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Anesthesia & Analgesia Anesthesia & Analgesia SHEA Expert Guidance: Infection Prevention in the Operating Room Anesthesia Work Area --Manuscript Draft-- Manuscript Number: AA-D-18-01467 Full Title: SHEA Expert Guidance: Infection Prevention in the Operating Room Anesthesia Work Area Short Title: Infection Prevention in the Anesthesia Work Area Article Type: Special Article Corresponding Author: Valerie M Deloney, MBA Society for Healthcare Epidemiology of America Arlington, VA UNITED STATES Corresponding Author Secondary Information: Corresponding Author's Institution: Society for Healthcare Epidemiology of America Corresponding Author's Secondary Institution: First Author: Valerie M Deloney, MBA First Author Secondary Information: Order of Authors: Valerie M Deloney, MBA L. Silvia Munoz-Price, MD, PhD Andrew Bowdle, MD, PhD B. Lynn Johnston, MD Gonzalo M. Bearman, MD, MPH Bernard C. Camins, MD, MSc E. Patchen Dellinger, MD Marjorie A. Geisz-Everson, PhD, CRNA Galit Holzmann-Pazgal, MD Rekha Murthy, MD David Pegues, MD Richard C. Prielipp, MD, MBA, FCCM Zachary A. Rubin, MD Joshua Schaffzin, MD, PhD Deborah Yokoe, MD, MPH David J. Birnbach, MD, MPH Order of Authors Secondary Information: Manuscript Region of Origin: UNITED STATES Abstract: This expert guidance document, written by a multidisciplinary panel of experts, provides recommendations specific to the anesthesia work area to improve infection prevention through hand hygiene (HH), environmental disinfection, and implementation of effective improvement efforts. The potential for clinically significant microbial cross- transmission in the intraoperative environment poses a threat to patient safety, and a growing body of literature has shown contamination in the anesthesia work area, including the anesthesia medical work cart, stopcocks, laryngeal masks and Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation laryngoscope blades, touchscreens, keyboards, and providers’ hands, resulting in transmissions, healthcare-associated infections, and increased risk of patient mortality. The guidance’s recommendations are based on a systematic literature search, surveys of individuals working in infection prevention and anesthesia providers, expert panel consensus, and considerations of feasibility and harm. Requested Editor: Suggested Reviewers: Opposed Reviewers: Funding Information: Author Comments: Dear Dr. Pittet and Mr. Pointe, As you review the "SHEA Expert Guidance: Infection Prevention in the Anesthesia Work Area," please feel free to reach out to me with questions. Until publication, I will serve as the corresponding author, and will contact the author group with questions related to content. I should not be listed as an author, as I work as a member of SHEA staff. Per the agreement signed earlier this year, joint publication will occur with the SHEA journal, Infection Control and Hospital Epidemiology (ICHE). A&A will do the copy- editing and provide the file to ICHE. Dr. Suzanne Bradley serves as the Editor, and Brian Mazeski [email protected] as the Associate Production Manager. You may contact him and copy me and our Managing Editor, Lindsay MacMurray, [email protected], to coordinate the joint publication. The conflict of interest disclosures for the authors are listed both in the title page, as requested, and in the Acknowledgements, per SHEA format. Finally, 2 supplemental files will be posted to the SHEA website, as identified in the manuscript. One is a letter from ASA, and the other is a file with four tables. Please let me know when I should provide the URLs. Thank you very much for working with SHEA on this project. We are looking forward to publication, Valerie Deloney, MBA [email protected] Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation Manuscript (All Manuscript Text Pages in MS Word format, including Title Page, References and Figure Legends) 1 2 3 4 SHEA Expert Guidance: Infection Prevention in the Operating Room Anesthesia Work 5 6 7 Area 8 9 L. Silvia Munoz-Price, MD, PhD, Froedtert & the Medical College of Wisconsin, 10 11 12 Milwaukee, WI 13 14 Andrew Bowdle, MD, PhD, University of Washington Medicine, Seattle, WA 15 16 B. Lynn Johnston, MD, Dalhousie University, Halifax, NS 17 18 19 Gonzalo M. Bearman, MD, MPH, Virginia Commonwealth University School of Medicine, 20 21 Richmond, VA 22 23 24 Bernard C. Camins, MD, MSc, University of Alabama at Birmingham, Birmingham, AL 25 26 E. Patchen Dellinger, MD, University of Washington Medicine, Seattle, WA 27 28 29 Marjorie A. Geisz-Everson, PhD, CRNA, University of Southern Mississippi, Hattiesburg, MS 30 31 Galit Holzmann-Pazgal, MD, Baylor College of Medicine, Houston, TX 32 33 34 Rekha Murthy, MD, Cedars-Sinai Medical Center, Los Angeles, CA 35 36 David Pegues, MD, University of Pennsylvania, Philadelphia, PA 37 38 Richard C. Prielipp, MD, MBA, FCCM, University of Minnesota, Minneapolis, MN 39 40 41 Zachary A. Rubin, MD, David Geffen School of Medicine at UCLA, Los Angeles, CA 42 43 Joshua Schaffzin, MD, PhD, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 44 45 46 Deborah Yokoe, MD, MPH, University of California San Francisco School of Medicine, San 47 48 Francisco, CA 49 50 51 David J. Birnbach, MD, MPH, University of Miami Miller School of Medicine, Miami, FL 52 53 Corresponding Author 54 55 L. Silvia Muñoz-Price, MD, PhD 56 57 58 Medical College of Wisconsin 59 60 61 62 1 63 64 65 1 2 3 4 8701 Watertown Plank Road 5 6 7 Milwaukee, WI 53226 8 9 (414) 955-0483 10 11 12 [email protected] 13 14 L. Silvia Munoz-Price: This author served as Chair of the writing panel that authored this 15 16 document, leading the processes for all discussions, deliberations, consensus-building, and 17 18 19 decision-making, and helped with the systematic literature search and writing of the document. 20 21 Andrew Bowdle: This author provided anesthesia expertise and helped lead discussions of all 22 23 24 aspects of the document and deliberations during the review phase, and helped with the 25 26 systematic literature search and writing of the document. 27 28 29 B. Lynn Johnston: This author provided infection prevention and healthcare epidemiology 30 31 expertise and led the development and analysis of the survey of the SHEA Research Network 32 33 34 and the survey of anesthesia providers. 35 36 Gonzalo M. Bearman: This author provided infection prevention and healthcare epidemiology 37 38 expertise and helped with the systematic literature search and writing of the document. 39 40 41 Bernard C. Camins: This author provided infection prevention and healthcare epidemiology 42 43 expertise, leading the literature search and writing process for the hand hygiene section of the 44 45 46 document. 47 48 E. Patchen Dellinger: This author provided expertise in infection prevention, healthcare 49 50 51 epidemiology, surgery, and insights into the operating room environment, and helped with the 52 53 systematic literature search and writing of the document. 54 55 56 57 58 59 60 61 62 2 63 64 65 1 2 3 4 Marjorie A. Geisz-Everson: This author provided anesthesia expertise, served as the liaison to 5 6 7 the American Association of Nurse Anesthetists (AANA), and helped with the systematic 8 9 literature search and writing of the document. 10 11 12 Galit Holzmann-Pazgal: This author provided infection prevention and healthcare 13 14 epidemiology expertise and helped with the systematic literature search and writing of the 15 16 document. 17 18 19 Rekha Murthy: This author provided infection prevention and healthcare epidemiology 20 21 expertise and helped with the systematic literature search and writing of the document, and 22 23 24 served as SHEA Guidelines Committee Chair and SHEA Guidelines Committee Past Chair 25 26 during the duration of its development. 27 28 29 David Pegues: This author provided infection prevention and healthcare epidemiology expertise 30 31 and helped with the systematic literature search and writing of the document. 32 33 34 Richard C. Prielipp, MD, MBA, FCCM, University of Minnesota, Minneapolis, MN 35 36 Zachary A. Rubin: This author provided infection prevention and healthcare epidemiology 37 38 expertise and helped with the systematic literature search and writing of the document 39 40 41 Joshua Schaffzin: This author provided infection prevention, healthcare epidemiology, and 42 43 implementation science expertise and helped with the systematic literature search and writing of 44 45 46 the document. 47 48 Deborah Yokoe: This author provided infection prevention and healthcare epidemiology 49 50 51 expertise and helped with the systematic literature search and writing of the document, and 52 53 served as SHEA Guidelines Committee Vice Chair and SHEA Guidelines Committee Chair 54 55 during the duration of its development. 56 57 58 59 60 61 62 3 63 64 65 1 2 3 4 David J. Birnbach: This author provided anesthesia expertise, served as liaison to the American 5 6 7 Society of Anesthesiologists (ASA), and helped with the systematic literature search and writing 8 9 of the document. 10 11 12 13 14 Financial Disclosure: The Society for Healthcare Epidemiology of America (SHEA) led and 15 16 funded the development of this manuscript. 17 18 19 Authors 20 21 The writing panel (the authors) consists of current and past members of the SHEA Guidelines 22 23 24 Committee and representatives of organizations that partnered with SHEA to write this 25 26 document: Dr. David J. Birnbach, American Society of Anesthesiologists (ASA); Dr. Richard
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