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Adoption of Double Gloving during Induction to Reduce Anesthesia Workstation Cross-Contamination

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2024-05
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Problem: Double glove omission among anesthesia providers during induction contributes to unfavorable patient outcomes resulting from surface contamination of the anesthesia workstation, leading to increased mortality, and increased hospital length of stay and costs. Underutilization of double gloving during routine induction of anesthesia was consistently observed among the majority of anesthesia providers at an inner-city medical center in Baltimore, Maryland. Purpose: The purpose of this quality improvement initiative was to reduce anesthesia workstation cross-contamination by improving the utilization of double gloving usage during induction among anesthesia providers over 15 weeks. Methods: A project team consisting of 16 anesthesia providers and two anesthesia technicians were mobilized to plan an initiative to implement the practice change, which was integrated into routine induction. Implementation strategies included education, visual reminders, badge attachments, weekly collaboration with stakeholders, use of change champions, and data collection and analysis. Data on double gloving compliance were tracked and analyzed on a weekly basis. This information was gathered using an audit tool placed on each anesthesia workstation as a laminated quick response code, which evaluated the percentage of anesthesia providers who performed double gloving during induction. Weekly oversite was provided to promote engagement and mitigate barriers and promote facilitators of the initiative. Results: Data analysis from the double gloving audit tool revealed 98% adherence to the practice change among anesthesia providers. Conclusion: Utilizing double gloving during induction is an evidence-based strategy that has been shown to significantly reduce anesthesia workstation cross-contamination and control the spread of pathogens. Findings suggest that anesthesia providers at this institution were amenable to the incorporation of this practice change. With sustainability and spread of the clinical practice strategy, the expectation is anesthesia providers will comply with double gloving during induction, leading to a cleaner anesthesia workstation and reduction in nosocomial infection potential.

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