As part of their efforts to ensure safety and maintain compliance with regulations from the Centers for Medicare & Medicaid Services (CMS), ASCs are expected to provide infection prevention and control training for their staff. Staff members who should receive such training include the following:
- medical staff;
- nursing staff;
- other staff providing direct patient care;
- staff responsible for sterile processing; and
- cleaning staff.
This training is imperative as even small lapses in proper infection prevention and control practices could lead to patient and staff harm. Providing this training can prove difficult. Here are five training challenges ASCs may face and guidance to overcome them.
1. Finding the time. In a busy ASC, available time is at a premium. That doesn't exempt any ASC from the necessity to deliver appropriate staff training. Finding that free time may require a little creativity.
Consider one or more of the following approaches:
- Schedule ongoing, monthly training. Monthly training allows frequent training in smaller "bites."
- Schedule longer, quarterly training sessions. While you will need to allocate more time and cover more information during a quarterly training session than a monthly training session, such an approach can be an effective way of reducing the number of days on the schedule affected by training.
- Rotate days. If training impacts the surgical schedule, consider rotating the days on which it's provided. This can help spread out the "burden" on surgeons. For example, if you want to provide monthly training at 7:00 AM, do so on a Monday one month, Tuesday the next month, Wednesday the following month, etc. That way, if you have different surgeons performing morning procedures on different days of the week, surgeons may lose a 7:30 AM start one month but not again until months later, when their day comes back up in the rotation. If you decide to stop the schedule early once a month for afternoon training, the same rotation of days can prove helpful and reduce physician pushback.
Regardless of the approach(es) you take, what matters is that you stick with that approach and ensure training consistently occurs. Try to plan your training schedule for the entire year, checking to see if there are any potential conflicts, such as those caused by holidays, before committing to a day.
2. Training all employees. Training for employees is mandatory. You must ensure all staff members that play a role in delivering care and preventing infections receive their necessary training — no excuses allowed.
Since staff members may sometimes miss a training session due to scheduling, sickness, vacations and other conflicts, consider recording your sessions. Require absent staff members to watch these recordings, setting a deadline for completion.
If your ASC uses per diem staff, they must also receive appropriate training. If these individuals are not working on the days when training is delivered, pay them to come to your ASC and watch the recordings of sessions they missed.
3. Training credentialed providers. Like your staff, credentialed providers must be trained — even those who infrequently perform procedures and provide services at your ASC. That's easier said than done when all credentialed providers are rarely, if ever, in the ASC at the same time.
Consider providing infection prevention and control training at the annual medical staff meeting. If you don't anticipate their willingness to sit through an hour-long training session, you can prepare an infection prevention and control training tool and provide it to all providers to supplement a shorter session. This tool could include the following:
- descriptions of the basic elements of your ASC's infection prevention program;
- description of your ASC's hand-hygiene guidelines;
- description of the nationally recognized infection prevention and control organizations and guidelines your ASC follows; and
- your infection preventionist's name and contact information.
4. Making training interesting. There are numerous topics you should address in your infection prevention and control training, including hand hygiene, safe injection practices, personal protective equipment, bloodborne pathogens, operating room protocols, and infection surveillance methods. If you cover all these topics using the same training approach (e.g., lecture with presentation), staff members may lose interest and focus, reducing the value of the training and increasing the chance for errors.
Consider changing how training is provided from one session to another or even within a single session. Some different ways to provide training include the following:
- in-services;
- computer-based training;
- providing resources such as checklists and toolkits;
- quizzes and tests; and
- games such as trivia and scavenger hunts.
The more you can switch things up and keep training fresh, the more likely it is that the training will be effective.
5. Proving training was completed. Surveyors from CMS and accreditation organizations may request proof that staff received their necessary training. Make sure you document all the training delivered, who received the training, and when they received the training. Make sure staff members, including credentialed and per diem staff, sign documentation following a training session that attests to their attendance and participation. Keep this documentation in your infection preventionist's notebooks, education records, or in individual staff members' files; it needs to be easily locatable upon request.
