CDC issues guide for infection control in outpatient care

Jul 14, 2011 (CIDRAP News) – Saying that infection control in outpatient settings is often inadequate, the Centers for Disease Control and Prevention (CDC) has issued a new guide and checklist to improve infection prevention in primary care offices, surgery centers, and other outpatient facilities.

The new "Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care" is based on existing CDC guidelines that apply to a wide range of healthcare facilities but are used mainly by hospitals, the agency said. The guide advises, among other things, that all outpatinet practices should have at lease one person with infection control training on staff or regularly available.

"Patients deserve the same basic levels of protection in a hospital or any other healthcare setting," said Michael Bell, MD, deputy director of the CDC's Division of Healthcare Quality Promotion, in a press release.

"Failure to follow standard precautions, such as correct injection practices, cannot be tolerated," Bell said. "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, indicate the need for better infection prevention across our entire health care system, including outpatient settings."

Along with the guide, the CDC is providing an "Infection Prevention Checklist for Outpatient Settings" and supporting materials, including a new, free course titled Unsafe Injection Practices: Outbreaks, Incidents, and Root Causes and offered on Medscape.org for clinicians in all healthcare settings. The video course was developed in collaboration with the Safe Injection Practices Coalition, a partnership of healthcare-related organizations formed to promote safe injection practices in all settings.

Outpatient settings for which the guidance was written include non-hospital based clinics and physician offices, urgent care centers, surgical centers, public health clinics, imaging centers, oncology clinics, behavioral health and substance abuse clinics, physical therapy and rehabilitation centers, and hospital-based outpatient departments and clinics, the CDC statement said.

The agency said more than three fourths of all operations in the United States are performed in outpatient facilities, and the total number of physician office visits approached 1 billion in 2007.

In a recent assessment of outpatient surgery centers, CDC researchers found that 46 of 68 (68%) randomly chosen centers in three states had at least one lapse in infection control practices, according to a report published in the Journal of the American Medical Association (JAMA) in 2010. Twelve of the 68 centers (18%) had lapses in three of the five main infection control categories, the report said.

The CDC advises that outpatient practices should, among other steps:

  • Follow proceudres for the safe handling of potentially contaminated medical equipment
  • Ensure safe injection practices are followed
  • Develop and maintain infection prevention and occupatonal health programs
  • Develop written infection prevention policies and procedures
  • Provide job- or task-specific infection preveniton education and training to all healthcare personnel

See also:

Jul 13 CDC press release

CDC page with links to new guidelines and related resources

2010 JAMA report on infection control in ambulatory surgery centers

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