Infection Prevention Update Marie Kassai, RN, MPH, CIC, FAPIC Surgery Center Coalition October 4, 2018

Miscellaneous Issues If One Room has no generator Battery is okay but you must follow the directions for testing the battery and for ensuring proper functioning If you have a generator, must follow the State rules This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-NC-ND

Infection Prevention Issues Infection Prevention Plan – being asked for by State and by Accrediting agencies Be clear in your Infection Prevention Plan what resources you are using for your policies: If you are STATE licensed CDC ST79 2017 - AAMI DOCUMENT – Sterilization Bible If you are CMS certified, you must also follow CMS Rules – Infection Prevention Document for Compliance - AORN Hand Hygiene – CDC – Know what source for your Hand Hygiene Posters and Guidelines – CDC or WHO

More Infection Prevention Hand Hygiene – Sorry to bring this up again Have specific policy – outline your requirement for nails and other issues like jewelry AORN has a great Policy Must use soap and water or alcohol gel after the removal of GLOVES – EVERY TIME Must comply with One Needle/One syringe and One vial – If not sure or if MD asks and you are not sure – ASK Linen must be covered Scrubs for Operating Rooms must be “facility-laundered) Sharps Containers – must be secured except in OR proper because of need to have container close to Point of Use Masks – regardless of where used – remove Items in drawers must being containers

Facts Related to Sterilization – NJDOH and AAMI Major Repair All Mechanical equipment - Anything that is outside the scope of Preventive Maintenance and alters the performance of the equipment If the situation meets this definition then 3 biologicals and Bowie Dick must be done prior to use. Note: differs with machine IFU – Should be available for all machinery and for all items used If you use – One Source – the staff must know how to access the information

Expiration Dates If you don’t understand, call the company Check all new supplies for expiration dates Make sure you understand what they mean Peel Packs – may mean that the pouch must be sterilized by the date and then it is event related If you do not understand the date or the way it is written – call the manufacturerTip Protectors – Date is the date by which the protector must be used If expiration is on outside of box and not on individual items (bandaids) must leave them in package Other Issues – Christmas Tree Connectors are single-use Electrodes have a shelf life – once opened

Miscellaneous Issues Two-Step TST – Remember MDs are employees Done on hire Is A TST has been done within the year only one has to be done If positive – chest x-ray and then annual medical screening. OR Surgical Attire – Follow AORN – has not changed its policy but is working on it Cloth caps are considered part of uniform and if worn must be sent to Laundry GI Center Attire If procedures done in an licensed OR - must follow surgical attire If not an OR , your policy will dictate – Follow SGNA, AORN or other guidance from an Endoscopy Resource such as CDC CAVI-WIPE and other Wipes – read the IFU – on label Most two step – Clean the surface, then disinfect with a second wipe, keep wet for the time indicated – may be one to 5 minutes depending on wipe

Miscellaneous Issues Temperature and Humidity Monitoring – Check AORN or AAMI Check all areas Examples Refrigerators Sterile Storage Decontam Area Central – workroom Monitor Devices – High and low numbers needed Have expiration dates Check and record numbers when the facility is closed

Eye Wash Stations Required by AAMI Certain Accrediting agencies require Metered Device Should not be on Decom Sink Signage important If metered – mixes cold and hot water – temperature 60 – 100 degrees Test weekly and record Best is the metered eye wash – ANSII requirement Eye Wash Bottles only acceptable as an alternative – not a replacement This Photo by Unknown Author is licensed under CC BY-SA This Photo by Unknown Author is licensed under CC BY-SA

Questions This Photo by Unknown Author is licensed under CC BY-NC