Abstract
885. Feasibility of Observing Traffic Patterns (FOOT Patter) in Veterans Health Administration Operating Rooms
Open forum infectious diseases, Vol.7(Suppl 1), pp.S478-S478
12/31/2020
DOI: 10.1093/ofid/ofaa439.1073
PMCID: PMC7777442
Appears in Diamond Open Access
Abstract
Background
Surgical site infections (SSIs) complicate nearly 6% of surgeries performed in Veterans Health Administration (VA) hospitals and occur despite adoption of practices known to reduce them. SSIs are associated with prolonged hospitalization and an increased risk of readmission, reoperation and mortality. Operating room (OR) door openings may increase SSI through disruption of desired OR air flow patterns and increased wound microbe counts. Our study objectives were to: 1) develop a methodological approach for collecting data on entry/exit traffic patterns in VA ORs and 2) characterize patterns across different surgery types.
Methods
Trained researchers from 10 VA-Centers for Disease Control and Prevention (CDC) Practice-based Research Network sites observed staff entering and exiting VA ORs. Staff were categorized and identified by role. Exits/entries were recorded on a standardized tracking sheet. Surgery type and observation duration from incision to closure were noted. Mean hourly door openings across procedure and role types were compared via a one-way ANOVA using Stata ver. 15.0.
Results
We observed 56 surgeries on 55 patients (Fig. 1). During 9,801 observation minutes, 766 staff opened doors 3,882 times. Door openings by role differed significantly (p < 0.001) with nurses, perfusionists, anesthesia and vendors having the highest mean door-opening rate. Coronary artery bypass grafts (CABGs) accounted for most door openings and significantly greater surgical duration than other procedures (p=0.012). Time-adjusted OR door opening rate was similar across procedure types at ~22-26 hourly openings (p=0.186).
Figure 1. FOOT Patter results
graphic
Conclusion
The hourly rate of door openings varied notably by staff role. Our data show that measurement of OR movements is feasible although gaining access and approval to observe, achieving ideal observer positioning in complex floor plans, and potential misidentification of entering/exiting staff are challenges of direct methods. Scaling this study up may require automated processes. Studies exploring influences of traffic patterns on OR air quality metrics and impact on risk of SSI, identifying rationale and necessity for door openings and effective strategies for reducing unneeded door openings are needed.
Details
- Title: Subtitle
- 885. Feasibility of Observing Traffic Patterns (FOOT Patter) in Veterans Health Administration Operating Rooms
- Creators
- Tola Ewers - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinBabak Aryanfar - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinMarvin J Bittner - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinErin C Balkenende - Iowa City VA Health Care SystemSuzanne F Bradley - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinMadisen Brown - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinMatthew B Goetz - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinKalpana Gupta - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinChristopher J Hostler - Duke UniversityEli N Perencevich - University of Iowa, General Internal MedicineJudith Strymish - Harvard UniversityGisel Urdaneta - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, WisconsinChristopher J Crnich - , Madison, WI , Los Angeles, California , Omaha, Nebraska , Iowa City, IA , Ann Arbor, Michigan , Jamaica Plain, Massachusetts , Los Angeles, California , West Roxbury, MA , Durham, North Carolina , Iowa city, Iowa , West Roxbury, MA , Miami, Florida , Madison, Wisconsin
- Resource Type
- Abstract
- Publication Details
- Open forum infectious diseases, Vol.7(Suppl 1), pp.S478-S478
- DOI
- 10.1093/ofid/ofaa439.1073
- PMCID
- PMC7777442
- eISSN
- 2328-8957
- Publisher
- Oxford University Press
- Language
- English
- Date published
- 12/31/2020
- Academic Unit
- Epidemiology; General Internal Medicine; Internal Medicine
- Record Identifier
- 9984267976902771
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