The Society for Healthcare Epidemiology of America (SHEA) today issued new guidance for preventing infections associated with anesthesiology procedures and equipment in the operating room (OR).
Published in SHEA’s journal Infection Control & Healthcare Epidemiology, the guidance provides steps for improving infection prevention using increased hand hygiene, environmental disinfection, and continuous improvement plans.
“Even though the demands on anesthesia providers make infection prevention best practices more challenging, there are opportunities for improvement,” said Silvia Munoz-Price, MD, PhD, lead author of the guidance and professor of medicine at Froedtert & Medical College of Wisconsin, in a release. “We describe how the anesthesiology team and hospital leaders can optimize infection prevention in operating room anesthesia, and we give suggestions for the future, including the need for better equipment design.”
Representatives from SHEA, the American Society of Anesthesiologists, the Anesthesia Patient Safety Foundation, and the American Association of Nurse Anesthetists developed the following recommendations:
- At a minimum, hand hygiene should be performed before aseptic tasks, after removing gloves, when hands are soiled, before touching the anesthesia cart, and when entering and exiting the OR. Alcohol-based hand sanitizer dispensers should be strategically placed.
- Double gloves should be used during airway management so one layer can be removed when contamination is likely and the procedure moves too quickly to perform hand hygiene. The guidance also recommends high-level disinfection of reusable laryngoscope handles or adoption of single-use laryngoscopes.
- Environmental disinfection should include high-touch surfaces on the anesthesia machines, as well as keyboards, monitors, and other items in work areas between surgeries. Organizations should also consider the use of disposable covers and re-engineering work surfaces to facilitate quick decontamination in what is often a short period of time.
- For IV drug injection, the guidance recommends using syringes and vials for only one patient, and only accessing injection ports and vial stoppers after disinfection.
Implementation of the guidance requires multi-level collaboration within the hospital, regular monitoring, and evaluation of infection prevention practices with regular feedback for providers as well as clarity in expectations about behaviors, according to the authors.