Researchers observe major hand hygiene problems in hospital operating theatres
Healthcare staff are missing 90% of opportunities for disinfecting their hands, study finds
A study by Sahlgrenska Academy researchers at a Swedish hospital found nearly 2,500 opportunities for hand disinfection and/or aseptic techniques, but doctors and nurses missed 90% of these opportunities.
The researchers observed procedures in connection with intubation and local anaesthesia, as well as insertion of catheters in the bloodstream and urinary tract, and found that the use of hand disinfection and aseptic techniques during such procedures is very low. Their research is published in the journal Antimicrobial Resistance and Infection Control.
'An operating room is radically different from other clinical settings in that anaesthesia-related tasks are so frequent,' said Anette Erichsen Andersson, a researcher at Sahlgrenska Academy. 'We counted an average of 30 opportunities, many of which were missed, for aseptic techniques every 24 minutes.'
Problems with aseptic techniques and insufficient teamwork led to a substantial increase in situations where hand disinfection should have been used. The study results also demonstrated that protective gloves are worn in an unsystematic manner, heightening the risk of hospital-acquired infections.
Problems with aseptic techniques and insufficient teamwork led to a substantial increase in situations where hand disinfection should have been used
'Gloves often take the place of hand disinfection and are reused for a number of different tasks,' said Andersson. 'Bacteria may be transmitted from the airways to the bloodstream as a result, increasing the risk of infection.'
The study did not examine the underlying reasons for inadequate use of aseptic techniques. One explanation may be that neither hygiene nor prevention of infection is a mandatory subject at medical school or during specialist training for doctors and nurses.
'There is little doubt that all doctors and nurses are familiar with the benefits of hand rub,' said Andersson. 'But simply possessing that knowledge is not good enough in the demanding setting of an operating room whose interdisciplinary teams rarely if ever have the chance to practise new working methods together, either in training or clinical situations.
'Awareness that you need to employ aseptic techniques must be supplemented by specific skills that work under complex, risky circumstances. The potential for interdisciplinary learning is enormous, and additional research is needed to maximise the prospects for safe, aseptic care in the operating room.'
The observations were not made during emergency surgery.
