Clinicians in Sweden aren’t deploying good hand hygiene in operating rooms: study
March 30, 2015
by Lauren Dubinsky
, Senior Reporter
At a large hospital in Sweden, the use of hand disinfection and aseptic techniques during invasive procedures is very low, according to a new study conducted by Sahlgrenska Academy and University of Gothenburg. This study is the first of its kind in northern Europe.
The researchers found that out of the 2,393 chances the physicians and nurses had to use alcohol-based hand rub and deploy the techniques, 90 percent were missed.
"An operating room is radically different from other clinical settings in that anesthesia-related tasks are so frequent," Dr. Anette Erichsen Andersson, a researcher at Sahlgrenska Academy, said in a statement. "We counted an average of 30 opportunities, many of which were missed, for aseptic techniques every 24 minutes."
Many of those missed opportunities were during risk-prone invasive procedures involving intubation, local anesthesia and inserting catheters in the bloodstream and urinary tract.
The researchers discovered that the physicians and nurses failed to carry out good hand hygiene because of issues with aseptic techniques and inadequate teamwork. Many of the clinicians used protective gloves, which often takes the place of hand disinfection, in a disorganized manner and ended up increasing the risk of hospital-acquired infections.
The researchers have not investigated the underlying reasons for the inadequate hand hygiene among clinicians but they speculate that it may be due to the fact that hygiene and infection prevention are not mandatory subjects at medical school or during specialist training.
Physicians and nurses are aware of the benefits of hand rub but they rarely have enough time in an operating room to practice new working methods together either in training or clinical situations.
"Awareness that you need to employ aseptic techniques must be supplemented by specific skills that work under complex, risky circumstances,” Andersson said in a statement. “The potential for interdisciplinary learning is enormous, and additional research is needed to maximize the prospects for safe, aseptic care in the operating room."