Healthcare News & Insights

Opening doors in OR increases infection risks

It’s critical to remind your operating room staff to be mindful of how often they leave the area during surgery. Research shows the risk a patient has for contracting a post-operative infection increases each time the OR door opens. 

ThinkstockPhotos-153637257According to a news release, Johns Hopkins researchers tracked the number of times the door opened during almost 200 hip and knee surgeries at Johns Hopkins Bayview Medical Center in a three-month period.

During almost a third of these procedures, there were enough door openings to potentially cancel out the safety effects of positive pressure systems designed to keep regular, germ-filled air out of the OR.

To find out when the doors were being opened in the OR, the researchers used a sensor system to determine when a door opened, how long it was open, and how it affected air pressure in the OR by comparing it to the pressure in surrounding corridors.

The study, which was published in the journal Orthopedics, found that the doors to the operating room opened on average every two and a half minutes. For each surgery, which lasted about 90 minutes, the door was open for an average of close to 10 minutes.

In all, there were 77 surgeries where the OR door was open long enough to compromise the positive pressure system, allowing contaminated air from outside areas to flow inside.

Reasons & dangers

The researchers observed OR staff secretly, so they couldn’t determine why they exited and entered the OR so often. However, they speculated that excessive door opening could be happening for a number of reasons, such as:

  • Necessary materials or equipment are missing from the operating room before surgery, or
  • Staff members are distracted and stepping away from the patient for personal reasons.

In the surgeries reviewed by researchers, infection risks were inherently low. The surgeries studied (arthoplasties) have traditionally small infection rates. In addition, Johns Hopkins’ infection rates tend to be lower than average for these procedures. (Only one of the surgeries monitored resulted in an infection.)

However, there’s still a significant chance that more high-risk procedures may not be as safe for patients if staff continuously open the door during surgery.

That’s why it’s important to remind surgical staff that the room to the OR should only be opened in case of emergency. Surgeons should double-check all equipment and tools are ready and available before surgery begins.

Once the procedure starts, staff shouldn’t be allowed to come and go freely. If a situation does arise where someone must exit the OR, the person should make sure the door’s only open for a short period of time while leaving.

Bottom line: Excessive door opening in the OR is an easily corrected error that could help your facility lower the chance that patients will contract infections during surgery.

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