A new federal study finds many same-day surgery centers have serious problems with infection control. Failure to wash hands, wear gloves and clean blood glucose meters were among the reported breaches. Clinics reused devices meant for one person or dipped into single-dose medicine vials for multiple patients.

The findings, appearing in the Journal of the American Medical Association  (JAMA), suggest lax infection practices may pervade the nation’s more than 5,000 outpatient centers, experts say.

"These are basic fundamentals of infection control, things like cleaning your hands, cleaning surfaces in patient care areas," said lead author Melissa Schaefer, MD, of the Centers for Disease Control and Prevention. "It’s all surprising and somewhat disappointing."

The study was prompted by a hepatitis C outbreak in Las Vegas believed to be caused by unsafe injection practices at two now-closed clinics.

It’s the first report from a push to more vigorously inspect US outpatient centers, a growing segment of the health care system that annually performs more than 6 million procedures and collects $3 billion from Medicare. Procedures performed at such centers include exams of the esophagus, colonoscopies, and plastic surgery.

In the study, state inspectors visited 68 centers in Maryland, North Carolina, and Oklahoma. They used a new audit tool focusing on infection control. At each site, inspectors followed at least one patient through an entire stay. Inspections weren’t announced ahead of time, but staff were notified once inspectors arrived.

The new study found 67% of the centers had at least one lapse in infection control and 57% were cited for deficiencies. The study didn’t look at whether any of the lapses actually led to infections in patients.

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[Source: Associated Press/JAMA]