Anaesthesiology practice in the prevention of perioperative transmission of infection at the Kenyatta national hospital

Abstract

Background: Anaesthesiologists play apivotal role in the prevention of nosocomial infections. In anaesthetic practice, physiologic barriers are routinely breached, leading to patient contamination with microorganisms and consequential development of infection. Hygiene practices of professionals, proper cleaning of equipment and adequate sterile execution of invasive procedures are among important aspects that reduce the risk of transmission of infections Objective: The purpose of this study was to evaluate the degree to which anaesthesia providers utilize appropriate hygiene techniques and anaesthetic equipment disinfection procedures for the prevention of infection during the perioperative period at the Kenyatta National Hospital. Design: This study was designed as a cross-sectional descriptive survey Methodology: Data for the study was collected using a structured questionnaire distributed to anaesthesia providers practicing in the Kenyatta National Hospital operating theatres. All consenting anaesthesia providers were recruited into the study. Data was collected over a period of 6 weeks at the main and satellite operating theatres in the Kenyatta National Hospital. Analysis was done using the Statistical Package for Social Scientists (SPSS) software version 20.0. The results were presented in the form of charts, tables and graphs. Results: A total of 85(83%) out of 102 anaesthesia providers participated in this study. Of the four different cadres of anaesthesia providers at the Kenyatta National Hospital; consultant anaesthesiologists were 29.4%, registered clinical officers in anaesthesia were 29.4%, registrars in anaesthesia were 15.3% while clinical officer students in anaesthesia were 25.9% of the participants. The distributed questionnaires were designed to assess the hygienic precautions taken to reduce the potential for transmission of infectious agents to and from the patients under their care. Face masks and gloves were always used by 65.9% and 23.5%, respectively, while only 28.2% washed their hands between cases. 13.1% of the respondents had never received a vaccination against hepatitis B. A higher proportion of anaesthetists continue to administer anaesthesia despite suffering from respiratory (87.1%) than gastrointestinal (37.6%) infections. Endotracheal tubes were maintained sterile by 36.5% whereas bacterial filters were used by 100% but changed after each case by 68.2%. On a scale of 0–10 (10 = significant) anaesthetists rated their potential for transmitting or contributing to patient infection at a mean of 5.14 (standard deviation 2.65). Conclusion: The results of this study show that, although anaesthesia providers at the Kenyatta National Hospital are well aware of proper hygienic guidelines, their practice falls short of accepted recommendations.