Innovative Approach to Moderating Risk of Nosocomial Infection During Anesthesia

ABSTRACT

Infection control concerns abound in the surgical anesthesia workstation, placing patients and providers at significant, documented risk because of many factors, including provider hand hygiene lapses, equipment design and complexity, and challenging disinfection. A trial was performed to mitigate cross-contamination involving 30 general anesthesia surgical operations matched 1:1 as control (no intervention) or intervention group (condom-like barriers to 4 anesthesia workstation components that are frequently touched and contaminated and very difficult to disinfect). Wraps were removed at the end of the operation and then replaced with fresh ones before the start of the subsequent operation. Baseline culture samples were obtained prior to the first surgical operation of the day in each room and then performed on operations that followed in each room over a 3-day period. Baseline colony-forming unit density was equivalent in both conditions with total density significantly lower in the covered/wrapped (mean rank = 5.81) vs uncovered condition (mean rank = 11.19) at P < 0.01, r = −0.64. Bacterial species diversity was markedly decreased in the covered condition. The covered condition served as a barrier to contamination of apparatus elements, preventing downstream patient exposure and mitigating between-procedure disinfection need. Intervention group providers were debriefed, finding only rare, addressable concerns. This research further validates the need for routine, periodic culturing of anesthetic apparatus to reveal lapses in provider behaviors and disinfection practices.