aren't likely to be running more than a few loads a day. "At a hospital,
it's pricey, but for an ASC that's doing 4 loads a day, cost shouldn't be
an issue."
5. Keep good records
In addition to being a hot spot for the Joint Commission and others,
subpar recordkeeping can be a ticking time bomb for infections.
"It's one of the problems I see almost routinely," says Mr. Duro. "If
instruments are put on the shelf or go up to the OR, and then there's a
problem — and you don't have accurate records — you won't be able
to recall the instruments you just sterilized." You always need to be
able to identify every patient a device has been used on.
6. Use safe-injection practices
When practitioners compound drugs, they're violating U.S.
Pharmacopeial Convention standards, and it's happening far too often,
says Mr. Myers. "We don't see it in hospital outpatient centers where
they have pharmacies that oversee the entire process. But in smaller
outpatient settings, where consultant pharmacists aren't there on a
daily basis, it's still happening."
Mr. Myers says he recently had a class in which about 20% of the
participants acknowledged that drugs were being combined — for
example, with vancomycin — at their facilities. "These were highly
motivated people from highly motivated organizations, people taking
the time and trouble to learn. Many facilities don't ever send infection
preventionists to national training courses. So it raises concerns about
what's happening overall."
There is, he says, a prevalent lack of understanding about how easi-
ly multi-dose vials can be contaminated and expose patients to blood-
borne pathogens. His advice: Insist on using single-dose vials to mini-
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