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ASC Nurses: 3 Tips to Investigate Infection

 

The Periop Life - ASC Nurses: 3 Tips to Investigate Infection

February 21, 2020

In an inpatient setting, there are infection preventionists who are continuously looking at culture and other lab results to monitor for infections. ASC nurses don’t always have access to lab results that happen after a patient has been discharged. 

Investigating an infection outbreak in an ASC requires leg work, phone calls, and research on background and chart review, according to Terri Link, MPH, BSN, CNOR, CIC, CAIP, FAPIC, an AORN perioperative education specialist and infection preventionist.

“When you do suspect an outbreak, don’t panic,” Link stresses. Instead, determine what the impact of a potential infection will be and base the expediency of your investigation on this factor.

For example, an uptick in infections for podiatry cases that occurred over the last year may be less urgent than urinary tract infections in all patients undergoing urology cases performed last week. It depends on the organism and its virulence and the resulting impact.

“Having a clear plan for an outbreak investigation is key,” Link advises. Here are her three tips for conducting an outbreak investigation in an ASC:

  1. Determine if it’s really an outbreak.
    There is some investigation that needs to be done and data collected before this can be determined, yet there is a fine line when it may be a serious event that must be addressed immediately. “It is always better to err on the side of caution,” Link says. “When you have small numbers in an ASC and less staff it is more difficult to find significance when there may be only two rooms and six people on staff.”
  2. Gather more information than you need.
    It takes a lot of time to collect data and do chart reviews, so even if you don’t think it is necessarily something you need, go ahead and gather the information. It is easier than having to go back into a chart. An example could be co-morbidities that increase a patient’s risk for SSI.
  3. Know the criteria for SSI and then provide a description of the event.

For example, a definition might be: Breast infections following mastectomy with reconstruction and insertion of tissue expanders. Always include a broad definition to start so you can capture all cases and then refine to narrow it down.

Link will be sharing a risk assessment template and more practical advice for an ASC infection outbreak investigation during the ASC Summit at AORN Global Surgical Conference & Expo in Anaheim, CA, March 28-April 1. As a bonus, each ASC Summit attendee will also receive complimentary access to AORN's ASC Infection Prevention online course ($300 value).

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