How to Improve Sterilization Processes in Ambulatory Settings

How to Improve Sterilization Processes in Ambulatory Settings

Outpatient surgeries are prevalent in the healthcare field. Medical professionals at outpatient centers, or ambulatory centers, perform a variety of ambulatory surgical procedures. The benefits of ambulatory settings are ample; they’re affordable, offer accessible scheduling, and allow patients to recover in the comfort of their own homes. In order to keep these surgical centers safe and effective for procedures like wisdom tooth removal, biopsies, small tendon repair, and more, all healthcare professionals must follow stringent sterilization processes for surgical instruments.

If the sterilization process at an ambulatory center isn’t as rigorous as it could be, healthcare workers and patients alike are at risk of infection. Ambulatory centers can follow specific guidelines to improve sterilization processes and implement proper infection control practices to keep everyone safe. Read on to learn more about how your ambulatory surgical center (ASC) can improve sterilization processes. 

What Are Common Clinic Issues That Contribute to Improper Sterilization?

When it comes to sterile processing in ASCs, there are many proper and improper protocols. Typically, there are a few issues that are the common denominator of improper sterilization events. These circumstances include:

  • Space deficiencies for instrument reprocessing. It isn’t uncommon for the number of procedures to increase without corresponding increases in personnel, instrumentation or space in the instrument processing area. 
  • Outdated supplies
  • Reuse of single-use devices
  • Use of non-surgical grade instruments, which is common in medical offices/clinics
  • Lack of knowledge about instrument cleaning and sterilization

Poorly designed healthcare facilities can lead to improper sterilization processes (e.g., cross contamination) if the space was not designed to have ample room for necessary decontamination, instrument preparation and packaging and sterilization. With these common circumstantial issues in mind, all ambulatory settings can look at their current sterilization process and assess where they have room for improvement. 

What Does the CDC Recommend?

The Center for Disease Control and Prevention (CDC) has disinfection and sterilization guidelines in place. To improve sterilization processes in ambulatory settings, the CDC places education, reporting, and standard precautions at the forefront. Sterile processing has adapted over the years, but proven methods still hold true. Continue reading to learn more about CDC sterilization guidelines for ambulatory care. 

1. Educate and Train Healthcare Personnel

For sterilization processes to be reliable and safe, ongoing education and training are essential for all healthcare professionals. Employees should be frequently educated on the fundamental practices and principles of sterilization and infection control. 

Training should be provided to all healthcare personnel during their initial orientation. After initial instruction, all individuals must repeat training annually, when policies are updated, or when new procedures or instrumentation are added. 

Competency assessment, through direct observation, should be completed by a knowledgeable person on all personnel responsible for instrument cleaning and sterilization initially and annually or as designated by facility policy. 

2. Hire an Infection Preventionist

At least one individual with infection prevention training should be employed or regularly hired by contract to help ensure instrument cleaning and sterilization processes meet national guidelines and standards of practice. This individual can manage the center’s infection prevention program and ensure all employees are thoroughly trained in the best sterilization practices.

When choosing an infection preventionist for your ASC, ensure they are certified in infection control by the Certification Board of Infection Control and Epidemiology. Additionally, an infection preventionist who is certified in sterile processing (instrument cleaning and sterilization processes)  provides your facility with the expertise in both infection control and instrument processing. An experienced infection control consultant can make all the difference in improving sterilization processes at your ASC and keep your practice or facility out of the headlines.  

3. Survey and Report Infections 

To improve health and reduce infections, ASCs must survey and track adherence to specific processes as a means to reduce infection. Patients should also be educated about signs of infection and instructed to notify the facility if any symptoms of infection occur. When notified, all facilities must report the infection based on local, state, and federal requirements.

Regular surveillance and reporting emphasizes the importance to all healthcare professionals of  infection control protocols to reduce the likelihood of postoperative or post procedure infections.    

4. Follow Recommended Precautions

All healthcare facilities should follow standard precautions, which are the minimum infection prevention practices that apply to all instances of patient care in any setting. These practices are in place to protect healthcare professionals and keep them from spreading infections among patients. Instrument cleaning and sterilization is one component of standard precautions, while the other components have a broader focus. 

Practice Suitable Hand Hygiene

All healthcare professionals in ambulatory settings must practice good hand hygiene to reduce the possibility of spreading infections. Alcohol-based hand rubs are acceptable in most healthcare settings because they are convenient. However, alcohol-based hand rubs are not suitable when hands are visibly soiled with blood or bodily fluids. In that case, soap and water should be used. Hand hygiene should be performed:

  • Before contact with a patient.
  • Before performing an aseptic task.
  • After contact with the patient or objects in the patient’s immediate vicinity.
  • After contact with blood, bodily fluids, or contaminated surfaces.
  • After removing personal protective equipment (PPE).

Wear Personal Protective Equipment

PPE is worn by healthcare professionals to protect them from exposure to infectious properties. Depending on the nature of the procedure and the potential for exposure to blood, bodily fluids, or infectious agents, healthcare workers should wear a combination of the following examples of PPE:

  • Gloves
  • Gowns
  • Face masks
  • Respirators
  • Goggles
  • Face shields
  • Surgical caps
  • Shoe covers

Follow Sterilization Instructions on Medical Devices

All medical devices are labeled as reusable or single-use by the manufacturer. Improving sterilization processes in ambulatory settings requires healthcare professionals to stringently follow all sterilization and disinfection instructions to prevent transmitting infectious agents from patient to patient. Keep in mind that if the manufacturer does not provide cleaning and sterilization instructions, the device may not be intended for multi-patient use. Single-use medical devices should never be reused. Even if the manufacturer provides detailed cleaning and sterilization instructions, if your setting doesn’t have the resources to follow the instructions as written, then that device should not be reprocessed. 

Adhere to Injection Safety Practices

The Occupational Safety and Health Administration’s (OSHA) Bloodborne Pathogens Standard has helped decrease blood exposure and sharps injuries, but there is still room for improvement in many ambulatory settings. Safe injection practices include, but are not limited to, the following:

  • Never administer medications from the same syringe to multiple patients, even if the needle is changed.
  • Do not reuse a syringe to enter a medication vial.
  • Do not administer medications from single-dose or single-use vials to more than one patient. 
  • Dispose of used sharps immediately after use in a puncture-resistant sharps container.
  • Wear a face mask when placing a catheter or injecting material into the subdural or epidural space.

Clean and Disinfect Environmental Surfaces

Outpatient facilities should implement routine cleaning and disinfecting policies for environmental surfaces as a necessary part of their infection control plan. Priority should be placed on surfaces that are most likely to get contaminated with pathogens, including surfaces that are in close proximity to the patient. 

Also, be sure to clean and disinfect frequently-touched surfaces throughout the facility such as doorknobs, elevator buttons, phones, and monitors. Use disinfectants approved by the Environmental Protection Agency (EPA) that are intended for use in healthcare facilities and follow all manufacturer’s recommendations for product use.

Practice Proper Cough Etiquette

Finally, respiratory hygiene is essential for keeping employees and patients in outpatient facilities safe. All people in ambulatory centers should cover their mouths and noses when coughing or sneezing. They should use and properly dispose of tissues and wash their hands afterward. The CDC recommends that facilities post signs and offer the needed supplies to remind people to cover their mouths and perform correct hand hygiene. 

Proper Sterilization Practices Are Essential for Health and Safety

Ambulatory surgical and procedure settings are valuable and offer accessible healthcare for many people across the nation. However, sterilization practices must be stringent to ensure patients are protected from healthcare associated infections. If you want to improve sterilization processes at your ASC, be sure to prioritize education and training, and closely follow all sterilization instructions on medical devices. Implement the CDC’s Standard Precautions throughout your facility to minimize the risk of infection.

The CDC recommends hiring an infection preventionist who can train your staff about the best sterilization and infection control practices annually. The skilled preventionists at Infection Control Results can help improve the sterilization processes at your facility. Contact us today to learn more about how we can help keep your employees and patients safe.