Medicare & Medicaid Services revised (CMS) conditions for coverage.
AORN Management Connections(AMC): It’s sort of a paradigm shift in ambulatory surgery centers (ASCs), in line with these conditions for coverage, to move from being reactive and educating after when something goes wrong to taking a more positive, proactive approach, so is it important to stress that shift in thinking?
Parsons: It is, and the first place this has to start is with the management of the ambulatory center. The administrative team has to realize that this is a critical part of not only maintaining their Medicare compliance but also in infection prevention and risk management, and it flows from there. It is all over the map in terms of who wants to really take the bull by the horns and say, “Okay, on every second Thursday of every month we will have a period of analysis and staff education, and we will pay staff to attend this.” That represents a significant change which some organizations have been unable to implement thus far.
AMC: In thinking about really establishing an infection control program, can you talk about the key roles and elements of the program that are required to make it successful in an ambulatory surgery center?
Parsons: Well they would be the same as in an acute care center. Obviously first you start with someone who is a qualified infection preventionist—that is a person who has had specific training in infection control—there are a number of places to obtain that. The most well known are the CDC courses that credential someone in infection control. A health care professional is not eligible to become credentialed until they have two years of employment in the role of infection preventionist. There are a series of courses that build upon each other leading to certification. The Association for Professionals in Infection Control and Epidemiology also provides resources for infection control practitioners.
AMC: How do things like surveillance and reporting fit into a successful infection control program?
Parsons: These are very critical elements. Once there is a qualified person who is willing to accept these responsibilities a three-pronged approach should be developed. The first consideration must be an organized system of data collection relate to surgical site infections working collaboratively with surgeons and their office personnel and following guideline established by the Center for Disease Control and specific States for reporting. Accuracy is essential.
Next the focus should be on staff competency and education related to infection control practices to identify deficiencies in these areas. The Infection Preventionist should work collaboratively with the nursing leadership in this effort. Included should be an in depth assessment of instrument processing activities. This has become a specific practice area based on exact science hence requires an adequately prepared staff to accomplish this critical function. It follows then, that the Infection Preventionist must be conversant with accepted practice in this area and with applicable national Standards.
AMC: What is your take away message to managers, directors and educators listening to this Q & A and reading the article about where they should be with their infection control programs and about the value of infection control in their facility, not from just CMS but in general?
Parsons: Well, infection control is absolutely critical to positive outcomes for patients. While the
tasks in looking at the revised [CMS] guidelines seem daunting in terms of setting up a program and having a well-trained professional in charge of the program, it is doable. I would suggest just tackling it one step at a time until you have something that is very functional in place, and use available resources.
As a perioperative nursing consultant Parsons works with AORN Works, a subsidiary of AORN.
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