Each year, approximately 23 million surgical procedures are performed in ambulatory surgery centers (ASCs). Surgical procedures in ASCs can be more cost effective and more convenient for patients and families.
Recently the Agency for Healthcare Research and Quality released a new Toolkit to Improve Safety in Ambulatory Surgical Centers. According to AHRQ, the Toolkit, “…combines proven practices with staff experiences at more than 650 ambulatory surgery centers.” The toolkit was developed based on the experiences of ASCs that participated in the AHRQ Safety Program for Ambulatory Surgery.
ASCs can use the toolkit to apply the proven principles and methods of AHRQ’s Comprehensive Unit-based Safety Program (CUSP) to prevent surgical site infections (SSI) and other complications and improve safety culture in their facilities.
The toolkit is organized into three sections that teach ASC team members how to apply CUSP to prevent surgical site infections and other complications. Each section contains guides, tools, slide sets, and videos to support implementation. All materials are publicly available and downloadable online. Many can be modified to meet local facility needs and criteria.
AHRQ has also developed the Ambulatory Surgery Center Survey on Patient Safety Culture in response to interest from ambulatory surgery centers (ASCs) in assessing patient safety culture in their facilities. This survey is designed specifically for ASC staff and asks for their opinions about the culture of patient safety in their facility.
On another note, the US Centers for Disease Control and Prevention’s (CDC) recently published the Guideline for the Prevention of Surgical Site Infection, 2017 in JAMA Surgery. The CDC estimates that approximately half of SSIs are preventable through the use of evidence-based strategies.
Here is a summary of key recommendations:
- On at least the night prior to surgery, patients should have a full body shower or bath with soap (antimicrobial or nonantimicrobial) or an antiseptic agent.
- The use of antimicrobial prophylaxis should be based on published clinical practice guidelines and be times in a manner that ensures bactericidal concentration of agents is established in the serum and tissues when the incision is made.
- In cesarean section procedures, antimicrobial prophylaxis should be administered before skin incision.
- Skin preparation in the operating room should be performed using an alcohol-based agent unless contraindicated.
- For clean and clean-contaminated procedures, additional prophylactic antimicrobial agent doses should not be administered after the surgical incision is closed in the operating room, even in the presence of a drain.
- Topical antimicrobial agents should not be applied to the surgical incision.
- During surgery, glycemic control should be implemented using blood glucose target levels less than 200 mg/dL, and normothermia should be maintained in all patients.
- Increased fraction of inspired oxygen should be administered during surgery and after extubation in the immediate postoperative period for patients with normal pulmonary function undergoing general anesthesia with endotracheal intubation.
- Transfusion of blood products should not be withheld from surgical patients as a means to prevent SSI
Use these tools and guidelines along with MCN Healthcare’s Ambulatory Surgical Center/Outpatient Surgery Department Policy and Procedure Manual to improve patient safety and avoid risk.
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