Reduction in intraoperative bacterial contamination of peripheral intravenous tubing through the use of a novel device.
BACKGROUND
Hand hygiene is a vital intervention to reduce health-care associated infections, but compliance remains low. The authors hypothesized that improvements in intraoperative hand hygiene compliance would reduce transmission of bacteria to surgical patients and reduce the incidence of postsurgical healthcare-associated infections.


METHODS
The authors performed a controlled before-and-after study over 2 consecutive months. One hundred fourteen operative cases were enrolled. Two predesignated sites on the anesthesia machine were selected, decontaminated, and cultured via aseptic technique. These sites and the peripheral intravenous stopcock were cultured again after completion of the surgery. The treatment phase used a novel personal hand-decontamination device capable of recording hand-decontamination events.


RESULTS
There were no significant differences in patient location, age, or case duration and procedure type between groups. Use of the Sprixx GJ device (Harbor Medical Inc., Santa Barbara, CA) increased hourly hand decontamination events by 27-fold as compared with baseline rates (P < 0.002; 95% confidence interval, 3.3-13.4). Use of the device was associated with a reduction in contamination in the anesthesia work area and peripheral intravenous tubing. Intravenous tubing contamination was identified in 32.8% of cases in the control group versus 7.5% in the treatment group (odds ratio, 0.17; 95% confidence interval, 0.06-0.51; P < 0.01). Healthcare-associated infections rates were reduced in the device group (3.8%) as compared with the control group (17.2%) (odds ratio, 0.19; 95% confidence interval, 0.00-0.81; P = 0.02).


CONCLUSIONS
Improved hand hygiene compliance through the use of a novel hand sanitation strategy reduces the risk of intraoperative bacterial transmission. The intervention was associated with a reduction in healthcare-associated infections.
Department of Anesthesiology, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA. matthew.koff@hitchcock.org
Matthew D
MD
Koff
Randy W
RW
Loftus
Corey C
CC
Burchman
Joseph D
JD
Schwartzman
Megan E
ME
Read
Elliot S
ES
Henry
Michael L
ML
Beach
D003428:Cross Infection / Q000382:microbiology / Q000517:prevention & control*; D004866:Equipment Contamination / Q000517:prevention & control*; D005260:Female; D006235:Hand Disinfection / Q000379:methods*; D006801:Humans; D017053:Infection Control / Q000295:instrumentation* / Q000379:methods*; D007262:Infusions, Intravenous / Q000009:adverse effects; D007431:Intraoperative Complications / Q000382:microbiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged