Surveyors have observed "many serious infection control-related risks" at community health centers that can lead to preliminary denial of accreditation, The Joint Commission announced in March.
The No. 1 standard health centers fail to comply with is implementing infection prevention and control activities when performing intermediate and high-level disinfection and sterilization of medical equipment, devices and supplies.
Here are five additional infection control-related issues.
1. Poor training. Surveyors noted a lack of frontline staff training specific to the sterilization process for infection control, as well as a lack of documented managerial or supervisory oversight of the sterilization process.
2. Overlooking evidence. On-site surveys revealed little adherence to sterilization Evidence Based Guidelines and manufacturers' instructions for medical and dental instruments. Surveyors also discovered a lack of oversight for evidence-based, manufacturer-supported reprocessing of surgical supplies and inaccurate measurements for pre-cleaning detergent and enzymatic products.
3. Ignoring indicators. Three main indicator issues were discovered: premature release of instruments before the manufacturer-required 24-hour read time of a biological indicator result; inconsistent use of chemical indicators; and inadequate documentation of time, temperature and pressure monitoring.
4. Non-compliant use of instruments. Hinged instruments were found closed in peel packs and staff failed to use personal protective equipment during decontamination procedures. In some cases, surveyors found no sink available for hand hygiene, as cleaned and decontaminated instruments were left to dry in the sole procedure room sink. They also noted inadequate separation of contaminated and clean instruments within dental procedure areas.
5. Broken processes. Insufficient documentation of monthly sterilizer preventative maintenance and cleaning was another observed issue. Some community health centers didn't implement the processes necessary to ensure brushes used in the decontamination area were cleaned, and some didn't properly track sterilizer maintenance.