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US surgery centers found to be lax on preventing infections

Failure to wash hands noted

By Carla K. Johnson
Associated Press / June 9, 2010

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CHICAGO — A new federal study found that many same-day surgery centers — where patients get such things as foot operations and pain injections — have serious problems with infection control.

Failure to wash hands, wear gloves, and clean blood glucose meters were among the reported breaches. Clinics reused devices meant for one person or dipped into single-dose medicine vials for multiple patients.

The findings, appearing in today’s Journal of the American Medical Association, suggest lax infection practices could pervade the nation’s more than 5,000 outpatient centers, specialists said.

“These are basic fundamentals of infection control, things like cleaning your hands, cleaning surfaces in patient care areas,’’ said lead author Dr. Melissa Schaefer of the Centers for Disease Control and Prevention. “It’s all surprising and somewhat disappointing.’’

The study was prompted by a hepatitis C outbreak in Las Vegas believed to be caused by unsafe injection practices at two now-closed clinics.

It was the first report from a push to more vigorously inspect US outpatient centers, a growing segment of the health care system that annually performs more than 6 million procedures and collects $3 billion from Medicare. Procedures performed included exams of the esophagus, colonoscopies, and plastic surgery.

State inspectors visited 68 centers in Maryland, North Carolina, and Oklahoma. At each site, inspectors followed at least one patient through an entire stay. Inspections were not announced ahead of time, but staff were notified once inspectors arrived.

The study found 67 percent of the centers had at least one lapse in infection control and 57 percent were cited for deficiencies. The study did not look at whether the lapses led to infections in patients.

“These people knew they were under observation, had the opportunity to be on their best behavior, and yet these lapses were still identified, some of which potentially are very dangerous and have been warned against explicitly,’’ said Dr. Philip Barie of Weill Cornell Medical College in New York.

Barie was not involved in the study but wrote an accompanying editorial in the journal.

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