![]() After discerning the likely onset and duration of the breach, an attempt should be made to determine which patients were exposed to the procedure or practices impacted by it. The exposure timeframe may correspond to the dates of employment of a particular healthcare provider whose individual practices are in question, the dates a specific procedure was performed, or the period of time during which there was a known breach-as indicated by staff interviews or reprocessing records. Additional data gathering The timeframe during which the breach occurred should be determined based on staff interviews and review of instrument reprocessing, procedure, or employee records.Once implemented, the plan of action should be rapidly assessed to determine whether the expected changes have occurred. If a breach appears to be ongoing, procedures should be halted until a plan can be implemented to correct the infection control lapse. Records of healthcare equipment disinfection procedures may be available to provide specific information on reprocessing methods that were followed. ![]() It should be noted that observed practices may not reflect procedures at the time of the breach, and fear of retaliation may reduce the reliability of staff interviews in certain situations. For example, the evaluation should include whether key steps in reprocessing of a device were completely omitted or performed, but in a suboptimal manner.ĭirect observation of practices that may have led to the breach should be conducted along with interviews of involved healthcare staff regarding their practices. The nature of the breach should be assessed relative to recommended practice to better understand the extent of the breach and its potential impact on overall disinfection and sterilization or aseptic technique. Recommendations for safe injection practices and handling of injectable medications are provided in the Standard Precautions section of the Healthcare Infection Control Practices Advisory Committee Guideline for Isolation Precautions.1 For breaches involving an instrument or device, the manufacturer’s instructions for use and recommended reprocessing methods should be reviewed and the degree to which the breach deviated from these recommendations should be determined. The body surfaces or spaces (e.g., mucosal membranes, solid organs or tissues, blood vessels) of exposed patients expected to come in contact with the contaminated device should also be identified. The types of potentially infectious substances that could have been harbored on the contaminated instrument or device should be determined. Identification of infection control breach Depending on the procedure(s), device(s), or practice(s) involved, an infection control breach may result in exposure to body fluids, tissues, or other biologic substances.* (assumes no known cases of bloodborne pathogen transmission as a result of the breach)ĭownload the above information in PDF format pdf icon
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