A survey of propofol injection practices reveals poor knowledge of and unsatisfactory adherence to the SASA Guidelines for Infection Control

Background: Propofol lipid emulsion supports bacterial growth and various outbreaks of postoperative infection are attributed to extrinsic contamination. This study's objectives were to ascertain propofol administration practices among South African anaesthesiologists and to determine the influ...

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Veröffentlicht in:Southern African journal of anaesthesia and analgesia 2017-07, Vol.23 (4), p.102-113
Hauptverfasser: Breedt, Anneme, (Jeff) F. Coetzee, Johan, Kluyts, Hyla, Scheepers, Pamela
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container_end_page 113
container_issue 4
container_start_page 102
container_title Southern African journal of anaesthesia and analgesia
container_volume 23
creator Breedt, Anneme
(Jeff) F. Coetzee, Johan
Kluyts, Hyla
Scheepers, Pamela
description Background: Propofol lipid emulsion supports bacterial growth and various outbreaks of postoperative infection are attributed to extrinsic contamination. This study's objectives were to ascertain propofol administration practices among South African anaesthesiologists and to determine the influence of the 2014 South African Society of Anaesthesiologists (SASA) Guidelines for Infection Control in Anaesthesia. Methods: A total of 1 598 SASA members were invited to participate anonymously and 634 replies were received. Using a risk-scoring system developed from 13 questionnaire items, 542 respondents who administer propofol infusions were stratified into Low-, Moderate-, High- and Very High-Risk groups. Results: The majority (65%) of the 542 participants who administer propofol infusions were classified as Moderate Risk, 29% as Low Risk and 6% as High and Very High Risk. Some 61% were aware of the SASA Guidelines, of whom 47.3% had studied them. The median risk-score of the Studied Guidelines group was significantly smaller (p < 0.001). They included a greater proportion who were categorised as low risk (58% vs. 45%) and a lower proportion who were moderate risk (38% vs. 51%). Proportions of high-risk individuals did not differ. Of the total 634 respondents, 247 used rubber-stoppered vials of whom 28% had studied the SASA Guidelines; 20% of the Studied Guidelines group often/always shared vial contents between patients versus 12% of those who had not studied them (p = 0.13). Conversely, 40% (studied group) versus 13.6% (not-studied group) often/always wiped the diaphragm and seldom/never shared vial contents between patients (p < 0.0001). In all, 25% of the total 634 respondents often/always pre-prepared multiple propofol syringes; 5.0% diluted propofol and often/always pre-prepared syringes. Conclusion: Penetration of the SASA Guidelines was low. Differences in unsafe practices among anaesthesiologists who had read the guidelines were statistically significant but clinically inconsequential. This highlights a need for greater publicity, emphasising their practical importance.
doi_str_mv 10.1080/22201181.2017.1336370
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Coetzee, Johan</creatorcontrib><creatorcontrib>Kluyts, Hyla</creatorcontrib><creatorcontrib>Scheepers, Pamela</creatorcontrib><title>A survey of propofol injection practices reveals poor knowledge of and unsatisfactory adherence to the SASA Guidelines for Infection Control</title><title>Southern African journal of anaesthesia and analgesia</title><description>Background: Propofol lipid emulsion supports bacterial growth and various outbreaks of postoperative infection are attributed to extrinsic contamination. This study's objectives were to ascertain propofol administration practices among South African anaesthesiologists and to determine the influence of the 2014 South African Society of Anaesthesiologists (SASA) Guidelines for Infection Control in Anaesthesia. Methods: A total of 1 598 SASA members were invited to participate anonymously and 634 replies were received. Using a risk-scoring system developed from 13 questionnaire items, 542 respondents who administer propofol infusions were stratified into Low-, Moderate-, High- and Very High-Risk groups. Results: The majority (65%) of the 542 participants who administer propofol infusions were classified as Moderate Risk, 29% as Low Risk and 6% as High and Very High Risk. Some 61% were aware of the SASA Guidelines, of whom 47.3% had studied them. The median risk-score of the Studied Guidelines group was significantly smaller (p &lt; 0.001). They included a greater proportion who were categorised as low risk (58% vs. 45%) and a lower proportion who were moderate risk (38% vs. 51%). Proportions of high-risk individuals did not differ. Of the total 634 respondents, 247 used rubber-stoppered vials of whom 28% had studied the SASA Guidelines; 20% of the Studied Guidelines group often/always shared vial contents between patients versus 12% of those who had not studied them (p = 0.13). Conversely, 40% (studied group) versus 13.6% (not-studied group) often/always wiped the diaphragm and seldom/never shared vial contents between patients (p &lt; 0.0001). In all, 25% of the total 634 respondents often/always pre-prepared multiple propofol syringes; 5.0% diluted propofol and often/always pre-prepared syringes. Conclusion: Penetration of the SASA Guidelines was low. Differences in unsafe practices among anaesthesiologists who had read the guidelines were statistically significant but clinically inconsequential. 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Coetzee, Johan</creatorcontrib><creatorcontrib>Kluyts, Hyla</creatorcontrib><creatorcontrib>Scheepers, Pamela</creatorcontrib><collection>Access via Taylor &amp; Francis (Open Access Collection)</collection><collection>Sabinet:Open Access</collection><collection>Sabinet African Journals Open Access Collection</collection><collection>CrossRef</collection><jtitle>Southern African journal of anaesthesia and analgesia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Breedt, Anneme</au><au>(Jeff) F. Coetzee, Johan</au><au>Kluyts, Hyla</au><au>Scheepers, Pamela</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A survey of propofol injection practices reveals poor knowledge of and unsatisfactory adherence to the SASA Guidelines for Infection Control</atitle><jtitle>Southern African journal of anaesthesia and analgesia</jtitle><date>2017-07-04</date><risdate>2017</risdate><volume>23</volume><issue>4</issue><spage>102</spage><epage>113</epage><pages>102-113</pages><issn>2220-1181</issn><eissn>2220-1173</eissn><abstract>Background: Propofol lipid emulsion supports bacterial growth and various outbreaks of postoperative infection are attributed to extrinsic contamination. This study's objectives were to ascertain propofol administration practices among South African anaesthesiologists and to determine the influence of the 2014 South African Society of Anaesthesiologists (SASA) Guidelines for Infection Control in Anaesthesia. 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Of the total 634 respondents, 247 used rubber-stoppered vials of whom 28% had studied the SASA Guidelines; 20% of the Studied Guidelines group often/always shared vial contents between patients versus 12% of those who had not studied them (p = 0.13). Conversely, 40% (studied group) versus 13.6% (not-studied group) often/always wiped the diaphragm and seldom/never shared vial contents between patients (p &lt; 0.0001). In all, 25% of the total 634 respondents often/always pre-prepared multiple propofol syringes; 5.0% diluted propofol and often/always pre-prepared syringes. Conclusion: Penetration of the SASA Guidelines was low. Differences in unsafe practices among anaesthesiologists who had read the guidelines were statistically significant but clinically inconsequential. 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source Sabinet African Journals Open Access Collection; Access via Taylor & Francis (Open Access Collection)
subjects Drug compounding
Infection control
post-operative complications
Postoperative complications
Practice guidelines as topic
Propofol
title A survey of propofol injection practices reveals poor knowledge of and unsatisfactory adherence to the SASA Guidelines for Infection Control
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