Most of the operating rooms in U.S. hospitals are equipped with atmospheric pressure systems that prevent potentially contaminated airflow from entering the operating space. New research suggests too much foot traffic in and out of ORs can overburden these systems, running the risk of increased infections during surgery.
Johns Hopkins investigators tracked the number and length of door openings during nearly 200 orthopedic surgeries at the Bayview Medical Center in over three months and found enough door openings in almost one-third of the procedures to potentially overpower the safety effects of the pressure systems. In these instances, the systems would've been unable to efficiently keep contaminated airflow out of the OR.
"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," Stephen Belkoff, PhD, an associate professor in the Johns Hopkins University School of Medicine's department of orthopedic surgery and senior author of the study, said in a statement.
A handful of door openings during surgeries are necessary and unavoidable, but researchers should take steps to mitigate the unnecessary foot traffic, Dr. Belkoff said. Part of the solution could be as simple better planning before beginning the procedure. However, an excessive of door openings and foot traffic could also signal distraction among OR staff or personnel inefficiencies. There could be factors at play in each instance that need individual attention.
While this study did confirm excessive foot traffic during surgeries, the authors concluded infection rates are so slow for orthopedic procedures there is no strong link between the impaired atmospheric pressure systems and infection rates.