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D E C E M B E R 2 0 1 5 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
Just the way it is?
Ultimately, what
we're talking about is
normalized deviance.
If we were to objec-
tively observe and
judge what we do,
we'd immediately rec-
ognize the inherent
problems. But we've
gotten away with it
for so long that we've
normalized our wrongful behavior.
And really, for a long time the idea that anesthesia providers
might be contributing to SSIs or other complications was off our
radar. After all, we typically lose touch with patients in the after-
math of our care, which is when complications usually manifest.
Only in the last few years have a significant number of voices
grown louder, trying to get this onto our radar screens as we've
realized it's very likely that we're contributing to the problem.
Unfortunately, there's no Holy Grail in the quest for aseptic anes-
thetic technique. The ergonomics of the current anesthesia work-
station make it impossible to engage in actions that those on the
surgical side would consider acceptable. Some cross-contamination
among the domains is inevitable. But that doesn't mean we can't do
much better. We need to think creatively about improving designs,
and there are steps we should be taking immediately. OSM
z CAUGHT IN THE ACT Have you observed your
anestheisa providers practicing poor hand hygiene?
Dr. Biddle (cjbiddle@vcu.edu) is a professor and staff anesthetist in the departments of Anesthesiology
and Nurse Anesthesia at Virginia Commonwealth University Medical Center in Richmond, Va.
