Skip to main content Accessibility help
×
Hostname: page-component-848d4c4894-v5vhk Total loading time: 0 Render date: 2024-07-01T01:39:41.617Z Has data issue: false hasContentIssue false

Chapter 34 - Infection Control for the Anesthesia Provider

Published online by Cambridge University Press:  24 May 2023

Alan David Kaye
Affiliation:
Louisiana State University School of Medicine
Richard D. Urman
Affiliation:
Brigham and Women’s Hospital, Boston
Get access

Summary

A newly acquired infection that a patient contracts during the course of receiving medical care is known as a healthcare-associated infection (HAI). These nosocomial infections are a serious source of morbidity and mortality for patients receiving care in hospitals, nursing homes, rehabilitation facilities, and surgery centers. HAIs include central line-associated bloodstream infections, catheter-associated urinary tract infections, ventilator-associated infections, and surgical site infections (SSIs). It is estimated that each day, 1 in every 31 patients in the United States is diagnosed with at least one of these nosocomial infections. Annually, approximately 2 million patients are diagnosed with a HAI in the United States, with 90,000 cases resulting in death [1, 2]. SSIs account for upward of 20% of all HAIs. Not only do they lead to an increase in the length of hospital stay, but they also are associated with increased readmission rates and the development of multidrug-resistant infections and drive up the cost of care. This contributes to an increase in healthcare costs of between 3.5 and 10 billion dollars per year [3, 4]. Just as staggering is the knowledge that it is estimated that up to 60% of SSIs are preventable. There are numerous factors that contribute to these infections. In recent years, there has been an increased awareness of the role that anesthesia providers can play in mitigating the risk of HAIs. Vigilant adherence to infection control measures is paramount to reducing perioperative HAIs [5].

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Centers for Disease Control (CDC). Public health focus: surveillance, prevention, and control of nosocomial infections. MMWR Morb Mortal Wkly Rep. 1992:41:783–7.Google Scholar
Centers for Disease Control and Prevention. 2018 National and state healthcare-associated infections progress report. 2019. Available from: www.cdc.gov/hai/data/archive/2018-HAI-progress-report.html.Google Scholar
Shepard, J, et al. Financial impact of surgical site infections on hospitals: the hospital management perspective. JAMA Surg. 2013;148:907–14.Google Scholar
Stone, PW. Economic burden of healthcare-associated infections: an American perspective. Expert Rev Pharmacoecon Outcomes Res. 2009;9:417–22.Google Scholar
Munoz-Price, L., et al. Infection prevention in the operating room anesthesia work area. Infect Control Hosp Epidemiol. 2019;40:117.Google Scholar
American Society of Anesthesiologists. Guidelines for surgical attire. 2019. Available from: www.asahq.org/standards-and-guidelines/guidelines-for-surgical-attire.Google Scholar
Hambraeus, A. Aerobiology in the operating room – a review. J Hosp Infect. 1988;11:6876.CrossRefGoogle ScholarPubMed
Centers for Disease Control and Prevention. Transmission-based precautions. Available from: www.cdc.gov/infectioncontrol/basics/transmission-based-precautions.html.Google Scholar
World Health Organization. WHO guidelines on hand hygiene in healthcare. 2009. Available from: www.who.int/publications/i/item/9789241597906.Google Scholar
Baillie, JK, et al. Contamination of anaesthetic machines with pathogenic organisms. Anaesthesia. 2007;62:1257–61.CrossRefGoogle ScholarPubMed
Loftus, RW, et al. The dynamics of Enterococcus transmission from bacterial reservoir commonly encountered by anesthesia providers. Anesth Analg. 2015;120:827–36.Google Scholar
Sharma, A, et al. Perioperative infection transmission: the role of the anesthesia provider in infection control and healthcare-associated infections. Curr Anesthesiol Rep. 2020;10(3):19.Google Scholar
Koff, MD, et al. Reduction in intraoperative bacterial contamination of peripheral intravenous tubing through the use of a novel device. Anesthesiology. 2009;110:978–85.Google Scholar
Loftus, RW, et al. The epidemiology of Staphylococcus aureus transmission in the anesthesia work area. Anesth Analg. 2015;120:807–18.Google Scholar
Loftus, RW, et al. Transmission dynamics of gram-negative bacterial pathogens in the anesthesia work area. Anesth Analg. 2015;120:819–26.Google Scholar
Jefferson, J, et al. A novel technique for identifying opportunities to improve environmental hygiene in the operating room. AORN J. 2011;93:358–64.CrossRefGoogle ScholarPubMed
Munoz-Price, LS, et al. Decreasing operating room environmental pathogen contamination through improved cleaning practices. Infect Control Hosp Epidemiol. 2012;33:897904.Google Scholar
Biddle, CJ, et al. Assessing a novel method to reduce anesthesia machine contamination: a prospective, observational trial. Can J Infect Dis Med Microbiol. 2018;2018:1905360.Google Scholar
Birnbach, DJ, et al. Double gloves: a randomized trial to evaluate a simple strategy to reduce contamination in the operating room. Anesth Analg. 2015;121:1209–14.Google Scholar
Schaffzin, J, et al. The hospital epidemiologist’s perspective on the anesthesia operating room work area. Anesthesia Patient Safety Foundation. 2019;34 :37–9.Google Scholar
Rutala, WA, Weber, DJ. Disinfection and sterilization in health care facilities: an overview and current issues. Infect Dis Clin North Am. 2016;30:609–37.CrossRefGoogle ScholarPubMed
Muscarella, LF. Reassessment of the risk of healthcare acquired infection during rigid laryngoscopy. J Hosp Infect. 2008;68:101–7.Google Scholar
Centers for Disease Control and Prevention. Safe injection practices to prevent transmission to patients. 2007. Available from: www.cdc.gov/injectionsafety/ip07-standardprecaution.html.Google Scholar
Loftus, RW, et al. Transmission of pathogenic bacterial organisms in the anesthetic work area. Anesthesiology. 2008;109:399407.Google Scholar
Gargiulo, DA, et al. Anaesthetic drug administration as a potential contributor to healthcare associated infections – a perspective simulation based evaluation of aseptic technique in administration of anaesthetic drugs. BMJ Qual Safe. 2012;21:826–34.Google Scholar
Moureau, NL, Flynn, J. Disinfection of needless connector hubs: clinical evidence systematic review. Nurs Res Pract. 2015;2015:796762.Google Scholar
Association of Surgical Technologists. AST standards of practice for skin prep of the surgical patient. 2008. Available from: www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Standard_Skin_Prep.pdfGoogle Scholar
[No authors listed]. Practice advisory for the prevention, diagnosis, and management of infectious complications associated with neuraxial techniques: an updated report by the American Society of Anesthesiologists Task Force on Infectious Complications Associated with Neuraxial Techniques and the American Society of Regional Anesthesia and Pain Medicine. Anesthesiology. 2017;126:585601.CrossRefGoogle Scholar
Schulz-Stubner, S, et al. Infection control in regional anesthesia. Available from: www.nysora.com/topics/complications/infection-control-regional-anesthesia/.Google Scholar
Zhang, Li, et al. Infection risks associated with vascular catheters. J Infect Prev. 2016;17:207–13.CrossRefGoogle ScholarPubMed
O’Grady, NP, et al. Guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis. 2011;52(9):e162–93.Google ScholarPubMed
Joint Commission International. Evidence based principles and practices for preventing surgical site infections. 2018. Available from: https://store.jointcommissioninternational.org/evidence-based-principles-and-practices-for-preventing-surgical-site-infections-toolkit/.Google Scholar
Berríos-Torres, SI, et al. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection. JAMA Surg. 2017;152:784–91.CrossRefGoogle ScholarPubMed
World Health Organization. Global guidelines for the prevention of surgical site infection. 2016. Available from: www.ncbi.nlm.nih.gov/pubmedhealth/PMH0095752/pdf/PubMedHealth_PMH0095752.pdf.Google Scholar
Gronnier, C, et al. Influence of Enhanced Recovery Pathway on surgical site infection after colonic surgery. Gastroenterol Res Pract. 2017;2017:9015854.Google Scholar
World Health Organization. Weekly epidemiological update – 3 November 2020. 2020. Available from: www.who.int/publications/m/item/weekly-epidemiological-update---3-november-2020.Google Scholar
Centers for Disease Control and Prevention. Infection control guidance for healthcare professionals about coronavirus (COVID-19). 2020. Available from: www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control.html.Google Scholar
Caputo, KM, et al. Intubation of SARS patients: infection and perspectives of healthcare workers. Can J Anaesth. 2006;53(2):122–9.Google Scholar
Centers for Disease Control and Prevention. Interim infection prevention and control recommendations for healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic. Atlanta, GA: Centers for Disease Control and Prevention; 2022.Google Scholar
Lockhart, SL, et al. Personal protective equipment (PPE) for both anesthesiologists and other airway managers: principles and practice during the COVID-19 pandemic. Can J Anaesth. 2020;67(8):1005–15.Google Scholar
Zucco, L, et al. Perioperative considerations for the 2019 novel coronavirus (COVID-19). Rochester, MN: Anesthesia Patient Safety Foundation; 2020.Google Scholar
Bauer, ME, et al. Obstetric anesthesia during the COVID-19 pandemic. Anesth Analg. 2020;131:715.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×