The wound clinic is usually an outpatient, ambulatory center. The distinctive characteristics of the ambulatory care setting affect the risk of contracting a health care acquired infection. Factors such as common waiting rooms, patients with multiple co-morbidities, and the performance of invasive procedures increase the risk of infection.

All wound clinics, regardless of setting, must have an infection prevention and control program. The program should be driven by three main goals: 1) Protect the patient 2) Protect the health care worker & visitors 3) Accomplish the goals in a cost effective manner. These three goals are the driving force behind every action of the infection prevention program.
Begin with looking at your current infection prevention & control program for your wound clinic. Even if your program falls under the umbrella of a hospital infection control program, you need to ensure that there is an active surveillance program that defines specific measures for prevention, early detection, control, education and investigation of infectious and communicable diseases designed for the wound clinic.

Policies and procedures need to include (at a minimum):
•Methods to minimize sources and transmission of infection
•Hand hygiene
•Cleaning , disinfection and sterilization techniques for supplies and equipment
•Educating health care workers about infection control and personal hygiene
•Procedures for isolation
•Aseptic technique
Set aside an hour to simply observe the activity in your wound center. Jot down all the activities that are performed that have some risk of infection transmission associated with the procedure or task, for example, removing a dressing, irrigating a wound, disinfecting the stretcher /chair, cleaning the hyperbaric chamber, managing the treatment cart, cleaning the computer on wheels etc. Some of these activities can fall under one policy, others need a separate policy. Possibly, the policy exists. See if what you currently do matches the written policy. If not, the policy needs to be revised. This is all part of performing a needs assessment of your clinic. It is the first step to ensure you have an effective infection prevention and control program for your clinic.
The next blog will discuss developing competency based training tools to demonstrate staff proficiency in infection prevention and control.

Bettina Magliato has thirty years of clinical & managerial experience across the continuum- acute care, ambulatory care, long-term & home care. She is president of Angel Care Inc. a consulting company that she founded in 1998. Bettina is certified in infection control, wound care and hyperbaric nursing. She is committed to preventing the spread of infection through education at every level. Contact her at bmagliato@sbcglobal.net