Mizuta Mitsuhiko, Shime Nobuaki, Matsuda Tomoyuki, Yoshioka Masami
Department of Anesthesiology, Kyoto Prefectural University of Medicine, Kyoto.
Masui. 2007 Feb;56(2):208-12.
Performing appropriate infection control procedures including barrier precautions with aseptic technique during anesthesia practice is extremely important in order to prevent nosocomial infection in surgical patients, as well as to avoid occupational exposure for anesthesiologists.
We conducted a survey to investigate current practice patterns of anesthesiologists with special emphasis on the application of barrier precautions during invasive procedure; intravascular catheter insertion or endotracheal intubation.
In general, the compliance of hand hygiene practice was poor specifically immediately before or after performing invasive procedures; approximately two-thirds of the anesthesiologists were not performing hand washing. Despite most anesthesiologists have knowledge regarding the importance of maximal barrir precautions (MBP) during central venous catheter insertion, only a half of them did perform the MPB. Concerns for additional costs or time for anesthesia preparation, as well as poor arrangement for alcohol-based antiseptics handrubs in the operation room could be the factors affecting the poor compliance.
Anesthesiologists should change their practice to adequately apply appropriate aseptic barrier precautions including hand hygiene. Improvement of the medical payment system to cover the costs for infection control in the operating room should also be considered.
在麻醉操作过程中执行适当的感染控制程序，包括采用无菌技术的屏障防护措施，对于预防外科手术患者的医院感染以及避免麻醉医生的职业暴露极为重要。
我们开展了一项调查，以研究麻醉医生当前的操作模式，特别着重于侵入性操作（血管内导管插入或气管插管）期间屏障防护措施的应用情况。
总体而言，手部卫生操作的依从性较差，尤其是在进行侵入性操作之前或之后；约三分之二的麻醉医生未进行洗手。尽管大多数麻醉医生了解在中心静脉导管插入过程中采取最大屏障防护措施（MBP）的重要性，但只有一半的人实施了MPB。对麻醉准备额外费用或时间的担忧，以及手术室中基于酒精的抗菌洗手液配置不佳，可能是导致依从性差的因素。
麻醉医生应改变其操作方式，以充分应用包括手部卫生在内的适当无菌屏障防护措施。还应考虑改进医疗支付系统，以涵盖手术室感染控制的费用。
