To protect patients and help educate clinicians about minimum
expectations of safe care, the Centers for Disease Control and Prevention (CDC)
yesterday released a new, concise guide and checklist specifically for health
care providers in outpatient care settings such as physical therapy and
rehabilitation centers, surgery centers, primary care offices and pain
“Repeated outbreaks resulting from unsafe practices, along with
breaches of infection control noted in ambulatory surgical centers during
inspections by the Centers for Medicare and Medicaid (CMS) indicate the need
for better infection prevention across our entire health care system, including
outpatient settings,” Michael Bell, MD, deputy director of
CDC’s Division of Health Care Quality Promotion, said in a press release.
The Guide to Infection Prevention for Outpatient Settings: Minimum
Expectations for Safe Care is based on existing, evidence-based CDC
guidelines that apply to a wide range of health care facilities but are mostly
used by hospitals. The easy-to-reference guide is accompanied by an Infection
Prevention Checklist for Outpatient Settings and supporting materials including
a new, no-cost, certified continuing medical education course titled
“Unsafe Injection Practices: Outbreaks, Incidents, and Root Causes”
and offered on Medscape.org
for clinicians in all health care settings. The video course was developed in
collaboration with the Safe Injection Practices Coalition, a partnership of
health care-related organizations formed to promote safe injection practices in
all US health care settings.
Among other important recommendations, the guide states that all
outpatient practices should ensure that at least one individual with specific
training in infection control is on staff or regularly available. This
individual should be involved in developing a written infection control policy
and have regular communication with health care providers to address specific
issues or concerns.
The guide and supporting materials can be used for internal assessment
within a facility or practice. They complement ongoing work by CDC and CMS to
integrate CDC guidelines into CMS surveys used during inspections of outpatient
settings including ambulatory surgery centers.
More than three quarters of all operations in the United States are
performed at outpatient facilities, according to a CDC press release. In
addition, between 1995 and 2007, the average person made three visits each year
to physician offices. By 2007, the total number of physician office visits
approached 1 billion. Vulnerable patient populations make up a significant
portion of health care users, and it is critical that care be provided under
conditions that minimize the risk for health care-associated infections (HAIs).
These new materials reinforce that health care personnel should always:
- follow procedures for the safe handling of potentially contaminated
- ensure safe medical injection practices are followed.
Outpatient facilities and practices should:
- develop and maintain infection prevention and occupational health
- ensure that at least one individual with training in infection
control is employed by or regularly available to the facility. This person
should be responsible for overseeing the facility’s infection prevention
- develop written infection-prevention policies and procedures
appropriate for the services provided by the facility and based upon
evidence-based guidelines, regulations or standards.
- provide job- or task-specific infection prevention education and
training to all health care personnel.
- make sure sufficient and appropriate supplies necessary for adherence
to standard precautions are available.
- perform regular audits and competency evaluations of staff’s
adherence to infection prevention practices.
- utilize CDC’s infection prevention checklist for outpatient
settings to assess infection control practices.
- adhere to local, state and federal requirements regarding HAI
surveillance, reportable diseases, and outbreak reporting.
To access the guide, checklist, and supporting materials including the
CME course, CDC and external commentary about the guide, clinician and patient
education materials, a CDC Safe Surgery feature, and additional information,