New Guidelines to Prevent Infection in Minor Surgery

Published in The Journal of Hospital Infection

London, 30 January, 2012 – New guidelines from the Healthcare Infection Society (HIS) aimed at minimising surgical infection in day centres and primary care are now published in The Journal of Hospital Infection.

“These guidelines are the first ever published guidance in the UK that define, from an infection prevention and control perspective, the basic physical requirements for facilities in which surgical procedures may be performed outside conventional operating theatres and carried out within day centres and primary care,” advises Professor Hilary Humphreys, lead author on the HIS guidelines and Professor of Clinical Microbiology at the Royal College of Surgeons in Ireland in Dublin.

Recent changes in healthcare include the provision of more surgical services in primary care and day centres where it may be cheaper and easier for patients to access them, rather than admit patients to an acute hospital. In addition, developments in certain areas of medicine, such as interventional radiology and cardiology, have expanded the range and complexity of procedures now undertaken outside an acute hospital setting. However, not all of these new settings are suitably equipped to prevent and control infection when undertaking minor surgery.

“The trend to carry out more minor surgery in day centres and primary care is presenting new challenges – as some of these facilities are not appropriately set up to undertake minor surgery,” continues Professor Humphreys.

To address this issue, HIS convened a multi-disciplinary group tasked with producing the first ever UK guidelines to minimise infection occurring outside conventional operating theatres. The guidelines, published in the February 2012 issue of The Journal of Hospital Infection, cover topics such as appropriate ventilation, use of instruments, flooring/ceiling requirements etc.

These guidelines should now be referred to by all infection prevention and control teams and others (e.g. practice managers) involved where minor surgical procedures are to be carried out in day centres or primary care settings. They should also be considered when developing new facilities or updating/refurbishing pre-existing facilities.

Dr. Tim Boswell, Consultant Microbiologist at Nottingham University Hospitals, and Chairman of HIS comments, “The Society hopes that these guidelines will improve the safety and quality of patient care in settings outside hospital operating theatres and also recommends that on-going surveillance of outcomes, such as surgical site infection, takes place to guide future guidelines and practice.”

The guidelines are published as: “Guidelines on the facilities required for minor surgical procedures and minimal access interventions” by H. Humphreys, J.E. Coia, A. Stacey, M. Thomas, A.-M. Belli, P. Hoffman, P. Jenks, C.A. Mackintosh (doi:10.1016/j.jhin.2011.11.010). The article appears in The Journal of Hospital Infection Volume 80, Issue 2 (February 2012) published by Elsevier.

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About the New HIS Guidelines
The recommendations include the need for solid ceilings, floors that are easily cleaned and disinfected, single use instruments rather than re-usable instruments owing to the difficulty of accessing sterilisation facilities and ventilated facilities with up to 15 air changes per hour for certain categories of procedure, i.e. minimal access interventions, which include laparoscopy or ‘key-hole’ surgery. Sterile gloves and a plastic apron are sufficient for minor procedures but full precautions, including sterile gowns, are required for more complex procedures. All the staff involved must be able to provide evidence of competency with appropriate mandatory training and ongoing professional development. The full journal article is available from the following link:
http://www.journalofhospitalinfection.com/article/S0195-6701(11)00444-0/fulltext

About the Healthcare Infection Society
The Healthcare Infection Society (HIS) exists to foster the advancement of knowledge and education of all those who have an interest in the important field of healthcare infection.

About The Journal of Hospital Infection 
The Journal of Hospital Infection is the official journal of HIS, and is published on its behalf by Elsevier Ltd. The Journal seeks to promote collaboration between the many disciplines in infection control in different countries resulting in multidisciplinary and international coverage of the latest developments in this crucial area.

About Elsevier

Elsevier is a world-leading provider of information solutions that enhance the performance of science, health, and technology professionals, empowering them to make better decisions, deliver better care, and sometimes make groundbreaking discoveries that advance the boundaries of knowledge and human progress. Elsevier provides web-based, digital solutions — among them ScienceDirect, Scopus, Elsevier Research Intelligence,and ClinicalKey—and publishes over 2,200 journals, including The Lancet and Cell, and over 25,000 book titles, including a number of iconic reference works.

The company is part of Reed Elsevier Group PLC, a world leading provider of professional information solutions in the Science, Medical, Legal and Risk and Business sectors, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).

Media contacts
Romilly Cook
Healthcare Infection Society
+ 44 1873 810272 / + 44 7792 079404
romillydcook@btinternet.com

Fiona Macnab
Elsevier
+44 20 7424 4259
f.macnab@elsevier.com