Individuals are at risk of developi...

Individuals are at risk of developing a number of postoperative complications after surgical intervention. Surgical site infections (SSIs), previously referr to in the literature as surgical damage infections (SWIs), are among the greatest in number serious adverse events that may proceed from surgical procedures. In addition to increasing the morbidity and mortality among the surgical patient population, SSIs spring in extended hospitalization and more than $1 billion annually in exces medical costs(1) Researchers reported that the average SSI defers a patient's hospital stay by way of 7.3 days and amounts in preciousnesss of approximately $3,152.(2) Other researchers indicated that these estimates are underrepresent because in the greatest degree SSIs occur after discharge and are associated with considerable resource use.(3)

Surgical site infections are among the four major adumbrations of hospital-acquired or nosocomial infections. Generally, infections that are not current (ie, clinically evident) nor incubating at the time of admission to an inpatient health care facility are classified as nosocomial infections. In contrast, community-acquired infections are those infections that are at hand or incubating at the time of hospital admission. In addition to SSIs, the Center for Disease govern and Prevention's (CDC) national surveillance program continuously has monitored other leading nosocomial infections, including urinary tract infections, pneumonias, and bloodstream infections.

In 1992 the Surgical injury Infection Task Force, composed of individuals representing the Society for Hospital Epidemiology of America (SHEA), the Association of Professionals in Infection curb and Epidemiology (APIC), the Surgical Infection Society (SIS), and the CDC modified the definitions of SSIs and divided these into

* superficial incisional SSI,

* down-reaching incisional SSI, and

* organ/space SSI.(4) Using these revised SSI definitions, in 1995 the National Nosocomial Infections Surveillance (NNIS) hypothesis described the distribution of nosocomial infections among surgical patients from infection site for different emblems of surgical procedures.(5) The NNIS reported that the surgical site was the chiefly common site of nosocomial infections in these patients.

Traditionally, ORs have welcomed observational experiences, particularly in large, academic medical center Consequently at any given time during a surgical act the number of people in the OR can become quite large--perhaps unnecessarily so--increasing the microbial tonnage AORN always has recognized that microbial contamination of the surgical site is a critical factor in the unfolding of SSIs and has established standards and make acceptableed practices designed to reduce the incident of such an event. With regard to traffic patterns in the perioperative practice setting, AORN recommendations include restrictions forward excessive conversations and the number of clan present during surgical procedures. The literature, however, reveals a lack of conclusive evidence to support restricting the number of persons in the OR during surgery

THE PROBLEM

The part of the perioperative nurse, as the facilitator of a safe OR environment, encompasses implementing nursing interventions that minimize the incidence of SSIs and other preventable postoperative complications. The controversial findings regarding the degree of transmission of microorganisms causing SSIs and the influence of the OR environment onward such infections continue to be topics of ongoing debate. The lack of conclusive evidence has l an researchers to believe that environmental contamination as a source of injury infection has received unwarranted notoriety. Other researchers believe that the OR environment, including the the community involved in a surgical deed and the existing traffic patterns, is a major source of contamination that increases with the pair movement and talking.(6)

AORN's "Recommend practices for traffic patterns in the surgical suite," is designed to bring into the amount of airborne contamination during surgery Specifically, AORN approves that movement of staff members should be kept to a minimum while a surgical practice is in progress.(7) This includes minimizing the number of populace in the OR, movement, and talking during surgery and maintaining that OR doors be clos with the exception of during movement of staff members or equipment. AORN provides the following rationales for these guidelines.(8)

* Greater amounts of airborne contamination can be reckon uponed with increased movement.

* The mixing of OR air with corridor air increases the bacterial enumerate in the room.

* Shedding increases with activity.

In addition to AORN recommendations, the Joint Commission forward Accreditation of Healthcare Organizations' (JCAHO) Accreditation Manual for Hospitals and the CDC's guidelines for infection hinder emphasize the importance of traffic patterns in the surgical suite and limiting the number of personnel involved in the procedure(9) The CDC guidelines state that airborne contamination decreases with increased ventilation that dilutes contaminated air with relatively clean filtered or outdoor air and with decreased numbers and activity of personnel(10)