Preventing perioperative transmission of infection: a survey of anesthesiology practice

Given the societal and economic impact of perioperative infection, it is essential that anesthesiologists and other operating room personnel use appropriate precautions to reduce the potential for transmission of infectious agents to the patients under their care. This study, therefore, was designed to evaluate the degree to which anesthesiologists utilize appropriate hygienic techniques for the prevention of infection in the perioperative period. A total of 1149 questionnaires were mailed to anesthesiologists randomly selected from the membership of the American Society of Anesthesiologists (ASA). Of these, 493 (44%) were completed and returned. Forty-nine percent and 75.3% of respondents always used gloves and masks, respectively, in their everyday practice. Only 58% of respondents stated that they always washed their hands after every patient contact and 85% reported that they always used aseptic technique for placing indwelling catheters. Knowledge of universal precautions for prevention of occupational transmission of infection was associated with good hygienic practice. Twenty percent of the respondents reported frequently or always reusing syringes for more than one patient and 34.4% reported never or rarely disinfecting the septum of multidose vials prior to use. The practice of reusing syringes was significantly greater among private than university practitioners (P < 0.01). On a scale of 0-10 (10 = high) anesthesiologists rated their potential for transmitting or contributing to patient potential for transmitting or contributing to patient infection as 4.7 +/- 0.12 (mean +/- SE). Results of this study suggest that, whereas most responding anesthesiologists exhibit appropriate infection control behaviors, there are several potentially hazardous practices that continue.