Guidelines Regarding HIV and Other Bloodborne Pathogens in Vascular/Interventional Radiology

Healthcare-Associated Infections (HAIs): Challenges and Measures Taken by the Radiology Department to Control Infection Transmission

Infections contracted during healthcare delivery in a hospital or ambulatory setting are collectively referred to as healthcare-associated infections (HAIs). Healthcare workers and patients alike are vulnerable to serious problems as a result of the risk of HAIs. In the healthcare system, HAIs are considered among the most common and serious health problems. However, the occurrence of HAIs differs between different types of clinical departments within the hospital. Recently, the risk of HAIs has been increasing in radiology departments globally due to the central role of radiology in guiding clinical decisions for the diagnosis, treatment, and monitoring of different diseases from almost all medical specialties. The radiology department is particularly vulnerable to HAIs because it serves as a transit hub for infected patients, non-infected patients, and healthcare workers. Furthermore, as the number of patients referred to radiology and the length of patient contact time has increased, thanks to modern imaging techniques such as computed tomography and magnetic resonance imaging, the risk of HAIs has also increased significantly. With the increasing use of interventional radiological procedures, patients and healthcare workers face a potentially greater risk of contracting HAIs due to the invasive nature of such procedures. Although not exhaustive, we attempted through a literature search to provide a general overview of infection prevention and control practices, address HAIs in the radiology departments, and highlight the challenges and measures taken to control infection transmission in the radiology departments.

Reducing blood-borne exposure in interventional radiology: what the IR should know

Interventional radiologists are at risk of exposure to blood-borne pathogens in their day-to-day practice. Percutaneous exposure from unsafe sharps handling, mucocutaneous exposure from body fluid splashes, and glove perforation from excessive wear can expose the radiologist to potentially infectious material. The increasing prevalence of blood-borne pathogens, including hepatitis B and C, and human immunodeficiency virus, puts nurses, residents, fellows, and interventional radiologists at risk for occupational exposure. This review outlines suggestions to establish a culture of safety in the interventional suite.

Infection in pediatric interventional radiology

Interventional radiology in children involves nearly every aspect of infectious disease. Diagnosis, treatment, prophylaxis and disease transmission in infectious disease are a daily part of pediatric interventional radiology practice. This article will discuss each of these aspects of infection with respect to interventional radiology.

Infection control practices among interventional radiologists: results of an online survey

PURPOSE

To assess current infection control practices of interventional radiologists (IRs) in the context of recommendations by the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration.

MATERIALS AND METHODS

From November 2006 to January 2007, members of the Society of Interventional Radiology (SIR) were invited to participate in an anonymous, online infection control questionnaire.

RESULTS

A total of 3,019 SIR members in the United States were contacted via e-mail, and 1,061 (35%) completed the 57-item survey. Of the respondents, 283 (25%) experienced a needlestick injury within the previous year, most often as a result of operator error (76%). Less than 65% reported compliance with annual tuberculosis skin testing; notably, those who received a yearly reminder were much more likely to receive annual testing than those who did not (odds ratio, 19.0; 95% CI, 12.6-28.7; P < .05). During central venous catheter placement, only 56% wore gowns, 50% wore caps, and 54% used full barrier precautions. Only 19% reported routine hand washing between glove applications. More than 40% noted a change in infection control practices within the previous 5 years, citing new hospital guidelines and recommendations by a professional organization as the reasons for change. Only 44% had infection control training at the onset of their practice.

CONCLUSIONS

IRs demonstrate a wide variety of infection control practices that are not in accordance with current guidelines. IRs were most likely to change infection control practice if required to do so by their own hospitals or a professional organization. SIR can play an important role in the prevention of health care-associated infection by reinforcing current infection control guidelines as they pertain to interventional radiology.

Hygiene precautions and the transmission of infections in radiology

Healthcare-associated infections are a critical challenge for the public health sector. Most are acquired through contact, predominantly with the hands of health care personnel. Hand hygiene, therefore, is the single most effective measure for preventing and controlling infectious diseases. Recently, cases of acute hepatitis C occurred in patients who had undergone contrast-enhanced computed tomography. This was probably related to inadequate handling by health care staff. Rigorous compliance with standard precautions is therefore compulsory even in radiology, a setting traditionally considered at low risk for the transmission of pathogens. Adherence to standard precautions is still poor and the persistence of inappropriate practices responsible for preventable incidents is very common in radiology, often owing to underestimation of risk. Radiology units must promote compliance with correct hand hygiene through appropriate education programmes and provision of adequate areas and hand hygiene products. The evidence base to support the use of alcohol-based hand rub is demonstrating that these formulations are effective in improving hand hygiene compliance and preventing infections.