Effectiveness and feasibility of an evidence-based intraoperative infection control program targeting improved basic measures: a post-implementation prospective case-cohort study

Quantifying and Interpreting Inequality in Surgical Site Infections per Quarter Among Anesthetizing Locations and Specialties

“…For example, while greater operating room ventilation (e.g., through the use of single large diffusers) may be beneficial for orthopedic trauma surgery [12,38], operating room ventilation systems are installed in operating rooms, not in locations for the exclusive use of one specialty. Results for a combination of location and specialty are useful for reducing the fixed costs of clinical trials aiming to reduce S. aureus (or other pathogens) transmission and surgical site infections [2,[4][5][6]. Case pairs are studied, consecutive patients of the same specialty in the same anesthetizing location on the same day [2,[4][5][6].…”

“…However, the infection prevention principles applied are not single interventions such as having a hand hygiene dispenser on the intravenous pole near each patient [2]. Rather, they are multiple interventions including providing feedback to anesthesia practitioners by swabbing specific sites within anesthesia work areas to measure the transmission of Staphylococcus aureus (e.g., from the patient's nose to the lumen of intravenous stopcock) [2][3][4][5]. The risk of surgical site infection was 2% without S. aureus transmission from one site within the anesthesia work area to another, 11% with the transmission in the anesthesia work area of S. aureus sensitive to the prophylactic antibiotic (e.g., hands of the anesthesiologist at the start of the case to the anesthesia machine at end of the case), and 18% with the transmission of S. aureus resistant to the antibiotic [6].…”

Patient Safety in Anesthesia: Hand Hygiene and Perioperative Infection Control

“…Recent evidence suggests that the anesthesia care team has a vital role in minimizing this risk by limiting transmission of infectious flora through HH and clean workspaces, appropriate and timely prophylactic antibiotic administration, as well as maintaining adequate patient physiologic conditions: normothermia, glucose management, etc. [ 2 – 4 ]. In a randomized controlled trial (RCT), Loftus et al demonstrated that basic preventive measures can significantly reduce transmission, and therefore infections, of Staphylococcus aureus [ 3 ].…”

“…In a randomized controlled trial (RCT), Loftus et al demonstrated that basic preventive measures can significantly reduce transmission, and therefore infections, of Staphylococcus aureus [ 3 ]. As a follow-up to this RCT, Wall et al evaluated the feasibility and effectiveness of these preventive measures in reducing transmission of S. aureus and subsequent surgical site infections (SSI) [ 4 ]. Results provided conclusive evidence that implementing basic preventive measures was both feasible and effective and should be a part of the routine care provided by anesthesia staff.…”

Evidence-based intraoperative infection control measures plus feedback are associated with attenuation of severe acute respiratory syndrome coronavirus-2 detection in operating rooms

“…EditordA recent review in the British Journal of Anaesthesia described the impact of optimised, basic intraoperative infection control measures. 1 Feedback is a critical implementation feature for prevention of bacterial transmission and associated surgical site infections, 2,3 but the importance of feedback for viral pathogens is unknown. We have observed a low rate of Staphylococcus aureus [0% (0/108)] and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) transmission [1% (1/ 108)] after implementation of recommended anaesthesia work area infection control measures.…”