Two New AAAHC Institute Tools Help Protect Patients, Avoid Risks

The AAAHC Institute for Quality Improvement announces it has released two toolkits focused on patient safety topics – one on preoperative evaluation and another on safe injection practices. Both are designed to help minimize risks of poor patient outcomes and maximize patient safety.

Safe Injection Practices
According to Marcia Patrick, MSN, RN, CIC, infection control consultant and surveyor for AAAHC, healthcare leaders are implementing advanced protocols and regulations to keep patient safety and outcomes at the forefront of all decision making.

“Almost everything we do in the healthcare industry is designed around one main focal point: patient safety,” said Patrick. “That is why it is so important to take a proactive approach to preventing complications by thoroughly assessing the risks.”

Healthcare organizations around the country have struggled to maintain safe injection practices (SIP) to prevent the transmission of blood borne viruses and other microbial pathogens to patients. In the United States, between 1998 and 2014, more than 700 patients contracted hepatitis B virus (HBV), hepatitis C virus (HCV), or were infected with bacterial pathogens as a result of unsafe injection practices, making safe injection protocols critical in both in-patient and out-patient settings. A patient should never be harmed as a result of receiving an injection.

When followed properly, safe injection practices do not harm the recipient, do not expose the provider to any avoidable risk and do not result in any waste that is dangerous for other people. In addition to potential transmission of blood borne disease, unsafe injection practices may result in personal and societal costs, such as:
• Time and cost of notifying and testing patients for potential risk and infection
• Worsening quality of life and productivity, higher morbidity and earlier mortality for infected patients
• Decreased patient trust
• Liability issues

The AAAHC Institute’s Patient Safety Toolkit: Safe Injection Practices offers a checklist of safe injection practices to help assess an organization’s risk by identifying where specific inadequacies in process may exist. After going through the checklist, organizations can use the toolkit’s step-by-step guide to develop a training plan to address any detected deficiencies and implement safe practices.

“Any risk assessment is more than just running down a list of potential hazards and informing personnel of best practices,” explains Patrick. “A sophisticated risk assessment is a living document that forms the foundation of comprehensive infection control and prevention programs. Organizational policies that result from a risk assessment evolve over time as goals and measurable objectives change, while maintaining a solid framework for consistent patient safety.”

Preoperative Evaluation
“ASC procedures include sedation or anesthesia, vulnerable patient populations with multiple or more severe co-morbidities, and/or lengthy procedures,” said Naomi Kuznets, PhD, vice president and senior director of the AAAHC Institute. “Given these circumstances, ASCs must strike a balance between routine testing that may be unnecessary and expensive for minimally invasive procedures, and the need to protect against risks for patients who are not as healthy or are undergoing more complex procedures.” 

The AAAHC Institute’s Patient Safety Toolkit: Ambulatory Surgery and Preoperative Evaluation guides ASC leaders on best practices for collecting preoperative medical history and performing a physical examination to better predict perioperative risks for complications. The process involves understanding the patient’s risk relative to the procedure and using the evaluation findings to ensure patient safety and positive outcomes.

Examples of best practices outlined in the toolkit include:
• Gathering medical history and physical health information when the surgeon/proceduralist first meets with the patient to better understand if the procedure is appropriate, the patient is a good candidate, if additional evaluation  is needed , whether special accommodations need to be made, and if changes to standard discharge instructions are necessary.
• Conducting a pre-anesthesia physical examination which includes, at the minimum, an airway exam, auscultation of the lungs, and a cardiovascular exam.

In addition, specific information is provided for indications for various tests for non-cardiac surgery.  These include chest x-rays, urinalysis, glucose or A1C tests, blood counts, coagulation testing, pregnancy testing, and ECGs.

Both the Patient Safety Toolkit: Ambulatory Surgery and Preoperative Evaluation and the Patient Safety Toolkit: Safe Injection Practices are available for purchase at for $10 each.

Source: AAAHC