Infection prevention and safe injection practice standards are among those with high deficiency percentages for organizations accredited by the Accreditation Association for Ambulatory Health Care (AAAHC).

This is according to the 2020 AAAHC Quality Roadmap, the accreditor's annual review and analysis of AAAHC standards compliance. The 2020 report reflects data from nearly 1,500 surveys conducted against AAAHC's 2018 standards, which were applied in 2019. Surveyed organizations include Medicare deemed status ambulatory surgery centers (ASCs), office-based surgery practices, and primary care settings.

Medicare Deemed Status Ambulatory Surgery Centers

For the 360 Medicare deemed status ambulatory surgery centers included in the surveys, standards rated as deficient on at least 15% of the surveys were identified. The following infection prevention and safe injection practice standards met this parameter (with approximate % deficient included in parentheses):

• 7.I.C.2 (27%) — The infection control and prevention program reduces the risk of healthcare-acquired infection as evidenced by education and active surveillance, consistent with: (2) Centers for Disease Control and Prevention (CDC) or other nationally recognized guidelines for safe injection practices.

• 9.S (24%) — A safe environment for providing anesthesia services is ensured through the provision of adequate space, equipment, supplies, medications, and appropriately trained personnel. Written policies must be in place for safe use of injectables and single-use syringes and needles. All equipment should be maintained, tested, and inspected according to the manufacturer's specifications. A log is kept of regular preventive maintenance.

• 11.J (22%) — The organization must have policies in place for safe use of injectables and single-use syringes and needles that, at minimum, include the CDC or comparable guidelines for safe injection practices. [416.51(a)]

• 11.B.1 (18%) — Pharmaceutical services are provided in accordance with ethical and professional practice and applicable federal and state laws. [416.48(a)] (1) Drugs are prepared and administered according to established policies and acceptable standards of practice. [416.48(a)]

• 7.I.C (17%) — The infection prevention and control program is under the direction of a designated and qualified healthcare professional with training and current competence in infection prevention and control.

• 11.M (16%) — If look-alike or sound-alike medications are present, the organization identifies and maintains a current list of these medications, and actions to prevent errors are evident.

Office-Based Surgery Practices

For the 138 office-based surgery practices included in the surveys, standards rated as deficient on at least 10% of the surveys were identified. The following infection prevention and safe injection practice standards met this parameter (with approximate % deficient included in parentheses):

• 7.II.E (14%) — All products, including medications, reagents, solutions, and supplies that have a manufacturer's printed expiration date are monitored and disposed of in compliance with facility policy and manufacturers' guidelines.

• 11.F (10%) — Procedures are in place to prevent errors from look-alike, sound-alike and high-alert medications, if present.

• 7.I.B (10%) — The written infection prevention and control program describes how infections and communicable diseases are prevented, identified, and managed.

• 7.I.C (10%) — The infection prevention and control program is under the direction of a designated and qualified healthcare professional with training and current competence in infection prevention and control.

Primary Care Settings

For the 161 primary care organizations included in the surveys, standards rated as deficient on at least 10% of the surveys were identified. The following infection prevention and safe injection practice standards met this parameter (with approximate % deficient included in parentheses):

• 7.II.E (14%) — All products, including medications, reagents, solutions, and supplies that have a manufacturer's printed expiration date are monitored and disposed of in compliance with facility policy and manufacturers' guidelines.

• 7.I.C (11%) — The infection prevention and control program is under the direction of a designated and qualified healthcare professional with training and current competence in infection prevention and control.

Noel Adachi, president and CEO of AAAHC, states in a news release, "The AAAHC Standards focused on infection prevention and control have never been more important. Today, healthcare organizations need to be even more vigilant about adherence to these practices to promote employee and patient safety."

The 2020 report is available for free download after filling out a form here.

Infection Control Consulting Services (ICCS), a national infection control and prevention consulting firm, reports that its findings during onsite visits and review of written programs in the outpatient setting, including ambulatory surgery centers and outpatient clinics, are generally consistent with this report.