Regional Audit Finds Uneven Infection Prevention Standards in Office-Based Surgery

Office-based surgery is expanding, yet a new regional audit shows that the infection prevention and control conditions under which these procedures take place vary widely across facilities.

The audit ran between July 2023 and January 2024 and included any healthcare facility with at least one room dedicated to office-based surgery. Two university hospitals, eight public hospitals, and five private clinics took part. Infection prevention and control professionals visited each site and collected data through direct observation and structured interviews, using standardised checklists covering four domains: architecture and organisation, cleaning procedures, patient pathways, and professional practices. Both individual criteria and composite scores were analysed.

The range of activity captured was broad. Across the participating rooms, the teams identified 173 procedures spanning seventeen specialties. Ophthalmology accounted for the largest share at 33 percent, followed by ear, nose and throat surgery at 27 percent, dermatology at 20 percent, and urology at 15 percent. This diversity underlines that office-based surgery is not a single, uniform activity but a collection of interventions performed in settings with very different infrastructure and staffing.

Ventilation emerged as one of the most variable technical parameters. Mechanical ventilation was present in 80 percent of the rooms audited, but only 20 percent had operating room-like ventilation meeting ISO Class 8 or ISO Class 7 cleanroom standards.

Professional practices showed comparable gaps. Written protocols for surgical hand disinfection by the surgeon before each procedure existed in only 33 percent of teams. Training coverage was similarly incomplete: 67 percent of teams reported having received infection prevention and control training, 56 percent had been trained in skin preparation, and just 40 percent in circulator roles. Skin preparation itself was explained to patients along 72 percent of care pathways but documented in only 44 percent, leaving much of a key safety step unrecorded.

The audit also revealed a consistent public-private divide. Public facilities scored significantly higher than private facilities on ventilation, room equipment, and patient pathway criteria, with all comparisons reaching statistical significance at p < 0.01.

The study is a regional observational audit based on direct observation and interviews at a single point in time, so it describes conditions as found rather than testing whether any intervention reduces infection rates. The audit assessed infection prevention and control conditions rather than clinical outcomes, and its findings describe one region during a single seven-month window between July 2023 and January 2024.

The authors conclude that office-based surgery encompasses diverse procedures across varied settings and is performed by teams with heterogeneous awareness of infection prevention measures. They argue that strengthening training, standardising protocols, and improving documentation could improve patient safety in these environments.

Subject of Research: Infection prevention and control practices in office-based surgery settings

Article Title: Assessment of infection prevention practices in office-based surgery: a multicentre regional audit

Article References: Ferriot, C., Jacquet, N., Bodet, N., Gallais, S., Martin, M., Billaud, N., Wiesel, S., Sury, E., Fonteille-Kermoal, G., Salaun, V., Bauer-Grandpierre, M., Dananché, C., Coroller-Bec, C., & Birgand, G. (2026). Assessment of infection prevention practices in office-based surgery: a multicentre regional audit. Antimicrobial Resistance & Infection Control. https://doi.org/10.1186/s13756-026-01836-2

Image Credits: AI Generated

DOI: 10.1186/s13756-026-01836-2

Keywords: office-based surgery, infection prevention and control, surgical audit, ventilation, surgical hand disinfection, skin preparation, patient safety, private clinics, public hospitals, healthcare quality, Assessment, infection