From the New York State Department of Health:
Don’t think staff are automatically following infection control procedures, just because an outpatient facility has such protocols in place.
That is among the disturbing new findings from researchers at the University of New Mexico School of Medicine and the New Mexico Department of Health; even when infection control policies were in place, a survey of 15 outpatient facilities showed that staff failed to do proper hand hygiene 37 percent of the time, and failed to follow all recommendations for safe injection practices 33 percent of the time.
The assessments were done by medical students who interviewed outpatient facility staff. The students used an outpatient infection prevention checklist developed by the Centers for Disease Control and Prevention (CDC),
http://www.oneandonlycampaign.org/sites/default/files/upload/pdf/Injection%20Safety%20Checklist-508.pdf, and directly observed hand hygiene technique and injections being prepared and administered. Improper practices included: failure to observe hand hygiene, failure to disinfect the rubber septum with alcohol before entering the medication vial, and failure to use a new needle/syringe each time a vial was entered, even when obtaining doses for the same patient.
The study, published in AJIC (the American Journal of Infection Control, the publishing arm of the Association for Professionals in Infection Control and Epidemiology-APIC) http://www.ajicjournal.org/article/S0196-6553(15)01222-5/abstract, found that 93 percent of the practices reported they had existing infection control policies in place, based on CDC guidance.
The study authors concluded: “These findings support the need for ongoing infection prevention quality improvement initiatives in outpatient settings and underscore the importance of assessing both self-report and observed behavior of infection prevention compliance.”
In January 2016, APIC updated its position paper on safe injection, infusion, and medication vial practices in health care. Along with CDC’s “Standard Precautions”, http://www.cdc.gov/HAI/settings/outpatient/basic-infection-control-prevention-plan-2011/standard-precautions-d-f.html this is a valuable resource to bookmark for times when questions about safe practices arise.