Safe Healthcare

Bret T. Petersen, MD, FASGE

Author – Bret T. Petersen, MD, FASGE,
Chairman, Quality Assurance in Endoscopy Committee,
American Society for Gastrointestinal Endoscopy

Reports of infections subsequent to gastrointestinal (GI) endoscopy intermittently gain national media coverage. Significant clusters of hepatitis, in Las Vegas (2007) and in New York (2003), highlight the risks of insufficient care with medication administration during sedation. Other incidents, such as those at the Veterans’ hospitals in 2008, have been related to potential risks from lapses in reprocessing of endoscopes between patients. These occurrences have not identified significant clusters of infection, yet they highlight the importance of constant diligence with regards to reprocessing in both hospital and outpatient settings.

To date, all published occurrences of pathogen transmission related to GI endoscopy have been associated with failure to follow established cleaning and disinfection/sterilization guidelines or use of defective equipment, but, it is unclear how widespread the problem of potential exposure may be. A June 2010 article in the Journal of the American Medical Association looked at 68 ASCs in three states and found that 28.4 percent failed to adhere to recommended practices regarding reprocessing of equipment.

Melissa Schaefer, MD

Author: Melissa Schaefer, MD
Medical Officer in CDC’s Division of Healthcare Quality Promotion

As healthcare professionals, we must recognize our responsibility to protect patients – care should not provide any avenue for the transmission of infections. By working together, we can ensure infection prevention practices are understood and followed by all, during every patient visit. Healthcare continues to transition to settings outside the hospital, and efforts to prevent infections must extend to all settings where patients receive care.

Today, CDC is pleased to present the Guide to Infection Prevention for Outpatient Settings: Minimum Expectations for Safe Care. a summary guide of infection prevention recommendations for outpatient settings. Although these recommendations are not new, this guide is a concise, one-stop resource where ambulatory care providers can quickly find evidence-based guidelines produced by the CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC).

Repeated outbreaks and notification events resulting from unsafe practices highlight the need for better infection prevention across our entire healthcare system, not just in our hospitals. Based primarily upon elements of Standard Precautions, including medical injection safety and reprocessing of reusable medical devices, this guide reminds healthcare providers of the basic infection prevention practices that must be followed to assure safe care.