Related Experiment Video
Updated: May 5, 2026
A Spine Robotic-Assisted Navigation System for Pedicle Screw Placement
Published on: May 11, 2020
Infection control assessment of ambulatory surgical centers
Melissa K Schaefer1, Michael Jhung, Marilyn Dahl
1Division of Healthcare Quality Promotion, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Rd NE, Mailstop A-31, Atlanta, GA 30333, USA. mschaefer@cdc.gov
Context:
More than 5000 ambulatory surgical centers (ASCs) in the United States participate in the Medicare program. Little is known about infection control practices in ASCs. The Centers for Medicare & Medicaid Services (CMS) piloted an infection control audit tool in a sample of ASC inspections to assess facility adherence to recommended practices.
Objective:
To describe infection control practices in a sample of ASCs.
Design, Setting, And Participants:
All State Survey Agencies were invited to participate. Seven states volunteered; 3 were selected based on geographic dispersion, number of ASCs each state committed to inspect, and relative cost per inspection. A stratified random sample of ASCs was selected from each state. Sample size was based on the number of inspections each state estimated it could complete between June and October 2008. Sixty-eight ASCs were assessed; 32 in Maryland, 16 in North Carolina, and 20 in Oklahoma. Surveyors from CMS, trained in use of the audit tool, assessed compliance with specific infection control practices. Assessments focused on 5 areas of infection control: hand hygiene, injection safety and medication handling, equipment reprocessing, environmental cleaning, and handling of blood glucose monitoring equipment.
Main Outcome Measures:
Proportion of facilities with lapses in each infection control category.
Results:
Overall, 46 of 68 ASCs (67.6%; 95% confidence interval [CI], 55.9%-77.9%) had at least 1 lapse in infection control; 12 of 68 ASCs (17.6%; 95% CI, 9.9%-28.1%) had lapses identified in 3 or more of the 5 infection control categories. Common lapses included using single-dose medication vials for more than 1 patient (18/64; 28.1%; 95% CI, 18.2%-40.0%), failing to adhere to recommended practices regarding reprocessing of equipment (19/67; 28.4%; 95% CI, 18.6%-40.0%), and lapses in handling of blood glucose monitoring equipment (25/54; 46.3%; 95% CI, 33.4%-59.6%).
Conclusion:
Among a sample of US ASCs in 3 states, lapses in infection control were common.
Insights
Infection control lapses were common in US ambulatory surgical centers (ASCs), with over two-thirds of facilities having at least one issue. Key problems included medication handling and equipment reprocessing, highlighting a need for improved safety practices in ASCs.
Area of Science:
- Healthcare quality and safety
- Infection prevention and control
- Ambulatory surgical care
Background:
- Over 5000 ambulatory surgical centers (ASCs) participate in Medicare.
- Little is known about infection control practices within ASCs.
- The Centers for Medicare & Medicaid Services (CMS) developed an audit tool to assess ASCs.
Purpose of the Study:
- To describe infection control practices in a sample of US ASCs.
- To identify common lapses in infection control within these facilities.
Main Methods:
- Seven states were invited to participate; three were selected based on geographic dispersion and cost.
- A stratified random sample of 68 ASCs was assessed between June and October 2008.
- Surveyors used a CMS audit tool to evaluate compliance in 5 key infection control areas.
Main Results:
- 67.6% of assessed ASCs (46/68) had at least one infection control lapse.
- 17.6% of ASCs (12/68) had lapses in three or more categories.
- Common issues included medication vial handling (28.1%), equipment reprocessing (28.4%), and blood glucose monitoring (46.3%).
Conclusions:
- Lapses in infection control are prevalent in US ASCs.
- Specific areas like medication handling and equipment reprocessing require attention.
- Findings underscore the need for enhanced infection control measures in ambulatory surgical settings.
Related Concept Videos
01:26Factors Affecting the Risk of Infection
The integrity and count of the white blood cells help the body resist pathogens and fight infection. When impaired, it reduces the body's resistance to pathogens. The acidic pH levels of the gastrointestinal, genitourinary tracts, and skin...
01:26Healthcare Associated Infections I: Iatrogenic, Exogenic and Endogenic
HAIs significantly increase the cost of health care. Extended stays in healthcare institutions, increased disability, increased costs of medications, including specialized antibiotics, and prolonged recovery times add to the patient's expenses and the healthcare institution and funding bodies.
01:22Healthcare Associated Infections II: Preventive Measures
The best practices for preventing healthcare-associated infections include hand hygiene, patient risk...
01:28Asepsis
01:30Cleaning, Sterilization, and Disinfection
Cleaning
The cleaning process usually involves using water with detergents or enzymatic cleaner and removing foreign material from objects and surfaces, including organic material such as body fluids or inorganic material like soil. Cleaning is performed before high-level disinfection and sterilization because foreign materials on the cover of the devices interfere with process...
01:26Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...