分流手术期间手术室人流量的前瞻性观察研究:谁来了,为什么?

IF 2.1 3区 医学 Q3 CLINICAL NEUROLOGY
Mallory Saleh, Emal Lesha, C Stewart Nichols, Nir Shimony, John E Dugan, Brandy Vaughn, Randaline Barnett, Paul Klimo
{"title":"分流手术期间手术室人流量的前瞻性观察研究:谁来了,为什么?","authors":"Mallory Saleh, Emal Lesha, C Stewart Nichols, Nir Shimony, John E Dugan, Brandy Vaughn, Randaline Barnett, Paul Klimo","doi":"10.3171/2024.7.PEDS24283","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Shunt infections are costly and stressful for families, patients, and providers. Many institutions use shunt checklists in an effort to reduce the risk of infection following shunt surgery. Such protocols often aim to limit operating room (OR) foot traffic, but there is little evidence that supports the theory that greater OR traffic increases the risk of acquiring a shunt infection through contamination of the air. The purpose of this study was to quantify foot traffic during shunt surgery at a children's hospital during a time period when a shunt checklist was used.</p><p><strong>Methods: </strong>Starting in 2019, a premedical student was tasked with covertly collecting data on 50 shunt operations. Data were recorded in real time and documented in a prospectively updated database. Recording foot traffic through the OR door began at onset of skin prep; data points included patient and surgical details, operative length, and who entered the room and why. Each operation was followed for a minimum of 180 days for infection. The primary outcome was \"door event,\" defined as any time a door to the OR was opened-fully or partially-with or without someone breaking the plane of the door (i.e., entering or exiting).</p><p><strong>Results: </strong>Fifty operations were observed with no primary shunt infection (mean follow-up 29.8 months, range 6.5-63.3 months). One patient experienced a late secondary infection due to systemic post-COVID-19 inflammatory syndrome causing gastrointestinal bacterial translocation. The average operative time-from applying sterile skin prep until surgery stop time-was 69.8 minutes. Overall, there were 1012 door openings with 1088 personnel entering or exiting. The average number of door openings per operation was 20.24. OR personnel (42.7%) and neurosurgery staff (31.6%) were responsible for the largest number of door events, followed by the anesthesiology service (18.9%). The most cited reasons for door events were for supplies (31.2%) and scrubbing in (26.5%).</p><p><strong>Conclusions: </strong>This study represents the first detailed analysis of OR traffic during pediatric shunt surgery. No patient developed a primary shunt infection. While minimizing OR traffic makes intuitive sense, it remains unknown whether a causal relationship exists. Further investigation is needed.</p>","PeriodicalId":16549,"journal":{"name":"Journal of neurosurgery. Pediatrics","volume":" ","pages":"1-7"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A prospective observational study of operating room traffic during shunt surgery: who comes in and why?\",\"authors\":\"Mallory Saleh, Emal Lesha, C Stewart Nichols, Nir Shimony, John E Dugan, Brandy Vaughn, Randaline Barnett, Paul Klimo\",\"doi\":\"10.3171/2024.7.PEDS24283\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Shunt infections are costly and stressful for families, patients, and providers. Many institutions use shunt checklists in an effort to reduce the risk of infection following shunt surgery. Such protocols often aim to limit operating room (OR) foot traffic, but there is little evidence that supports the theory that greater OR traffic increases the risk of acquiring a shunt infection through contamination of the air. The purpose of this study was to quantify foot traffic during shunt surgery at a children's hospital during a time period when a shunt checklist was used.</p><p><strong>Methods: </strong>Starting in 2019, a premedical student was tasked with covertly collecting data on 50 shunt operations. Data were recorded in real time and documented in a prospectively updated database. Recording foot traffic through the OR door began at onset of skin prep; data points included patient and surgical details, operative length, and who entered the room and why. Each operation was followed for a minimum of 180 days for infection. The primary outcome was \\\"door event,\\\" defined as any time a door to the OR was opened-fully or partially-with or without someone breaking the plane of the door (i.e., entering or exiting).</p><p><strong>Results: </strong>Fifty operations were observed with no primary shunt infection (mean follow-up 29.8 months, range 6.5-63.3 months). One patient experienced a late secondary infection due to systemic post-COVID-19 inflammatory syndrome causing gastrointestinal bacterial translocation. The average operative time-from applying sterile skin prep until surgery stop time-was 69.8 minutes. Overall, there were 1012 door openings with 1088 personnel entering or exiting. The average number of door openings per operation was 20.24. OR personnel (42.7%) and neurosurgery staff (31.6%) were responsible for the largest number of door events, followed by the anesthesiology service (18.9%). The most cited reasons for door events were for supplies (31.2%) and scrubbing in (26.5%).</p><p><strong>Conclusions: </strong>This study represents the first detailed analysis of OR traffic during pediatric shunt surgery. No patient developed a primary shunt infection. While minimizing OR traffic makes intuitive sense, it remains unknown whether a causal relationship exists. Further investigation is needed.</p>\",\"PeriodicalId\":16549,\"journal\":{\"name\":\"Journal of neurosurgery. Pediatrics\",\"volume\":\" \",\"pages\":\"1-7\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-11-22\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of neurosurgery. Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3171/2024.7.PEDS24283\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of neurosurgery. Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3171/2024.7.PEDS24283","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

摘要

目的:分流管感染对家属、患者和医疗服务提供者来说代价高昂且压力巨大。许多医疗机构使用分流器检查表来降低分流手术后的感染风险。此类协议通常旨在限制手术室(OR)的人流量,但几乎没有证据支持这样一种理论,即手术室人流量增加会通过空气污染增加感染分流术的风险。本研究旨在量化一家儿童医院在使用分流检查表期间分流手术中的人流量:从 2019 年开始,一名医学预科生负责秘密收集 50 例分流手术的数据。数据被实时记录下来,并记录在一个前瞻性更新的数据库中。从备皮开始,记录通过手术室门的人流量;数据点包括患者和手术细节、手术时间、进入手术室的人员和原因。对每台手术进行至少 180 天的感染跟踪。主要结果是 "门事件",即手术室的门被完全或部分打开的任何时间,无论是否有人打破门的平面(即进入或离开):共观察了 50 例手术,无原发性分流感染(平均随访 29.8 个月,范围为 6.5-63.3 个月)。一名患者因 COVID-19 术后全身炎症综合征导致胃肠道细菌易位而发生晚期继发感染。从无菌备皮到手术停止的平均手术时间为 69.8 分钟。总体而言,共有 1012 次开门,1088 名人员进出。每次手术的平均开门次数为 20.24 次。手术室人员(42.7%)和神经外科人员(31.6%)造成的开门次数最多,其次是麻醉科(18.9%)。门事件发生的最主要原因是耗材(31.2%)和擦洗(26.5%):本研究首次详细分析了小儿分流手术期间手术室的交通情况。没有患者发生原发性分流感染。虽然最大限度地减少手术室流量具有直观意义,但是否存在因果关系仍是未知数。需要进一步调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
A prospective observational study of operating room traffic during shunt surgery: who comes in and why?

Objective: Shunt infections are costly and stressful for families, patients, and providers. Many institutions use shunt checklists in an effort to reduce the risk of infection following shunt surgery. Such protocols often aim to limit operating room (OR) foot traffic, but there is little evidence that supports the theory that greater OR traffic increases the risk of acquiring a shunt infection through contamination of the air. The purpose of this study was to quantify foot traffic during shunt surgery at a children's hospital during a time period when a shunt checklist was used.

Methods: Starting in 2019, a premedical student was tasked with covertly collecting data on 50 shunt operations. Data were recorded in real time and documented in a prospectively updated database. Recording foot traffic through the OR door began at onset of skin prep; data points included patient and surgical details, operative length, and who entered the room and why. Each operation was followed for a minimum of 180 days for infection. The primary outcome was "door event," defined as any time a door to the OR was opened-fully or partially-with or without someone breaking the plane of the door (i.e., entering or exiting).

Results: Fifty operations were observed with no primary shunt infection (mean follow-up 29.8 months, range 6.5-63.3 months). One patient experienced a late secondary infection due to systemic post-COVID-19 inflammatory syndrome causing gastrointestinal bacterial translocation. The average operative time-from applying sterile skin prep until surgery stop time-was 69.8 minutes. Overall, there were 1012 door openings with 1088 personnel entering or exiting. The average number of door openings per operation was 20.24. OR personnel (42.7%) and neurosurgery staff (31.6%) were responsible for the largest number of door events, followed by the anesthesiology service (18.9%). The most cited reasons for door events were for supplies (31.2%) and scrubbing in (26.5%).

Conclusions: This study represents the first detailed analysis of OR traffic during pediatric shunt surgery. No patient developed a primary shunt infection. While minimizing OR traffic makes intuitive sense, it remains unknown whether a causal relationship exists. Further investigation is needed.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Journal of neurosurgery. Pediatrics
Journal of neurosurgery. Pediatrics 医学-临床神经学
CiteScore
3.40
自引率
10.50%
发文量
307
审稿时长
2 months
期刊介绍: Information not localiced
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信