Why ambulatory risk is underestimated
Outpatient rooms look low-acuity, but turnover is fast and surfaces are shared. Small lapses—missed hand rubs, rushed cleaning, poorly stored instruments—create avoidable downstream infections. A light, visible bundle owned by the clinic lead keeps the standard high and the environment calm.
The outpatient IC bundle
Five Moments hand hygiene
ABHR at point of care; visible dispensers; before touching patient and before clean/aseptic tasks are non-negotiable.
Clean field & room turnover
Wipe high-touch surfaces (bed/plinth, handles, switches) with approved disinfectant; wet contact time respected.
Single-use covers or laundered linens changed every patient.
Device IFU compliance
Reusable instruments cleaned/disinfected/sterilised per manufacturer instructions; logs signed per cycle.
Single-patient devices stored separately; no “just this once” reuse.
Waste & sharps discipline
Sharps bins at arm’s reach; do not overfill. Clinical waste segregated; end-of-day seal + date recorded.
Respiratory etiquette & isolation lite
Surgical masks available; symptomatic patients fast-tracked or separated; room aired between such consults.
Documented room-ready check
Before first patient: stock, expiry dates, ABHR levels, wipe canisters, PPE sizes; five-line checklist initialled.
VIP/UHNWI overlay (privacy without shortcuts)
Prepare the room before the patient arrives; doors closed; neutral language in reception corridors.
Chaperone offered for intimate exams; minimal staff presence; no devices with visible identifiers in view.
Use the same IC bundle—quiet choreography, identical rigor.
Vaccination & staff screening (signals, not promises)
Vaccines in date: Hep B, influenza (seasonal), others per facility policy; status logged for all clinicians.
TB screening as per local policy; fit testing for respirators where indicated.
Do not schedule staff with infectious symptoms in direct care; provide a simple escalation route for cover.
Linen, instruments & storage hygiene
Linen to sealed hampers; clean and used never share surfaces.
Instruments: dirty → clean flow unidirectional; never cross paths.
Fluids and gels within expiry and temperature ranges; daily visual checks recorded.
Physiotherapy & procedure-room specifics
Plinth turnover: disinfectant contact time; pillows with wipe-clean covers; exercise bands assigned per patient or single-use.
Minor procedures: sterile pack pause; label opened packs with time; discard after time-out window; local anaesthetic vials single-patient use.
Micro-audits (10 minutes each morning)
ABHR dispensers full and reachable at point of care.
Room-ready checklist initialled; wipe canisters in date, lids sealed.
One device IFU step most often missed is pinned in the workroom.
Last three turnover logs show contact time respected.
Sharps bins below the fill line and mounted at safe height.
Common pitfalls—and calm fixes
Dry wiping (no contact time) → add a visible timer cue (10–60 sec per product).
Reusable instruments parked “just for now” → enforce dirty → clean unidirectional flow; add marked trays.
Expired gels/bandages → daily stock scan at opening; remove expiring stock to a “use-first” bin.
Crowded rooms → one clinician + patient + chaperone if required; others wait outside.
Ready checklists
Opening (clinic lead, 5 minutes per room)
ABHR, wipes, PPE stocked; expiry dates checked
Plinth paper/linen ready; bins at safe fill level
Device IFU sheet visible; sterilisation log current
Room-ready checklist signed
Between patients (clinician)
Hand rub → clean field → exam → hand rub
High-touch surfaces wiped; contact time respected
Linen changed; waste segregated; sharps disposed
Closing (assistant/lead)
Sharps bins sealed if near limit; clinical waste removed
Instruments reprocessed; logs signed
Floors, sinks, and handles cleaned; door locked