Hand hygiene compliance low among anesthesia providers

Anesthesia providers demonstrated a low rate of hand hygiene compliance during surgical procedures, according to researchers from Dartmouth-Hitchcock Medical Center.

“In recent studies, we have shown … that residual contamination of representatives of the anesthesia environment often link patient and provider bacterial reservoirs in part through hand contact,” the researchers wrote in American Journal of Infection Control. “Further work is needed to characterize the process of [operating room] environmental contamination so improved strategies can be developed to prevent bacterial transmission events.”

The study took place in two phases and each included five surgical cases. In the first phase, five randomly selected operating rooms were set up for video observation. During the five surgical cases, the researchers evaluated hand contact interactions between the anesthesia provider’s hands and 90 objects in the anesthesia work area.

They also evaluated hand hygiene compliance based on WHO’s Five Moments for Hand Hygiene criteria. In the second phase of the study, the researchers identified the 20 most frequently touched objects and subjected them to pathogen culture for five new surgical cases.

The number of touches for the 20 most frequently touched objects ranged from 20 to 77 touches within a mean case duration of 77 minutes. The providers wore gloves an average of 39.7% of the time when touching an object. There was no correlation between number of hand contacts and total colony forming united cultured on the 20 most frequently touched objects.

There were an average of 149 hand hygiene opportunities per hour of anesthesia time. The overall hand hygiene compliance rate was 2.9%, with the lowest compliance rate during the first and last 20 minutes. These two timeframes also had the highest bacterial contamination on the most frequently touched products.

“These results suggest that increased frequency and quality of [anesthesia work area] decontamination in addition to better hand hygiene compliance are indicated, especially during the induction and emergence phases of anesthesia,” the researchers wrote.

“Effective interventions to prevent [anesthesia work area] contamination by improving hand hygiene compliance may require development and implementation of novel approaches.”

Disclosure: The researchers report no relevant financial disclosures.