As a growing number of patients receive care in outpatient settings as opposed to hospitals, the risk of healthcare-acquired infections and patient safety issues will increase, prompting a need for care facilities to focus more on implementing infection control programs, according to a guide for infectious disease control in clinics published in Open Forum Infectious Diseases.
The authors, infectious disease experts at The University of Texas Health Science Center at Houston, offer a step-by-step guide listing what clinicians must do to achieve better infection prevention and control.
"Our mantra is 'It's OK to ask.' So it's OK to ask your doctor or nurse if they washed their hands and if the instrument they are using on you is sterilized," said Luis Ostrosky, MD, professor of infectious diseases at McGovern Medical School at UTHealth. "People need to be their own advocates to make sure they're being taken care of safely."
Here are three infection prevention methods for outpatient facilities to prioritize, according to the guide.
1. Hand hygiene. The paper argues for hand hygiene facilities to be present in patient care areas, medication preparation areas and medical equipment cleaning areas. "Patients should also make use of the hand gel sanitizer dispensers in clinic reception areas. We advocate for the use of these gels for medical professionals before and after they finish an examination," Dr. Ostrosky said. "In addition, using soap and water is necessary when there's visible soiling of the hands because the gel will not wash it away."
2. Injection safety. In recent years, most reported viral and bacterial outbreaks due to dirty syringes have happened in outpatient settings, the authors noted. These outbreaks are frequently attributed to a lack of access to hand hygiene facilities, reuse of vials and syringes and medication mixing. In all of the reported outbreaks, the implementation of basic infection prevention measures led to a decline in subsequent infection transmission.
"People can make sure the injection is drawn in a sterile fashion and that an antiseptic is used. It needs to be a brand new syringe and the little stopper for the vial must be wiped. Think fresh, in front of you, sterile materials and antiseptics," Dr. Ostrosky said.
3. Cleaning, sterilization and high-level disinfection. For older clinics that only have one room for cleaning reusable medical devices, the authors advise facilities to focus on the separation of clean and dirty processes.
"For example, when your dental or minor procedure surgical instruments are presented to you or opened there should be a chemical indicator in the pack marking whether it has met the sterilization parameters," said first author Fozia Steinkuller. "The other things you can ask are whether their instrument and scopes used to examine inside cavities such as the nose and colon have been reprocessed and if the people reprocessing have been trained? These are simple answers that every provider should have."
To read the full guide, click here.