Eight hours of observation found anesthesia providers performed only 13 hand hygiene events, and they did not perform hand hygiene after line insertions, bronchoscopies or blood exposures, according to a study in the American Journal of Infection Control.
One person from the infection control department at Jackson Memorial Hospital in Miami observed 19 anesthesia providers during portions of seven surgical procedures for one week in 2010. Of the eight hours observed, there were 1,132 contacts between anesthesia providers and the operating room. The most common objects touched were switches or monitors of anesthesia machines at 16 percent of touches, keyboards at 13 percent and clean fields on top of anesthesia machines at 10 percent.
Anesthesia providers performed only 13 hand hygiene events, all with alcohol hand sanitizer. Nearly half — 46 percent — of these events were performed by nurse anesthetists during one hour of observation. Here are some other key findings from the study:
• No hand hygiene events were observed in three of the seven procedures.
• None of the two intubations or one bronchoscopy performed was immediately followed by hand hygiene.
• The anesthesia providers' intubations and bronchoscopy led to obvious blood exposure in three instances, none of which was followed by immediate hand hygiene.
• While the intubations and bronchoscopy were handled with gloves, only two of the blood exposures occurred while wearing gloves, and the gloves were not removed afterward.
• None of the four line placements or one nasogastric tube placement was preceded or followed by hand hygiene.
• There were 17 instances of contact with objects from the floor, none of which was followed by hand hygiene.
• Only 15 percent of accesses of stopcocks (a type of valve) were preceded by disinfection, but 47 percent were preceded by contact with the anesthesia machine's clean green field.
• A single pair of gloves touched a median 13 objects and a maximum of 88.
• The length of time a single pair of gloves was worn ranged from one to 28 minutes, with a median of six minutes.
• Only five of the 21 glove removals were followed by hand hygiene.
The authors noted several limitations, including the relatively short length of observations and the fact that observations occurred during only certain parts of surgical procedures. They suggested the large number of hand contacts in the OR may cause compliance with certain hand hygiene guidelines to reduce efficiency of patient care, and that anesthesia providers may need hand hygiene guidelines specific to the OR setting.
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One person from the infection control department at Jackson Memorial Hospital in Miami observed 19 anesthesia providers during portions of seven surgical procedures for one week in 2010. Of the eight hours observed, there were 1,132 contacts between anesthesia providers and the operating room. The most common objects touched were switches or monitors of anesthesia machines at 16 percent of touches, keyboards at 13 percent and clean fields on top of anesthesia machines at 10 percent.
Anesthesia providers performed only 13 hand hygiene events, all with alcohol hand sanitizer. Nearly half — 46 percent — of these events were performed by nurse anesthetists during one hour of observation. Here are some other key findings from the study:
• No hand hygiene events were observed in three of the seven procedures.
• None of the two intubations or one bronchoscopy performed was immediately followed by hand hygiene.
• The anesthesia providers' intubations and bronchoscopy led to obvious blood exposure in three instances, none of which was followed by immediate hand hygiene.
• While the intubations and bronchoscopy were handled with gloves, only two of the blood exposures occurred while wearing gloves, and the gloves were not removed afterward.
• None of the four line placements or one nasogastric tube placement was preceded or followed by hand hygiene.
• There were 17 instances of contact with objects from the floor, none of which was followed by hand hygiene.
• Only 15 percent of accesses of stopcocks (a type of valve) were preceded by disinfection, but 47 percent were preceded by contact with the anesthesia machine's clean green field.
• A single pair of gloves touched a median 13 objects and a maximum of 88.
• The length of time a single pair of gloves was worn ranged from one to 28 minutes, with a median of six minutes.
• Only five of the 21 glove removals were followed by hand hygiene.
The authors noted several limitations, including the relatively short length of observations and the fact that observations occurred during only certain parts of surgical procedures. They suggested the large number of hand contacts in the OR may cause compliance with certain hand hygiene guidelines to reduce efficiency of patient care, and that anesthesia providers may need hand hygiene guidelines specific to the OR setting.
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