Operating Room

In a recent online survey of ICT readers, 73 percent of respondents indicated that they are involved in infection prevention-related product evaluation and/or purchasing for their healthcare institution, confirming the findings of Hoeksema (2011) who emphasizes that perioperative nurses play a key role in evaluating product safety, effectiveness and efficiency, environmental concerns, and cost and how these factors affect patient care. Well-informed product evaluation and purchasing is a significant way for hospitals to combat rising expenses in an environment of moderate reimbursements, Hoeksema (2011) adds.

Infection prevention and surgical services departments share a united concern about retained surgical items, a healthcare threat that was No. 8 on the ECRI Institute's 2016 Top 10 Patient Safety Concerns list.

Maintaining normothermia of the surgical patient is part of the prevention of surgical site infections, and a study by Steelman, et al. (2013) found that perioperative hypothermia was among the top patient safety issues identified by perioperative nurses. In this study, AORN members employed in ambulatory and hospital settings (N = 37,022) received an electronic survey; of the 3,137 returned surveys that contained complete information, 966 respondents (30.8 percent) identified prevention of hypothermia as a high priority. However, debate over the safety of forced-air warming systems continues, and clinicians should first and foremost consider all sides of the argument when making product evaluation and purchasing decisions. Alternatives to forced-air warming include direct-conduction fluid warming systems and systems that use conductive fabric technology. Conductive fabric systems do not require the use of a disposable blanket, which can help reduce waste and keep costs down.

This year's state of the industry report for the operating room, with data provided through an online survey of ICT readers who work in surgical services, is designed to offer a snapshot of the key issues and challenges relating to budgets, resourcing and workloads, as well as ongoing shortages in time, personnel and educational opportunities.

Over the last few years, a growing number of serious infections have been linked to bacteria forming in heater-cooler devices (HCDs) used in cardiac surgery operating rooms. In these cases, aerosolized bacteria, predominantly nontuberculous mycobacterium (NTM) from the HCDs, contaminated the operative field. Emerging evidence regarding the incidence and challenges of detecting the infections has triggered alarms at the Food and Drug Administration (FDA) and regulatory agencies in Europe.

A chance meeting between a spider expert and a chemist has led to the development of antibiotic synthetic spider silk. After five years' work an interdisciplinary team of scientists at the University of Nottingham has developed a technique to produce chemically functionalized spider silk that can be tailored to applications used in drug delivery, regenerative medicine and wound healing.

Q:  At our facility, we discussed in detail that under no circumstances can an opened but not used rigid container be sent from the OR to the clean side of SPD whether the patient was in room or not. Can you help with this?

Every year, the Association of periOperative Registered Nurses (AORN) releases the latest version of its Guidelines for Perioperative Practice to its 41,000 members. Each edition of the book features updated instruction on practices that help perioperative nurses and, in turn, infection preventionists, ensure patient health and safety. For example, the 2017 publication contains detailed new insight into hand hygiene in the surgi-cal suite. The information discusses how fingernails, and even polish, can harbor germs, and offers best practices for preventing contamination that could hurt the patient. Through the teaching efforts of AORN members, and the acceptance of the U.S. Agency for Healthcare Research and Quality National Guideline Clearinghouse, these directions will reach more than 2,500 hospitals and more than 160,000 RNs.

A Washington State University (WSU) research team has successfully used a mild electric current to take on and beat drug-resistant bacterial infections, a technology that may eventually be used to treat chronic wound infections. The researchers report on their work in the online edition of npj Biofilms and Microbiomes.

Shorter wound healing time, fewer dressing changes and the opportunity for earlier discharge from the hospital. These are some of the benefits of negative pressure wound therapy to treat wound infections in connection with vascular surgery at the groin. The method, which has become increasingly common, is also cost-effective. This is shown in a thesis from Lund University in Sweden in which the method has undergone its first major scientific evaluation in deep perivascular groin infections after vascular surgery.

Good news for the millions of people who suffer from skin wounds that won’t heal. A team of researchers at Ohio State University has brought a potentially transformative solution to the problem by creating a portable adhesive patch that drives a continuous, small electrical current to stimulate healing and reduce the risk of infection.

The American College of Surgeons (ACS) has released a statement on professional attire for surgeons in and out of the operating room (OR).  The new ACS guideline for appropriate attire is based on professionalism, common sense, decorum, and the available evidence.

Imbed Biosciences announces it has received clearance from the Food and Drug Administration (FDA) to market its patented wound dressing for human use. The dressing it calls Microlyte Ag is a sheet as thin as Saran Wrap and can conform to the bumps and crevices of a wound, says company CEO Ankit Agarwal.

In Uganda, taking a bath before surgery, closing the door to the operating theater and ensuring surgeons clean their hands properly can be the difference between life and death. A study involving more than 650 surgical patients, showed the rate of infections halved after new measures were introduced. As a result, patients are spending less time in hospital, resulting in cost-savings for both the patient and the hospital.