INF ECTIO N CO NTRO L
Project Tracks, Improves Hospital-wide Infection Control Procedures By MARCUS A. BANKS
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perating room staff are likely to get prompt feedback from aware of which infection control supplies they had on hand or sterile processing colleagues if they do not properly preclean which supplies could be disposed of and which needed to go to or spray a medical instrument before sterilization, but such feed- sterile processing. back is less likely to occur for employees in units farther from the In a joint effort involving nursing, infection prevention and OR, such as the women’s health or endoscopy units, according to sterile processing leaders encompassing every unit of the hospiinfection preventionist Jill Holdsworth, CIC, CRCST, of Emory tal, Ms. Holdsworth said, “we figured out what was there, what Hospital Midtown, in Atlanta. needed to be there and what maybe didn’t need to be stocked anyAt the 2021 virtual meeting of the Association for Profes- more.” After taking this inventory, Ms. Holdsworth and her colsionals in Infection Control and Epidemiology, Ms. Holdsworth leagues proactively listed exactly which infection control supplies described Emory’s ongoing strategy for standardizing infection a given unit needed, so there would be no waste when ordering. control procedures throughout her facility. “We didn’t want them to buy a bunch of biohazard bins that “We had so many inconsistencies throughout the hospital with didn’t fit their instruments,” Ms. Holdsworth said, noting that transportation of soiled instruments,” Ms. Holdsworth said, not- this inventory support effort was one major achievement of the ing that sometimes these instruments are carried in Tupperware- initiative. type storage containers. “I see that in a lot of facilities right now, In addition to the inventory support, in April 2018, so we set out just to standardize everything.” Ms. Holdsworth’s team launched an intensive education camWhen Ms. Holdsworth began this paign about infection prevention best effort in 2018, she and her colleagues ‘We had so many inconsistencies practices throughout the hospital. One noticed that OR employees had a consisaspect of this effort was simple, engaging throughout the hospital tent process for managing soiled instruflyers, including one that highlighted the ments that involved spraying them with with transportation of soiled “three easy steps” involved in precleaning surfactant gel and transporting them in medical instruments (box). instruments. I see that in a lot of closed carts that reduce the risk for conAs of February 2019, audits of the tamination. OR employees also received facilities right now, so we set out units outside the OR showed an increase regular training on how to avoid contamin compliance from 20% to 91%. In June just to standardize everything.’ inating surgical equipment. 2019, compliance reached 100%. —Jill Holdsworth, CIC, CRCST In contrast, within procedural or clinCommenting on the Emory project, ical areas outside of the OR, practices Casey Czarnowski, CIC, CRCST, the were much more inconsistent. Infection control training by sterile sterile processing educator at Stanford Health Care, in the San processing staff occurred less frequently or not at all in these areas, Francisco Bay Area, said the initiative points to the fact that infecand proper equipment was not always on hand. Unlike within the tion control will always be crucial. “There’s no time constraint OR, which used an electronic system to audit compliance with when it comes to patient safety,” Mr. Czarnowski said. infection control procedures, there was no consistent way to docHe said he promotes the idea that any member of a hospiument whether staff in other units followed proper protocols. tal staff, regardless of their role or the unit they work in, should Ms. Holdsworth’s first step was to develop a documentation feel empowered to speak up if they think any medical instrument form to track other units’ compliance with best practices for might be contaminated. Mr. Czarnowski likens this to the “stop infection control, using a biohazard container for transport of the line” philosophy of automobile manufacturing, in which any soiled instruments to the sterile processing unit and precleaning employee can request a production halt if they think something and spraying instruments before taking them away. dangerous happened somewhere along the line. With the available data, Ms. Holdsworth determined that For her part, Ms. Holdsworth is not resting on the laurels of units outside the OR were compliant with best infection con- hitting 100% compliance in managing soiled instruments, saying trol practices less than 20% of the time when the project began. that the work of optimizing infection control at Emory Midtown ■ This intake stage also revealed that staff in many units were not will always be ongoing.
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OR Management News • Volume 7 • March 2022
