Hand-hygiene practices in the operating theatre: an observational study.

Abstract:

BACKGROUND:The current prevalence of healthcare-associated infections (HCAIs) is a major public health concern. Patient contact in the operating theatre (OT) can contribute to HCAI via microbial contamination. The application of hand hygiene is effective in reducing infection rates. Limited data are available on adherence to hand-hygiene guidelines by OT staff. METHODS:Covert direct observations of OT staff at an academic medical centre were performed by a single, trained observer. The primary outcome was the frequency of hand-hygiene application by OT staff, including anaesthesiologists, anaesthesia nurses, surgeons, surgical nurses, and medical students. 'Sterile' scrubbed staff members were excluded. The following hand-hygiene opportunities were monitored: (i) entering or leaving the OT; and (ii) before patient contact. Furthermore, the frequency of 'potential contamination' was recorded (touching OT implements after contact with patient/patient body fluids without the subsequent application of hand hygiene). We recorded non-surgical glove usage for invasive procedures, for example, intubation or insertion of intravascular devices. Finally, we collected qualitative data on incentives for hand hygiene. RESULTS:A total of 28 operations were observed (60 h of observations). On average, 0.14 hand-hygiene applications per hour per staff member were witnessed. Upon entering or leaving the OT, hand hygiene was performed in 2% (7/363) and 8% (28/333) of opportunities. CONCLUSIONS:Frequent interactions between patient, staff, and OT environment were observed. Adherence to hand-hygiene guidelines by OT staff was extremely low. This potentially exposes patients to microbial transmission, HCAIs, and patient harm.

journal_name

Br J Anaesth

authors

Krediet AC,Kalkman CJ,Bonten MJ,Gigengack AC,Barach P

doi

10.1093/bja/aer162

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

553-8

issue

4

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)33037-4

journal_volume

107

pub_type

杂志文章
  • Cardiac rate and rhythm during anaesthesia for dental extraction. A comparison of halothane, enflurane and isoflurane.

    abstract::Cardiac rate and rhythm were compared in 60 patients having dental extractions under conventional general anaesthesia using halothane, enflurane or isoflurane to supplement nitrous oxide in oxygen. The incidence of arrhythmia was higher in the halothane group when compared with both the enflurane (P less than 0.05) an...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/57.5.476

    authors: Casson WR,Jones RM

    更新日期:1985-05-01 00:00:00

  • Fresh gas flow requirements during spontaneous ventilation: fresh gas flow to total ventilation ratio or ml kg-1 min-1?

    abstract::Both the performance of breathing systems and recommendations for the fresh gas flows to be used in patients breathing spontaneously can be expressed in ml kg-1 min-1 or fresh gas: total ventilation ratio (VF:VE). We have examined the relationship between these two descriptions. The data of 106 subjects (awake volunte...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/71.6.796

    authors: Soni N,Ooi R

    更新日期:1993-12-01 00:00:00

  • Feasibility of closed-loop co-administration of propofol and remifentanil guided by the bispectral index in obese patients: a prospective cohort comparison.

    abstract:BACKGROUND:We used an automated bispectral index (BIS)-guided dual-loop controller to determine propofol and remifentanil requirements during general anaesthesia in obese and lean surgical patients. METHODS:Obese patients, BMI>35 kg m(-2), and lean patients (<25 kg m(-2)) having laparoscopic procedures were prospectiv...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1093/bja/aeu401

    authors: Liu N,Lory C,Assenzo V,Cocard V,Chazot T,Le Guen M,Sessler DI,Journois D,Fischler M

    更新日期:2015-04-01 00:00:00

  • Environmental and economic impact of using increased fresh gas flow to reduce carbon dioxide absorbent consumption in the absence of inhalational anaesthetics.

    abstract:BACKGROUND:Increasing fresh gas flow (FGF) to a circle breathing system reduces carbon dioxide (CO2) absorbent consumption. We assessed the environmental and economic impacts of this trade-off between gas flow and absorbent consumption when no inhalational anaesthetic agent is used. METHODS:A test lung with fixed CO2 ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1016/j.bja.2020.07.043

    authors: Zhong G,Abbas A,Jones J,Kong S,McCulloch T

    更新日期:2020-11-01 00:00:00

  • Studies of the neuromuscular blocking effects of BW 403C65 in frog and cat muscle.

    abstract::BW 403C65, an isoquinolinium bisquaternary compound, was investigated for its neuromuscular blocking properties. In vitro in from preparations, low concentrations induced an increase in miniature endplate potentials (m.e.p.p.) frequency without altering their amplitude. With increasing concentrations m.e.p.p. frequenc...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/47.9.929

    authors: Post EL,Sokoll MD,Gergis SD,Dretchen KL,Cronnelly R

    更新日期:1975-09-01 00:00:00

  • Baroreceptor control of regional haemodynamics during halothane anaesthesia in the dog.

    abstract::Regional haemodynamic control by the cardiovascular baroreceptors was examined in dogs anaesthetized with 1 + MAC halothane in oxygen (1%). The open-loop relationships between carotid sinus pressure (CSP) and regional haemodynamics in the iliac, renal, mesenteric, aortic and coeliac beds were examined before vagotomy,...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/49.6.535

    authors: Bagshaw RJ,Cox RH

    更新日期:1977-06-01 00:00:00

  • Effect of i.v. omeprazole on the pH and volume of gastric contents before surgery.

    abstract::Gastric pH and volume were measured in 87 patients who had received i.v. omeprazole (a new gastric antisecretory agent) 40 mg or placebo 1 or 3 h before surgery. Omeprazole increased the pH of gastric contents in the majority of patients. Administration 1 h before surgery produced greater gastric pH and smaller volume...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/63.5.536

    authors: Cruickshank RH,Morrison DA,Bamber PA,Nimmo WS

    更新日期:1989-11-01 00:00:00

  • Cardiovascular and neuromuscular effects of dimethyl tubocurarine in anaesthetized cats and rhesus monkeys.

    abstract::Intravenous dose-response relationships for dimethyl tubocurarine showed that vagal blockade only became appreciable (50-83%) at doses 8-16 times those sufficient for full neuromuscular paralysis in anaesthetized cats (0.0625 mg/kg) and rhesus monkeys (0.125 mg/kg); heart rate was unchanged. Sympathetic function was u...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/48.9.847

    authors: Hughes R,Chapple DJ

    更新日期:1976-09-01 00:00:00

  • Technique training: endoscopic percutaneous tracheostomy.

    abstract::Percutaneous tracheostomy is being used increasingly in the intensive care unit and endoscopic control of this procedure affords an improved level of safety. Training in such new minimal access techniques can be a significant risk factor in patient outcome. Surgical simulation provides training which minimizes this ri...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/81.3.401

    authors: Gardiner Q,White PS,Carson D,Shearer A,Frizelle F,Dunkley P

    更新日期:1998-09-01 00:00:00

  • Neuroleptic malignant syndrome and malignant hyperthermia. In vitro comparison with halothane and caffeine contracture tests.

    abstract::The in vitro halothane and caffeine contracture tests have been performed on muscle tissue from six survivors of the neuroleptic malignant syndrome. The results, which are expressed in accordance with the criteria of the European MH Group, defined five of the subjects as MHN and one patient as MHE. It is concluded tha...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/59.12.1554

    authors: Krivosic-Horber R,Adnet P,Guevart E,Theunynck D,Lestavel P

    更新日期:1987-12-01 00:00:00

  • Assessment of scoring systems to describe the position of tracheostomy tubes within the airway - the lunar study.

    abstract:BACKGROUND:Malposition of tracheostomy tubes is difficult to detect at the bedside and may contribute to eventual device misplacement. Endoscopic examination can be undertaken via tracheoscopic (T-view) or trans-laryngeal (L-view) approach, offering more precise detail regarding positioning within the airway. The aims ...

    journal_title:British journal of anaesthesia

    pub_type: 评论,信件

    doi:10.1093/bja/aew336

    authors: McGrath BA,Lynch K,Templeton R,Webster K,Simpson W,Alexander P,Columb MO

    更新日期:2017-01-01 00:00:00

  • Postoperative hypoxaemia: continuous extradural infusion of bupivacaine and morphine vs patient-controlled analgesia with intravenous morphine.

    abstract::We carried out a randomized prospective study in 60 patients who had undergone major abdominal surgery for cancer. For postoperative pain control, 30 patients received continuous extradural infusion of 0.125% bupivacaine 12.5 mg h-1 and morphine 0.25 mg h-1 (EXI group) and 30 received patient-controlled analgesia (PCA...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/80.6.742

    authors: Motamed C,Spencer A,Farhat F,Bourgain JL,Lasser P,Jayr C

    更新日期:1998-06-01 00:00:00

  • Cardiovascular and electroencephalographic effects of laudanosine in "nephrectomized" cats.

    abstract::We studied a cat model simulating laudanosine accumulation in the "anephric" patient. Cardiovascular effects were seen only with the bolus doses of laudanosine 2 mg kg-1, and at plasma laudanosine concentrations unlikely to be achieved clinically. Similarly, EEG and power spectra analysis showed no evidence of epilept...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/58.suppl_1.14s

    authors: Ingram MD,Sclabassi RJ,Cook DR,Stiller RL,Bennett MH

    更新日期:1986-01-01 00:00:00

  • Sex and oestrous cycle differences in visceromotor responses and vasopressin release in response to colonic distension in male and female rats anaesthetized with halothane.

    abstract::Visceromotor responses and vasopressin release before and after colonic visceral distension were compared between male (n=5 (n=4 for vasopressin)) and female rats and between females during the oestrous cycle (proestrus n=6, oestrus n=5, metestrus n=5, diestrus n=6) at a controlled depth of anaesthesia. Pre-stimulatio...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/85.6.907

    authors: Holdcroft A,Sapsed-Byrne S,Ma D,Hammal D,Forsling ML

    更新日期:2000-12-01 00:00:00

  • Dose-dependent effect of metoclopramide on cholinesterases and suxamethonium metabolism.

    abstract::In obstetric patients undergoing postpartum tubal ligation, we found that metoclopramide produced dose-dependent prolongation of suxamethonium-induced neuromuscular block. Mean block times after suxamethonium 1 mg kg-1 were 8.0 min, 9.83 min and 12.45 min for control and metoclopramide 10 mg and metoclopramide 20 mg g...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章

    doi:10.1093/bja/65.2.220

    authors: Kao YJ,Tellez J,Turner DR

    更新日期:1990-08-01 00:00:00

  • Extradural block in patients who have previously undergone caesarean section.

    abstract::The 119 patients who had undergone previous Caesarean section lumbar extradural block was administered to 77 (65%); the other 42 (35%) received analgesia with ketobemidone 0.8-1.0 ml i.m. or nitrous oxide in oxygen intermittently, or both. Controlled i.v. infusion of oxytocin for induction or acceleration of labour wa...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/52.8.827

    authors: Carlsson C,Nybell-Lindahl G,Ingemarsson I

    更新日期:1980-08-01 00:00:00

  • A hazard of the pollard endotracheal tube.

    abstract::Two patients are described in whom failure of the Pollard endotracheal tube produced complete respiratory obstruction. Comparisons are made of external diameters, resistance to gas flow and resistance to compression between Pollard tubes and several conventional tubes. It is concluded that the Pollard tube is not sati...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/49.2.179

    authors: Child DA,Ali MM

    更新日期:1977-02-01 00:00:00

  • Comparison of nitroglycerine, verapamil and nifedipine in the management of arterial pressure during coronary artery surgery.

    abstract::The efficacy of nitroglycerine, verapamil and nifedipine in controlling post-sternotomy hypertension was compared in four groups of 20 patients anaesthetized with fentanyl 100 micrograms kg-1 undergoing elective coronary artery surgery. Vasodilators were started before surgery and adjusted to maintain systolic arteria...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/58.3.267

    authors: van Wezel HB,Bovill JG,Schuller J,Gielen J,Hoeneveld MH

    更新日期:1986-03-01 00:00:00

  • Pharmacokinetics and pharmacodynamics of ketamine enantiomers in surgical patients using a stereoselective analytical method.

    abstract::In a randomized, double-blind study, we have examined the stereoselective disposition and pharmacodynamic characteristics of ketamine in surgical patients after i.v. administration of S(+)-ketamine 1 mg/kg body weight (25 patients) or racemic ketamine 2 mg/kg body weight (25 patients). S(+)-Ketamine was not inverted t...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/70.6.666

    authors: Geisslinger G,Hering W,Thomann P,Knoll R,Kamp HD,Brune K

    更新日期:1993-06-01 00:00:00

  • Prospective observational study of the non-invasive assessment of immediate postoperative pain using the analgesia/nociception index (ANI).

    abstract:BACKGROUND:The analgesia/nociception index (ANI), a 0-100 non-invasive index calculated from heart rate variability, reflects the analgesia/nociception balance during general anaesthesia. The aim of this study was to evaluate the ANI in the assessment of immediate postoperative pain in adult patients undergoing general...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aet110

    authors: Boselli E,Daniela-Ionescu M,Bégou G,Bouvet L,Dabouz R,Magnin C,Allaouchiche B

    更新日期:2013-09-01 00:00:00

  • Perioperative management of clopidogrel therapy: the effects on in-hospital cardiac morbidity in older patients with hip fractures.

    abstract:BACKGROUND:Increasing numbers of older patients prescribed clopidogrel are presenting for urgent hip fracture surgery. Best practice for the management of clopidogrel therapy is unknown, although delays to surgery are associated with increased mortality. We investigated the influence of perioperative management of clop...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/aer288

    authors: Collyer TC,Reynolds HC,Truyens E,Kilshaw L,Corcoran T

    更新日期:2011-12-01 00:00:00

  • Zomepirac, dihydrocodeine and placebo compared in postoperative pain after day-case surgery. The relationship between the effects of single and multiple doses.

    abstract::Zomepirac 100 mg and dihydrocodeine 30 mg were compared with placebo in a controlled randomized, double-blind, single-dose postoperative study. Patients continued to receive either zomepirac or dihydrocodeine for pain relief for 5 days at home in a double-blind study, being allowed to titrate the consumption of tablet...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/57.4.412

    authors: McQuay HJ,Bullingham RE,Moore RA,Carroll D,Evans PJ,O'Sullivan G,Collin J,Lloyd JW

    更新日期:1985-04-01 00:00:00

  • Inhibition of fetal methionine synthase by nitrous oxide.

    abstract::The activity of the enzyme methionine synthase in fetal and maternal liver was investigated before and after exposure to nitrous oxide. Timed-pregnant rats on day 19 of gestation were exposed to either 10% or 50% nitrous oxide for various times up to 240 min. After exposure, fetal and maternal livers were removed and ...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/56.5.523

    authors: Baden JM,Serra M,Mazze RI

    更新日期:1984-05-01 00:00:00

  • Selective depression by alfentanil of group III and IV somatosympathetic reflexes in the dog.

    abstract::The effect of alfentanil on sympathetic reflexes evoked by supramaximal electrical stimulation of the radial nerve has been observed in five dogs anaesthetized with alpha-chloralose, paralysed with suxamethonium and artificially ventilated. In five dogs during the infusion of alfentanil at a rate of 20 micrograms kg-1...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/61.4.441

    authors: Swenzen GO,Chakrabarti MK,Sapsed-Byrne S,Whitwam JG

    更新日期:1988-10-01 00:00:00

  • Propofol metabolism is enhanced after repetitive ketamine administration in rats: the role of cytochrome P-450 2B induction.

    abstract:BACKGROUND:In a series of ex vivo and in vivo studies we investigated the ability of repetitive ketamine administration to alter the metabolism and anaesthetic effect of propofol and the role of ketamine-mediated P-450 2B induction in rats. METHODS:Male Wistar rats were pretreated with 80 mg kg(-1) ketamine i.p. twice...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/ael173

    authors: Chan WH,Chen TL,Chen RM,Sun WZ,Ueng TH

    更新日期:2006-09-01 00:00:00

  • Comparison of candidates who passed or failed the final (Part Three) examination for the F.F.A.R.C.S. (Eng.) in 1988.

    abstract::All 484 candidates for the 1988 Fellowship in Anaesthesia (Part Three) were surveyed to investigate any differences between successful and unsuccessful candidates in study techniques, work and domestic factors, and examination history that might lead to better guidance to those preparing for the examination and an imp...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/64.6.752

    authors: David AC,Elton RA,Spence AA,Hatch DJ

    更新日期:1990-06-01 00:00:00

  • Enhanced visual memory effect for negative versus positive emotional content is potentiated at sub-anaesthetic concentrations of thiopental.

    abstract:BACKGROUND:Emotional information has the ability to alter the formation and strength of a memory ('memory modulation'). Memory modulation by negative emotion is mediated by the amygdala. It is not known how gamma aminobutyric acid (GABA)ergic drugs affect the processes involved in memory modulation. This study investig...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/aeh211

    authors: Pryor KO,Veselis RA,Reinsel RA,Feshchenko VA

    更新日期:2004-09-01 00:00:00

  • Components of the inspiratory-arterial isoflurane partial pressure difference.

    abstract::We have measured the partial pressure of isoflurane simultaneously in inspired gas (PIiso), end-expired gas (PE'iso), mixed-expired gas (PEiso), arterial (Paiso) and mixed venous blood (Pviso) in six patients (aged 57-79 yr) anaesthetized with nitrous oxide, oxygen and isoflurane before surgery and after PE'iso had be...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章

    doi:10.1093/bja/70.6.605

    authors: Landon MJ,Matson AM,Royston BD,Hewlett AM,White DC,Nunn JF

    更新日期:1993-06-01 00:00:00

  • Chronic pain epidemiology and its clinical relevance.

    abstract::Chronic pain affects ∼20% of the European population and is commoner in women, older people, and with relative deprivation. Its management in the community remains generally unsatisfactory, partly because of lack of evidence for effective interventions. Epidemiological study of chronic pain, through an understanding o...

    journal_title:British journal of anaesthesia

    pub_type: 杂志文章,评审

    doi:10.1093/bja/aet123

    authors: van Hecke O,Torrance N,Smith BH

    更新日期:2013-07-01 00:00:00

  • Patient-controlled interscalene analgesia with ropivacaine after major shoulder surgery: PCIA vs PCA.

    abstract::We have compared the efficacy of patient-controlled interscalene analgesia (PCIA) using ropivacaine with patient-controlled analgesia (PCA) using nicomorphine in 60 patients (n = 30 in each group), in a prospective, randomized study. In both groups, all patients received interscalene block with 0.75% ropivacaine befor...

    journal_title:British journal of anaesthesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/bja/81.4.603

    authors: Borgeat A,Tewes E,Biasca N,Gerber C

    更新日期:1998-10-01 00:00:00