Special Considerations | Reporting Requirements | General Resources | Ambulatory Surgical Centers | Dialysis Facilities | Other Settings
Ambulatory care settings provide healthcare on an outpatient basis. That is, patients do not stay overnight in the facility. The term "ambulatory care" encompasses a large variety of healthcare settings that include but are not limited to physician offices, urgent care centers, dialysis facilities, ambulatory surgical centers, cancer clinics, imaging centers, endoscopy clinics, public health clinics, and other types of outpatient clinics.
Special considerations for infection prevention in these settings:
- This category covers a wide range of facilities, providing a variety of different medical care services and having a range of licensing requirements, staff training needs, and surveillance procedures.
- For more information on licensure and certification, click here
- The degree to which the infection prevention program is formalized may differ, but for each setting, infection prevention is a high priority. The infection prevention programs range, depending on the type of setting and licensing requirements, from policies established by the facility to accountability defined by the Centers for Medicare and Medicaid Services or another certifying organization.
- Patients play an important role in preventing infections and in identifying any that might be associated with outpatient care. It is important to know the signs and symptoms of infection and contact your provider for follow up if any symptoms develop.
- This is especially true for ambulatory care settings because the signs of an infection may not present until after the patient leaves the facility.
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Reporting requirements
- Virginia Reportable Disease List
- Outlines diseases and conditions (including outbreaks) that are reportable to the local health department by physicians, directors of medical care facilities, and directors of laboratories.
- In January 2012, the Centers for Medicare and Medicaid Services (CMS) will begin requiring dialysis facilities participating in the End-Stage Renal Disease (ESRD) Quality Incentive Program (QIP) to report certain infection events to the National Healthcare Safety Network (NHSN).
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Resources
- General
- Presentations
- Infection Prevention and Control: Prevention Strategies – an overview of standard precautions, transmission-based precautions, environmental cleaning, safe injection practices, and vaccination. Suitable for use in an ambulatory care setting to teach infection prevention principles to staff.
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Ambulatory surgical centers
- ASC Quality Collaboration – an organization for ambulatory surgical centers focused on measure development, public reporting of quality data, advancing ASC quality, and advocacy.
- ASC tools for infection prevention (ASC TIPs) – includes basic and expanded versions of toolkits that address hand hygiene, safe injection practices, point of care devices, environmental infection prevention, single-use device reprocessing, endoscope reprocessing, and sterilization and high-level disinfection.
- Association of periOperative Registered Nurses (AORN) – professional association that provides educational opportunities to members as well as non-members
- Health and Human Services (HHS) Action Plan to Prevent HAIs (Phase II): Ambulatory Surgical Centers
- Infection control audit tool used by state surveyors during inspections of CMS-certified ambulatory surgical centers
- Infection Prevention Training for Ambulatory Surgical Centers – sponsored by the HHS Office of Healthcare Quality
- Monitoring and Reporting HAIs in ASCs
- Safe Injection Practices
- Point of Care Devices
- Environmental Infection Control and Preventing Infections in Healthcare Workers
- Hand Hygiene
- Cleaning, Sterilization, & High-Level Disinfection
- Surgical site infections page
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Dialysis facilities
- CDC website on dialysis safety
- Dialysis Bloodstream Infection (BSI) Prevention Collaborative
- Includes audit tools for hand hygiene, fistula/graft care observations, catheter accessing and disengaging observations, and catheter exit site care observations
- Dialysis Compare – a searchable database of dialysis providers that permits the user to compare facilities on a variety of quality measures and other facility characteristics.
- Infection Control Requirements for Dialysis Facilities and Clarification Regarding Guidance on Parenteral Medication Vials, MMWR (2008)
- National Healthcare Safety Network (NHSN) Device-Associated Module, Dialysis Event – protocol and instructions, training, and forms
- Facilities report the date an intravenous antimicrobial is started, any positive blood culture, and any occurrence of pus, redness, or increased swelling at the vascular access site
- Local access site infections, access-related bloodstream infections, and vascular access infections are determined with a computer algorithm from the reported data
- HHS Action Plan to Prevent HAIs (Phase II): End-Stage Renal Disease Facilities
- Patient resources
- Recommendations for Preventing Transmission of Infections Among Chronic Hemodialysis Patients, MMWR (2001)
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Other settings
- Dental settings
- Outpatient oncology settings
