Literature DB >> 19618819

Hands-free technique in the operating room: reduction in body fluid exposure and the value of a training video.

Bernadette Stringer1, Ted Haines, Charles H Goldsmith, Jennifer Blythe, Ramon Berguer, Joel Andersen, Christopher J De Gara.   

Abstract

OBJECTIVES: This study sought to determine if (1) using a hands-free technique (HFT)--whereby no two surgical team members touch the same sharp item simultaneously--> or = 75% of the time reduced the rate of percutaneous injury, glove tear, and contamination (incidents); and (2) if a video-based intervention increased HFT use to > or = 75%, immediately and over time.
METHODS: During three and four periods, in three intervention and three control hospitals, respectively, nurses recorded incidents, percentage of HFT use, and other information in 10,596 surgeries. The video was shown in intervention hospitals between Periods 1 and 2, and in control hospitals between Periods 3 and 4. HFT, considered used when > or = 75% passes were done hands-free, was practiced in 35% of all surgeries. We applied logistic regression to (1) estimate the rate reduction for incidents in surgeries when the HFT was used and not used, while adjusting for potential risk factors, and (2) estimate HFT use of about 75% and 100%, in intervention compared with control hospitals, in Period 2 compared with Period 1, and Period 3 compared with Period 2.
RESULTS: A total of 202 incidents (49 injuries, 125 glove tears, and 28 contaminations) were reported. Adjusted for differences in surgical type, length, emergency status, blood loss, time of day, and number of personnel present for > or = 75% of the surgery, the HFT-associated reduction in rate was 35%. An increase in use of HFT of > or = 75% was significantly greater in intervention hospitals, during the first post-intervention period, and was sustained five months later.
CONCLUSION: The use of HFT and the HFT video were both found to be effective.

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Mesh:

Year:  2009        PMID: 19618819      PMCID: PMC2708668          DOI: 10.1177/00333549091244S119

Source DB:  PubMed          Journal:  Public Health Rep        ISSN: 0033-3549            Impact factor:   2.792


  22 in total

Review 1.  Use of videotaped interventions in research.

Authors:  E E Steinke
Journal:  West J Nurs Res       Date:  2001-10       Impact factor: 1.967

2.  Effectiveness of the hands-free technique in reducing operating theatre injuries.

Authors:  B Stringer; C Infante-Rivard; J A Hanley
Journal:  Occup Environ Med       Date:  2002-10       Impact factor: 4.402

3.  Double gloving and practice attitudes among surgeons.

Authors:  Ronald L St Germaine; John Hanson; Christopher J de Gara
Journal:  Am J Surg       Date:  2003-02       Impact factor: 2.565

4.  Blood contact and exposure in the operating room.

Authors:  S L Popejoy; D E Fry
Journal:  Surg Gynecol Obstet       Date:  1991-06

Review 5.  Could the death of a BC or nurse have been prevented by using the hands-free technique?

Authors:  Ted Haines; Bernadette Stringer
Journal:  Can Oper Room Nurs J       Date:  2007-12

6.  Percutaneous injuries during surgical procedures.

Authors:  J I Tokars; D M Bell; D H Culver; R Marcus; M H Mendelson; E P Sloan; B F Farber; D Fligner; M E Chamberland; P S McKibben
Journal:  JAMA       Date:  1992-06-03       Impact factor: 56.272

7.  Risk of exposure of surgical personnel to patients' blood during surgery at San Francisco General Hospital.

Authors:  J L Gerberding; C Littell; A Tarkington; A Brown; W P Schecter
Journal:  N Engl J Med       Date:  1990-06-21       Impact factor: 91.245

8.  Occupational exposure to bloodborne pathogens--OSHA. Final rule.

Authors: 
Journal:  Fed Regist       Date:  1991-12-06

9.  Risk of blood contamination and injury to operating room personnel.

Authors:  E J Quebbeman; G L Telford; S Hubbard; K Wadsworth; B Hardman; H Goodman; M S Gottlieb
Journal:  Ann Surg       Date:  1991-11       Impact factor: 12.969

10.  Blood contacts during surgical procedures.

Authors:  A L Panlilio; D R Foy; J R Edwards; D M Bell; B A Welch; C M Parrish; D H Culver; P W Lowry; W R Jarvis; C A Perlino
Journal:  JAMA       Date:  1991-03-27       Impact factor: 56.272

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Review 2.  Needlestick and Sharps Injuries in Dermatologic Surgery: A Review of Preventative Techniques and Post-exposure Protocols.

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Review 3.  Use of safety scalpels and other safety practices to reduce sharps injury in the operating room: what is the evidence?

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4.  Surgeons' and residents' double-gloving practices at 2 teaching hospitals in Ontario.

Authors:  Ted Haines; Bernadette Stringer; Jeremy Herring; Achilleas Thoma; Kenneth A Harris
Journal:  Can J Surg       Date:  2011-04       Impact factor: 2.089

5.  Sharps injuries in ophthalmic practice.

Authors:  A-J Ghauri; K N Amissah-Arthur; A Rashid; B Mushtaq; M Nessim; S Elsherbiny
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6.  Education and training for preventing sharps injuries and splash exposures in healthcare workers.

Authors:  Shelley Cheetham; Hanh Tt Ngo; Juha Liira; Helena Liira
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  6 in total

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