Important interventions in the operating room to prevent bacterial contamination and surgical site infections

Ann-Sofie Sundqvist,Camilla Wistrand,Karin Falk-Brynhildsen

doi:10.1016/j.ajic.2021.12.021

Ann-Sofie Sundqvist, Camilla Wistrand + Show 1 more

Open Access

https://doi.org/10.1016/j.ajic.2021.12.021

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Abstract

The aim of this study was to explore interventions that Swedish operating room (OR) nurses considered important for the prevention of bacterial contamination and surgical site infections (SSIs). A web-based cross-sectional survey with an open-ended question was answered by OR nurses and analyzed using summative content analysis and descriptive statistics. The OR nurses (n=890) worked within 11 surgical specialties and most of them worked at university hospitals (37%) or county hospitals (53%). The nurses described twelve important interventions to prevent bacterial contamination and SSI: skin disinfection (25.9%), the OR environment (18.2%), aseptic technique (16.4%), OR clothes (13.4%), draping (9.8%), preparation (6.1%), dressing (3.6%), basic hygiene (3.4%), normothermia (2.1%), communication (0.7%), knowledge (0.3%), and work strategies (0.2%). Skin disinfection was considered the most important intervention in order to prevent bacterial contamination and SSI. The responses indicated that many OR nurses believed the patients' skin to be sterile after the skin disinfection process. This is not a certainty, but skin disinfection does significantly decrease the amount of bacterial growth. This study shows that many OR nurses' interventions are in line with recommendations. Although, knowledge regarding the effect of skin disinfection needs further research, and continued education.

Highlights

The aim of this study was to explore interventions that Swedish operating room (OR) nurses considered important for the prevention of bacterial contamination and surgical site infections (SSIs)
The nurses represented more than eleven different surgical specialties including orthopedic, thoracic, vascular, and general surgery (Table 1)
The 3 categories of interventions mentioned most frequently when the nurses described what they considered important to prevent bacterial contamination and SSI were skin disinfection (25.9%), the OR environment (18.2%), and aseptic technique (16.4%)

Summary

Introduction

The aim of this study was to explore interventions that Swedish operating room (OR) nurses considered important for the prevention of bacterial contamination and surgical site infections (SSIs). The nurses described twelve important interventions to prevent bacterial contamination and SSI: skin disinfection (25.9%), the OR environment (18.2%), aseptic technique (16.4%), OR clothes (13.4%), draping (9.8%), preparation (6.1%), dressing (3.6%), basic hygiene (3.4%), normothermia (2.1%), communication (0.7%), knowledge (0.3%), and work strategies (0.2%). Discussion: Skin disinfection was considered the most important intervention in order to prevent bacterial contamination and SSI. Patient safety and prevention of surgical site infections (SSIs) are of international concern.[1,2] Swedish law (SFS:2017:30) states that patients should be given health care with good standards on equal terms.[3] The clinical work in Swedish operating rooms (ORs) is designed to have high hygiene standards[4] in order to prevent bacterial contamination. The private healthcare sector is relatively small, consisting of 6 hospitals.[6]

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