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More than 90% of hand hygiene opportunities missed during anesthetic procedures
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Adherence to hand hygiene guidelines was low among those performing risk-prone invasive procedures requiring anesthetic care, according to recently published data.
“An operating room is radically different from other clinical settings in that anesthesia-related tasks are so frequent,” Annette Erichsen Andersson, RN, PhD, of the Sahlgrenska Academy at the University of Gothenburg, Sweden, said in a press release. “We counted an average of 30 opportunities, many of which were missed, for aseptic techniques every 24 minutes.”
Andersson and colleagues performed an observational study to gauge hand hygiene adherence within a Swedish 460-bed general hospital from 2012-2013. Opportunities for aseptic practices, which were defined using a modified version of WHO’s hand-hygiene observational method, were tallied among workers actively taking part in an anesthetic care procedure. All data was collected by a single trained observer, with emergency surgeries excluded from analysis. Proper use of gloves to prevent surgical infection was also observed.
There were 2,393 opportunities for hand hygiene recorded over the course of 94 surgical procedures and three observation sessions in the preoperative center. The researchers reported an average of 10.9 opportunities per hour during full-length surgeries, with an adherence rate of 8.1%. Lowest adherence was observed preceding aseptic tasks during the induction phase (2.2%), while appropriate hand hygiene practices were most frequent during full-length surgery following the exposure of body fluids (15.9%).
Glove use was observed during 249 care procedures, and were used incorrectly in 43% of cases. Disposable gloves were used during 242 procedures, but were previously used or contaminated in 65.7% of these cases.
“There is little doubt that all doctors and nurses are familiar with the benefits of hand rub,” Andersson said. “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 practice 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 maximize the prospects for safe, aseptic care in the operating room.”
Disclosure: The researchers report no relevant financial disclosures.
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