Why not?
It's a combination of several factors. Staff see garbage and clutter, but
they don't see bacteria. It's easy to focus on what's obvious — remov-
ing waste — but detailed cleaning of surfaces and equipment doesn't
always occur. Staff are also under constant pressure to ready rooms
between cases as quickly as possible. Turnover times are tangible,
measurable outcomes, but if staff check a box to show they cleaned
an OR, who confirms that they did it right every time?
Do you think surgical teams fully appreciate infection risks in the OR?
Not always. Bacteria exposure isn't an immediate outcome. It's also
nearly impossible to associate contaminated ORs with poor out-
comes. Surgical professionals want to see data before changing their
routines. New studies are being developed that aim to use genome
sequencing of microorganisms to link bacteria in the operating room
to bacteria that cause post-op infections. Once that link is established,
surgical staffs will hopefully be more proactive in taking care of the
OR environment.
What can facility leaders do to improve infection prevention practices?
The biggest thing I've learned during my career is that policies on
paper don't always reflect what happens in real life. It's important to
observe what staff do on a daily basis to ensure staff who care for
patients and handle instruments always follow recommended prac-
tices. Everyone, in all areas of surgical care, must buy in to doing a
better job in order to eliminate infection risks from the OR.
OSM
Dr. Munoz-Price (smunozprice@mcw.edu) is an enterprise epidemiologist
and a professor of medicine in the division of infectious diseases at the
Froedtert & the Medical College of Wisconsin in Milwaukee, Wis.
M A Y 2 0 1 9 • O U T PA T I E N T S U R G E R Y. N E T • 6 7
