Risk Assessment Tool for Infection Surveillance, Prevention and Control Programs In Ambulatory Healthcare Settings This grid provides examples of risk factors for acquiring and transmitting organisms in the ambulatory care setting Event or Condition on patients and this? COMMUNITY & POPULATIONS SERVED: levels of MRSA in community Obesity, diabetes Elderly or pediatric patients Community outbreak of influenza TB in community Other community/region/state conditions Ebola potential Zika Virus potential POTENTIAL FOR SPECIFIC INFECTIONS: Surgical Site Infection
on patients and this? Hepatitis B or C Pink eye, viral conjunctivitis Multidrug resistant organisms (MRSA, VRE, ESBL, etc.) Emerging Infectious Diseases: Parainfluenza, Enterobacter D68, Pertussis, Measles, Influenza, MERS CoV, Chickungunya, Zika Virus Upper Respiratory Infections Diarrheal diseases Skin and soft tissue infx Exclusion policy for ill patients or employees CARE PRACTICES: Lack of hand hygiene monitoring, compliance
on patients and this? Personnel flu vaccine noncompliance Reuse of single dose vials Improper use of multidose vials Improper use of IV bag as source for flushes Other unsafe injection practices Lack of competency evaluations for specific care practices Lack of screening of pts/escorts for communicable diseases Lack of isolation precautions for patients INSTRUMENT & MEDICAL DEVICE CLEANING, DISINFECTION & HANDLING Improper cleaning or disinfection of blood glucose meters Improper cleaning or disinfection of endoscopes: esp. elevator scopes (ERCP)
on patients and this? Improper handling or storage of endoscopes Lack of quality assurance monitoring program on liquid high level disinfectant Lack of physical or chemical monitoring for steam sterilizer Lack of biological monitoring for steam sterilizer Lack of recall protocol if positive biological test occurs for steam sterilizer Lack of competency evaluations for each staff member on scope processing and sterilization of instruments Failure to follow mfr IFUssterilizer; container/wrapper; instrument or device; HLD and test strips ENVIRONMENT OF CARE: Improper cleaning of equipment Improper cleaning of environmental surfaces
on patients and this? Lack of pre-construction or renovation IC Plan and risk assessment No water intrusion plan Chemical exposure Improper storage of items in medication refrigerator Improper temperature of medication refrigerator Lack of separation between clean and soiled operations Improper infectious (medical) waste disposal Improper sharps disposal Food and drinks in work area Lack of separation of infectious and non-infectious patients in waiting room Improper storage of sterile items Corrugated cardboard outside shipping containers in sterile storage area No tissues, masks, ABHR in waiting room
on patients and this? EMERGENCY MANAGEMENT: Lack of plan for influx of infectious patients Lack of plan for water shortage or outage Lack of plan for hurricane/flood/earthquake Lack of coordination with local EM agencies Lack of plan for power outage
on patients and this?