Video observation of sharps handling and infection control practices during routine companion animal appointments

BACKGROUND Infection control in veterinary clinics is important for preventing pathogen spread between patients, staff and the public. There has been no direct evaluation of the use of many basic infection control practices, including sharps handling, environmental cleaning, and personal protective clothing (PPC), in companion animal clinics. The objective of this study was to describe these and other infection control practices associated with routine companion animal appointments in veterinary clinics in Ontario. RESULTS Video observation of practices was performed in 51 clinics for approximately 3 weeks each as part of another study evaluating the effect of a poster campaign on hand hygiene compliance. Two small wireless surveillance cameras were used: one in an exam room, one in what was considered the most likely location for hand hygiene to be performed outside the exam room following an appointment. Video footage was coded and analyzed for 47 clinics, including 2713 appointments and 4903 individual staff-animal contacts. Recapping of a needle was seen in 84% (1137/1353) of appointments in which use was observed. Only one apparent needlestick injury (NSI) was seen, during recapping. Exam tables were cleaned and floors were mopped following 76% (2015/2646) and 7% (174/2643) of appointments, respectively. Contact time with spray used to clean the exam table ranged from 0-4611 s (mean 39 s, median 9 s). Appropriate PPC was worn for 72% (3518/4903) of staff-animal contacts. CONCLUSIONS Although there was significant room for improvement in sharps handling behaviours in participating clinics, the number of observed NSIs was low. Contact time with environmental disinfectants and use of PPC could also be improved, as well as other basic infection control practices. Education and motivation of veterinary staff to use these simple measures more effectively could potentially have a significant impact on infection control in veterinary clinics for relatively little cost.