Some Infection Prevention Guidelines Remain Stubbornly Unclear
In the absence of adequate published guidance, Iowa researchers produce a five-tiered classification of procedures, encompassing "clean, aseptic, sterile-superficial, sterile-invasive," and "surgical-like procedures."
A team of physicians from the University of Iowa Hospitals and Clinics has put forward a strategy that aims to standardize infection prevention guidelines for procedures performed outside the operating room.
The team contends that for most procedures, from skin biopsies to chest tube insertions, there is no authoritative guidance on infection prevention.
Writing in the American Journal of Infection Control, it also notes that there is little published evidence for existing practices.
The strategy emerged from a hospital epidemiology leadership meeting, says Vincent Masse, MD, the study's lead author.
They discussed a scenario whereby an interventional radiologist had been asked to wear a surgical hat and a mask while doing a fine needle aspiration. The radiologist had not worn the protection in 20 years of doing the procedure.
So the clinician asked what the hospitals policy was.
"Not only were we unable to provide evidence to support this practice, but we also had no comprehensive policy regarding infection prevention practices for medical procedures performed outside an operating room," the authors write.
Masse and his fellow researchers looked at what kind of research had been done.
"We realized that there is very little data for most procedures and there is no simple model to follow," he said.
The researchers reviewed the available literature: textbooks, technical notes, and practice guides, but described them as unhelpful.