HAZARDS ON HAND Anesthesia providers' role in spreading microbes is often overlooked.

Double-gloving can keep your anesthesia providers from cross-contaminating surgical patients — but only sometimes. If they really want to minimize their risk of spreading infections, they'll have to do a better job cleaning their workstations between cases, says a study published in the August 1 issue of the American Journal of Infection Control.

For the study, Chuck Biddle, CRNA, PhD, a professor and staff anesthetist at Virginia Commonwealth Medical Center in Richmond, Va., and his colleagues had 20 providers simulate a general anesthesia induction. A dye substance standing in for pathogens was placed in the mannequin's mouth and tracked throughout the providers' workspaces following the simulation and standard cleaning. Also, some of the subjects wore a single pair of surgical gloves while the other half double-gloved.

The researchers found that cart drawers, gas flow dials, medication vials and ventilator controls ended up more "contaminated" by single-gloved than double-gloved hands. But airway equipment, the breathing system, IV access ports and rolls of tape that secure endotracheal tubes were equally contaminated, no matter the gloving technique.

In addition, they found that routine between-case cleaning proved ineffective in entirely removing the dye, leaving open the possibility that it would contaminate subsequent patients undergoing anesthesia care.

Given "the rambunctious journey of the anesthesia provider's hands" and the complexity of anesthesia workstation design, Dr. Biddle and his team suggest further simulations of clinical processes to boost best practices and help to resolve challenges at the intersection of epidemiology and ergonomics.

David Bernard