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Observation of Neurosurgical Operating Room Door Traffic to Establish Baseline for Intraoperative Prevention of Surgical Site Infections

Schafer, Mathea (2023) Observation of Neurosurgical Operating Room Door Traffic to Establish Baseline for Intraoperative Prevention of Surgical Site Infections. Master's Thesis, University of Pittsburgh. (Unpublished)

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Background: Surgical site infections (SSIs) are healthcare-associated infections that cause increased morbidity and mortality. Operating room (OR) traffic disrupts airflow and increases the particle counts in the surgical field. Increasing particle counts in the surgical field are correlated with increased incidence of SSIs. To evaluate OR traffic, this study aimed to (1) evaluate two different methods of observation; (2) identify behaviors of staff related to OR traffic and infection control intraoperatively; and (3) interview OR staff to understand their perceptions about OR traffic.

Methods: OR traffic was observed through direct observation by the researcher and indirect observation through a sensor. Three surgeons performed the 107 observed neurosurgeries. Direct observation recorded the number of people and times the door opened as well as why staff entered/exited. Indirect observations recorded the number of people entering/exiting per hour on a larger scale. Short interviews with multiple types of staff were performed to determine reasons for entering/exiting the OR, how often they and all staff entered/exited the OR, and their recommendations to reduce OR traffic.

Results: Direct observation resulted in the OR door opening 18.1 times per hour, with 20.2 people entering/exiting per hour. Going to get supplies, performing hand hygiene, or having a clearly observable task made up 39% of the reasons the door was opened while a procedure was taking place. The remaining 61% of the reasons were not observable. The indirect observations resulted in an average of 31.4 people entering/exiting the OR per hour. The procedure length was significantly associated with the number of people entering/exiting the OR per hour (p-value <0.0001). Interviews with staff revealed that most believed 1-6 people entered/exited per hour. Most staff were shocked to hear the OR traffic averaged 31 people per hour.

Conclusions: OR traffic is higher than the staff expected, and processes should be implemented to reduce the number of times the OR door opens. Implementing simple practices such as using the phone for updates during the procedure and staff education can reduce the OR traffic and control for at least one factor in SSIs.


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Item Type: University of Pittsburgh ETD
Status: Unpublished
CreatorsEmailPitt UsernameORCID
Schafer, Matheamatheaschafer@pitt.edumas975
ETD Committee:
TitleMemberEmail AddressPitt UsernameORCID
Committee ChairYassin,
Committee MemberMartinson, Jeremyjmartins@pitt.edujmartins
Committee MemberBaumann, Sarasarabaumann@pitt.edusarabaumann
Date: 15 May 2023
Date Type: Publication
Defense Date: 21 April 2023
Approval Date: 15 May 2023
Submission Date: 27 April 2023
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Number of Pages: 58
Institution: University of Pittsburgh
Schools and Programs: School of Public Health > Infectious Diseases and Microbiology
Degree: MPH - Master of Public Health
Thesis Type: Master's Thesis
Refereed: Yes
Uncontrolled Keywords: surgical site infections, OR traffic, door traffic, infection prevention
Date Deposited: 15 May 2023 22:38
Last Modified: 15 May 2023 22:38


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