Anesthesia providers miss chances to clean their hands during surgical procedures and have low hand-hygiene compliance according to a study published in the American Journal of Infection Control.
Researchers from Dartmouth-Hitchcock Medical Center used intraoperative video observation to map the temporal patterns of anesthesia providers’ hand contact with the anesthesia work environment. They assessed hand-hygiene compliance based on World Health Organization criteria: before touching the patient, before a clean procedure, after exposure to body fluids, after touching the patient and after touching the patient’s surroundings.
The research team identified the 20 most frequently touched objects–including the patient bed, pens and anesthesia cart drawer handle, and how much bacteria those objects collected. The mean number of colony forming units cultured from those objects varied during the course of surgery, with a sharp increase in contamination during anesthesia induction and anesthesia emergence.
Providers were least likely to perform hand hygiene immediately before patient contact and after contact with the patient’s environment, while they were most likely to follow proper hand-hygiene protocols after potential exposure to body fluids.
Hand-hygiene compliance rates in the aneshesia work environment are extremely low, researchers concluded, adding that hospitals should develop and implement novel approaches to hand hygiene.
Patient observation could be the key to healthcare worker hand hygiene. Canadian researchers found that almost 97 percent of healthcare providers followed hand-hygiene guidelines before direct contact with the patient. Fifty-eight percent of providers audited by patients through the study reported a change in their hand-hygiene practices and 88 percent reported being more motivated to comply because they knew their patients were watching. Thirty-three percent said patients had more discussions about infection protection and control.