Original ContributionA survey of anesthesiologist and anesthetist attitudes toward single-use vials in an academic medical center
Introduction
In 1990, the Centers for Disease Control (CDC) was notified of a surge of simultaneous and sudden infections that were investigated and linked to the appearance of a new anesthetic hypnotic known as propofol. Previously, outbreaks of postoperative infections were attributed largely to surgeons’ habits or to the surgical procedure itself. However, this contamination was later identified as extrinsic and a direct result of improper technique by the anesthesia provider [1]. Since that time, the controversy surrounding proper aseptic techniques including multiple use of single-use vials has been widely debated and a topic of intense scrutiny by the medical field. The CDC initially stated that “intravenous medication vials labeled for single use, including erythropoietin, should not be punctured more than once” [2]. Subsequently, multiple statements have been released by the CDC reinforcing infection control and proper use of single-use vials. We aimed to answer whether this recommendation has been followed and to evaluate reasons for compliance versus noncompliance in our anesthetic community.
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Materials and methods
After a waiver from the Emory University Institutional Review Board was obtained, an electronic survey was sent to all anesthesia providers at 5 Atlanta area hospitals (n=319). Each email address was issued a unique login, which prevented multiple responses by any individual. We obtained 89 survey responses from a variety of anesthesia providers including attending anesthesiologists (n=39), residents (n=18), fellows (n=7), anesthetists [certified registered nurse-anesthetists (CRNAs) and
Results
Of the 319 anesthesia providers polled, 89 responded to the survey. Data were collected and analyzed using simple statistical methods. Of the 89 respondents, most (43.8%) were anesthesia attendings. Eighteen (20.2%) respondents were residents, 15 (16.9%) were CRNAs, 7 (7.9%) were fellows, and 6 (6.7%) were AAs. Four PAs made up the smallest group of respondents (4.5%) (Table 1). There were no significant differences in the response rate across groups (P > 0.05 for all groups surveyed).
Discussion
The possible occult transmission of infections, including hepatitis C, by anesthesiology providers engaging in improper aseptic techniques and improper use of single-use vials, has given further credence to a report of an identified cluster of hepatitis C cases that was made public in the state of Nevada in 2007. Three individuals, identified by a local health district as having a singular link as common patients of a local endoscopic clinic, brought to light the specter of massive
Acknowledgments
The authors wish to thank Patrick Wiseman for his assistance in creating an anonymous internet survey system.
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