Ambulatory Health Care

There are many patient safety concerns in today’s healthcare system. One that is not on the forefront, but is still a prevalent and concerning issue, is lack of infection control in outpatient or ambulatory settings. Since there has been a large transition of care from the hospital setting to an ambulatory setting, there is a necessity to improve infection control secondary to patient notifications and outbreaks within the past years1. Ambulatory settings include all outpatient clinics. An example is an ambulatory surgical center ASC), which increased in numbers by 50% from 2001 to 20082. In 2007, ASC’s performed over 6 million procedures2. Also in 2007, an estimated 994.3 million physician office visits were made in the U.S3. So, almost 1

The cause of this outbreak was due to improper injection practices where the clinic reused syringes and used medication vials on multiple people6. A study by Thompson et al. reviewed all outbreaks of Hepatitis B virus (HBV) and HCV reported by the CDC from 1998-2008, in nonhospital healthcare settings7. The study found 33 outbreaks of HBV and HCV that resulted from a lapse in infection control procedures, putting over 60,000 people at risk7. Settings listed in the article include private physician offices, endoscopy clinic, pain remediation clinic, hematology and oncology clinic, hemodialysis centers, and

The study found volunteers from State Survey Agencies to inspect ASC’s of states that volunteered for the study as well2. Seven states participated and a random sample of ASC’s was chosen from each state2. A total of 68 ASC’s were inspected and were assessed on 5 areas of infection control: hand hygiene, injection safety and medical handling, equipment reprocessing, environmental cleaning and handling of blood glucose monitoring equipment2. The results showed 46 of the 68 ASC’s had at least 1 error in infection control, and 12 of the 68 ASC’s had errors in 3 or more of the 5 assessed areas2. The study concluded that errors in infection control were