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Chapter 7 - Fundamentals of Infection Prevention and Control in the Operating Department

Published online by Cambridge University Press:  18 August 2022

By
Joanne Fielding  and
Mark Milligan
Edited by
Daniel Rodger ,
Kevin Henshaw ,
Paul Rawling  and
Scott Miller
Daniel Rodger
Affiliation:
Senior Lecturer in Perioperative Practice, London South Bank University
Kevin Henshaw
Affiliation:
Associate Head of Allied Health Professions, Edge Hill University, Ormskirk
Paul Rawling
Affiliation:
Senior Lecturer in Perioperative Practice, Edge Hill University, Ormskirk
Scott Miller
Affiliation:
Consultant Anaesthetist, St Helens and Knowsley Hospitals NHS Trust
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Summary

Healthcare-associated infections and more specifically surgical site infections, represent one of the biggest challenges facing practitioners in the perioperative environment. This chapter addresses the key points related to the causes of infection, and how they can be prevented. Infections are caused by pathogenic organisms, consequently, it is important to understand how they enter the body. The chain of infection model describes a series of links that outlines how infections can spread and provides a foundation to understand how they can be prevented. It is essential that perioperative practitioners understand how to break the chain of infection as well as the consequences of not doing so.

Keywords

Infection controlVirusBacteriaChain of infectionVentilationHand washingPPEScrubbingSurgery
Type
Chapter
Information
Fundamentals of Operating Department Practice , pp. 69 - 80
Publisher: Cambridge University Press
Print publication year: 2022

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References

European Centre for Disease Prevention and Control. Healthcare-associated infections: surgical site infections, annual epidemiological report for 2017. Available from: www.ecdc.europa.eu/en/publications-data/healthcare-associated-infections-surgical-site-infections-annual-1#no-link.Google Scholar
Public Health England. Start smart – then focus: antimicrobial stewardship toolkit for English hospitals. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/417032/Start_Smart_Then_Focus_FINAL.PDF.Google Scholar
Weston, D.. Fundamentals of Infection Prevention and Control: Theory and Practice, 2nd ed. Chichester: John Wiley & Sons Ltd, 2013.Google Scholar
Thomas, C.. Intrinsic and extrinsic sources and prevention of infection (in surgery). Surgery 2019; 37: 26–32.Google Scholar
Cavaillon, J. and Chrétien, F.. From septicaemia to sepsis 3.0: from Ignaz Semmelweis to Louis Pasteur. Genes and Immunity 2019; 20: 371–382.Google Scholar
The Care and Quality Commission. Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Regulation 12. Available from: www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-12-safe-care-treatment.Google Scholar
Health and Care Professions Council. Standards of proficiency: operating department practitioners. Available from: www.hcpc-uk.org/standards/standards-of-proficiency/operating-department-practitioners/.Google Scholar
The Health and Social Care Act 2008: code of practice on the prevention and control of infections. Available from: www.gov.uk/government/publications/the-health-and-social-care-act-2008-code-of-practice-on-the-prevention-and-control-of-infections-and-related-guidance.Google Scholar
Chowdhury, D., Tahir, S., Legge, M., et al. Transfer of dry surface biofilm in the healthcare environment: the role of healthcare workers’ hands as vehicles. Journal of Hospital Infection 2018; 100: 85–90.Google Scholar
World Health Organization. Evidence of hand hygiene to reduce transmission and infections by multi-drug resistant organisms in health-care settings. Available from: www.who.int/gpsc/5may/MDRO_literature-review.pdf.Google Scholar
Mayhall, C. G.. Hospital Epidemiology and Infection Control. Philadelphia, PA: Wolters Kluwer Health, 2011.Google Scholar
Ledwoch, K., Dancer, S. J., Otter, J. A., et al. Beware biofilm! Dry biofilms containing bacterial pathogens on multiple healthcare surfaces; a multicentre study. Journal of Hospital Infection 2018; 100: 47–56.Google Scholar
Parvin, F., Hu, H., Whiteley, G. S., et al. Difficulty in removing biofilm from dry surfaces. Journal of Hospital Infection 2018; 100: 85–90.Google Scholar
French, K.. Ten unusual sites in healthcare facilities harbouring pathogens that have been reported in the Journal of Hospital Infection. Journal of Infection Control 2018; 100: 361–362.Google Scholar
National Institute for Health and Care Excellence. Healthcare-associated infections: prevention and control in primary and community care. Available from: www.nice.org.uk/guidance/cg139/resources/healthcareassociated-infections-prevention-and-control-in-primary-and-community-care-35109518767045.Google Scholar
National institute for Health and Care Excellence. Infection prevention and control, quality standard [QS61] . Available from: www.nice.org.uk/guidance/qs61.Google Scholar
World Health Organization. Report on the burden of endemic health-care-associated infection worldwide, January 2011. Available from: www.who.int/publications/i/item/report-on-the-burden-of-endemic-health-care-associated-infection-worldwide.Google Scholar
Department of Health. Winning ways: working together to reduce healthcare associated infection in England. Available from: https://webarchive.nationalarchives.gov.uk/20120510091859/http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4064689.pdf.Google Scholar
World Health Organization. Save lives: clean your hands. Available from: www.who.int/gpsc/5may_advocacy-toolkit.pdf?ua=1.Google Scholar
Department of Health. Saving lives: a delivery program to reduce healthcare associated infections including MRSA. Available from: https://webarchive.nationalarchives.gov.uk/ukgwa/+/www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4113889.Google Scholar
Public Health England. Annual epidemiological commentary: gram-negative bacteraemia, MRSA bacteraemia, MSSA bacteraemia and C. difficile infections, up to and including financial year April 2018 to March 2019. Available from: www.gov.uk/government/statistics/mrsa-mssa-and-e-coli-bacteraemia-and-c-difficile-infection-annual-epidemiological-commentary.Google Scholar
Allegranzi, B., Bischoff, P., de Jonge, S., et al. Surgical site infections 1. New WHO recommendations on preoperative measures for surgical site infection prevention: an evidence-based global perspective. Lancet Infectious Diseases 2016; 16: e276–287.Google Scholar
Guest, J., Keating, T., Gould, D., and Wigglesworth, N.. Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England. British Medical Journal 2020; 10: e033367.Google Scholar
World Health Organization. WHO guidelines on hand hygiene in health care, 2009. Available from: https://apps.who.int/iris/bitstream/handle/10665/44102/9789241597906_eng.pdf;jsessionid=C1D950BB42FE9CA543C751149797DA77?sequence=1.Google Scholar
National Health Service, Standard infection control precautions: national hand hygiene and personal protective equipment policy, 2019. Available from: www.england.nhs.uk/publication/standard-infection-control-precautions-national-hand-hygiene-and-personal-protective-equipment-policy/.Google Scholar
Association for Perioperative Practice. Standards and Recommendations for Safe Perioperative Practice, 4th ed. Harrogate: Association for Perioperative Practice, 2016Google Scholar
Tanner, J.. Surgical hand antisepsis: the evidence. Journal of Perioperative Practice 2008; 18: 330–339.CrossRefGoogle ScholarPubMed
Gaspar, G. G., Menegueti, M. G., Lopes, A. E. R, et al. Alcohol-based surgical hand preparation: translating scientific evidence into clinical practice. Antimicrobial Resistance and Infection Control 2018; 7: 80.Google Scholar
Ho, Y. H., Wang, Y. C., Loh, E. W., and Tam, K. W.. Antiseptic efficacies of waterless hand rub, chlorhexidine scrub and povidone-iodine scrub in surgical settings: a meta-analysis of randomized controlled trials. Journal of Hospital Infection 2019; 101: 370–379.Google Scholar
Department of Health. Uniforms and workwear: guidance for NHS employers, 2020. Available from; www.england.nhs.uk/wp-content/uploads/2020/04/Uniforms-and-Workwear-Guidance-2-April-2020.pdf.Google Scholar
World Health Organization. Glove use information leaflet, 2009. Available from: www.who.int/gpsc/5may/Glove_Use_Information_Leaflet.pdf.Google Scholar
Wangensteen, O. H. and Wangensteen, S. D.. The Rise of Surgery from Empiric Craft to Scientific Discipline. Minneapolis, MN: University of Minnesota Press, 1978.Google Scholar
National Institute for Health and Care Excellence. Surgical site infections: prevention and treatment. Available from: www.nice.org.uk/guidance/ng125.Google Scholar
One Together. Surgical skin preparation: quality improvement resource. Available from: www.onetogether.org.uk/downloads/Surgical%20Skin%20Preparation%20Quality%20Improvement%20Guide_AW.pdf.Google Scholar
World Health Organization. Global guidelines for the prevention of surgical site infection. Available from: www.who.int/gpsc/global-guidelines-web.pdf.Google Scholar
Arumlampalam, T. H. A.. Principles and techniques of operative surgery including neurosurgery. In Quick, C. R. G., Biers, S., and Arumlampalam, T. H. A. (eds.), Essential Surgery, 6th ed. London: Elsevier, 2020, pp. 124–151.Google Scholar
National Institute for Health and Care Excellence. Surgical site infection, quality standard [QS49], 2013. Available from: www.nice.org.uk/guidance/qs49/resources/surgical-site-infection-pdf-2098675107781.Google Scholar
One Together. Surgical environment: quality improvement resource. Available from: www.onetogether.org.uk/downloads/OneTogether%20Surgical%20Environment%20QIR_2019.pdf.Google Scholar
Roy, M. C.. The operating theatre. In Bearman, G. M. L., Stevens, M., Edmond, M. B., and Wenzel, R. P. (eds.), A Guide to Infection Control in the Hospital, 5th ed. Boston, MA: The International Society for Infectious Diseases (ISID), 2014, pp. 137–145.Google Scholar
Association of Anaesthetists. Guidelines, Infection Prevention and Control 2020. London: Association of Anaesthetists, 2020.Google Scholar
Perez, P., Holloway, J., Ehrenfeld, L., et al. Door openings in the operating room are associated with increased environmental contamination. American Journal of Infection Control 2018; 46: 954–956.CrossRefGoogle ScholarPubMed
Wang, C., Holmberg, S., and Sadrizadeh, S.. Impact of door opening on the risk of surgical site infections in an operating room with mixing ventilation. Indoor and Built Environment 2021; 30: 166–179.Google Scholar
Spry, C.. Infection prevention and control. In Rothrock, J. C. (ed.), Alexander’s Care of the Patient in the Surgical Environment, 15th ed. St Louis, MO: Elsevier, 2015.Google Scholar
Department of Health (United Kingdom). Heating and ventilation systems health technical memorandum 03–01: specialised ventilation for healthcare premises. Part B: operational management and performance verification. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/144030/HTM_03-01_Part_B.pdf.Google Scholar
Kiernan, M.. Infection prevention. In Woodhead, K. and Fudge, L. (eds.), Manual of Perioperative Care, An Essential Guide. Oxford: Wiley Blackwell, 2012, pp. 43–55.Google Scholar
House of Commons Health and Social Care Committee. Antimicrobial resistance: eleventh report of session 2017–19. Available from: https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/962/962.pdf.Google Scholar
National Institute for Health and Care Excellence. NICE impact antimicrobial resistance. Available from: www.nice.org.uk/media/default/about/what-we-do/into-practice/measuring-uptake/niceimpact-antimicrobial-resistance.pdf.Google Scholar
HM Government. Tackling antimicrobial resistance 2019–2024: the UK’s five-year national action plan HM Government. Available from: www.gov.uk/government/publications/uk-5-year-action-plan-for-antimicrobial-resistance-2019-to-2024.Google Scholar
World Health Organization. Global action plan on antimicrobial resistance. Available from: www.who.int/publications/i/item/9789241509763.Google Scholar
Public Health England. English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR): report 2020–2021. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/843129/English_Surveillance_Programme_for_Antimicrobial_Utilisation_and_Resistance_2019.pdf.Google Scholar

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