1
|
Novel Designed Surgical Drapes Reducing Fluid Permeability in the Surgical Critical Area of a Sterile Operation Interface: A Randomized Controlled Trial. J Nurs Manag 2023. [DOI: 10.1155/2023/9295307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Aim. To compare the impact and cost effects of medical long fiber polyester drapes and cotton fabric drapes on operative sterile operation interfaces. Background. The comparison of the properties of the commonly used surgical drapes materials in terms of leakage, device slip, and prevention of intraoperative adverse events is not clear. Method. A prospective randomized controlled study was conducted in the operating room of a tertiary hospital in Chengdu, China. A total of 400 patients who underwent urology surgery were enrolled and randomly divided into two groups by computer, the study group (200 cases) selected the new long-fiber polyester cloth, while the control group (200 cases) selected conventional cotton fabric surgical drapes during the operation to maintain a sterile operating interface. The impermeability and water absorption of surgical drapes, the rate of device slip and skin scald in surgical patients, and the cost effect of the two kinds of surgical drapes were compared. Results. The long fiber polyester surgical drapes were superior to conventional cotton cloth in water absorption (g/m2) (835 ± 15.8 VS 225 ± 21.0, t = 328.261,
), preventing surgical site infections (2.5% VS 8.0%, χ2 = 6.081,
), device slip (7.5% VS 17.0%, χ2 = 8.396,
), patients from burning (0 VS 1, Fisher
), and total cost per use ($) (0.83 VS 0.96–1.09). Conclusion. Long fiber polyester fabric has a stronger antipenetration ability of fluid and microorganisms thus forming an effective protective barrier. It also has strong hygroscopicity, and its special design can prevent the occurrence of sliding of surface instruments and skin scald in patients. In addition, its cost effect is superior. Implications for Nursing Management. Operating room nursing managers can introduce long fiber polyester drapes into the selection of medical textiles to construct aseptic surgical barriers and prevent surgical site infection.
Collapse
|
2
|
Pandemic Operating Room Supply Shortage and Surgical Site Infection: Considerations as We Emerge from the Coronavirus Disease 2019 Pandemic. J Am Coll Surg 2022; 234:571-578. [PMID: 35290277 DOI: 10.1097/xcs.0000000000000087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic created shortages of operating room (OR) supplies, forcing healthcare systems to make concessions regarding "standard" OR attire. At our institution, we were required to reduce shoe covers, reuse face masks, and allow washable head coverings. We determined if these changes affected surgical site infection (SSI) rates. STUDY DESIGN A single institutional study was performed to compare the SSI rates reported to the National Healthcare Safety Network in the 2 years preceding COVID-19 (PRE, January 1, 2018, to December 31, 2020) with the first 12 months after the pandemic (POST, April 1, 2020, to March 31, 2021). We confirmed our findings using propensity score matching and multivariate analysis. RESULTS Elimination of traditional shoe covers, disposable head covers, and single-use face masks was associated with a decreased SSI rate from 5.1% PRE to 2.6% POST (p < 0.001). Furthermore, this was despite a 14% increase in surgical volume and an increase in the number of contaminated/dirty cases (2.2% PRE vs 7.4% POST, p < 0.001). Use of disposable face masks decreased by 4.3-fold during this period from 3.5 million/y PRE to 0.8 million/y POST. Of note, inpatient hand hygiene throughout the hospital increased from 71% PRE to 85% POST (p < 0.001). CONCLUSIONS This analysis has practical applications as we emerge from the pandemic and make decisions regarding OR attire. These data suggest that disposable head covers and shoe covers and frequent changes of face masks are unnecessary, and discontinuation of these practices will have significant cost and environmental implications. These data also reinforce the importance of good hand hygiene for infection prevention.
Collapse
|
3
|
Svetanoff WJ, St Peter SD. Debunking the Myth on Surgical Site Infection: In Reply to Spruce. J Am Coll Surg 2021; 233:159-161. [PMID: 34006433 DOI: 10.1016/j.jamcollsurg.2021.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 04/06/2021] [Indexed: 10/21/2022]
|
4
|
Svetanoff WJ, Dekonenko C, Briggs KB, Sujka JA, Osuchukwu O, Dorman RM, Oyetunji TA, St Peter SD. Debunking the Myth: What You Really Need to Know about Clothing, Electronic Devices, and Surgical Site Infection. J Am Coll Surg 2021; 232:320-331.e7. [PMID: 33453379 DOI: 10.1016/j.jamcollsurg.2020.11.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Wendy Jo Svetanoff
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO
| | - Charlene Dekonenko
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO
| | - Kayla B Briggs
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO
| | - Joseph A Sujka
- Department of General Surgery, Tampa General Hospital, Tampa, FL
| | - Obiyo Osuchukwu
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO
| | - Robert M Dorman
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO; Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH
| | - Tolulope A Oyetunji
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO; University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO
| | - Shawn D St Peter
- Department of General and Thoracic Surgery, Children's Mercy Hospital, Kansas City, MO; University of Missouri-Kansas City (UMKC) School of Medicine, Kansas City, MO.
| |
Collapse
|
5
|
Williams G, Grewal N, Wegner R, Contreras D, Patterson V. Regulations Regarding Operating Room Head Attire Appear Discordant With Literature. Clin Infect Dis 2019; 67:1470-1471. [PMID: 29846558 DOI: 10.1093/cid/ciy366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- George Williams
- Division of Critical Care Medicine, Department of Anesthesiology, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston
| | - Navneet Grewal
- Division of Critical Care Medicine, Department of Anesthesiology, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston
| | - Robert Wegner
- Division of Critical Care Medicine, Department of Anesthesiology, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston
| | - Daniel Contreras
- Division of Critical Care Medicine, Department of Anesthesiology, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston
| | - Velvet Patterson
- Division of Critical Care Medicine, Department of Anesthesiology, University of Texas Health Science Center at Houston (UTHealth), McGovern Medical School, Houston
| |
Collapse
|
6
|
Routine Disinfection of Mobile Communication Devices in the Postanesthesia Care Unit. J Perianesth Nurs 2019; 34:1176-1180. [PMID: 31255438 DOI: 10.1016/j.jopan.2019.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 03/14/2019] [Accepted: 03/23/2019] [Indexed: 11/22/2022]
Abstract
PURPOSE Explore the effect of routine disinfection of mobile communication devices (MCDs) in postanesthesia care unit (PACU). DESIGN Experimental, repeated measures design. METHODS At a 247-bed, 20-bed PACU hospital, Mid-Atlantic region, United States, mean baseline bacterial adenosine triphosphate (ATP) counts of six MCDs were established with 3M Clean-Trace Luminometer. MCDs were routinely disinfected with CaviWipes for 10 days, every 12 hours. Mean bacterial ATP counts on six MCDs were repeated at day 11 and month 36. FINDINGS For six MCDs, baseline ATP counts identified Failure for cleanliness. Postroutine disinfection bacterial ATP counts identified Caution and Passing; 36-month bacterial ATP counts identified sustained Passing for cleanliness. CONCLUSIONS Routine disinfection of MCDs in the PACU defined by time and method, obtains, and sustains Passing level of cleanliness. Staff nurses identified trigger, researched practice, changed practice, and implemented quality improvement follow-up.
Collapse
|
7
|
Baldini A, Blevins K, Del Gaizo D, Enke O, Goswami K, Griffin W, Indelli PF, Jennison T, Kenanidis E, Manner P, Patel R, Puhto T, Sancheti P, Sharma R, Sharma R, Shetty R, Sorial R, Talati N, Tarity TD, Tetsworth K, Topalis C, Tsiridis E, W-Dahl A, Wilson M. General Assembly, Prevention, Operating Room - Personnel: Proceedings of International Consensus on Orthopedic Infections. J Arthroplasty 2019; 34:S97-S104. [PMID: 30360975 PMCID: PMC7111314 DOI: 10.1016/j.arth.2018.09.059] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
|
8
|
Operating Room Attire Policy and Healthcare Cost: Favoring Evidence over Action for Prevention of Surgical Site Infections. J Am Coll Surg 2019; 228:98-106. [DOI: 10.1016/j.jamcollsurg.2018.06.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 06/22/2018] [Accepted: 06/22/2018] [Indexed: 12/13/2022]
|
9
|
Gologorsky Y. Bouffant Versus Skull Cap: Does Operating Room Headwear Really Matter? World Neurosurg 2018; 119:437. [PMID: 30205214 DOI: 10.1016/j.wneu.2018.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Yakov Gologorsky
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
10
|
Kothari SN, Anderson MJ, Borgert AJ, Kallies KJ, Kowalski TJ. Bouffant vs Skull Cap and Impact on Surgical Site Infection: Does Operating Room Headwear Really Matter? J Am Coll Surg 2018; 227:198-202. [PMID: 29733905 DOI: 10.1016/j.jamcollsurg.2018.04.029] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Revised: 04/16/2018] [Accepted: 04/16/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND The American College of Surgeons guidelines indicate that skull caps are acceptable, and the Association of Perioperative Registered Nurses recommends bouffant caps. However, no scientific evidence has shown a significant advantage in surgical site infection (SSI) reduction with either cap. The objective of this study was to determine the influence of surgical cap choice on SSIs. STUDY DESIGN Data from a previously published prospective randomized trial on the impact of hair clipping on SSIs were analyzed. Patients were grouped by the attending surgeons' preferred cap choice into either bouffant or skull cap groups. RESULTS Overall, 1,543 patients were included in the trial. Attending surgeons wore bouffant caps in 39% and skull caps in 61% of cases. Prevalence of diabetes and tobacco use were similar between the groups. Bouffant caps were used in 71% of colon/intestinal cases, 42% of hernia/other cases, 40% of biliary cases, and only 1% of foregut cases. Overall, SSIs occurred in 8% and 5% of cases with a bouffant and skull cap, respectively (p = 0.016); with 6% vs 4% classified as superficial (p = 0.041), 0.8% vs 0.2% classified as deep (p = 0.12), and 1% vs 0.9% classified as organ space (p = 0.79); however, when adjusting for the type of operation, no significant differences in SSI rates were observed for skull caps vs bouffant caps. CONCLUSIONS Attending surgeon preference for bouffant vs skull cap does not significantly impact SSI rates after accounting for surgical procedure type. Future guidelines should consider these clinical outcomes data and surgeon preference should dictate operating room headwear.
Collapse
Affiliation(s)
- Shanu N Kothari
- Department of General Surgery, Gundersen Health System, La Crosse, WI.
| | | | - Andrew J Borgert
- Department of Medical Research, Gundersen Health System, La Crosse, WI
| | - Kara J Kallies
- Department of Medical Research, Gundersen Health System, La Crosse, WI
| | - Todd J Kowalski
- Department of Infectious Diseases, Gundersen Health System, La Crosse, WI
| |
Collapse
|
11
|
Farach SM, Kelly KN, Farkas RL, Ruan DT, Matroniano A, Linehan DC, Moalem J. Have Recent Modifications of Operating Room Attire Policies Decreased Surgical Site Infections? An American College of Surgeons NSQIP Review of 6,517 Patients. J Am Coll Surg 2018; 226:804-813. [DOI: 10.1016/j.jamcollsurg.2018.01.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/04/2018] [Accepted: 01/05/2018] [Indexed: 01/23/2023]
|
12
|
Shallwani H, Shakir HJ, Aldridge AM, Donovan MT, Levy EI, Gibbons KJ. Mandatory Change From Surgical Skull Caps to Bouffant Caps Among Operating Room Personnel Does Not Reduce Surgical Site Infections in Class I Surgical Cases: A Single-Center Experience With More Than 15 000 Patients. Neurosurgery 2017; 82:548-554. [DOI: 10.1093/neuros/nyx211] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/28/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Hussain Shallwani
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sci-ences, University at Buffalo, State Univ-ersity of New York, Buffalo, New York
- Department of Neurosurgery/Gates Vas-cular Institute, Buffalo General Medical Center, Kaleida Health, Buffalo, New York
| | - Hakeem J Shakir
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sci-ences, University at Buffalo, State Univ-ersity of New York, Buffalo, New York
- Department of Neurosurgery/Gates Vas-cular Institute, Buffalo General Medical Center, Kaleida Health, Buffalo, New York
| | - Ashley M Aldridge
- Department of Neurosurgery/Gates Vas-cular Institute, Buffalo General Medical Center, Kaleida Health, Buffalo, New York
| | - Maureen T Donovan
- Department of Neurosurgery/Gates Vas-cular Institute, Buffalo General Medical Center, Kaleida Health, Buffalo, New York
| | - Elad I Levy
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sci-ences, University at Buffalo, State Univ-ersity of New York, Buffalo, New York
- Department of Neurosurgery/Gates Vas-cular Institute, Buffalo General Medical Center, Kaleida Health, Buffalo, New York
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
- Toshiba Stroke and Vascular Research Center, University at Buffalo, State University of New York, Buffalo, New York
| | - Kevin J Gibbons
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sci-ences, University at Buffalo, State Univ-ersity of New York, Buffalo, New York
- Department of Neurosurgery/Gates Vas-cular Institute, Buffalo General Medical Center, Kaleida Health, Buffalo, New York
- Department of Radiology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, State University of New York, Buffalo, New York
| |
Collapse
|