Clean hands are caring hands: Improving anesthesia provider hand hygiene and double-glove compliance during induction of general anesthesia

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.