Clean hands are caring hands: Improving anesthesia provider hand hygiene and double-glove compliance during induction of general anesthesia.
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2025-01
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Abstract
Background
Hand hygiene and double-gloving practices during induction of general anesthesia can decrease transmission of bacteria to patients and subsequent health care-associated infections; however, compliance to these practices is low.Methods
A pre- and postimplementation quality improvement design was used with Plan-Do-Study-Act cycles. Several implementation strategies were used to improve hand hygiene and double-glove compliance among anesthesia providers, including printed educational materials, video, in-person, and virtual meetings, visual reminders, audit, and feedback, and improved access to hand sanitizer dispensers in the anesthesia workstation.Results
Average hand hygiene compliance increased from 0% to 11.8% and double-gloving compliance increased from 18.5% to 34.5%. A decrease in surgical site infections was shown in the postimplementation period.Discussion
Although hand hygiene and double-gloving practices increased after the initial implementation, the improvements were not sustained long-term. Practices to support sustainability, such as routine booster sessions, may be considered.Conclusions
Incorporating these quality improvement measures into practice may improve anesthesia provider hand hygiene compliance during induction of general anesthesia and impact subsequent infection rates.Type
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Regier, Allie-Lane F, Virginia C Simmons, Sarah Kempel and Staci S Reynolds (2025). Clean hands are caring hands: Improving anesthesia provider hand hygiene and double-glove compliance during induction of general anesthesia. American journal of infection control, 53(1). pp. 53–57. 10.1016/j.ajic.2024.09.010 Retrieved from https://hdl.handle.net/10161/33754.
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Virginia Chris Simmons
Virginia “Chris” Simmons, DNP, CRNA, CHSE-A, ANEF, FAANA, FAAN is a Clinical Professor at the School of Nursing. In the Nurse Anesthesia Program (DUNAP), Dr. Simmons served as the Clinical Education Coordinator (CEC) from 2011-2018, the Assistant Program Director from 2018-2019, and the Program Director from 2019-2024.
After serving on active duty in the United States Air Force, Dr. Simmons earned a BSN at Auburn University Montgomery (AUM). She completed a MSN at the University of North Carolina at Greensboro/Raleigh School of Nurse Anesthesia and joined the staff of Duke Regional Hospital (DRH) in 2002. During her time at DRH, she served as a clinical preceptor and clinical associate for DUNAP students, held CRNA managerial and staff positions, and served on multiple nursing and hospital committees.
Dr. Simmons earned her DNP degree from Duke University School of Nursing in 2011 with “Focused Anesthesia Interview Resources (FAIR) to Improve Efficiency and Quality” as her DNP project. Her scholarly interests include simulation, suspension of disbelief, the evaluation of educational preparation of registered nurses for preoperative anesthesia, day-of-surgery cancellations and delays, and the use and effect of perioperative oral and intravenous acetaminophen. She is a member of the American Association of Nurse Anesthetists, North Carolina American Association of Nurse Anesthetists, Sigma Theta Tau, American Nurses Association, North Carolina Nurses Association, the International Nurses Association for Clinical Simulation and Learning (INACSL), and the Society for Simulation in Healthcare (SSH). She was the first CRNA to complete the National League for Nursing's (NLN) Simulation Leader Program, has taught simulation in the US, Ghana, and Norway and introduced transgender simulation in the DUNAP. Dr. Simmons was a 2019 Duke Clinical Leaders Program Fellow and was competitively selected among 55,000 CRNAs as recommended by the AANA to participate in a federally funded simulation study involving a 12-member simulation expert panel. Dr. Simmons currently serves on the Council on Accreditation of Nurse Anesthesia Educational Programs (COA) and is an Associate Editor with Clinical Simulation in Nursing journal.
Staci Reynolds
Dr. Staci Reynolds is a Clinical Professor at Duke University School of Nursing (DUSON). At DUSON, Dr. Reynolds primarily teaches in the DNP program. Previously, she clinically served as a Clinical Nurse Specialist (CNS) at Duke University Hospital within the neuroscience inpatient units and Infection Prevention and Hospital Epidemiology department. In January 2023, Dr. Reynolds was appointed the Editor-in-Chief of the Journal of Nursing Care Quality. Before coming to DUSON, she was a neurocritical care nurse and a neuroscience CNS at Indiana University Health Methodist Hospital.
Dr. Reynolds received a baccalaureate degree in nursing science from Indiana University (IU) School of Nursing in Indianapolis, Indiana. She earned a Master’s degree as a Clinical Nurse Specialist at IU in 2011, and completed her PhD at IU in May 2016. Dr. Reynolds’ current scholarship interests include evidence-based practice implementation and evaluation, and she is an expert in quality improvement.
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