Archive August 2018 XIX, No. 8

Infection Prevention: Are You Opening the Door to SSIs?

Simple steps to reduce OR foot traffic - a preventable infection risk.

Margaret Thomas

Margaret Thomas, MSN, BS, RN, CNOR


STOP THE POP-IN Even a quick stop into the OR during a procedure increases the risk for infections.

Ever count the number of times the OR doors open during a case? You'd be amazed and alarmed. It could be as many as 40 door openings per hour. In and out, in and out, all case long. Why so much foot traffic during a sterile procedure? When I asked my colleagues, I got all kinds of answers.

Not surprisingly, the most common reason for door openings was to speak to someone in the room (I was guilty of that!) — to ask questions, to check on cases or to process paperwork. Some said they enter and leave for breaks or to relieve someone, while others said they left and came back to retrieve and deliver supplies during a case. Some even used the OR as a shortcut, passing through the room to get to another place in the building or to exit.

We all know that foot traffic in the OR is an infection risk. Door openings disturb the room's airflow, which can increase contamination above the incision. It can take the door as long as 20 seconds to fully close, ample time for bacteria to rush in from areas outside the OR. Here are a few simple steps to reduce foot traffic in and out of the OR — and possibly lower your infection rate.

1Let your fingers do the walking.
You just popped in the OR to ask someone a quick question or to see if they need any help, but those pop-ins aren't always necessary. We now realize that, in many cases, we don't need to talk to someone face-to-face during surgery. We now communicate with them via the phone. The phone is right outside the OR so that the person on it is visible to the OR team through a window. We've posted a list of phone numbers at every phone station, so no one has a reason to give up on using the phone because they don't have the right number. A seemingly obvious step, but one that people don't do because they're focusing more on the amount of time they're in the room rather than the fact that they opened the door to get in there and get out ("I was only in there a few minutes!"). I was guilty of this. Sometimes I'd go into the room to check on the staff or the progress of the case. Now I just pick up the phone and ask if they need anything or any help. It's kind of like Facetiming through the OR window.

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