BACKGROUND: Door openings disrupt the laminar air flow and increase the bacterial count in the operating room (OR). We aimed to define the incidence of door openings in the OR during primary total joint arthroplasty (TJA) surgeries and determine whether measures were needed and/or possible to reduce OR staff traffic. METHODS: We recorded the number of door openings during 100 primary elective TJA surgeries; the OR personnel were unaware of the observer's intention. Operating time was divided into the preincision period, defined as the time from the opening of surgical trays to skin incision, and the postincision period, defined as time from incision to dressing application. RESULTS: The mean number of door openings during primary TJA was 71.1 (range 35-176) with a mean operative time of 111.9 (range 53-220) minutes, for an average of 0.64 (range 0.36-1.05) door openings/min. Nursing staff were responsible for 52.2% of total door openings, followed by anesthesia staff at 23.9% and orthopedic staff at 12.7%. In the preincision period, we observed an average of 0.84 door openings/ min, with nursing and orthopedic personnel responsible for most of the door openings. The postincision period yielded an average of 0.54 door openings/min, with nursing and anesthesia personnel being responsible for most of the door openings. CONCLUSION: There is a high incidence of door openings during TJA. Because we observed a range in the number of door openings per surgery, we believe it is possible to reduce this number during TJA.
BACKGROUND: Door openings disrupt the laminar air flow and increase the bacterial count in the operating room (OR). We aimed to define the incidence of door openings in the OR during primary total joint arthroplasty (TJA) surgeries and determine whether measures were needed and/or possible to reduce OR staff traffic. METHODS: We recorded the number of door openings during 100 primary elective TJA surgeries; the OR personnel were unaware of the observer's intention. Operating time was divided into the preincision period, defined as the time from the opening of surgical trays to skin incision, and the postincision period, defined as time from incision to dressing application. RESULTS: The mean number of door openings during primary TJA was 71.1 (range 35-176) with a mean operative time of 111.9 (range 53-220) minutes, for an average of 0.64 (range 0.36-1.05) door openings/min. Nursing staff were responsible for 52.2% of total door openings, followed by anesthesia staff at 23.9% and orthopedic staff at 12.7%. In the preincision period, we observed an average of 0.84 door openings/ min, with nursing and orthopedic personnel responsible for most of the door openings. The postincision period yielded an average of 0.54 door openings/min, with nursing and anesthesia personnel being responsible for most of the door openings. CONCLUSION: There is a high incidence of door openings during TJA. Because we observed a range in the number of door openings per surgery, we believe it is possible to reduce this number during TJA.
Authors: Eric B Smith; Ibrahim J Raphael; Mitchell G Maltenfort; Sittisak Honsawek; Kyle Dolan; Elizabeth A Younkins Journal: J Arthroplasty Date: 2013-07-25 Impact factor: 4.757
Authors: Raymond J Lynch; Michael J Englesbe; Lisa Sturm; Amira Bitar; Karn Budhiraj; Sandeep Kolla; Yuliya Polyachenko; Mary G Duck; Darrell A Campbell Journal: Am J Med Qual Date: 2009 Jan-Feb Impact factor: 1.852
Authors: Andrea Baldini; Kier Blevins; Daniel Del Gaizo; Oliver Enke; Karan Goswami; William Griffin; Pier Francesco Indelli; Toby Jennison; Eustathios Kenanidis; Paul Manner; Robin Patel; Teija Puhto; Parag Sancheti; Rahul Sharma; Rajeev Sharma; Rjajendra Shetty; Rami Sorial; Naasha Talati; T David Tarity; Kevin Tetsworth; Christos Topalis; Eleftherios Tsiridis; Annette W-Dahl; Matthew Wilson Journal: J Arthroplasty Date: 2018-10-22 Impact factor: 4.757