Archive Infection Control 2019

Hold Anesthesia Providers

Accountable in the Battle Against SSIs Q&A with Silvia Munoz-Price, MD, PhD, infectious disease specialist and proponent of proper infection control practices.

NEW APPROACH

You were the lead author of the Society for Healthcare Epidemiology of America’s new guidance on infection control in anesthesia work areas. Why were those recommendations necessary?

Members of the surgical team who work at the table are meticulous about using proper sterile technique, but additional staffers, including anesthesia providers, who don’t have direct contact with the surgical site sometimes exhibit the complete opposite behavior. It’s difficult, but critically important, for anesthesia providers to maintain a clean workspace and do their part to reduce infection risks.

What’s the biggest infection control challenge among anesthesia providers?

Providers don’t always clean their hands between cases and tend to wear a single pair of gloves for long periods of time as they touch patients, equipment, surfaces, medications and IV hubs. If providers don’t follow proper hand hygiene practices, their work areas and the supplies they use become contaminated. That wouldn’t be an issue if work stations and ORs were properly cleaned between cases, but that’s not always the case.

Why not?

It’s a combination of several factors. Staff see garbage and clutter, but they don’t see bacteria. It’s easy to focus on what’s obvious — removing waste — but detailed cleaning of surfaces and equipment doesn’t always occur. Staff are also under constant pressure to ready rooms between cases as quickly as possible. Turnover times are tangible, measurable outcomes, but if staff check a box to show they cleaned an OR, who confirms that they did it right every time?

Do you think surgical teams fully appreciate infection risks in the OR?

Not always. Bacteria exposure isn’t an immediate outcome. It’s also nearly impossible to associate contaminated ORs with poor outcomes. Surgical professionals want to see data before changing their routines. New studies are being developed that aim to use genome sequencing of microorganisms to link bacteria in the operating room to bacteria that cause post-op infections. Once that link is established, surgical staffs will hopefully be more proactive in taking care of the OR environment.

What can facility leaders do to improve infection prevention practices?

The biggest thing I’ve learned during my career is that policies on paper don’t always reflect what happens in real life. It’s important to observe what staff do on a daily basis to ensure staff who care for patients and handle instruments always follow recommended practices. Everyone, in all areas of surgical care, must buy in to doing a better job in order to eliminate infection risks from the OR. OSM

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