Illinois surgery centers slip on infection control

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This image released by the Lyon Hospital Friday Dec. 2, 2005 shows the face partial transplant operation performed in Amiens, northern France, last Sunday Nov. 27, 2005. A 38-year-old woman, whose identity has not been disclosed, had surgery last Sunday by French surgeons Jean-Michel Dubernard and Bernard Devauchelle to replace her nose, lips and chin in Amiens, northern France. The donor was a brain-dead patient whose family gave consent. (AP Photo/CHU Lyon)

Updated: September 9, 2011 12:34AM

It might look harmless, maybe even sexy, when you see a hunky TV doctor with a surgical mask dangling from his neck, or when his hair peeks out from under his surgical cap, but in real life that looks like a pathway for germs, according to state of Illinois health officials who found a host of problems at the state’s same-day surgery centers they say could be deadly.

Inspection reports cite dangling masks, exposed hair and other serious problems seen during the past year by inspectors trying to stop the spread of dangerous bacteria and viruses that included

†A Chicago eye-surgery center that inspectors said routinely skimped on sterilizing time for surgical instruments, cutting the recommended 10 minutes down to four minutes — and sometimes just three minutes.

†A suburban Chicago center that cleaned instruments in a sink that had no hot water.

†A central Illinois center that didn’t investigate why one of its surgeons had a high rate of post-operative infections.

Of 21 Illinois surgery centers inspected over the past year, 14 — or two-thirds — were cited for infection-control problems. All of the problems they were cited for have now been corrected, according to state health officials.

The lapses at same-day surgery centers were found throughout the state, as regulators continue a crackdown prompted by a 2008 hepatitis C outbreak in Las Vegas believed to be caused by unsafe clinic practices.

In Illinois, 36 surgical centers still haven’t been inspected using a tougher new approach required by federal health officials since the Las Vegas scare.

Surgery centers are a growing segment of the health-care system. They perform procedures including cataract surgeries, colonoscopies and foot operations — often at a lower cost than hospitals. Across the nation, the centers do more than 6 million procedures a year and collect $3 billion from Medicare.

Surgery centers face challenges that are different than hospitals. Turnaround times between surgeries are shorter, for example. But the centers are expected to uphold the same infection-control standards as in hospitals, said Jan Davidson, a registered nurse and infection-control expert at the Denver-based Association of periOperative Registered Nurses, a group that writes recommendations for infection control.

The person in charge of infection control at a surgery center is often a nurse who has other jobs, too, Davidson said, while hospitals typically have one staff member who does nothing else but head the infection-control program.

In Illinois, no disease outbreaks have been linked to the centers, but there’s no way to tell how many people might have suffered infections because of the problems seen during the unannounced inspections.

The new scrutiny is meant to bring surgery-center practices in line with what’s enforced at hospitals. That makes it unlikely for a center to get a completely clean report, said Janis Licari, an executive with Midwest Surgical Management Group, which operates Midwest Center for Day Surgery in Downers Grove, which was cited for problems.

“With hospitals and surgery centers held to the same infection-control practices, and the increased frequency and depth of [government] reviews, it is unlikely any provider will not receive some minimal recommendations for improvement,” Licari said.

The public should be confident that regulators are watching with a sharper eye, said Bill Bell, division chief for Health Care Facilities and Programs for the Illinois Department of Public Health.

“We want people to know there is regulatory oversight of these types of facilities and that we are closely monitoring infection control,” Bell said.

Inspectors follow at least one patient through a surgery from start to finish, rather than basing their reports on a look at a facility’s written policies, as in the past, he said.

Some of the situations discovered by Illinois inspectors during the past year could have led to patient infections. For example:

† A staff member at a Libertyville surgery center carried a tray of instruments out of an operating room and placed it on a table with clean instruments.

† Multi-dose vials of a medication were unlabeled at a surgery center in Joliet, placing 19 patients “at risk for cross-contamination,” according to an inspection report.

Patients concerned about infection control can choose surgery centers that are accredited, experts said. They also can check with the state health department to see if a center has been cited for problems, said Sharon Van Wicklin, a registered nurse and infection-control expert.

Nurses often know the surgery centers with the best practices, Van Wicklin said: “Ask point-blank where they would go for their procedure.”

AP