Improving Infection Control Practices Related to Anesthesia Care in the OR

The Society for Healthcare Epidemiology of America (SHEA) released new recommendations for improving infection control practices specific to OR anesthesia care. Lead author of the new guidelines Silvia Munoz-Price says the guidance is important because, until now, there were no universal “infection prevention and control policies specific to anesthesia care in the OR.”  The guidelines are intended to “protect patients from nosocomial infections” which, as noted by Munoz-Price, could potentially be transmitted in the intraoperative environment without sufficient protocol. The SHEA recommendations are heavily focused on hand hygiene because, according to the panel of authors, this basic task is not performed frequently enough by anesthesia providers. The following best practices are outlined by Anesthesiology News in an article about the new guidelines:

• At a minimum, hand hygiene should be performed “before aseptic tasks, such as inserting central venous catheters and arterial catheters; when drawing medications and spiking IV bags; every time gloves are removed and before touching the anesthesia cart; when going in and out of the OR; and when hands are contaminated, for example, with oropharyngeal secretions.”
• Providers should “consider double-gloving during airway management to reduce the risk for contamination in the OR and to remove their outer gloves immediately after airway manipulation.” Hands should be washed or hand sanitizer used “as soon as possible” after that management.
• Alcohol-based hand rub (ABHR) dispensers should be wall-mounted at OR entrances and near anesthesia providers inside the OR.
• Standard direct laryngoscope and video laryngoscope reusable blades and handles should undergo, at a minimum, high-level disinfection or sterilization before use.
• Stopcocks should not be used because they are easily contaminated and a source of infection.
• High-touch areas, particularly the anesthesia cart, should receive detailed attention and be cleaned often.

MLMIC encourages all insured providers to be proactive in reducing risk related to microbial cross transmission in the OR environment through staff education and skills assessment. A complete overview and more information on the recommendations is available here.