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Many Anesthesiologists Fail to Wash Hands

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Specializes in Vents, Telemetry, Home Care, Home infusion. Has 44 years experience.

Dartmouth-Hitchcock Medical Center study finds low hand hygiene compliance rates during anesthesia administration

Philadelphia Inquirer

7/8/14

Many Anesthesiologists Fail to Wash Hands

...Researchers observed anesthesiologists during operations and found that they had an average of 149 "hand hygiene opportunities" per hour of patient anesthesia time.

There are five hand hygiene opportunities that help reduce the risk of health care-associated infections, according to the World Health Organization. They are: before touching a patient; before a clean procedure; after exposure to body fluids; after touching a patient; after touching a patient's surroundings.

Anesthesiologists were least likely to properly clean their hands during the first and last 20 minutes of patient anesthesia, which corresponds with sharp increases in bacterial contamination of the 20 most frequently touched objects during these same time periods.

The Dartmouth-Hitchcock Medical Center researchers also found that anesthesiologists were least likely to properly clean their hands immediately before patient contact and after contact with the patient's surroundings, and most likely to properly clean their hands after potential exposure to body fluids.

Read more at http://www.philly.com/philly/health/HealthDay689388_20140707_Many_Anesthesiologists_Fail_to_Wash_Hands__Study_Shows.html#roaOKdGs3oT5JHpi.99

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

Wow - I am so shocked (not). In other news, sun rises in the East, water is wet.

Nah - just kidding. I recently completed a Coursera offering on the Science of Health Care Safety (Great Course!!!) in which the Johns Hopkins folks explained how they basically eliminated central line infections... this same issue was one of their "aha" moments. They were only successful when they empowered other staff to 'stop the line' whenever an infection control breach was noticed. The JH initiative was physician-led & had full support of Senior Level execs. I don't think that anything less would make a difference.

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

Yet an ICU's high VAP rates are somehow a nursing problem.... :facepalm:

laKrugRN

Specializes in Cardiac, ER, Pediatrics, Corrections.

I can remember doing clinical rotations at the VA. CDC actually came in and stood in the hallways...the WHOLE 3-11 shift and watched to see who "gel'd in and gel'd out." They were keeping tabs literally! I am almost robotic when it comes to hand hygiene. I maybe even overwash/sanitize.

wtbcrna, MSN, DNP, CRNA

Specializes in Anesthesia.

Healthcare infections from anesthesia providers is rare. These guidelines are unrealistic for the OR, and isn't supported by research concerning anesthesia caused infection rates.

The study points out that complete compliance with hand hygiene guidelines that are established for non-operating room environments would consume more than the 60 minutes available in each hour of anesthesia time, “a fact that identifies a need to create more practical – but still effective – methods of controlling bacterial transmission in anesthesia work environments,” the authors write. “New methods to reduce bacterial contamination of the anesthesia work environment are needed to prevent healthcare-associated infections.” http://www.infectioncontroltoday.com/news/2014/07/study-finds-low-hand-hygiene-compliance-rates-during-anesthesia-administration.aspx

Rose_Queen, BSN, MSN, RN

Specializes in OR, education. Has 16 years experience.

Healthcare infections from anesthesia providers is rare. These guidelines are unrealistic for the OR, and isn't supported by research concerning anesthesia caused infection rates.

The study points out that complete compliance with hand hygiene guidelines that are established for non-operating room environments would consume more than the 60 minutes available in each hour of anesthesia time, “a fact that identifies a need to create more practical – but still effective – methods of controlling bacterial transmission in anesthesia work environments,” the authors write. “New methods to reduce bacterial contamination of the anesthesia work environment are needed to prevent healthcare-associated infections.” http://www.infectioncontroltoday.com/news/2014/07/study-finds-low-hand-hygiene-compliance-rates-during-anesthesia-administration.aspx

While I mostly do agree with you that such frequent hand hygiene is impractical, I think that there are many anesthesiologists (and others) out there that do things hazardous to infection control. I work with many who will utilize the gowns worn while inserting central lines as warm up jackets by simply turning them around- blood and all. An anesthesia technician also never wears gloves when working with patients, regardless of blood splashes and known HIV+/HEPC+ status. There is room for improvement of infection control out there.

wtbcrna, MSN, DNP, CRNA

Specializes in Anesthesia.

While I mostly do agree with you that such frequent hand hygiene is impractical, I think that there are many anesthesiologists (and others) out there that do things hazardous to infection control. I work with many who will utilize the gowns worn while inserting central lines as warm up jackets by simply turning them around- blood and all. An anesthesia technician also never wears gloves when working with patients, regardless of blood splashes and known HIV+/HEPC+ status. There is room for improvement of infection control out there.

There is always room for improvement, but it should be based on research specific to the OR environment and anesthesia.

There are already recommendations for infection control from the ASA and AANA. These are the recommendations that should be evaluated not policies that are not specific to the OR and probably have no benefit when dealing with a closed environment and a only one patient at a time.