Why is it important to ensure OHPs are complying with IPAC standards?  

IPAC is an important element of care in any health care institution. Given the nature of the procedures done in OHPs, for example the level of invasiveness, it is important to ensure that appropriate IPAC practices are in place. Failure to do so can have serious consequences for both patients and staff.

What are common IPAC infractions observed during inspections?

Many OHPs that fail their inspections do so from a failure to comply with appropriate IPAC practices. Common IPAC deficiencies observed during inspections include the following:

• Sinks with no backsplash
• Items are stored underneath sinks
• Aerosol or spray trigger cleaning chemicals
• Cloth furniture is porous
• Biomedical waste is stored inappropriately (e.g., with other supplies)
• No temperature log is kept for refrigerators used to store medications
• Multi-use gel or cleaning solutions are not dated upon opening
• Multi-use medications are not dated upon opening
• Intravenous solution bags are used as a common source of supply for multiple patients  
• Housekeeping supplies are not stored in a designated space
• Laundry is not in a dedicated space
• Reprocessing issues (e.g., technicians are not appropriately trained, reprocessing is done incorrectly, there are missing items essential to reprocessing, reprocessing brushes that are not designed for re-use are being used multiple times).

Medical Directors are responsible for ensuring compliance with Public Health Ontario’s Infection Prevention and Control for Clinical Office Practice¹ and for ensuring the practices within the OHP meet current guidelines.

What are some actions that minimize risk of infection in the operating room?

Actions that minimize risk of infection in the operating room include adherence to proper use of disinfectants, proper maintenance of medical equipment that uses water (e.g., automated endoscope reprocessors), proper ventilation standards for specialized care environments (i.e., airborne infection isolation, protective environment, and operating rooms), and prompt management of water intrusion into OHP structural elements.

Where can I find more information about appropriate IPAC practices?

Public Health Ontario has a number of resources to support physicians in complying with appropriate IPAC practices, including the following:

• IPAC Checklist for Clinical Office Practice: Core Elements
• IPAC Checklist for Clinical Office Practice: Reprocessing of Medical Equipment/Devices 
• IPAC Checklist for Clinical Office Practice: Endoscopy.

Please see their website for more information and additional resources.

Endnote

^1. Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Infection Prevention and Control for Clinical Office Practice. 1st Revision. Toronto, ON: Queen’s Printer for Ontario; April 2015.