Infectious Disease Considerations for the Operating Room

The risk of infection transmission by anesthesia providers in their work area environment is reviewed. The dynamics of transmission and the strategies for preventing infection transmission in health care institutions are discussed. Anesthesiologists have long been patient safety advocates and have taken on increasing responsibility for preventing health care–associated infections. Anesthesia providers practice in a nonsterile environment within the operating room and have an impact on bacterial transmission and infection rates. Understanding the characteristics of transmission elements provides the practicing anesthesiologist with methods to protect susceptible patients and themselves to avoid spreading infection. It is vital to have in place proper systems to remove contaminated air to minimize the risk of airborne pathogens being transmitted by children. Preoperative patient skin and other bacterial reservoir decontamination and hand hygiene by anesthesia providers reduces contamination of the work area and IV access ports. Hand hygiene is a well-known and effective solution to the problem of bacterial transmission within and across patients and is considered the most important and cost-effective individual intervention in the prevention of health care–associated infections in children and health care providers Compliance with the current “5 moments” World Health Organization guidelines could make a major inroad into reducing provider hand and workspace contamination. Surgical antimicrobial prophylaxis is an essential tool to reduce the risk of postoperative infections, and the anesthesia team plays a central role in ensuring the proper timing of drug administration. Protocols, although effective, require continuous feedback and revision.