Highlights
- •Self-report and behavior observation should both be part of infection prevention assessments.
- •Outpatient attention is needed on infection prevention, hand hygiene, and injection safety.
- •Medical students can identify and share quality improvement opportunities during rotations.
- •Public health and medical practice collaboration can enhance healthcare provider education.
Background
Health care-associated infection outbreaks have occurred in outpatient settings due
to lapses in infection prevention. However, little is known about the overall infection
prevention status in outpatient environments.
Methods
A cross-sectional design was employed to assess infection prevention policies and
practices at 15 outpatient sites across New Mexico in 2014 during a medical student
outpatient rotation. A standardized infection prevention checklist was completed via
staff interview; observations of injection safety practices and hand hygiene behavior
were conducted. Aggregate data were analyzed using Excel (Microsoft, Redmond, WA)
and Stata (version 12.1, Stata Corp, College Station, TX) statistical software.
Results
Medical practice staff interviews reported a mean of 92.8% (median, 96.7%; range,
75.0%-98.9%) presence of recommended policies and practices. One hundred sixty-three
injection safety observations were performed that revealed medication vial rubber
septums were disinfected with alcohol 78.4% (95% confidence interval [CI], 71.1%-84.7%)
of the time before piercing. Three hundred thirty hand hygiene observations revealed
33.9% (95% CI, 28.8%-39.1%) use of alcohol-based handrub, 29.1% (95% CI, 24.2%-34.0%)
use of soap and water, and 37.0% (95% CI, 31.8%-42.4%) use of no hand hygiene.
Discussion and Conclusion
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.
Key Words
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Article info
Publication history
Published online: January 21, 2016
Footnotes
Conflicts of Interest: None to report.
Identification
Copyright
© 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
