The Case for Using Evidence-Based Guidelines in Setting Hospital and Public Health Policy

Abstract

ObjectiveHospital systems and regulating agencies enforce strict guidelines barring personal items from entering the operating room (OR) – touting surgical site infections (SSIs) and patient safety as the rationale. We sought to determine whether or not evidence supporting this recommendation exists by reviewing available literature.Background dataRules and guidelines that are not evidence based may lead to increased hospital expenses and limitations on healthcare provider autonomy.MethodsPubMed, Embase, Scopus, Cochrane Library, Web of Science, and CINAHL were searched in order to find articles that correlated personal items in the OR to documented SSIs. Articles that satisfied the following criteria were included: (1) studies looking at personal items in the OR, such as handbags, purses, badges, pagers, backpacks, jewelry phones, and eyeglasses, but not just OR equipment; and (2) the primary outcome measure was infection at the surgical site.ResultsSeventeen articles met inclusion criteria and were evaluated. Of the 17, the majority did not determine if personal items increased risk for SSIs. Only one article examined the correlation between a personal item near the operative site and SSI, concluding that wedding rings worn in the OR had no impact on SSIs. Most studies examined colonization rates on personal items as potential infection risk; however, no personal items were causally linked to SSI in any of these studies.ConclusionThere is no objective evidence to suggest that personal items in the OR increase risk for SSIs.

Bacterial Pathogens Associated With Eyeglasses and Risks of Infection among Staff and Students of a Private University in South–West Nigeria

“…Daily, whether in the market, schools, churches, the comfort of our homes, or even in our offices, we are unknowingly exposed to many pathogens [5]. Unfortunately, many frequently used devices, such as eyeglasses and contact lenses, are rarely sterilized or kept clean, which increases the likelihood of bacterial contamination and colonization [6,7].…”

The Association between Hand Disinfection Techniques and Their Barriers, as Well as the “Bare below the Elbows” Concept, among Healthcare Professionals—A Study Based on a Polish Population

“…This may be connected to the implementation of regulations and solid experimental and epidemiological data in medical practice. It is more likely that medical staff adopts guidelines if they are based on evidence-based medicine and expert opinions [ 20 ]. Moreover, our publication shows that hand disinfection was performed best among surgical department personnel, especially operating theatre staff.…”

Isolation and identification of bacterial isolates associated with spectacle lens surface

“…Ocular infections are common [3,4] and have been associated with microbial contamination of contact lenses and eyeglasses [5,6]. Many frequently used devices, such as eyeglasses and contact lenses, are rarely sterilized or kept clean, which increases the likelihood of bacterial contamination and colonization [7,8]. Significant number of people wear eyeglasses for functional or purely cosmetic reasons [9].…”