Analysis of Air Purification Methods in Operating Rooms of Chinese Hospitals

Current Status and Factors Associated with Clean Operating Rooms: A Survey of Hospitals in China

Background

Indoor air quality is controlled in the clean operating room (OR) to reduce the risk of surgical-site infections (SSIs). The aim of this study is to assess the usage and management of clean ORs in China and to identify factors associated with the risk of SSIs.

Methods

An online survey was distributed to hospitals in China from August 5 to September 5, 2018 via the WeChat account of the Shanghai International Forum for Infection Control and Prevention. The questionnaire consisted of two parts: basic information (hospital type, level, and number of beds) and usage and management (number of ORs, usage time, maintenance mode, test frequency, compliance with current standards, and comfort of healthcare workers). The significance of factors associated with the cleanliness and maintenance of clean ORs was assessed by univariate and multivariate logistic regression analyses.

Results

Among 1,308 responding hospitals, 25.7% failed to comply with current standards. “Maintenance mode” had a significant effect on compliance with current standards for clean ORs (p < 0.0001) and “professional” maintenance was superior to “outsource or no” maintenance (odds ratio = 0.511, 95% confidence interval = 0.367–0.711). There was a significant difference in the comfort of healthcare workers in clean ORs that complied with current standards vs. those that did not (39.92% [388/972] vs. 64.28% [216/336], respectively, p < 0.0001). Humidity was the chief complaint among healthcare workers.

Conclusion

Maintenance of clean ORs was significantly associated with the compliance of current standards. Noncompliance with current standards was associated with greater risks of SSIs. Maintenance of ORs for prevention of SSIs should consider the costs and benefits.

Organizing a safe operating room during a pandemic. What did we learn from COVID-19?

During the COVID-19 pandemic, multiple guidelines have been issued on hospital safety and protection measures to prevent transmission to healthcare workers and to other patients. The operating room is a high-risk environment where enhanced precautions are required. The guidelines differ and practical implementation between hospitals can also vary, according to interpretation and budget. Staff at risk may question if the local policies are sufficient and correct. This article provides an overview and theoretical background to the additional safety measures required in the operating room during a viral pandemic like the COVID-19 pandemic. This may serve as a touchstone and tool for anesthetists and OR managers.