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Anesthesia Infection in the Operating Room Anesthesia Work Area

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106 Commerce Street, Suite 105 Lake Mary, FL 32746 TEL: 407.878.7606 • FAX: 407.878.7611 Order additional copies at GuidelineCentral.com Copyright © 2018 All rights reserved SHEAANE18113a Disclaimer is pocket guide attempts to define principles of practice that should produce high- quality patient care. It is applicable to specialists, primary care, and providers at all levels. is pocket guide should not be considered exclusive of other methods of care reasonably directed at obtaining the same results. e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician aer consideration of each individual patient situation. Neither IGC, the medical associations, nor the authors endorse any product or service associated with the distributor of this clinical reference tool. Abbreviations ABHR, alcohol-based hand rub; HAI, hospital-acquired infection; HH, hand hygiene; ISO, International Organization for Standardization; IV, intravenous; OR, operating room; PPE, personal protective equipment; USP, United States Pharmacopeia; WHO, World Health Organization Source Munoz-Price LS et al. Infection prevention in the operating room anesthesia work area. Infection Control & Hospital Epidemiolog y (2018), 0, 1–17. doi:10.1017/ice.2018.303. ➤ Facilities should require cleaning and disinfection of computer keyboards and touchscreen computer monitors after each anesthesia case using a hospital-approved disinfectant consistent with manufacturers' recommendations. Additionally, cleaning and disinfection should also occur every time there is obvious soiling or contamination of anesthesia work surfaces. Facilities should consider use of commercial plastic keyboard shields, sealed medical keyboards, or washable keyboards and touchscreens to facilitate thorough disinfection. ➤ Anesthesia providers should follow all institution-specific guidelines when caring for patients on contact isolation in the OR, including performing HH and using appropriate personal protective equipment (PPE). Environmental disinfection should follow recommendations regarding cleaning between cases, irrespective of an individual patient's multidrug-resistant organism status. ➤ Facilities should conduct regular monitoring and evaluation of infection prevention practices. To promote adherence, improvement efforts should be collaborative and should include input from frontline anesthesia personnel and local champions. Hospital and physician leadership should identify clear expectations and goals, should ensure data transparency, and should facilitate use of process measures to improve performance. ➤ Facilities should monitor providers' HH performance and give them feedback as part of a comprehensive program to improve and maintain adherence. Insufficient data exist to recommend the routine use of automated, electronic, or video monitoring and feedback, although examples in the literature demonstrate efficacy of such technology. ➤ Facilities should utilize measures to assess the appropriateness and adequacy of environmental disinfection, track the measures, and share the results with stakeholders to optimize adherence to recommended disinfection practices.

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