Department of Anesthesia, University of Iowa Healthcare, Iowa City, IA.
Department of Biomedical Engineering, University of Iowa, Iowa City, IA.
Am J Infect Control. 2020 Jun;48(6):675-681. doi: 10.1016/j.ajic.2019.09.016. Epub 2019 Nov 14.
The use of surface disinfection wipes after induction of anesthesia improves anesthesia machine cleaning. We assessed whether anesthesia machine surface redesign improves disinfection wipe cleaning by anesthesia residents.
Sixteen anesthesia residents were assigned to 2 cases in series. The first case was randomly assigned to regional knee or hip surgery, a brief or detailed checklist, and the Perseus A500 (redesigned) or GE Aespire 7900 (conventional) machine. The second case was assigned to the opposite for each condition. Setup checklists included cleaning instructions. Eight machine sites representing redesign were contaminated with fluorescent gel prior to setup and reassessed after setup to assess cleaning efficacy. Cleaning was compared by fluorescence quantification of before and after setup images. Our primary hypothesis was that, overall, more sites would be cleaned on the Perseus machine. Our secondary hypothesis was that redesign would affect some sites.
Overall, the number of sites cleaned did not differ between machines (median 0.74 more sites out of 8 for the Perseus A500; 25th and 75th percentiles, -0.34 and 1.04; P = .093). However, greater cleaning was observed for the work surface and manual bag arm/hose of the Perseus machine (0.58 more sites out of 2; 25th and 75th percentiles, 0.35 and 1.05; P = .0004).
The number of sites cleaned overall did not differ between the conventional and redesigned Perseus A500 machines. However, the redesigned work surface and smooth manual bag arm features improved resident cleaning with surface disinfection wipes.
麻醉诱导后使用表面消毒湿巾可提高麻醉机的清洁度。我们评估了麻醉科住院医师对麻醉机表面重新设计是否会改善消毒湿巾的清洁效果。
16 名麻醉科住院医师被分配到连续 2 例患者。第一例患者随机分配到区域膝关节或髋关节手术、简短或详细的检查表以及 Perseus A500(重新设计)或 GE Aespire 7900(常规)机器。每种情况下的第二例患者被分配到相反的情况。设置检查表包括清洁说明。在设置之前,用荧光凝胶污染了 8 个代表重新设计的机器部位,并在设置后重新评估,以评估清洁效果。通过荧光定量评估设置前后的图像来比较清洁度。我们的主要假设是,总体而言,Perseus 机器上会有更多的部位被清洁。我们的次要假设是重新设计会影响某些部位。
总体而言,机器之间清洁的部位数量没有差异(Perseus A500 多清洁 0.74 个部位;中位数,25%和 75%分位数,-0.34 和 1.04;P=0.093)。然而,在 Perseus 机器上观察到工作表面和手动袋臂/管的清洁度更高(多清洁 0.58 个部位;中位数,25%和 75%分位数,0.35 和 1.05;P=0.0004)。
常规和重新设计的 Perseus A500 机器之间总体上清洁的部位数量没有差异。然而,重新设计的工作表面和光滑的手动袋臂特征提高了居民使用表面消毒湿巾的清洁效果。