Methodology for analyzing environmental quality indicators in a dynamic operating room environment

Gormley, Thomas; Markel, Troy A.; Jones, Howard W.; Wagner, Jennifer A.; Greeley, Damon; Clarke, James H.; Abkowitz, Mark; Ostojic, John

doi:10.1016/j.ajic.2016.11.001

Cited by 41 publications

(56 citation statements)

References 4 publications

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“…The EQI method was used to compare the 3 OR air delivery configurations with respect to air velocity, temperature, pressurization, airborne microbial load, CO 2 levels, and airborne particles within the sterile field and outside the sterile zone at the back instrument table. The 1-hour-long scripted surgical procedure, which included realistic movement of the surgical team within the OR, door opening and closing, and staff entering and exiting, was repeated 3 times in each of the 3 ORs, for a total of 9 tests (N = 3 each, for a total of N = 9), as further described in Gormley et al 9 The order of rooms tested was randomized prior to beginning the study.…”

Section: Methodsmentioning

confidence: 99%

“…These 5 people, in addition to 4 surgical nurses and a script timekeeper, performed 1-hour-long simulated surgical procedures as previously described. 9 Study personnel wore standard hospital-issued scrub attire, head covers, surgical masks, and shoe covers and scrubbed for the procedure as per standard procedures.…”

Section: Personnel and Simulated Surgical Proceduresmentioning

confidence: 99%

“…To further explore the applicability of cleanroom design, we compared the performance of 3 different, fully functional, currently used operating theaters with respect to their environmental quality indicators (EQIs) during dynamic, simulated surgical procedures. 9 The OR configured to incorporate cleanroom air delivery concepts, commonly referred to as a single large diffuser (SLD), was compared with an OR configured with a more conventional multidiffuser array (MDA). Both newer ORs were compared with an older OR configured with 4-way throw diffusers (4TDs).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Comparison of operating room air distribution systems using the environmental quality indicator method of dynamic simulated surgical procedures

Wagner¹,

Greeley²,

Gormley

et al. 2019

American Journal of Infection Control

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Section: Methodsmentioning

confidence: 99%

Section: Personnel and Simulated Surgical Proceduresmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Comparison of operating room air distribution systems using the environmental quality indicator method of dynamic simulated surgical procedures

Wagner¹,

Greeley²,

Gormley

et al. 2019

American Journal of Infection Control

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“…Airborne or aerosolized particles, which can carry microorganisms, can be measured using a counter that reports the air-particulate count (APC), using a microbiologic aircollection device that reports colony-forming units (CFUs), and by culturing the air (eg, with agar plates). [6][7][8]10,[20][21][22][23][24][25][26] Microorganisms that researchers have identified in OR air include Staphylococcus aureus, Staphylococcus epidermidis, Bacillus species, and Streptococcus species. 23 Sources for airborne contaminants can be human skin squames, respiratory aerosols, and dust containing microbial particles.…”

Section: Airborne Sources and Control Of Contaminantsmentioning

confidence: 99%

Minimizing Sources of Airborne, Aerosolized, and Contact Contaminants in the OR Environment

Armellino¹

2017

AORN Journal

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Surgical site infections are unintended consequences of surgery that can cause harm to patients and place financial burdens on health care organizations. Extrinsic factors in the OR-including health care providers' behavior and practices that modify air movement, the physical environment, equipment, or surgical instruments-can increase microbial contamination. Microbes can be transported into the surgical incision by airborne or contact routes and contribute to a surgical site infection. Simple practices to prevent infection-such as minimizing airborne particles and contaminants, maintaining equipment according to the manufacturer's recommendations, cleaning and disinfecting the environment and surgical instruments, and performing proper hand hygiene-can reduce the degree of microbial contamination. Perioperative leaders and health care providers can help decrease the patient's risk of surgical site infection with proactive preventive practices that break the chain of infection.

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“…The optimal layout of surgical departments has been widely analyzed from different perspectives, e.g. patient flow [6], [7], efficiency and economics [8]- [11], hygiene [12], patient outcome [13] and equipment [14]. Nevertheless, little attention has been devoted so far to the design of the internal OR layout with respect to OR and instrument tables as well as staff positions.…”

Section: Introductionmentioning

confidence: 99%

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

Neumann

Angrick

Höhn

et al. 2019

Preprint

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Abstract Background The design and internal layout of modern operating rooms are influencing the team’s collaboration and communication, ergonomics, as well as intraoperative hygiene substantially. Nevertheless, there is no objective method for the assessment and design of the personnel and table positions for different surgical disciplines and intervention types available. The aim of this work is to establish an improved OR setup for common procedures in arthroplasty. Methods With the help of computer simulation techniques, a method for the objective design and assessment of enhanced OR setups was developed. In this work, new OR setups were designed, analyzed in a computer simulation environment and evaluated in the actual intraoperative setting. Results The implementation of improved OR setups reduces the instrument handover time between the surgeon and the scrub nurse, the travel paths of the OR team as well as shortens the procedure duration. Additionally, the ergonomics of the OR staff were improved. Conclusion The developed simulation method was intraoperatively evaluated and proved its benefit for the design and optimization of OR setups for different surgical intervention types. As a clinical result, enhanced setups for total knee arthroplasty and total hip arthroplasty surgeries were established in daily clinical routine and the OR efficiency was improved.

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Methodology for analyzing environmental quality indicators in a dynamic operating room environment

Cited by 41 publications

References 4 publications

Comparison of operating room air distribution systems using the environmental quality indicator method of dynamic simulated surgical procedures

Comparison of operating room air distribution systems using the environmental quality indicator method of dynamic simulated surgical procedures

Minimizing Sources of Airborne, Aerosolized, and Contact Contaminants in the OR Environment

Surgical Workflow Simulation for the Design and Assessment of Operating Room Setups in Orthopedic Surgery

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