A covert study by researchers at Johns Hopkins University revealed that as foot traffic in and out of an operating room increases, so too does a patient’s infection risk.
The study, published in the most recent issue of Orthopedics, analyzed foot traffic in and out of operating rooms for the sake of patient safety. The vast majority of OR staff were unaware of the ongoing study, but researchers slyly tracked how often an operating door was opened and for how long it was opened during nearly 200 knee and hip arthroplasty operations preformed at Johns Hopkins Bayview Medical Center.
For those of you unfamiliar with large medical center operating rooms, they are often fitted with systems that keep their atmospheric pressure slightly higher than other areas of the hospital. They do this to ensure air flows out of the operating room when the doors are open, preventing potentially infection-causing germs from blowing into the room. That pressure system can become overwhelmed should a door be opened for too long or in too rapid a succession.
OR Door Study
After tracking the operations, researchers uncovered:
- About 1 in 3 operations involved enough door openings to defeat the safety effects of the positive pressure systems.
- The OR doors opened on average once every 2.5 minutes.
- OR doors were open for a total of 9.6 minutes per operation, on average.
Researchers believe the findings weren’t unique to the Johns Hopkins Bayview Medical Center.
“Our findings add to a growing body of evidence of a relatively common practice that could be a potential safety concern, and raises questions about why doors get opened and how we can prevent or minimize the frequency and duration of behaviors that could compromise OR sterility,” says study senior author Dr. Stephen Belkoff. “What we know for sure is that there was a whole lot more traffic in and out of the OR than seems necessary or easily explained.”
Researchers couldn’t speak to why doors were opened so frequently in some cases, as the study was conducted without the knowledge of the OR staff.
“Undoubtedly, a handful of door openings during surgery are necessary and unavoidable,” Belkoff says. “What we ought to figure out next is what’s causing the unnecessary and avoidable ones.”
The study also indicated that although about one-third of operations saw enough door openings to potentially compromise the pressure system’s effects, only one patient of the 191 operations preformed acquired an infection.
“Yes, we have low infection rates, and yes, we take great many precautions, but we cannot be complacent, and we must remain vigilant about practices that pose risk — theoretical or otherwise,” said study co-author Dr. Simon Mears. “Excessive door opening is one such practice.”
Researchers recommended that surgeons should ensure all necessary tools and materials are stocked prior to surgery, and all surgery team members should refrain from entering and leaving the OR if possible.
Related source: Infection Control Today