Datta Subhradeep, Dexter Franklin, Ledolter Johannes, Wall Russell T, Loftus Randy W
Medical student 2022 class, Georgetown University, United States.
Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA, 52242, United States.
Perioper Care Oper Room Manag. 2020 Dec;21:100137. doi: 10.1016/j.pcorm.2020.100137. Epub 2020 Oct 10.
Reductions in perioperative surgical site infections are obtained by a multifaceted approach including patient decolonization, vascular care, hand hygiene, and environmental cleaning. Associated surveillance of transmission quantifies the effectiveness of these basic measures to prevent transmission of pathogenic bacteria and viruses to patients and clinicians, including Coronavirus Disease 2019 (COVID-19). To measure transmission, the observational units are pairs of successive surgical cases in the same operating room on the same day. In this prospective cohort study, we measured sampling times for inexperienced and experienced personnel.
OR PathTrac kits included 6 samples collected before the start of surgery and 7 after surgery. The time for consent also was recorded. We obtained 1677 measurements of time among 132 cases.
Sampling times were not significantly affected by technician's experience, type of anesthetic, or patient's American Society of Anesthesiologists' Physical Status. Sampling times before the start of surgery averaged less than 5 min (3.39 min [SE 0.23], < 0.0001). Sampling times after surgery took approximately 5 min (4.39 [SE 0.25], = 0.015). Total sampling times averaged less than 10 min without consent (7.79 [SE 0.50], < 0.0001), and approximately 10 min with consent (10.22 [0.56], = 0.70).
For routine use of monitoring transmission, when done by personnel already present in the operating rooms of the cases, the personnel time budget can be 10 min per case.
通过多方面措施可降低围手术期手术部位感染，这些措施包括患者去定植、血管护理、手部卫生和环境清洁。相关的传播监测可量化这些基本措施预防病原菌和病毒传播给患者及医护人员（包括2019冠状病毒病（COVID - 19））的有效性。为了测量传播情况，观察单位是同一天在同一手术室连续进行的手术病例对。在这项前瞻性队列研究中，我们测量了经验不足和经验丰富人员的采样时间。
手术室病原体追踪试剂盒包括手术开始前采集的6份样本和术后采集的7份样本。还记录了获得知情同意的时间。我们在132例病例中获得了1677次时间测量值。
采样时间不受技术人员经验、麻醉类型或患者美国麻醉医师协会身体状况的显著影响。手术开始前的采样时间平均不到5分钟（3.39分钟[标准误0.23]，<0.0001）。术后采样时间约为5分钟（4.39[标准误0.25]，P = 0.015）。未经知情同意的总采样时间平均不到10分钟（7.79[标准误0.50]，<0.0001），经知情同意的总采样时间约为10分钟（10.22[0.56]，P = 0.70）。
对于常规的监测传播工作，由病例手术室中已有的人员进行时，每个病例的人员时间预算可为10分钟。
