Improving hand hygiene compliance in the anesthesia working room work area: More than just more hand rubs.
BACKGROUND
The anesthesia working area represents an environment with a high density of invasive and, thus, infection-prone procedures. The 2 primary goals of this study were (1) to perform a precise analysis of anesthesia-related hand hygiene (HH) procedures and (2) to optimize HH compliance.


METHODS
We conducted a prospective, triphase before/after study to determine opportunities for and compliance with hand disinfection (World Health Organization definition) in an anesthesia working area. Standard operating procedures were optimized for invasive procedures during 2 predefined intervention periods to improve work flow practices.


RESULTS
Seven hundred fifty anesthesia procedures were evaluated with 12,142 indications for HH. Compliance significantly increased from 10% (465/4,636) to 30% (1,202/4,029) and finally to 55% (1,881/3,477; all P < .001) in phases I, II, and III, respectively. We identified a significant increase in the number of hand rubs performed during 1 anesthesia procedure (2 to 8, respectively; P < .001) in parallel with a significant decrease in number of opportunities needing a hand rub (24 to 14, respectively; P < .0001) because of improved work flow practices. Notably, the greatest improvement was seen before aseptic tasks (8% to 55%, respectively).


CONCLUSION
Our study provides the first detailed data on anesthesia-related and indication-specific HH. Importantly, HH compliance improved significantly without a noticeable increasing workload.
['Scheithauer|Simone|S|', 'Rosarius|Anna|A|', 'Rex|Steffen|S|', 'Post|Peter|P|', 'Heisel|Hans|H|', 'Krizanovic|Vedranka|V|', 'Schulze-Röbbecke|Roland|R|', 'Rossaint|Rolf|R|', 'Lemmen|Sebastian W|SW|']
D000758:Anesthesia D003428:Cross Infection D019983:Guideline Adherence D063373:Hand Hygiene D006801:Humans D011446:Prospective Studies
Cross-transmission Infection control Operating theatre Quality management Surveillance