Study finds low hand hygiene compliance rates during anaesthesia administration

Published: 2-Jul-2014

Low compliance rates at start and last 20-minute time periods corresponded with sharp peaks in bacterial contamination


Anaesthesia providers are missing opportunities to clean their hands during surgical procedures, according to a study published in the July issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).

In the study, researchers at Dartmouth-Hitchcock Medical Center in New Hampshire in the US used video observation to map patterns of anaesthesia provider hand contact with anesthesia work environment surfaces to assess hand hygiene compliance.

They observed an average of 149 hand washing opportunities per hour of anaesthesia time. Hand hygiene compliance was lowest during the first and last 20-minute time periods. The low compliance rates at case start and case end corresponded with sharp peaks in bacterial contamination of the 20 most frequently touched objects.

According to the study, anaesthesia providers were least likely to wash their hands immediately before patient contact and after contact with the patient’s environment. They were most likely to perform hand hygiene after potential exposure to body fluids.

This work identifies targets for improved frequency and quality of environmental cleaning

The World Healthcare Organization specifies five moments for hand hygiene to reduce the risk of healthcare-associated infection: before touching a patient; before a clean procedure; after exposure to body fluids; after touching a patient; and after touching a patient’s surroundings.

'This work adds to the body of evidence pertaining to intra-operative bacterial transmission because it identifies targets for improved frequency and quality of environmental cleaning as well as important periods for hand hygiene compliance, namely induction and emergence from general anaesthesia,' the authors said.

The study points out that complete compliance with hand washing guidelines that are established for non-operating room environments would consume more than the 60 minutes available in each hour of anaesthesia time, 'a fact that identifies a need to create more practical – but still effective – methods of controlling bacterial transmission in anaesthesia work environments,', the authors added. 'New methods to reduce bacterial contamination of the anaesthesia work environment are needed to prevent healthcare-associated infections.'

Infections that occur after surgery are one of the most common types of healthcare-associated infections. According to the US Centers for Disease Control and Prevention, there are approximately 157,000 surgical site infections each year.

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