Preventing perioperative transmission of infection: a survey of anesthesiology practice.

Given the societal and economic impact of perioperative infection, it is essential that anesthesiologists and other operating room personnel use appropriate precautions to reduce the potential for transmission of infectious agents to the patients under their care. This study, therefore, was designed to evaluate the degree to which anesthesiologists utilize appropriate hygienic techniques for the prevention of infection in the perioperative period. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the membership of the American Society of Anesthesiologists (ASA). Of these, 493 (44%) were completed and returned. Forty-nine percent and 75.3% of respondents always used gloves and masks, respectively, in their everyday practice. Only 58% of respondents stated that they always washed their hands after every patient contact and 85% reported that they always used aseptic technique for placing indwelling catheters. Knowledge of universal precautions for prevention of occupational transmission of infection was associated with good hygienic practice. Twenty percent of the respondents reported frequently or always reusing syringes for more than one patient and 34.4% reported never or rarely disinfecting the septum of multidose vials prior to use. The practice of reusing syringes was significantly greater among private than university practitioners (P < 0.01). On a scale of 0-10 (10 = high) anesthesiologists rated their potential for transmitting or contributing to patient potential for transmitting or contributing to patient infection as 4.7 +/- 0.12 (mean +/- SE). Results of this study suggest that, whereas most responding anesthesiologists exhibit appropriate infection control behaviors, there are several potentially hazardous practices that continue.

Prevention of occupational transmission of human immunodeficiency virus and hepatitis B virus among anesthesiologists: a survey of anesthesiology practice.

In light of the increasing prevalence of the human immunodeficiency virus (HIV) and hepatitis B virus (HBV), anesthesiologists are now likely to see more patients who are at high risk for these viruses. Therefore, it is important that they adopt infection control policies aimed at preventing occupational transmission of these and other pathogens during their clinical practice. This study was designed, using a questionnaire format, to evaluate anesthesiologist compliance with Centers for Disease Control (CDC) guidelines for the prevention of occupational transmission of HIV and HBV. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the members' directory of the American Society of Anesthesiologists (ASA). Of these, 493 (44%) were completed and returned. Eighty-eight percent of respondents reported that they always complied with CDC guidelines when presented with an HIV-infected patient, but only 24.7% adhered to the guidelines when the patient was considered low risk (P < 0.01). This trend was also reflected in the use of gloves and other protective wear in the perioperative period. Although 70% of respondents indicated that they recapped needles on a regular basis, this practice was not associated with an increased incidence of needlestick injuries. However, anesthesiologists who reported recapping needles using the one-handed technique were less likely to sustain a needlestick injury than those who recapped using the two-handed technique. Thirty-one percent and 72% of respondents respectively reported a clean or contaminated needlestick within the preceeding 12 mo. Only 45.4% of those receiving a contaminated needlestick sought treatment.(ABSTRACT TRUNCATED AT 250 WORDS)