Parikh Shital N, Grice Salih S, Schnell Beverly M, Salisbury Shelia R
Division of Orthopaedic Surgery, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue ML 2017, Cincinnati, OH 45229, USA.
J Pediatr Orthop. 2010 Sep;30(6):617-23. doi: 10.1097/BPO.0b013e3181e4f3be.
Operating room (OR) human traffic has been implicated as a cause of surgical site infection. We first observed the normal human traffic pattern in our Pediatric Orthopedic ORs, and then examined the effect of surveillance on that traffic pattern.
This study consisted of 2 phases: phase I sought to observe the OR traffic pattern (number of door swings, maximum and minimum number of OR personnel, number of OR personnel at 30-minute intervals, or changes in nursing, anesthesia, or surgeon staff) during surgical cases without OR personnel being notified, and for phase II, the same traffic pattern was monitored with their knowledge.
Two thousand four hundred forty-two minutes of surgical time were observed in phase I, and 1908 minutes were observed in phase II. There was no difference (P=0.06) in the time between door swings between phase I (1.39 min) and phase II (1.70 min), no difference (P=1.000) in the maximum number of people in the OR between phase I (11.5 people, range: 7-15 people) and phase II (11.5 people, range: 8-20 people), and no difference (P=1.000) in the minimum number of people in the OR between phase I (4.67 people, range: 4-6 people) and phase II (4.71 people, range: 3-6 people). There was a difference in the time between door swings (P=0.03) and maximum number of people in the OR (P=0.005) based on the length of the surgery (less or more than 120 min). There was no difference in the time between door swings (P=0.11), but there was a difference in the maximum number of people in the OR (P=0.002) based on type of surgery (spine vs. others).
There was no role of surveillance of human traffic in the OR. To achieve any change in the OR traffic pattern, monitoring alone may not be sufficient; other novel techniques or incentives may need to be considered.
手术室人员流动被认为是手术部位感染的一个原因。我们首先观察了我院小儿骨科手术室的正常人员流动模式，然后研究了监测对该流动模式的影响。
本研究包括两个阶段：第一阶段旨在观察手术过程中的手术室人员流动模式（门摆动次数、手术室人员的最大和最小数量、每隔30分钟的手术室人员数量，或护理、麻醉或外科工作人员的变化），且不通知手术室人员；第二阶段，在手术室人员知晓的情况下监测相同的人员流动模式。
第一阶段观察到2442分钟的手术时间，第二阶段观察到1908分钟。第一阶段（1.39分钟）和第二阶段（1.70分钟）之间门摆动的时间间隔无差异（P = 0.06），第一阶段（11.5人，范围：7 - 15人）和第二阶段（11.5人，范围：8 - 20人）之间手术室人员的最大数量无差异（P = 1.000），第一阶段（4.67人，范围：4 - 6人）和第二阶段（4.71人，范围：3 - 6人）之间手术室人员的最小数量无差异（P = 1.000）。根据手术时长（少于或多于120分钟），门摆动的时间间隔（P = 0.03）和手术室人员的最大数量（P = 0.005）存在差异。根据手术类型（脊柱手术与其他手术），门摆动的时间间隔无差异（P = 0.11），但手术室人员的最大数量存在差异（P = 0.002）。
手术室人员流动监测没有作用。要实现手术室人员流动模式的任何改变，仅靠监测可能是不够的；可能需要考虑其他新的技术或激励措施。
