Infection Prevention in Ambulatory Care: Navigating a Patchwork of Practices

The non-acute healthcare environment continues to expand, with increasingly complex patients receiving care across outpatient clinics, ambulatory surgery centers (ASCs), and other settings. As care shifts beyond the hospital, infection prevention and control (IPC) programs are expected to operate across diverse environments with variable oversight, resources, and infrastructure.These conditions can create significant challenges for infection prevention. This session will review trends shaping ambulatory care, examine current infection prevention expectations across settings, and outline practical, real-world approaches to help reduce transmission in the environments where care is increasingly delivered. Learning Objectives    Describe key trends driving the shift from acute care to ambulatory and outpatient settings, including increasing patient complexity    Identify variability in infection prevention expectations, oversight, and resources across ambulatory care environments    Apply practical, setting-specific strategies to help reduce transmission in outpatient and non-acute care settingsDespite sustained focus and decades of guidance, Clostridioides difficile remains the most commonhealthcare-associated infection and an ongoing challenge for hospitals. Many organizations haveachieved meaningful reductions, yet “breakthrough” transmission persists—often driven not by lackof effort, but by overlooked operational blind spots.This session examines where C. diff prevention programs may still be faltering and why doing moreof the same may no longer be enough. Drawing on evolving epidemiology, frontline workflowrealities, and real-world IPC–EVS intersections, this webinar will highlight prevention gaps that havesurfaced outside traditional playbooks. While environmental cleaning and disinfection will beexplored in depth, the discussion will also address complementary blind spots, including but notlimited to delayed identification and isolation, communication failures, diagnostic stewardship, andcare transitions.Participants will leave with practical, actionable strategies that emphasize universal controls, earlyinterventions, and reliable execution across care transitions - closing gaps that matter for reducinghospital-onset C. diff infections.Effective environmental cleaning and disinfection is essential for prevention of healthcare-associated infections. However, in a culture survey of 30 hospitals sponsored by APIC, we found that surfaces were often contaminated after cleaning and disinfection. To better understand why surfaces remain contaminated, we have conducted observational studies in collaboration with our EVS program to identify cleaning practices and products that may lead to ineffective cleaning and disinfection. Important findings include frequent malfunction of automated disinfectant dispensers, incorrect use of disinfectants, and suboptimal monitoring of cleaning practices and products. This presentation will review factors that were identified as contributors to ineffective cleaning and disinfection and discuss strategies for implementation of monitoring that involve collaboration between environmental services personnel and infection prevention.

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