The Impact of Optimizing Details in the Operating Room on the Level of Knowledge, Attitude, and Practice of Hospital Infection Prevention and Control by Surgeons, as Well as the Effectiveness of Infection Control

Objective: This paper aims to explore the impact of optimizing details in the operating room on the level of knowledge, attitude, and practice of hospital infection prevention and control by surgeons, as well as the effectiveness of infection control. Methods: From January 2022 to June 2023, a total of 120 patients were screened and randomly divided into a control group (routine care and hospital infection management) and a study group (optimizing details in the operating room). Results: Significant differences were found between the two groups in the data of surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, infection rates, and nursing satisfaction, with the study group showing better results (P Conclusion: The use of optimizing details in the operating room among surgeons can effectively improve surgeons’ level of knowledge, attitude, and practice in hospital infection prevention and control, reduce infection occurrence, and is worth promoting.

Analysis of the Influence of Operating Room Nursing Care Management on the Incidence Rate of Nosocomial Infection in Orthopedic Surgery Patients

Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups,which were the control group(under general management)and the observation group(under the operating room nursing care management).Further,the incidence rate of nosocomial infections,the incidence rate of irregular nursing care phenomena,the satisfaction score of nursing care management,and the quality of life score were observed and recorded.Result:The incidence rate of nosocomial infection,the incidence rate of irregular nursing care management,the satisfaction score of nursing care management,and the quality of life score of the observation group were compared to that of the control group,and the result showed P<0.05,indicates the statistical significance between the data indicators.Conclusion:The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.

Preventing surgical site infection using operating room bundle of care in patients undergoing elective exploratory laparotomy cholecystectomy surgery

Objective:Surgical procedures manifest immense risks to patients.One of the adverse events that healthcare professionals see as a threat to the patient’s health is the development of complications known as surgical site infection(SSI).Although several effor ts are being under taken to determine the proper means to reduce such complications,there is still a high incidence of SSI worldwide.Surgery requires knowledge in infection control and high precision in maintaining a clean surgical site.This study tested the effectiveness of an operating room(OR)bundle of care in preventing SSI in patients undergoing elective exploratory laparotomy cholecystectomy surgery.Methods:A quasi-experimental pretest and posttest design was utilized to determine its effectiveness.The study was composed of 60 par ticipants divided into two groups:30 subjects were selected to receive the OR bundle of care,while the other 30 subjects received the usual care.The groupings were determined through a systematic random sampling technique.The OR bundle of care had three interventions,namely:(1)maintaining perioperative normothermia,(2)no pre-operative surgical site hair removal,and(3)changing gloves before abdominal wall closure.These patients were evaluated using the standard instrument,Bates–Jensen Wound Assessment Tool(BWAT)in the post-intervention phases of the wound healing process,which are as follows:hemostasis,inflammatory,and proliferative phases.To describe the difference in the patients’wound status after implementation of the OR bundle of care in each post-intervention phase,Friedman’s test was used.To describe the difference in the patients’wound status in both groups after implementation of the OR bundle of care,the Mann–Whitney U test was used.Results:The patient’s wound status was lower,indicating a more healing process.Differences between the wound status of the control and the experimental group were observed on the third postoperative day.This indicates that the experimental group’s wound status healed much faster and more effectively than the control group based on the BWAT scoring severity scoring.A significant difference in the patient’s wound status from the hemostasis phase compared with the proliferative phase was observed.Conclusions:The OR bundle of care has been shown to be effective in preventing SSI in patients who had undergone exploratory laparotomy cholecystectomy surgery in the selected hospital,if there is uniform and consistent implementation of the said intervention.

Operating Site Infections at General Surgery Department of Gabriel Toure Training Hospital

The operating site infections constitute the major postoperative issue in surgery. Our objectives were to determine the hospital frequency, the risk factors, the involved germs as well as the cost generated by the operating site infections. Method: Our three months prospective survey run from September the 1st to November the 30th 2013 has included all department patients being operated on and hospitalized. The criteria have been set by CDC d’Atlanta. Results: 374 files were involved, among them 229 (61.2%) were emergencies and 145 (38.8%) were scheduled. The average age was 41 (extremes 7 and 95 standard deviation 17.46), the sex ratio 1.67. The infective risk according to Altmeier has found 17.5% type 1, 25.1% type 2, 11.2% type 3 and 46.3% type 4;according to NNISS, 96 (25.7) were NNISS 0;94 (51.9%) NNISS 1;80 (21.4%) NNISS 2;and 4 (1.1%) NNISS. In the Altmeier class I have not got antibiotic before infection signs appearances. Our overall rate of operating site infections was 7.9% (29 cases), with 24 (82.8%) emergency cases. According to Altmeier’s class of infective risk, the rate of operating site infections was 1.54% making 1 out of 65 type I patients;4.3% making 4 out of 93 type II patients;11.9% making 5 out of 42 type III patients;10.9% making 19 out of 174 type IV patients. According to NNISS, the infective risk has been assessed and was 2.08% for score 0, we have got 8.25% score 1, and 12.5% for score 2, and 25% for score 3. The bacteriology has been dominated by Escherichia colii(51.7), Proteus mirabilisi(13.8), and Klebsiella pneumoniaei(10.34). The germs have been resistant to the combination Amoxicillin-clavulanic Acid between 50% and 87% of cases. The most active antibiotics on the germs have been Cephalosporin, Polypeptides, and aminoglycosides. The hospital stay has been delayed to 12 days on average by operating site infections, making 2.5 times greater than those uninfected. The infection has increased the cost of management around 600 Euro.

What Is the Evidence Supporting the Use of Surgical Face Masks in the Operating Room in Preventing Surgical Site Infection after Clean Surgery? A Systematic Review

Background: Facemask is an essential component of the surgical outfit adorned by operating room staff to filter microorganisms by droplets from the oral and nasopharynx of the personnel, thereby reducing contamination, protecting the patient’s wound and minimising the risk of Surgical Site Infections (SSI). Objective: The objective of this review was to explore the available evidence and provide a better understanding of the effect of a surgical facemask in preventing SSI in clean surgery performed in the operating room. Data sources: Key electronic databases related to nursing, allied health, life science, biomedicine and research were searched for published literature on the use of facemask in the operating room. Methodology: A systematic review of quantitative research studies of randomised controlled trials was conducted with a meta-analysis of the results. Results: No variation in the rate of infection between the two (masked and unmasked) groups. Conclusion: The effect of facemask in minimising SSI after clean surgery remains questionable due to the limited results. More comprehensive research is needed.

Analysis of the Role of Nursing Intervention in Operating Room in the Prevention of Incision Infection in Orthopedic Aseptic Surgery

Objective:To explore and analyze the role of nursing in the operating room in the prevention of incision infection in aseptic orthopedic surgery.Methods:68 patients that underwent aseptic orthopedic surgery in our hospital from January 2021 to December 2022.They were divided into a research group(n=34)and a control group(n=34)by the random number table method.The patients in the control group received conventional nursing intervention in the operating room,and the patients in the study group received the optimized and modified nursing intervention in the operating room;then,the related indicators of nursing intervention of the two groups were compared.Results:The incidence of incision infection in the study group was lower than that of the control group(P<0.05);the average duration of surgery and length of stay the study group were lower than those in the control group(P<0.05);the stress response indexes of patients in the study group were lower than those in the control group 24 hours after operation(P<0.05);the degree of satisfaction of the patients in the study group to the services provided by the nursing staff was significantly higher than that of the control group(P<0.05).Conclusion:High-quality nursing intervention in the operating room for aseptic orthopedic surgery patients can significantly reduce the incidence of incision infection,reduce the stress response caused by surgery,shorten the duration of surgery and length of stay,and improve nursing satisfaction,which makes it worthy of popularization.

Timing of surgical operation for patients with intra-abdominal infection:A systematic review and meta-analysis

BACKGROUND Intra-abdominal infections(IAIs)is the most common type of surgical infection,with high associated morbidity and mortality rates.In recent years,due to the use of antibiotics,various drug-resistant bacteria have emerged,making the treatment of abdominal infections more challenging.Early surgical exploration can reduce the mortality of patients with abdominal infection and the occurrence of complications.However,available evidence regarding the optimal timing of IAI surgery is still weak.In study,we compared the effects of operation time on patients with abdominal cavity infection and tried to confirm the best timing of surgery.AIM To assess the efficacy of early vs delayed surgical exploration in the treatment of IAI,in terms of overall mortality.METHODS A systematic literature search was performed using PubMed,EMBASE,Cochrane Central Register of Controlled Trials,Ovid,and ScienceDirect.The systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses method.Based on the timing of the surgical operation,we divided the literature into two groups:Early surgery and delayed surgery.For the early and delayed surgery groups,the intervention was performed with and after 12 h of the initial surgical intervention,respectively.The main outcome measure was the mortality rate.The literature search was performed from May 5 to 20,2021.We also searched the World Health Organization International Clinical Trials Registry Platform search portal and ClinicalTrials.gov on May 20,2021,for ongoing trials.This study was registered with the International Prospective Register of Systematic Reviews.RESULTS We identified nine eligible trial comparisons.Early surgical exploration of patients with IAIs(performed within 12 h)has significantly reduced the mortality and complications of patients,improved the survival rate,and shortened the hospital stay.CONCLUSION Early surgical exploration within 12 h may be more effective for the treatment of IAIs relative to a delayed operation.

Analysis of the Effect of Infection Control in Hospital Operation Room

Objective:To explore the implementation effect of nursing management in operating room for hospital infection control.Methods:100 cases of patients who received surgical treatment in our hospital from 2019 to 2020 were selected and divided into observation group and control group according to different nursing management methods in operating room.Patients in the control group received routine nursing management services,while patients in the observation group received systematic and highquality comprehensive management services based on routine nursing management services.Results:The air colony count and hand colony count of the observation group were significantly better than those of the control group.At the same time,the incidence probability of infection in the observation group was also significantly lower than that of the control group,with significant difference between the groups,with statistical value(P<0.05).Conclusions:In view of the occurrence of nosocomial infection,the implementation of high-quality operating room nursing service can effectively control it,reduce the probability of occurrence,and ensure the safety of patient treatment,which is worthy of clinical application.

Antimicrobial Susceptibility Patterns of the Bacterial Isolates in Post-Operative Wound Infections in a Tertiary Care Hospital, Kathmandu, Nepal

Unrestrained anti-microbial resistance (AMR) among bacterial pathogens has made the management and treatment of post-operative wound infections difficult. This study assessed the current AMR patterns of bacterial isolates in post-operative wound infections in a tertiary care hospital in Kathmandu,Nepal. Pus swabs collected from post-operative wound infections and submitted for culture and sensitivity were included in this study. Isolation and identification of the organism was done by standard microbiological methods. Antibiotic susceptibility test was performed by Kirby Bauer disc diffusion method and result was interpreted as per National Committee for Clinical Laboratory Standards (NCCLS) guide lines. Of the 120 pus swabs processed for culture, 96 showed bacterial growth. Staphylococcus aureus 36 (37.5%) was the predominant gram positive isolate and Escherichia coli 24 (25%) was the major gram negative isolate .The infection was most prevalent in the age group 20-40 years. All S. aureus isolates were sensitive to aminoglycosides and vancomycin. Out of 36 S. aureus, 15 (41.66%) isolates were methicillin resistant S. aureus (MRSA). Staphylococcus epidermidis showed high resistance (50%-100%) to all antibiotics but were sensitive to vancomycin. All gram negative isolates showed high resistance against cephalexin (75%-100%) and ceftriaxone (25%-100%). Overall multi-drug resistant isolates were 66.7%. A high level of AMR was observed in gram negative bacterial isolates. Rational use of antibiotics and a regular monitoring of AMR patterns in post-operative wound infections are essential and mandatory to avert further emergence and spread of anti-microbial resistance among bacterial pathogens.

Surveillance to encephalic infection after foramen drainge operation

Objective To know about the status of encephalic infection after foramen drainage operation,and explore correlative risk factors and preventive measures. Methods Retrospective survey on patients performed foramen drainage operation in neurosurgery department from Jan to Dec 2008 was performed,and set as control group; Targed monitoring to the patients performed

Risk Factor of Postoperative Lumbar Surgical Site Infection: A Literature Review

Nowadays there have been various advanced techniques to overcome disparate types of lumbar degenerative diseases. However, post-operation complications such as Surgical Site Infection (SSI) still give the surgeon with a big challenge. This article is going to study the risk factor that causes the lumbar SSI by reviewing all the articles that can be assessed through PubMed, websites of science and other internet data base. Numerous articles have stated different reported prevalence rates of 0.7% to 16% for surgical site infection. This article will document the most common and significant risk factors for SSI. At last, we suggest that there should be preoperative patient screening and postoperative internal environment maintenance, this will be the best way to reduce postoperative SSI rate or prevent SSI from happening.

Etiological factors for subphrenic infection after hepatectomy for patients with hepatic malignancy

BACKGROUND: This study was to clarify the high riskfactors for subphrenic infection (SI) after liver resection forpatients with hepatic malignancy.METHODS: Three hundred and sixty-eight patients whohad undergone hepatectomy from January 1985 throughJune 2002 were randomly divided into 2 groups accordingto resection of liver parenchyma, hepatic cirrhosis, primaryliver cancer, intraoperative blood loss, and subphrenicdrainage. The chi-square was used for statistical analysis.RESULTS: Thirteen patients (3.53%) of the 368 patientshad SI. The high-risk factors for SI after hepatectomy wererelated to resection of liver parenchyma and hepatic cirrho-sis ; but the course or stage of primary liver cancer was notrelated to the incidence of SI. Intraoperative blood loss ofover 1500 ml was found to be a significant risk factor forpostoperative SI. Adequate drainage of the subdiaphragmand the raw surface of the liver after operation was essentialto decreasing SI after liver resection.CONCLUSION: Inadequate subphrenic drainage maylargely contribute to SI in patients with hepatic malignancyundergoing hepatectomy apart from other factors. Com-prehensive measures should be taken to prevent the infec-tion after hepatectomy.

Experimental Investigation of Operating Room Air Distribution in a Full-Scale Laboratory Chamber Using Particle Image Velocimetry and Flow Visualization

Room air distribution in hospital operating rooms (OR) is critical to the effective functioning of surgical procedures, but the air distribution patterns are governed by complex physics that are currently not well understood. Both qualitative and quantitative flow visualization techniques were used to evaluate the room air distribution in a full-scale chamber designed to simulate a hospital operating room. A laser sheet illumination technique was used to identify key features of the room air distribution, and particle image velocimetry (PIV) was used to measure the velocity field in a plane crossing the surgical site. Hospital operating rooms require the use of ASHRAE Group E diffusers in an array above the surgical table, providing downward, unidirectional, non-aspirating air flow across the sterile region of the room. The supply air jet is characterized by complex physics, including annular shape, impingement, buoyancy, a large jet to room aspect ratio, and recirculation. The large diameter of the jet relative to the room size makes the overall room air distribution highly sensitive to the parameters of the supply air. The air distribution pattern in the room was found to have relatively low velocity and turbulence near the supply air diffuser, but increasing velocity and turbulence in the shear region at the edge of the supply air jet. Flow visualization and PIV methods both demonstrated an angle of the shear layer inwards towards the center of the jet. This flow feature reduces the overall coverage area for the sterile air flow and may pose a risk to the protection of the surgical patient.

Diagnosis and Treatment and Infection Protection Strategy of Osteoporotic Vertebral Compression Fractures Minimally Invasive Percutaneous Kyphoplasty Surgery during the Prevention and Control of COVID-19

Background: As the global novel coronavirus pneumonia (NCP) remains severe, elderly people are at high risk for NCP and osteoporotic vertebral compression fractures, with high complications and mortality. How to treat patients and protect medical staff from infection, and at the same time strictly prevent the occurrence of clustered transmission events in the hospital, the establishment of perfect pre-hospital emergency measures and infection prevention and control strategy is the first element to ensure success. Objective: To establish the diagnosis and treatment and infection protection strategy for Osteoporotic vertebral compression fractures (OVCF) patients undergoing minimally invasive percutaneous kyphoplasty (PKP) surgery during the prevention and control of COVID-19, so as to ensure the stable, orderly and safe medical treatment. Methods: A total of 583 OVCF patients were admitted to the First Affiliated Hospital of Hebei North University during the epidemic prevention and control period from January 2020 to July 2022. After urgent and outpatient strict standardized screening, 382 patients met the inclusion criteria, including 112 males and 270 females, aged (70.50 ± 5.49) years. The preoperative visual analogue scale (VAS) score was 6.92 ± 1.86. Preoperative Oswestry disability index (ODI) was 74.67 ± 4.84. The satisfaction rate was (45.89 ± 3.67) %. According to the clinical diagnostic criteria and classification, 367 patients were diagnosed as ordinary OVCF, including 156 cases of mild compression and 226 cases of moderate compression. The clinical classification of 15 patients with OVCF diagnosed as COVID-19 was type I, including 10 cases of mild COVID-19 and 5 cases of common COVID-19. All patients were treated with PKP. Results: All patients were followed up at 1 day, 1 month and 3 months after operation, VAS (2.01 ± 0.56, 0.45 ± 0.11, 0 ± 0), ODI (45.41 ± 4.15, 10.22 ± 2.73, 4.03 ± 1.57) and satisfaction (90.12%, 95.57%, 99.23%) were significantly improved compared with those before operation (p < 0.05), and the original medical diseases were not aggravated. In this group, 15 cases of OVCF diagnosed with COVID-19 were given priority to treat COVID-19 under strict three-level protection in the designated isolation ward. PKP was carried out after the condition was stable, and the areas, items and personnel in contact with patients during the perioperative period must be strictly and thoroughly disinfected. The patient had a good prognosis, no complications, no cross-infection in the hospital, and no infection rate among medical staff. Conclusions: The implementation of the diagnosis and treatment and infection protection strategy for OVCF patients undergoing minimally invasive PKP surgery during the prevention and control of COVID-19 has a guiding role in preventing the spread of infection, improving the cure rate, promoting rapid recovery, reducing complications and reducing mortality.

Vertebral body infection due to esophageal perforation caused by ingestion of fishbone:a case report

Background:Esophageal injury is a common complication of foreign bodies in the upper gastrointestinal tract,but bilateral pleural effusion or vertebral infection is a rare condition due to a swallowed fishbone.It is considerably difficult for a physician to diagnose quickly because of incomplete patient history of foreign bodies ingestion and/or insufficient experiences.Patient concerns:We describe the case of a 56-year-old man who was admitted to an emergency medical department owing to a low to moderate fever for 7 days.After a series of examinations,the patient was diagnosed with esophageal perforation(EP)caused by a fishbone that was swallowed half a month ago.Diagnoses:About 12 days after the onset of fever,he was diagnosed with EP based on the gastric endoscopic images combined with histological section and sufficient history of the disease.About 2 months later,the patient has obvious back pain and lack of strength in two legs and was diagnosed with vertebral body infection.Interventions:Antibiotic therapy,multi-disciplinary team(MDT),and surgical intervention had been exerted.Outcomes:It is very fortunate for this patient to have a good prognosis due to a timely diagnosis and proper management.Muscle power has attained level 5.Lessons:Several lessons can be learned from this case;for example,physicians should be alerted to the EP,endoscopic intervention should be prompt,antibiotics should be used regularly,and so on.

Cleaning Technology of Operating Rooms in Hospitals

This paper is based on a literature review of foreign research regarding the relationship between： SSI （surgical-site infection） and operating room cleaning ventilation, the change of cleanroom technical factors of ventilation, and air conditioning in operating rooms. The differences between foreign codes and Chinese codes on cleaning and the air conditioning index of operating rooms are discussed. The historic background of the founding of the current Chinese clean operating room codes was analyzed. The author appealed to insiders for awareness and concentration on international medical research results involved in cleaning and air conditioning techniques of operating rooms. The current domestic codes should be modified based on the real situation of China. Therefore, the development of medical facilities can be fulfilled.

Yersinia enterocolitica Infection of a Prosthetic Knee Joint.Case Report and Review of the Literature on Deep Sited Infections Caused by Y.enterocolitica

Prosthetic joint infection is a rare manifestation of Yersinia enterocolitica. We report a case of a patient presenting with fever and a purulent infection in his prosthetic knee joint caused by Y. enterocolitica. He had been operated in 1990 for arthrosis of the right knee. Re-operation was performed in 2007 for loosening of the prosthesis. Seven months later, following progressively increasing knee pain, he became acutely febrile and a purulent knee joint infection was diagnosed. Y. enterocolitica was isolated from the joint fluid. Serum antibodies against Y. enterocolitica were also positive. He was treated with debridement, replacement of the liner component of the prosthesis and a long course of intravenous antimicrobial therapy. The infection was thought to be in a chronic suppressive state. The final outcome after all therapy was good.

Einstein Hybrid Structure of q-Rung Orthopair Fuzzy Soft Set and Its Application for Diagnosis of Waterborne Infectious Disease

This research is devoted to diagnosing water-borne infectious diseases caused by floods employing a novel diagnosis approach,the Einstein hybrid structure of q-rung orthopair fuzzy soft set.This approach integrates parts of fuzzy logic and soft set theory to develop a robust alternative for disease detection in stressful situations,especially in areas affected by floods.Compared to the traditional intuitionistic fuzzy soft set and Pythagorean fuzzy soft set,the q-rung orthopair fuzzy soft set(q-ROFSS)adequately incorporates unclear and indeterminate facts.The major objective of this investigation is to formulate the q-rung orthopair fuzzy soft Einstein hybrid weighted average(q-ROFSEHWA)operator and its specific characteristics.Moreover,our stated operator is implementing intelligentmulti-criteria group decision-making(MCGDM)methodology.Floods are severe natural catastrophes that raise the risk of diseases and epidemics,particularly those caused by contaminants in the water,such as gastrointestinal diseases,respiratory infections,vector-borne diseases,skin infections,and water-borne parasites.The designed MCGDM strategy tackles the prevalence of certain conditions in flood-affected patients.A comparative investigation determined that the suggested method for detecting water-borne infectious disease due to floods is more effective and productive than conventional methods because of its logical structure.

Antibiotic Prescribing Patterns and Prevalence of Surgical Site Infections in Caesarean Section Deliveries at Two Tertiary Hospitals in Lusaka, Zambia

Introduction: A caesarean section (CS) is one of the most frequently performed obstetric surgeries in the world and its use has increased dramatically in recent years. The number of caesarean section cases worldwide has been increasing each year, and the World Health Organization (WHO) reported an excess of 10% - 15% of CS procedures for all births. However, some women experience surgical site infections (SSIs) after undergoing CS delivery. This study investigated the prescribing patterns of antibiotics in CS deliveries and the prevalence of SSIs at two tertiary hospitals in Lusaka, Zambia. Materials and Methods: A retrospective cross-sectional study was conducted from January 2020 to December 2020 at the Women and Newborn University Teaching Hospital (UTH) and the Levy Mwanawasa University Teaching Hospital, in Lusaka, Zambia. Results: Of a total of 838 women who delivered via CS, more than half were aged between 21 and 25 years (n = 461, 55.0%), 56.3% were from low-cost residential areas, and 57% had emergency CS delivery. The prevalence of SSIs was 6.0%, with the level of education (OR 0.377, 95% CI 0.150 - 0.946), type of caesarean section (OR 6.253, 95% CI 2.833 - 13.803), and oral antibiotics post-caesarean (OR 0.218, 95% CI 0.049 - 0.963). The duration of IV antibiotic treatment significantly predicted SSI (p Conclusion: This study found that the third-generation cephalosporin (cefotaxime) and triple combination therapy (benzylpenicillin, gentamicin, and metronidazole) were the most frequently prescribed antibiotics before and after CS. The level of education, type of CS, oral antibiotics post-CS, facility, and duration of administering IV antibiotics were all predictors of SSIs.