One way an ASC can reduce infection risk is by requiring staff to be up to date on vaccinations.
“This is about people raising their expectations of how infection control is performed at surgery centers,” says Jeffrey Silvers, MD, noting ASCs should adhere to the same infection control practices as acute care hospitals. “There are a lot of activities and practices at surgery centers that would not be tolerated at acute care hospitals ... People need to make sure they follow all the infection prevention guidelines. One area I like to focus on is immunization of healthcare workers, which is a form of infection control in terms of keeping people from getting ill.”
For example, from October through April, there is a serious risk of staff contracting influenza. “Influenza transmission from healthcare workers to patients or vice versa is a very significant risk in ASCs,” Silvers says. “People do not necessarily take off work when they’re ill.”
The flu vaccine is not perfect, but it is helpful and should be encouraged. “In hospitals, we require a vaccinator mask,” Silvers says. “Either you get vaccinated, or you wear a mask from Oct. 1 through the end of April every year to reduce the risk of transmission to other healthcare people or to patients.”
Some local government ordinances require healthcare staff to take the annual flu vaccine or wear a mask during flu season. Even when the flu vaccine has lower immunity, it still covers 25-50% of strains circulating. Further, the flu vaccine could prevent healthy adults from infecting older or less healthy people, Silvers notes.
“Even if you never get sick, and you say you’re healthy, you may have a mother, father, brother, and sister who can’t afford to get sick, and they get sick because you don’t take the vaccine,” he says. “Getting the flu vaccine is really about everyone.”
Shingles is another potential problem. “Recently, I was contacted by an ASC because of an issue they had with possible exposure by an employee with shingles,” Silvers says. “We expect people to have immunity to chicken pox as part of the condition of their employment, and now we’ll look at shingles. At Sutter Health, we consider immunization such an important component of our providing safe care that we mandate it. But not all hospitals and surgery centers will do that.”
Sutter Health’s vaccination rate rose dramatically after the policy change.
“It requires you to make vaccines available to staff,” Silvers notes. “We offer them at no charge, making it easy for people to get vaccinated at work at scheduled times.”
Sutter Health reports a high compliance rate. Physicians must show proof of vaccination before they get privileges. Healthcare workers need proof of immunization before they are hired.
ASCs could require physicians and staff to be up to date on vaccinations, too. Administrators also could place hand hygiene stations with masks, gloves, and gel at the entrance of the facility. Signs might read, “Cover your cough,” or “If you have something contagious, please tell the facility,” Silvers suggests.
“If these hygiene stations are easy and convenient, people will use them,” he says. “We had a lot of success with them this past winter.”
When one health system required immunization for all staff, compliance rose, thanks in part to the system offering all employees vaccines for free but also tying privileges to policy adherence.
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