Adopt single-use laryngoscopes for airway management, recommends new Infection control Guideline issued by The Society for Healthcare Epidemiology of America. The new guidelines intend to suggest as to how hospitals and healthcare providers may reduce infections associated with anesthesiology procedures and equipment in the operating room.
Infection prevention and control practices specific to anesthesia care in the operating room is not universal. There is no routine audit of infection prevention policies. As a result, health care providers have no clarity over policies and practices in this regard.
The guidance was published in SHEA’s journal, Infection Control & Hospital Epidemiology. The guidance has recommended steps to improve infection prevention through increased hand hygiene, environmental disinfection, and continuous improvement plans.
According to the authors, implementation of the recommendations 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 guidance, leadership should define goals, remove barriers to infection prevention, and empower practitioners to meet standards.
The key recommendations included are:
- During airway management, the authors suggest the use of double gloves so one layer can be removed when contamination is likely and the procedure moves too quickly to perform hand hygiene. The report also recommends high-level disinfection of reusable laryngoscope handles or adoption of single-use laryngoscopes.
- For environmental disinfection, the guidance recommends disinfecting high-touch surfaces on the anesthesia machines, as well as keyboards, monitors and other items in work areas in between surgeries, while also exploring the use of disposable covers and re-engineering of the work surfaces to facilitate quick decontamination in what is often a short window of time.
- IV drug injection recommendations include using syringes and vials for only one patient, and that injection ports and vial stoppers should only be accessed after disinfection.
- Hand hygiene should be performed, at a minimum, before aseptic tasks, after removing gloves, when hands are soiled, before touching the anesthesia cart, and upon room entry and exit. The authors also suggest strategic placement of alcohol-based hand sanitizer dispensers.
This guidance builds on the foundational premise that all facilities where anesthesia services are delivered have formal infection prevention and control programs.
“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,” said Silvia Munoz-Price, MD, Ph.D., lead author of the guidance.
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