The Effect of a Door Alarm on Operating Room Traffic During Total Joint Arthroplasty

Operating room traffic has been implicated in several studies to contribute to the risk of surgical site infections and periprosthetic joint infections. The purpose of this study was to evaluate the effect of a door alarm on operating room traffic during total joint arthroplasty. This prospective cohort study evaluated 100 consecutive primary total hip and knee arthroplasty surgeries performed by a single surgeon. An inconspicuous electronic door counter was placed on the substerile operating room door. Door openings and time left ajar were recorded. After 50 cases, an audible alarm was placed on the substerile operating room door that sounded continuously when the door was ajar. Door-opening data were then recorded for an additional 50 cases. There was a significant difference in the overall mean door openings per minute (P<.001) between the period with no alarm (0.53±0.1) and with an alarm (0.42±0.1). This effect slowly decreased over the time of the intervention, with door openings per minute increasing by a factor of 1.01. The percentage of time the door was left ajar per case also decreased significantly (P<.001) with the alarm (6.63%±1.6%) compared with no alarm (8.65%±1.5%). This study indicates that the use of a door alarm can decrease door openings and potentially the risk for surgical site infection. However, the effect is subject to tolerance and may not result in the elimination of unnecessary operating room traffic long term. [Orthopedics. 2017; 40(6):e1081-e1085.].