Cerrahi Alan Enfeksiyonlarını Önlemede Ameliyathane Trafiği

Yıl 2024, Cilt: 4 Sayı: 3, 115 - 122, 27.12.2024

Fatma Saklı , Meryem Yavuz Van Giersbergen

Öz

Ameliyathane trafiğinin cerrahi alan enfeksiyonlarının (CAE) önlenmesi üzerindeki etkisi iyi anlaşılmamış veya kapsamlı bir şekilde araştırılmamıştır. Bu çalışma, ameliyathane trafiğinin CAE’nın önlenmesine etkisini inceleyen araştırmaları analiz etmeyi ve kanıta dayalı uygulamaları öne çıkarmayı amaçlamaktadır. Ameliyathane trafiği ile CAE önleme arasındaki ilişkiyi araştıran 2019’dan 2024’e kadar yayınlanan çalışmalara odaklanan sistematik bir inceleme yapıldı. Çalışmalar, Mayıs 2024’te PubMed, Ovid ve Science Direct veritabanları taranarak belirlendi. İncelemede 2019 ile 2024 yılları arasında yayınlanan sekiz ilgili çalışma belirlendi. Bunlar arasında dört ileriye dönük çalışma, bir ileriye dönük randomize olmayan karşılaştırmalı çalışma, bir deneysel çalışma, bir sistematik inceleme ve bir ön test/son test çalışması yer alıyordu. Ameliyathane trafiğinin artması ve kapıların sık sık açılması, daha yüksek cerrahi alan enfeksiyonu riskiyle ilişkilidir. Kapsamlı bir ameliyat öncesi hazırlık, kısıtlayıcı işaretlerin asılması ve ameliyathane personeline eğitim sağlanması gibi ameliyathane trafiğini kısıtlamaya yönelik önlemlerin uygulanması, trafik oranlarını iyileştirebilir ve potansiyel olarak CAE risklerini azaltabilir. Bu önlemler özellikle ortopedik implant ameliyatlarında enfeksiyon risklerini azaltmak açısından önemlidir.

Anahtar Kelimeler

Ameliyathaneler, Cerrahi hemşireliği, Cerrahi yara enfeksiyonu, Hasta güvenliği

Etik Beyan

Bu çalışmanın hazırlanma sürecinde bilimsel ve etik ilkelere, Helsinki Bildirgesi’ndeki araştırma ilkelerine bağlı kalındığı ve yararlanılan tüm çalışmaların kaynakçada belirtilmiştir.

Destekleyen Kurum

Destekleyen kurum yoktur.

Operating Room Traffic in Prevention of Surgical Site Infections

Öz

The impact of operating room traffic on the prevention of surgical site infections (SSIs) is not well understood or extensively studied. This study aims to analyze research examining the effect of operating room traffic on SSI prevention and to highlight evidence-based practices. A systematic review was conducted, focusing on studies published from 2019 to 2024 that investigate the relationship between operating room traffic and SSI prevention. The studies were identified by searching PubMed, Ovid and Science Direct databases in May 2024. The review identified eight relevant studies published between 2019 and 2024. These included four prospective studies, one prospective non-randomized comparative study, one experimental study, one systematic review and one pre-test/post-test study. Increased operating room traffic and frequent door openings are associated with a higher risk of surgical site infections. Implementing measures to restrict operating room traffic, such as thorough preoperative preparation, hanging restrictive signs, and providing training for operating room staff, can improve traffic rates and potentially reduce SSI risks. These measures are particularly important in orthopedic implant surgeries to mitigate infection risks.

Anahtar Kelimeler

Operatin rooms, Surgical nursing, Surgical wound infection, Patient safety

Kaynakça

• Birgand G, Azevedo C, Rukly S, et al. Motion-capture system to assess intraoperative staff movements and door openings: Impact on surrogates of the infectious risk in surgery. Infect Control Hosp Epidemiol. 2019;40(5):566-573.
• Berríos-Torres SI, Umscheid CA, Bratzler DW, et al. Centers for Disease Control and Prevention guideline for the prevention of surgical site infection, 2017. JAMA Surg. 2017;152:784–791.
• Buckner L, Lacy J, Young K, Dishman D. Decreasing foot traffic in the orthopedic operating room: A narrative review of the literature. J Patient Saf. 2022;18(2):414-423.
• Centers for Disease Control and Prevention. Surgical site infection (SSI) event. 2024. https://www.cdc.gov/nhsn/pdfs/pscmanual/9pscssicurrent.pdf. Erişim tarihi: 27.05.2024
• World Health Organization. Global guidelines for the prevention of surgical site infection, 2nd ed.. 2018. https://iris.who.int/handle/10665/277399. Erişim tarihi: 27.05.2024.
• Parent M. Operating room traffic and surgical site infections: A quality improvement project. AORN J. 2021 113 (4): 379-388.
• DiBartola AC, Barron C, Smith S, et al. Decreasing room traffic in orthopedic surgery: A quality ımprovement ınitiative. Am J Med Qual. 2019;34(6):561-568.
• Osborn NS, Hoehmann CL, McCormack R, Owens J. Operating room traffic in total joint arthroplasty: One simple measure toward solving a complex problem. JB JS Open Access. 2020;5(3):1-4.
• Sunagawa S, Koseki H, Noguchi C, et al. Airborne particle dispersion around the feet of surgical staff while walking in and out of a bio-clean operating theatre. J Hosp Infect. 2020;106(2):318-324.
• Patel PG, DiBartola AC, Phieffer LS, et al. Room traffic in orthopedic surgery: A prospective clinical observational study of time of day. J Patient Saf. 2021;17(3):241-246.
• Shahroudi P, Aarabi A. Quality improvement through lean A3 method for foot traffic in operating room. Perioperative Care and Operating Room Management. 2021; 23 (100155):1-8.
• Erivan R, Villatte G, Haverlan A, et al. Does a sign restricting operating room access reduce staff traffic in the surgical department? Orthop Traumatol Surg Res. 2024;21:103843.
• Schafer M, Dixon H, Palladino K, et al. Automated traffic monitoring of neurosurgical operating room. Am J Infect Control. 2024; 52(6):630-634.
• Centre of Health Protection. Recommendations on prevention of surgical site infection. Scientific Committee on Infection Control, and Infection Control Branch, Centre for Health Protection, Department of Health. 2nd Edition. Hong Kong, 2017. https://www.chp.gov.hk/files/pdf/. Erişim tarihi: 27.05.2024.
• The Canadian Patient Safety Institute. Prevent surgical site infections. Getting started kit. Safer Healthcare Now. 2014. Erişim tarihi: 04.01.2021.
• Ling ML, Apisarnthanarak A, Abbas A, et al. APSIC guidelines for the prevention of surgical site infections. 2019, 1-55. htpp://apsic-apac.org/guidelines-and-resources/apsic-guidelines/ Erişim: 27.05.2024
• Association of Surgical Technologists. Guidelines for best practices for establishing the sterile field in the operating room. 2019. https://www.ast.org/uploadedFiles/Main_Site/Content/About_Us/Guidelines%20Establishing%20the%20Sterile%20Field.pdf. Erişim tarihi: 27.05.2024
• National Institute for Health and Care Excellence. Surgical site infections: Prevention and treatment. 2020. https://www.ncbi.nlm.nih.gov/books/NBK542473. Erişim tarihi: 27.05.2024.
• Anderson DJ, Podgorny K, Berríos-Torres SI, et al. Strategies to prevent surgical site infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol. 2014;35 Suppl 2:66-88.
• Calderwood MS, Anderson DJ, Bratzler DW, et al. Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update. Infection Control & Hospital Epidemiology. 2023;44(5):695-720.
• Humphreys H, Bak A, Ridgway E, et al. Rituals and behaviours in the operating theatre - joint guidelines of the Healthcare Infection Society and the European Society of Clinical Microbiology and Infectious Diseases. J Hosp Infect. 2023;140:165.e1-165.e28.