University of Pittsburgh Medical Center Mercy Hospital, Infection Prevention, Surgery and Anesthesia Departments, Pittsburgh, PA; University of Pittsburgh School of Public Health, Infectious Diseases, Microbiology, Behavioral and Community Health Sciences Departments, Pittsburgh, PA.
University of Pittsburgh Medical Center Mercy Hospital, Infection Prevention, Surgery and Anesthesia Departments, Pittsburgh, PA.
Am J Infect Control. 2024 Jun;52(6):630-634. doi: 10.1016/j.ajic.2024.01.016. Epub 2024 Jan 26.
Operating room (OR) traffic disrupts airflow and increases particle count, which predisposes patients to surgical site infections, particularly in longer surgeries with hardware placement. The aim of this study is to evaluate the rate of traffic during neurosurgical procedures, as well as reasons for and perceptions of OR traffic.
This is a single-center, multimethod study monitoring neurosurgical OR traffic through direct observation, automated monitoring, and interviews. Traffic was observed between the skin incision and closure. Personal interviews with OR teams including surgeons, anesthesia, and nurses were conducted to evaluate their perceptions of the frequency of OR traffic and reasons for OR traffic.
Direct observation reported OR door opening an average of 18 times, with 20 people entering or exiting per hour. The exact reason for traffic was not verified in all traffic cases and was able to be confirmed in only a third of the cases. Automated monitoring resulted in an average of 31 people entering or exiting the OR per hour. The procedure length was significantly associated with the number of people entering or exiting the OR per hour (P < .0001). Interviews highlighted that OR teams reported traffic to be significantly lower than observed and automated monitoring results, with approximately <6 people entering or exiting per hour.
OR traffic is higher than staff expected, and updated processes are required to reduce the number of times the OR door opens. Implementing automated observation of OR traffic could reduce the OR traffic and the risk for surgical site infection.
手术室(OR)的人员流动会扰乱气流并增加粒子计数,从而使患者更容易发生手术部位感染,尤其是在硬件放置时间较长的手术中。本研究旨在评估神经外科手术过程中的人员流动率,以及人员流动的原因和手术室人员对人员流动的看法。
这是一项单中心、多方法研究,通过直接观察、自动监测和访谈来监测神经外科手术室的人员流动情况。人员流动观察从皮肤切口到关闭期间进行。对手术室团队(包括外科医生、麻醉师和护士)进行个人访谈,以评估他们对手术室人员流动频率的看法以及人员流动的原因。
直接观察报告手术室门平均每 18 次打开,每小时有 20 人进出。并非所有人员流动情况下都能核实确切的人员流动原因,只有三分之一的情况下能够确认。自动监测结果显示,每小时平均有 31 人进出手术室。手术时间与每小时进出手术室的人数显著相关(P<.0001)。访谈强调,手术室团队报告的人员流动明显低于观察和自动监测结果,每小时进出人员约为<6 人。
手术室的人员流动高于工作人员的预期,需要更新流程以减少手术室门打开的次数。实施手术室人员流动的自动监测可以减少手术室人员流动和手术部位感染的风险。