Infection Control in Ambulatory Surgical Centers

Richard T. Ellison III, MD


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In This Article

Abstract and Introduction


A survey of randomly selected centers in the U.S. identified lapses in infection-control practices in 68%.


A hepatitis C outbreak stemming from unsafe injection practices at an ambulatory surgical center (ASC) in Nevada highlighted the potential for healthcare-associated infections in such facilities. Subsequent inspections of all 51 Nevada ASCs identified lapses in infection-control practices in 53%. To determine the magnitude of the problem nationally, the Centers for Medicare & Medicaid Services (CMS) conducted assessments in a random sample of ASCs in three other states.

In 2008, trained surveyors performed full, unannounced inspections of 68 ASCs (including endoscopy, dental, and pain centers). They assessed adherence to five general categories of infection control practices: hand hygiene and use of personal protective equipment; injection safety and medication handling; equipment reprocessing; environmental cleaning; and handling of blood glucose monitoring equipment.

Overall, the surveyors noted at least one lapse in practice at 46 centers (68%) and deficiencies in three or more of the five practice categories at 12 centers (18%). The lapses seen at the highest proportion of centers involved handling of blood glucose monitoring equipment (46%), equipment reprocessing (28%), and injection practices (mainly use of single-dose medications for more than 1 patient; 28%).


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