Gore S, Kuehl M. Evaluating the impact of operating room traffic on airborne microbial counts during hysteroctomy and colon surgery. Research podium presentation at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.
Research podium presentation at Nursing Passion: Re-Igniting the Art & Science, Advocate Aurora Health Nursing & Research Conference 2022; November 9, 2022; virtual.
Background: Hospital-acquired surgical site infections (SSI) are costly and may occur in the operating room (OR) despite use of best practices. Research aimed at reducing SSI events by controlling environmental factors has not been reported for colon and hysterectomy. Research evaluating environmental risks warrant study.
Study Aims: 1) To describe current use of SSI prevention strategies and OR traffic patterns (door opening and personnel counts) during elective single-organ colon and abdominal hysterectomy cases 2) to evaluate if traffic has an impact on airborne microbial counts.
Methodology: A mixed methods design was used to describe existing SSI prevention practices and prospectively gather observational data about traffic with a convenience sample of colon (n=15 cases/site at two sites) and abdominal hysterectomy (n=15 cases/site at two sites) at four Midwestern acute care hospitals. Trained non-participant observers tracked OR traffic and monitored agar settle plates airborne microbial testing using established methodology (Harp, 2018) with no patient contact/cost with minimal non-PHI data collection.
Results: SSI prevention standards were in place at all sites with laminar airflow, low wall returns, and standard air exchange (M=18/min). Microbial environmental testing under simulated conditions yielded minimal/no growth. Nonparticipant observations were completed in 16 rooms with adults (N=60), average age of 57.2 years (SD= 16, range 26-90), female (80%), white (88%), nonsmokers (92%), non-diabetic (85%), and not hospitalized (95%) prior to colon (n=30) or hysterectomy (n=30). Preliminary microbial (CFU) results showed no growth in control plates (M=0.1,SD=0.5), and minimal growth in set up (M=1.0,SD=4.5), wound zone (M 2.1,SD=3.1) and back table (M=5.9,SD=6.4) plates. One SSI reported at 30 days.
Discussion: In-depth statistical analysis of traffic/room observations, patient, and environmental factors and the impact on airborne microbial testing is in progress.
Implications: Findings from this preliminary study will be used to inform practice and provide evidence to determine if more rigorous evaluation is warranted.