CMS tool for hospitals will go beyond ASC survey
Hand hygiene, needle use likely included
A survey tool to assess infection control in ambulatory surgical centers (ASCs) was created by the Centers for Disease Control and Prevention for use by inspectors for the Centers for Medicare & Medicaid Services. As the two agencies discuss creating a similar tool for hospital inspections, an expansion beyond the ambulatory care model is expected. That survey tool included some basic environmental cleaning, disinfection and sterilization requirements along with soliciting a "yes" or "no" response in the following areas:
I. Hand Hygiene
- Soap and water are available in patient care areas
- Alcohol-based hand rub is available in patient care areas
- Staff perform hand hygiene:
- Before and after an invasive procedure (e.g., insertion of IV catheter, intubation/extubation, surgical procedure) even if gloves are worn
- After contact with blood, body fluids, or nonintact skin (even if gloves are worn)
- After contact with used, contaminated medical equipment or visibly contaminated environmental surfaces (even if gloves are worn)
Regarding gloves, staff:
- Wear gloves for procedures that might involve contact with blood or body fluids
- Wear gloves when handling potentially contaminated patient equipment
- Remove soiled gloves before moving to next task
II. Injection Practices (medications, saline, other infusates)
- Needles and syringes are used for only one patient
- Injections are prepared in a clean area that is free from contamination with blood, body fluids, other visible contamination, or used contaminated equipment
- The patient's skin is prepped with an antiseptic before IV placement
- List all injectable medication/infusates that are in a vial/container used for more than one patient. This should include the medication name, size of vial (cc/mL) and the typical dose per patient (cc/mL)
- Single-dose medications/infusates are used for only one patient and not collected or combined (bags of normal saline are ALWAYS single use)
- Multidose medications/infusates are used for only one patient (note: a "No" answer here is not necessarily a breach in infection control. Circle N/A if no multidose medications/infusates are used.)
- Medication vials used for more than one patient are always entered with a new needle and new syringe
- The rubber septum on a medication/ infusate vial is disinfected with alcohol prior to piercing after initial entry
- Medications/infusates that are packaged as prefilled syringes are used for only one patient
- Medications/infusates are drawn up at start of each procedure
- Fluid infusion and administration sets (e.g., intravenous bags, tubing, and connectors) are:
- Used for one patient only
- Disposed of after use
- Needles and syringes are discarded intact in an appropriate sharps container after use.
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