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Clamping down on infection the JCAHO way

Ambulatory Safety Monitor, October 7, 2004

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In June, the JCAHO released its 2005 prepublication infection control (IC) standards for nonhospital settings. These standards emphasize leadership and present a unified set of standards across all settings for the first time.

The pre-publication versions of the ambulatory care standards will remain online until the publication of the Comprehensive Accreditation Manual for Ambulatory Care this month. View the latest batch of standards at www.jcaho.org/accredited+organizations/index.htm. The standards and elements of performance become effective January 1, 2005.

Seven actions for reducing infections

The overview for the standards emphasize the importance of preventing healthcare-associated infections (HAIs) and lists the following seven actions ambulatory surgery centers (ASCs) must take to reduce the risk of catching and transmitting HAIs:

1.  Incorporate your infection program into your safety and performance improvement programs

2.  Perform an ongoing risk assessment of infectious agents

3.  Conduct surveillance, gather data, and interpret the information

4.  Effectively carry out infection prevention and control processes

5.  Educate and collaborate with leaders to effectively participate in the design and use of the IC program

6.  Integrate efforts with healthcare and community leaders

7.  Establish plans for responding to infections that may potentially overwhelm your resources.

Barbara Ann Harmer, RN, BSN, MHA, senior health consultant for Healthcare Consultants International, in Celebration, FL, says compliance with IC should be a part of the facility's quality management program and under surveillance across all levels of the organization. "Organizations have to understand where the risk is in order to minimize it," she says. "Enlist a person who knows how to collect IC data and analyze it so relevant education gets to all the staff."

Revised standard addresses influx of patients

A new standard, IC.6.10, requires facilities to prepare a response plan to epidemics and outbreaks. The accreditor revised the wording of the standard to say organizations must prepare to respond to an influx-or the risk of an influx-of infectious patients.

The response could include a variety of actions, including the temporary halting of services/admissions, delaying transfer or discharge of patients, limiting visitors, or fully activating the emergency management plan.

In the elements of performance for IC.6.10, the JCAHO notes that ASCs must have plans for handling the ongoing influx of potentially infectious residents over an extended period.

They must also do the following: determine how to stay informed about potential epidemics and infections that could result in the organization activating its emergency response plan; determine how to communicate vital information to staff and other key practitioners; and identify community resources (i.e., through local, state, and federal health systems) for obtaining additional information

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