Review of three magnetic resonance arthrography related infections

Table 1 Summary of infection control recommendations for radiology arthrogram procedures

Procedure room scheduling

Avoid performing barium studies and arthrograms in the same procedure room

If it is necessary to share a procedure room provide block time slots for barium studies and arthrogram procedures separated by thorough cleaning.

Where possible, scheduling arthrograms (along with ports/hickmans, etc.) first thing in the morning prior to barium studies and other potentially contaminating procedures such as enteric stenting/abscess drainage, etc.

Procedure room cleaning

If the room is to be used for both barium and arthrogram procedures, a thorough cleaning must be performed between barium studies and arthrograms

Staffing

Limit the staffing options to assistants for all arthrograms

Arthrogram kit

Replace the kit drape with a larger drape to ensure a maximum sterile barrier

Chlorhexidine gluconate swabs should be used to sterilize skin

Use proper swab technique: Circle from the inside to the outside

Maintain the sterile field

Use a sterile sleeve over the image intensifier for each procedure

The assistant must wear sterile gloves, hat and mask

Ensure that sterile gloves are worn when in contact with the sterile kit, when preparing the injectate

All staff must change gloves if they leave the procedure room and re-enter

Any tool used to mark the patient prior to the arthrogram must be wiped down with the hospital-approved disinfectant wipes before and after use

Any tool that may contact the patient or anything in the sterile field must be sterilized