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Hand Contamination, Cross-Transmission, and Risk-Associated Behaviors:An Observational Study of Team Members in ORs
VERONIKA MEGEUS, MSc, RN; KERSTIN NILSSON, PhD, RN; J [notdef]
ON KARLSSON, PhD, MD; BENGT I. ERIKSSON, PhD, MD; ANNETTE ERICHSEN ANDERSSON, PhD, RN
ABSTRACT
Team members in ORs have frequent hand contact with many surfaces and sites during high workload, thus increasing the risk for microorganism cross-transmission. This study aimed at identifying risks for hand contamination and microorganism cross-transmission during invasive procedures in ORs. We carried out observations during 22 daytime sessions and analyzed data using qualitative content analysis. The results revealed that clinicians hands may be contaminated by self-contamination, via objects, or by touching the patient. Contamination may occur before, during, or directly after performing an invasive procedure requiring the use of aseptic technique, which risks cross-transmitting microorganisms. The results of the study contribute detailed knowledge about risk-associated activities and behaviors in relation to performing invasive procedures in the OR. This knowledge provides clinicians, managers, and educators with specic information that can be used in nursing and medical education and in quality improvement projects aimed at improving hand hygiene routines and enhancing aseptic technique. AORN J 102 (December 2015) 645.e1645.e12. AORN, Inc, 2015. http://dx.doi.org/10.1016/j.aorn.2015.06.018
Key words: hand hygiene, hand contamination, infection control, infectious disease transmission, professional-to-patient.
Hand hygiene is considered an important and cost-effective method1 to prevent health care-associated infections (HAIs)1,2 and an important patient safety measure. Inadequate hand hygiene practices or use of poor aseptic technique can increase the risk for transmitting potentially pathogenic microorganisms to the patient or the patients immediate surroundings.3,4
Patients undergoing surgical procedures are exposed to multiple risks for HAIs during the use or insertion of invasive medical devices, and these risks increase with poor hand hygiene practices.5 Previously, we carried out a study in the OR that showed alarmingly low (5.3%) adherence to hand hygiene guidelines.6 This motivated us to carry out the present study. There is a paucity of information regarding
http://dx.doi.org/10.1016/j.aorn.2015.06.018
Web End =http://dx.doi.org/10.1016/j.aorn.2015.06.018 AORN, Inc, 2015
http://www.aornjournal.org
Web End =www.aornjournal.org AORN Journal j 645.e1
Megeus et al December 2015, Vol. 102, No. 6
behaviors during the provision of invasive care associated with the risk for transmitting microorganisms to patients via medical devices and anesthetic medications. We therefore wanted to explore which...