Influence of Staff Behavior on Infectious Risk in Operating Rooms: What Is the Evidence?

Birgand, Gabriel; Saliou, Philippe; Lucet, Jean‐Christophe

doi:10.1017/ice.2014.9

Cited by 70 publications

(55 citation statements)

References 47 publications

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“…Also, the doors of an OR must be closed as much as possible, because every time the door opens, the pressure drops and turbulence in air movements occur, contributing to wound contamination [80]. To reduce the frequency of door openings, Birgand et al suggest a more practical storage of frequently used materials, advanced communication systems and an improved organisation of surgical team shift changes [79,82].…”

Section: Operative Environmentmentioning

confidence: 99%

Prevention of fracture-related infection: a multidisciplinary care package

Metsemakers

Onsea

Neutjens

et al. 2017

International Orthopaedics (SICOT)

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Fracture-related infection (FRI) remains a challenging complication. It may result in permanent functional loss or even amputation in otherwise healthy patients. For these reasons, it is important to focus attention on prevention. In treatment algorithms for FRI, antibiotic stewardship programmes have already proved their use by means of a multidisciplinary collaboration between microbiologists, surgeons, pharmacists, infectious disease physicians and nursing staff. A similar approach, however, has not been described for infection prevention. As a first step towards achieving a multidisciplinary care package for infection prevention, this review summarises the most recent guidelines published by the World Health Organization (WHO) and US National Institutes of Health Centers for Disease Control and Prevention (CDC), primarily focusing on the musculoskeletal trauma patient. The implementation of these guidelines, together with close collaboration between infection control physicians, surgeons, anaesthesiologists and nursing staff, can potentially have a beneficial effect on the rate of FRI after musculoskeletal trauma surgery. It must be stated that most evidence presented here in support of these guidelines was not obtained from musculoskeletal trauma research. Although most preventive measures described in these studies can be generalised to the musculoskeletal trauma patient, there are still important differences with nontrauma patients that require further attention. Future research should therefore focus more on this very defined patient population and more specifically on FRI prevention.

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Section: Operative Environmentmentioning

confidence: 99%

Prevention of fracture-related infection: a multidisciplinary care package

Metsemakers

Onsea

Neutjens

et al. 2017

International Orthopaedics (SICOT)

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Section: Airborne Sources and Control Of Contaminantsmentioning

confidence: 99%

“…In a literature review, Birgand et al 33 reported that in two studies, the number of personnel in the OR and SSI rates or airborne contaminants were correlated; they also reported that in an additional three studies, door openings and airborne contaminants were linked. Reducing traffic and door openings, especially involving the main door, may be a practical solution to maintaining optimal airflow with minimal circulating particles and contaminants; however, data were limited, and the level of evidence was low 33 . Esser et al 34 counted the number of OR door openings before and after developing a policy that included staff member education, reminder signs on OR doors, and use of communication devices such as voice‐activated phones to minimize the need to leave the OR for supplies or instruments.…”

Section: Airborne Sources and Control Of Contaminantsmentioning

confidence: 99%

“…Reducing traffic and door openings, especially involving the main door, may be a practical solution to maintaining optimal airflow with minimal circulating particles and contaminants; however, data were limited, and the level of evidence was low. 33 Esser et al 34 counted the number of OR door openings before and after developing a policy that included staff member education, reminder signs on OR doors, and use of communication devices such as voice-activated phones to minimize the need to leave the OR for supplies or instruments. Door openings diminished from an average of 37.8 to 32.8 per hour (P ¼ .001), which was a 13% reduction.…”

Section: Or Behavior and Practicementioning

confidence: 99%

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Minimizing Sources of Airborne, Aerosolized, and Contact Contaminants in the OR Environment

Armellino¹

2017

AORN Journal

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Surgical site infections are unintended consequences of surgery that can cause harm to patients and place financial burdens on health care organizations. Extrinsic factors in the OR-including health care providers' behavior and practices that modify air movement, the physical environment, equipment, or surgical instruments-can increase microbial contamination. Microbes can be transported into the surgical incision by airborne or contact routes and contribute to a surgical site infection. Simple practices to prevent infection-such as minimizing airborne particles and contaminants, maintaining equipment according to the manufacturer's recommendations, cleaning and disinfecting the environment and surgical instruments, and performing proper hand hygiene-can reduce the degree of microbial contamination. Perioperative leaders and health care providers can help decrease the patient's risk of surgical site infection with proactive preventive practices that break the chain of infection.

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“…Operating room traffic is often associated with transitions of care and handoffs, which are believed to contribute to adverse patient outcomes [27][28][29][30][31][32], including infection [33]. It is unclear whether operating room traffic in general or the traffic of specific personnel groups impacts SSI risk [34].…”

mentioning

confidence: 99%