A leading infection preventionist (IP) provided expert review on anesthesia infection control for recent guidelines issued by the Society for Healthcare Epidemiology of America (SHEA).1
Sue Dolan, RN, an IP at Children’s Hospital Colorado in Aurora, is a past president of the Association for Professionals in Infection Control and Epidemiology. Dolan had previously developed an infection control assessment tool2 for anesthesiology, which was cited by SHEA but not formally included in its recommendations.
Aware that many IPs are unfamiliar with anesthesia practice, Dolan emphasizes common sense measures that include the following:
Environment (clean vs. dirty)
- “Clean and dirty spaces are clearly defined and treated as such. Staff responsible are trained on steps involved in the process. What to discard and where, surface cleaning, and disinfection.
- Method is in place that indicates the OR/procedure room is complete for the environment and medications and room is ready for next patient. (A technician may be responsible for room turnover and the anesthesia staff for the medications).
- Sharps containers and trash bins are easy to access, not overfilled, and are located away from clean areas.
- Laryngoscope blades are bagged in storage.”
Disinfection
- “Proper disinfection with hospital-approved product at end of case includes but is not limited to: anesthesia med/supply cart, anesthesia machine (knobs, surfaces, cords, keyboard, monitor, adjustable pressure limiting (APL) valve, IV pole, laryngoscope handle).
- Single patient use items are discarded at the end of each case (e.g., circuits, airway bags, suction tubing).
- Stethoscopes are disinfected per hospital policies and procedures.
- Are anesthesia staff responsible for cleaning and high-level disinfection and/or sterilization of any reusable equipment? If yes, competencies in place and all quality control measures performed and documented.”
Exposure management
- Staff can articulate when and how to handle and report exposures to blood/body fluids (HIV, Hepatitis B, Hepatitis C) or other contagious diseases (e.g., tuberculosis, pertussis).
- Munoz-Price LS, Bowdle A, Johnston BL, et al. Infection prevention in the operating room anesthesia work area. Infect Control Hosp Epidem 2019;40(1):1-17 doi:10.1017/ice.2018.303.
- Dolan, SA. Heath J, Potter-Bynoe, G. Infection prevention in anesthesia practice: A tool to assess risk and compliance. AJIC 2013;41:1077-1082.
