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3 best practices to protect surgical patients from transmissible infections (including your own)

Publish Date: 12/19/2012
In the fight to prevent surgical site infections, it’s important to remember that perioperative professionals can transmit their own infection to their patients. Last week a news report in the Los Angeles Times discussed surgical site infections among cardiac surgical patients at Cedars-Sinai Medical Center tied to a strain of Staphylococcus epidermidis also found on their surgeon's hands.

“Everyone who provides surgical patient care needs to raise their awareness of the risks they may present to their patients when they suspect that they may have an infection,” advises Ramona Conner, MSN, RN, CNOR, AORN manager of standards and recommended practices.

She says the incidence of these infections provides a good opportunity for all perioperative professionals to review best safety practices from AORN and the Centers for Disease Control and Prevention (CDC) for protecting surgical patients from transmissible infections.

Specifically, she points to two AORN recommended practices (RPs) “hot off the press” that were updated in 2012 for the 2013 edition of Perioperative Standards and Recommended Practices, including:
  • Recommended Practices for Prevention of Transmissible Infections in the Perioperative Practice Setting
  • Recommended Practices for Sterile Technique
Here are the top three practice recommendations within these AORN RPs that Conner suggests perioperative professionals take time to review:

1. Report your own infection, immediately
Recommendation IX in AORN Recommended Practices for Prevention of Transmissible Infections in the Perioperative Practice Setting states:

Activities of health care personnel with infections, exudative lesions, and nonintact skin should be restricted when these activities pose a risk of transmission of infection to patients and other health care providers. State, federal, and professional guidelines and strategies should be followed to determine the need for work restrictions for health care personnel with bloodborne infections.

The evidence cited for this recommendation includes reference to the CDC’s Guideline for Infection Control in Healthcare Personnel, 1998 (reference #28).

“Health care workers should report any suspected infection on their body to their infection preventionist or employee health office as soon as they identify it,” Conner says, noting that medical clearance is necessary before a perioperative professional can return to providing direct patient care.

2. Double glove during surgical and other invasive procedures

Recommendation III.f. in AORN Recommended Practices for Sterile Technique states:

Scrubbed team members should wear two pairs of surgical gloves, one over the other, during surgical and other invasive procedures with the potential for exposure to blood, body fluids, or other potentially infectious materials.

The CDC, the American College of Surgeons, and the American Academy of Orthopedic Surgeons support double gloving during invasive surgical procedures to reduce perforations to the inner glove.

3. Change gloves every 90 to 150 minutes during the procedure

Recommendation III.h. in AORN Recommended Practices for Sterile Technique states:

Surgical gloves worn during invasive surgical procedures should be changed when a visible defect or perforation is noted or when a suspected or actual perforation from a needle, suture, bone, or other object occurs; and every 90 to 150 minutes.

Conner encourages perioperative professionals to also review the referenced evidence supporting each of these recommendations.

Additional Resources

Congress Intensive Workshops focus on Sterile Processing and Cleaning, Decontamination, and Sterilization. Learn more.

Published in Perioperative Standards and Recommended Practices, 2013 edition
  • Recommended Practices for Sterile Technique
  • Recommended Practices for the Prevention of Transmissible Infections in the Perioperative Practice Setting

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