Cent Eur J Public Health 2019, 27(4):292-295 | DOI: 10.21101/cejph.a4932

Hospital infection control and behaviour of operating room staff

Daniela Lo Giudice1, Giuseppe Trimarchi2, Vincenza La Fauci1, Raffaele Squeri1, Sebastiano Calimeri1
1 Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
2 SIR - Faculty of Medicine and Surgery, University of Messina, Messina, Italy

Objectives: Surgical site infections (SSIs) are a frequent complication of surgical procedures and one of the most common forms of hospital acquired infection (HAI). National/international guidelines and recommendations have been issued for prevention. The objective of this study was to observe the behaviour of healthcare workers engaged in surgical procedures and hence assess compliance with SSI guidelines.

Methods: An observational descriptive study was conducted at a University hospital in southern Italy. A specifically designed form was used to record the actions of the surgical team during randomly selected surgical operations. Observations comprised the use of surgical attire, the frequency of doors opening and the number of staff in the operating room.

Results: A total of 308 operating room personnel was observed during 402 surgical procedures: 127 surgeons (41%), 39 anaesthesiologists (13%), 62 nurses (20%) and 80 students in training (26%). 96% of the surgical team wore scrubs, 93% of health workers wore a mask and of these 78% wore it correctly in order to completely cover the nose, mouth and beard (when present), 99% wore a cap (only in 48% was the hair completely covered), 50% of the operators wore gloves, 95% wore shoes dedicated to the operating theater and 23% also wore shoe covers, 56% wore gowns, and 22% had eye protection. Furthermore, the average number of health personnel in the operating theater was 8, the doors remained closed in 261 (65%) surgical operations.

Conclusion: As the results indicated a low adherence to international guidelines among the personnel, it is suggested that training courses should be provided to increase staff awareness on prevention and management of HAI.

Klíčová slova: practice, attitude, infection control, surgical site infection, international guidelines, operating room

Vloženo: 20. září 2016; Revidováno: 5. duben 2019; Přijato: 5. duben 2019; Zveřejněno: 31. prosinec 2019  Zobrazit citaci

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Lo Giudice D, Trimarchi G, La Fauci V, Squeri R, Calimeri S. Hospital infection control and behaviour of operating room staff. Cent Eur J Public Health. 2019;27(4):292-295. doi: 10.21101/cejph.a4932. PubMed PMID: 31951688.
Stáhnout citaci

Reference

  1. European Centre for Disease Prevention and Control. Point prevalence survey of healthcare-associated infections and antimicrobial use in European acute care hospitals 2011-2012 [Internet]. Solna: ECDC; 2013 [cited 2019 Dec 8]. Available from: http://ecdc.europa.eu/en/publications/Publications/healthcare-associated-infections-antimicrobial-use-PPS.pdf.
  2. Reilly J, Twaddle S, McIntosh J, Kean L. An economic analysis of surgical wound infection. J Hosp Infect. 2001;49(4):245-9. Přejít k původnímu zdroji... Přejít na PubMed...
  3. Ministry of Health. Training manual for clinical governance: patient and operator safety [Internet]. 2012 [cited 2019 Dec 8]. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_1688_allegato.pdf.
  4. Gaynes RP, Culver DH, Horan TC, Edwards JR, Richards C, Tolson JS. Surgical site infection (SSI) rates in the United States, 1992-1998: the National Nosocomial Infections Surveillance System basic SSI risk index. Clin Infect Dis. 2001 Sep 1;33 Suppl 2:S69-77. Přejít k původnímu zdroji... Přejít na PubMed...
  5. Nichols RL. Preventing surgical sit infections: a surgeon's perspective. Emerg Infect Dis. 2001;7(2):220-4. Přejít k původnímu zdroji... Přejít na PubMed...
  6. Mangram AJ, Horan TC, Pearson ML, Silver LC, Jarvis WR; Hospital Infection Control Practices Advisory Committee. Guideline for prevention of surgical site infection, 1999. Infect Control Hosp Epidemiol. 1999 Apr;20(4):247-80. Přejít k původnímu zdroji... Přejít na PubMed...
  7. World Health Organization, World Alliance for Patient Safety. WHO guidelines for safe surgery [Internet]. Geneva: WHO; 2008 [cited 2019 Dec 8]. Available from: http://www.who.int/patientsafety/safesurgery/knowledge_base/WHO_Guidelines_Safe_Surgery_finalJun08.pdf.
  8. Pasquarella C, Sansebastiano GE, Ferretti S, Saccani E, Fanti M, Moscato U, et al. A mobile laminar airflow unit to reduce air bacterial contamination at surgical area in a conventionally ventilated operating theatre. J Hosp Infect. 2007;66(4):313-9. Přejít k původnímu zdroji... Přejít na PubMed...
  9. Parikh SN, Grice SS, Schnell BM, Salisbury SR. Operating room traffic: is there any role of monitoring it? J Pediatr Orthop. 2010 Sep;30(6):617-23. Přejít k původnímu zdroji... Přejít na PubMed...
  10. Sossai D, Dagnino G, Sanguineti F, Franchin F. Mobile laminar air flow screen for additional operating room ventilation: reduction of intraoperative bacterial contamination during total knee arthroplasty. J Orthop Traumatol. 2011 Dec;12(4):207-11. Přejít k původnímu zdroji... Přejít na PubMed...
  11. Tammelin A, Ljungqvist B, Reinmüller B. Single-use surgical clothing system for reduction of airborne bacteria in the operating room. J Hosp Infect. 2013;84(3):245-7. Přejít k původnímu zdroji... Přejít na PubMed...
  12. Tammelin A, Ljungqvist B. Reinmüller B. Comparison of three distinct surgical clothing systems for protection from air-borne bacteria: a prospective observational study. Patient Saf Surg. 2012 Oct 15;6(1):23. doi: 10.1186/1754-9493-6-23. Přejít k původnímu zdroji... Přejít na PubMed...
  13. Ministry of Labour, Health and Social Policies. Operating room safety manual: recommendations and checklist [Internet]. 2009 [cited 2019 Dec 8]. Available from: http://www.salute.gov.it/imgs/C_17_pubblicazioni_1119_allegato.pdf.
  14. Demir F. A survey on prevention of surgical infections in operating theaters. Worldviews Evid Based Nurs. 2009;6(2):102-13. Přejít k původnímu zdroji... Přejít na PubMed...
  15. Geubbels EL, Nagelkerke NJ, Mintjes-De Groot AJ, Vandenbroucke-Grauls CM, Grobbee DE, De Boer AS. Reduced risk of surgical site infections through surveillance in a network. Int J Qual Health Care. 2006;18(2):127-33. Přejít k původnímu zdroji... Přejít na PubMed...
  16. Gastmeier P, Geffers C, Brandt C, Zuschneid I, Sohr D, Schwab F, et al. Effectiveness of a nationwide nosocomial infection surveillance system for reducing nosocomial infections. J Hosp Infect. 2006;64(1):16-22. Přejít k původnímu zdroji... Přejít na PubMed...
  17. Birgand G, Azevedo C, Toupet G, Pissard-Gibollet R, Grandbastien B, Fleury E, et al. Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study. BMJ Open. 2014;4(1):e004274. doi: 10.1136/bmjopen-2013-004274. Přejít k původnímu zdroji... Přejít na PubMed...
  18. Birgand G, Saliou P, Lucet JC. Influence of staff behavior on infectious risk in operating rooms: what is the evidence? Infect Control Hosp Epidemiol. 2015 Jan;36(1):93-106. Přejít k původnímu zdroji... Přejít na PubMed...
  19. Scaltriti S, Cencetti S, Rovesti S, Marchesi I, Bargellini A, Borella P. Risk factors for particulate and microbial contamination of air in operating theatres. J Hosp Infect. 2007;66(4):320-6. Přejít k původnímu zdroji... Přejít na PubMed...
  20. Alwitry A, Jackson E, Chen H, Holden R. The use of surgical facemasks during cataract surgery: is it necessary? Br J Ophthalmol. 2002;86(9):975-7. Přejít k původnímu zdroji... Přejít na PubMed...
  21. McHugh SM, Corrigan MA, Hill ADK, Humphreys H. Surgical attire, practices and their perception in the prevention of surgical site infection. Surgeon. 2014;12(1):47-52. Přejít k původnímu zdroji... Přejít na PubMed...
  22. Baldini A, Blevins K, Del Gaizo D, Enke O, Goswami K, Griffin W, et al. General assembly, prevention, operating room - personnel: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty. 2019 Feb;34(2S):S97-S104. Přejít k původnímu zdroji... Přejít na PubMed...
  23. Teter J, Guajardo I, Al-Rammah T, Rosson G, Perl TM, Manahan M. Assessment of operating room airflow using air particle counts and direct observation of door openings. Am J Infect Control. 2017 May 1;45(5):477-82. Přejít k původnímu zdroji... Přejít na PubMed...
  24. Amirfeyz R, Tasker A, Ali S, Bowker K, Blom A. Theatre shoes - a link in the common pathway of postoperative wound infection? Ann R Coll Surg Engl. 2007;89(6):605-8. Přejít k původnímu zdroji... Přejít na PubMed...
  25. Berríos-Torres SI, Umscheid CA, Bratzler DW, Leas B, Stone EC, Kelz RR, et al.; Healthcare Infection Control Practices Advisory Committee. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017 Aug 1;152(8):784-91. Přejít k původnímu zdroji... Přejít na PubMed...