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ALBUQUERQUE, NM – Medical practices might be doing everything they should to put policies in place to prevent the spread of infections, but that doesn’t mean all staff members are following them.
In fact, a study published recently in the American Journal of Infection Control found that personnel at New Mexico outpatient care facilities failed to follow recommendations for hand hygiene 37% of the time, and for safe injection practices 33% of the time.
The cross-sectional study of 15 geographically-dispersed outpatient facilities was conducted by researchers from the University of New Mexico and the New Mexico Health Department. At the 15 outpatient sites, which included a variety of practice types, medical specialties, and number of healthcare providers, medical students assessed infection prevention policies and practices during the summer of 2014.
The articles notes that interviews with outpatient facility staff indicated that 93% of recommended policies were in place across the practices.
"Despite high levels of report of hand hygiene education and observed supply availability, observations of hand hygiene and aseptic injection technique showed lack of similarly high behavior compliance," study authors pointed out. "This project highlights the importance of assessing both the report of recommended infection prevention policies and practices, as well as behavior compliance through observational audits. This is critical because there have been outbreaks and infection transmission to patients reported in outpatient settings due to these types of infection prevention breaches, including transmission of hepatitis B and C."
To assess prevention policies, medical students used an outpatient infection prevention checklist developed by the national Centers for Disease Control and Prevention (CDC) that included 14 topic areas such as administrative policies, education and training, occupational health, environment cleaning, hand hygiene, and injection safety. The students also employed direct observation of injection safety and hand hygiene, with each participant asked to observe 10 injections and 20 hand hygiene opportunities at their assigned outpatient practice.
Results indicate that, of the 163 injection safety observations, only 66% of the preparations complied with all of the recommended infection prevention steps, which included performing hand hygiene, disinfecting the rubber septum, using a new needle and syringe, properly discarding single-dose vials, and dating multi-dose vials upon opening.
During the 330 hand hygiene observations, where protocols weren’t followed more than a third of the time, students reported that hand hygiene supplies were always available. Alcohol-based hand rub was used in 3.9% of the observed incidences and soap and water was used 39.1% of cases.
"These findings highlight the need for ongoing quality improvement initiatives regarding infection prevention policies and practices in outpatient settings," the study authors concluded.