AHS surgeon shares hand hygiene expertise internationally

September 8, 2023

First Alberta clinician to have video posted by New England Journal of Medicine

EDMONTON – An Alberta Health Services (AHS) surgeon has become the first clinician from the province to have an educational video published by the New England Journal of Medicine (NEJM), which is among the most prestigious peer-reviewed medical journals in the world.

University of Alberta Hospital surgeon Dr. Rachel Khadaroo developed the eight-minute video with the aim to decrease surgical site infections (SSI) by teaching proper preoperative surgical hand hygiene technique. The video was submitted to the NEJM in 2021 and was published in September 2023.

“The NEJM videos in Clinical Medicine education series presented a great opportunity and natural fit for our provincial surgery teams to come together to help other surgical teams around the world to reduce post-surgical infections,” says Dr. Khadaroo. “Starting everything right at the scrub sink is really the first step in preventing surgical infections for our patients.”

The Alberta-made video joins about 100 other peer-reviewed educational videos shared and promoted by the world’s oldest continuously published medical journal. These videos teach procedures requiring skilled techniques and specialized physical examination.

“This is clearly great news for Dr. Khadaroo and her team but this is also great news for Albertans,” says Oscar Larios, Interim Senior Medical Director with AHS Infection Prevention and Control. 

“This accomplishment underscores the fact that, here in Alberta, we have many talented and pioneering clinicians whose expertise is respected and sought out by peers around the world. In this case, Dr. Khadaroo’s passion and expertise for proper preoperative surgical hand hygiene can be shared with other surgical teams to minimize the risk of surgical infections, both here in Alberta and around the world.”

Reducing the risk of SSI benefits patients and the health system. Although advances have been made in infection control practices, SSIs still occur in about two to five per cent of all surgeries. They increase the length of a hospital stay by an average of 11 days; lead to a longer recovery and/or unplanned hospital readmissions following surgery; and result in 60 per cent more time spent in intensive care units. About 400,000 surgeries are performed in Alberta annually.

Some infections can be superficial involving only the skin, while others can be more serious and may involve deep tissue, organs, or implanted material. While most can be treated with antibiotics, additional surgery or procedures may sometimes be required.

“This is not a new concept – sterile surgical hand preparation,” says Dr. Khadaroo. “By using a novel approach to teaching, the importance of the act is greatly strengthened through video by showing the nuanced movement of steps required. It allows for a reliable teaching source that can be used worldwide, particularly in developing countries or smaller hospitals that may not have nurse educators.”

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Our mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans. Our current focus is on reducing emergency department wait-times, improving EMS response times, increasing access to surgeries, and improving patient flow.