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Surgery Centers Need Better Infection Control Practices Posted: September 8th, 2010

By Lisa Tortorello

A recent study by the Centers for Disease Control and Prevention found that many U.S. surgery centers are lax in infection control prevention.

Study reveals infection protection lacking in surgery centers

Surgery centers, often considered a more convenient alternative to hospitals, have been growing in popularity for outpatient medical procedures. In fact, in the United States more than 5,000 centers account for approximately 6 million procedures and $3 billion in Medicare collections each year. With the majority of health insurance carriers covering outpatient procedures, surgery centers have become a common alternative to the hustle and bustle of busy hospitals and medical centers. But are surgery centers a safe alternative?

The Centers for Disease Control and Prevention (CDC) decided to take a look at infection control practices of the nation's surgery centers after a hepatitis C outbreak in Las Vegas. The outbreak was believed to be caused by unsafe injection practices at two clinics, which have been subsequently closed. The two clinics are reported to have exposed 63,000 patients to blood-borne diseases and caused nine confirmed cases of hepatitis C.

What the CDC found in their study was frightening. Of the 68 centers state inspectors visited in Maryland, North Carolina and Oklahoma, 67 percent revealed at least one lapse in infection control and more than half, 57 percent, were cited for deficiencies. Inspections were executed as follows:

  • State inspectors arrived on site unannounced. Employees were notified after they were on the premises.
  • Inspectors followed at least one patient through his/her entire stay at the surgery center.
  • Evaluations were made based on a newly developed audit tool which focuses on infection control when examining the location.

Infection control breaches in surgery centers

The following were among the most prevalent lapses in infection control practices:

  • Lack of hand washing
  • Inconsistent glove wearing
  • Unsanitary blood glucose meters
  • Using single-dose medication vials for more than one patient
  • Reusing equipment meant for one patients

"These are basic fundamentals of infection control, things like cleaning your hands, cleaning surfaces in patient care areas," said the study's lead author Dr. Melissa Schaefer of the CDC. Dr. Philipe Barie of Weill Cornell Medical College in New York added, "These people knew they were under observation, had the opportunity to be on their best behavior and yet these lapses were still identified, some of which are potentially very dangerous and have been warned against explicitly." Dr. Barie was not involved in the study, but wrote an accompanying editorial in the Journal of the American Medical Association where the study's findings appeared in June.

The study is not being taken lightly by the health care community. The United States Department of Health and Human Services reported it is expanding its hospital infection control plan to include ambulatory surgery and dialysis centers. So far 61 percent of the surgery centers surveyed have been cited for deficiencies in their infection control practices.