Patient, protect thyself in ambulatory care
Get answers about injections, IP, hand hygiene
The Association for Professionals in Infection Control and Epidemiology (APIC) is urging patients to heighten awareness and become quite inquisitive before undergoing outpatient care.
"As more health care is delivered outside the hospital, consumers can arm themselves by asking questions before undergoing a surgical procedure or receiving care at an ambulatory facility," APIC advised. APIC's tips for patients include the following:
• Injection practices: In 2008, more than 60,000 people were notified of their risk of hepatitis C due to reuse of syringes at a Nevada endoscopy clinic. There also have been reports of reuse of fingerstick devices and insulin injection devices meant for individual use. Reused syringes can transport tiny fragments of a patient's blood to the next medication vial, potentially infecting other patients. Syringes and needles must be used one time only. Before receiving an injection, ask if the needle and syringe have been newly opened for you. Inquire if the center uses single-dose vials of medication or multidose vials with strict controls. If they use multidose vials, ask if they unwrap a new syringe and needle for each dose of medication. If you will receive intravenous fluids, ask that they do not use the bag for other patients or set up the intravenous tubing until they are ready to administer to you.
• Infection preventionist: Each facility should employ an infection preventionist either on staff or as a consultant to oversee their infection prevention program. Unfortunately, there is often less oversight in ambulatory care clinics as opposed to hospitals, which are more highly regulated. Ask if there is an infection prevention program and a staff person or consultant dedicated to this function. Find out how often they receive training or recertification. Ongoing training and recertification of facility staff is essential.
• Cleaning: Each facility must have written policies and procedures on cleaning of instruments, operation of sterilizers, and routine preventive maintenance of equipment and all other facets of operation. Ask who is responsible for ensuring that daily cleaning and disinfection, as well as preventive maintenance of equipment is occurring. Find out if there are policies and appropriate checks on procedures for cleaning and sterilization of instruments and equipment.
• Hand hygiene: Hand hygiene is the most effective way of preventing the spread of infection. The chances of developing an infection can be significantly reduced if health care staff cleanse their hands before and after examining patients. Please ask health care staff who come to examine you if they have washed their hands or used the alcohol hand rub. Do not feel embarrassed or awkward when requesting this information, as they welcome your help in keeping you safe. As a patient, you also should practice good hand hygiene after using the bathroom, before eating, after shaking hands, after blowing your nose, and before and after touching the bandage on your surgical incision. This applies to visitors and care providers at home as well.
• Protective gear: Personal protective equipment, such as gowns, head cover, masks, gloves and goggles are worn by health care workers to reduce the transmission of microorganisms (germs) that could cause infection. Be sure to ask if health care workers, including the surgeons, wear protective apparel when performing sterile procedures.
• Your health care team: Ask who will perform the procedure and who will be providing the anesthesia services. Find out what their experience is in providing these services. You have every right to ask about the surgeon's infection rate and inquire about the experience of the rest of staff at the facility. This is particularly important when services are being provided to children or seniors.
• Clinic licensing: Some states require ambulatory care facilities to have a license to perform certain procedures. Ask if the procedure you are having is required to be done at a licensed facility and if this center has such a license.
The Association for Professionals in Infection Control and Epidemiology (APIC) is urging patients to heighten awareness and become quite inquisitive before undergoing outpatient care.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
- Award-winning Medical Content
- Latest Advances & Development in Medicine
- Unbiased Content