A clear threat
We can do better when
it comes to hand
hygiene, cleaning
between cases, and
capping ports and
stopcocks, but we
need to be thinking
bigger. How can we
redesign the anesthe-
sia machine so it's easier to clean? What research questions do we
need to ask about the threat of infection? We want to design improve-
ments that make the OR safer. It's a big task, and one that can get over-
looked in the daily grind of patient care. We need more research look-
ing at the possible contamination of anesthesia equipment (and
providers) and its impact on clinical outcomes.
So why don't we know more? For one thing, we don't have the
urgency. When a patient acquires MRSA, it's hard to pinpoint when
the infection happened. It could have occurred anywhere in a 30-per-
son chain of interactions during an outpatient surgery stay. It could
stem from a single instrument in the anesthesia drawer or a provider
who didn't wash his hands frequently enough. The delay between
exposure and infection makes it harder to hold ourselves account-
able, but we should still try. If we could only see the bacterial threats
living in our ORs, we'd all be rushing to get started.
OSM
Dr. Munoz-Price (smunozprice@mcw.edu) is an enterprise epidemiologist and
a professor of medicine in the Division of Infectious Diseases at the Froedtert &
Medical College of Wisconsin in Milwaukee, Wisc. Dr. Bowdle (bowdle@uw.edu)
is a professor of anesthesiology and pharmaceutics in the Department of
Anesthesiology at the University of Washington in Seattle, Wash.
M A R C H 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 4 3
• TAKE COVER Two simple steps can help avoid contamination in the anesthesia work
area: Place a disposable cover over your anesthesia machine and close your stopcocks by
installing a closed injection port and isopropyl alcohol cap.
