OPERATING ROOM Perioperative protection
Maintaining a sterile fi eld guards patients, staff from infections by Ebony Smith
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any factors contribute to the onset of surgical site infections (SSIs) and other healthcare-associated infections (HAIs) while patients are in the operating room, recovery and treatment during hospital stays. Patients are highly susceptible to these infections by nature of this critical care, types of procedures and sterility of equipment, their health status, as well as the surfaces, people and environ- ments around them.
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“Truth be told, every hospitalized patient is at risk of acquiring an SSI or HAI simply by receiving medical care or undergoing sur- gery, and those risks are well documented,” expressed Eric Jungslager, Vice President of Healthcare, GP PRO. “Some of that risk stems from the patient — their age and gender, their tobacco use, their weight or if they have a pre-existing medical condition like diabetes.”
He continued, “Some of that risk is more application-based — the surgical technique that’s used, whether or not catheters are used, and the patient’s length of stay. Of course, there are environmental risks, such as the cleanliness of surfaces, the quality of air fi ltration and the effi cacy of water management systems. And there are risks associated with human contact from both healthcare practitioners and patient visitors — having unclean hands, wearing non- sterile gowns or gloves or failing to wear a mask.”
These infections happen frequently and are life-threatening.
“Infection at the surgical site remains the second most common adverse event occur- ring to hospitalized patients and a major source of morbidity following surgical pro- cedures,” indicated Shawn Malek, Sales and Marketing Manager, Far UV Technologies, Inc. “Infections are more likely to occur after surgery on parts of the body that harbor lots of germs (or are susceptible to cross- contamination). Surgical site infections have been shown to increase mortality, readmis- sion rate, length of stay and cost for patients who incur them.”
According to Deva Rea, MPH, BSN, BS, CIC, PDI Healthcare, “Some potential pro- cedural-, environmental-, and pathogen- related risk factors would be: • Emergent/complex procedure • Preexisting infection/colonization • Hair removal method
• Skin prep/nasal decolonization
• Antibiotic prophylaxis (timing, choice, dosing)
• Glycemic control • Blood transfusion
• Aseptic technique/surgical scrub/ glov- ing
• Skill/technique • Duration of surgery
• OR ventilation, traffic, equipment/ surfaces.”¹
She added, “Risk factors that are poten-
tially able to be modifi ed are diabetes glucose control, obesity (BMI >30), smok- ing, malnutrition and immunosuppres- sive medications. Unmodifi able patient risk factors include advanced age, recent radiotherapy and history of SSI/ skin infection.”
Repelling infectious agents Pathogens exist throughout hospitals and healthcare facilities and pose a threat to patients and staff.
“The perioperative environment is an area of high risk for cross-contamination,” emphasized Dana Goossen, MSN, RN, Senior Clinical Consultant, Northeast Region, Ansell Healthcare. “Inadequate cleaning and room turnover procedures put patients and healthcare workers at risk of injury, healthcare-associated infec- tions (HAIs) and surgical site infections (SSIs). The lack of barrier protection in reusable linens exposes patients, increas- ing the risk for HAIs and SSIs. In addition, there are growing concerns regarding airborne particles and the role it plays in the development of SSIs. Efforts should be taken to reduce debris and particulate in the OR by evaluating materials with lower lint levels.2
14 June 2021 • HEALTHCARE PURCHASING NEWS •
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Protective barriers on patient beds can help improve patient care and safety, notes Bruce Rippe, CEO, Trinity Guardion, Inc. “Mattresses are the #2 caregiver touch point in a patient room and a recent SHEA presentation demonstrates 72% of hospital mattresses are not safe, making them a sig- nifi cant patient safety concern. Mattresses routinely come into contact with non- intact patient skin and clinically relevant fluids requiring mid–level disinfection. Contaminated mattresses offer a bevy of transmission modes, such as through the hands of caregivers or wounds from surgi- cal incisions, pressure ulcers, burns, etc.,” he indicated. “Research continues to show that mattresses play a major role in infec- tion risk, a problem that must be addressed to protect patients.”
See webinar: 3 Cleaning and Disinfecting Mistakes that Put Patients at Risk at https://
hpnonline.com/21147507. Patrick Kammer, Managing Director/ CEO, C Change Surgical, adds, “Disruption of sterile barriers can result in contamina- tion. Clinicians have long reported that a single layer of plastic for making sterile ice is not always suffi cient.”
Further, Don Lowe, Spokesperson,
ProTEC-USA, points out, “Inferior PPE must be considered as a risk when in a surgical site infection (SSI) or healthcare- associated infection (HAI) situation. Too many ‘upstart’ and ‘opportunistic’ sellers of PPE have jeopardized the health of those that wear and those that come in contact with those that wear such poor quality products. (Facilities should) institute and practice a solid strategy and process for assuring suffi cient supply of high-quality PPE is available at all times, regardless of the current need or anticipated short-term requirements.”
At Virginia Mason Medical Center, part of Virginia Mason Franciscan Health, their staff keeps a constant pulse on patient infections and safety, stresses, Charleen Tachibana, RN, Senior Vice President for Quality, Safety and Patient Experience.
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