Infection Prevention: Ask for Outside Help

Our endoscopy center opened in December 2019, a few months before COVID-19 hit. My head was spinning not only from trying to run a brand new facility, but from rapidly changing infection prevention protocols issued by state and federal governments. I wanted to make sure our team provided a safe environment for patients by keeping up with each new directive, but it was nearly impossible to do as my daily responsibilities began to mount.

To help alleviate some of my stress, I called the infection preventionist I used to work with at our local hospital and asked if she wanted to moonlight at our center as a part-time consultant. She agreed and has become indispensable as we move beyond the pandemic with the same goal of providing safe surgical care. The infection preventionist has a master’s degree in epidemiology and is more than qualified — probably overqualified — to assist our team in many invaluable ways.

• Constant updates. The consultant sends real-time updates on changes to COVID-related guidelines or guidance on new threats such as monkeypox. I regularly receive texts from her that alert me to necessary changes in infection prevention protocols and what we need to do to comply with the new recommendations.

In 2020, during the height of the pandemic, she made sure we implemented measures such as having wipeable chairs in the waiting room and installing signs in the lobby to help patients and their loved ones comply with social distancing requirements. When visitors were prohibited from entering the facility, she helped us implement the process of having patients meet their loved ones at the door at the time of discharge.

• Risk evaluations. The consultant handles our annual infection control risk assessments for requirements such as the management of aerosolized transmissible diseases. We keep the assessments on file in case we need to handle such events and she trains our staff on what to do if they occur. We also rewrote our policies and procedures this year with assistance from a different consultant. A lot of the content was simply beyond my scope, so the infection preventionist reviewed and proofread the updated language and tweaked it to make it specific to our facility.

• Performance audits. The consultant comes in each quarter to conduct a thorough infection control audit to make sure our daily practices are up to speed. She watches our entire perioperative process for about an hour, starting with observing how pre-op nurses perform hand hygiene and start IVs. In procedure rooms, she looks for cross-contamination issues and makes sure staff keep spaces clean, wipe down surfaces adequately between procedures and properly dispose of soiled items. She observes the entire flexible endoscope reprocessing cycle and checks the recovery room to make sure nurses are wearing proper PPE.

Each performance audit is followed by an in-service to review what she saw with the staff and alert them to areas of needed improvement. For example, we wound up changing some of the surface disinfectant products we used based on her recommendations. 

The best part about the arrangement is the convenience of it.

• Annual reviews. The consultant conducts yearly inspections that include watching the environmental services crew clean the facility at night. After reviewing what she observes during the inspection, she goes over our environmental cleaning and disinfection policy with the team and educates its members on contact times for various disinfectants and other cleaning-related topics. She also provides them with links to training videos from the Association for Professionals in Infection Control and Epidemiology on basic infection control principles, PPE usage, chemical safety, and surface cleaning and disinfection procedures and techniques.

• Employee health. She’s helped us adhere to vaccine schedules to make sure staff members are up to date on their required shots upon being hired and remain current throughout their employment. Staying on top of our staff’s vaccination status is important as we attempt to minimize the transmission of infectious diseases to patients and staff.

The best part about the arrangement is the convenience of it. The consultant simply bills us for the hours she logs. Yes, I could spend a great deal of my time figuring out whether a new state department of public health regulation applies to us and, if so, how to apply it. But instead, I just send the consultant a text and get a quick response. She provides a plan of action for us to follow within a week when new policies need to be implemented. Paying the consultant is money well spent and frees me up to focus on running our high-volume facility, which is more than enough to keep me busy. OSM