Operating Room Traffic in Total Joint Arthroplasty: One Simple Measure Toward Solving a Complex Problem.

Area of Science:

• Orthopedic Surgery
• Infection Control
• Operating Room Management

Background:

• Periprosthetic joint infection is a serious complication following total joint arthroplasty (TJA).
• Increased operating room (OR) traffic is linked to higher bacterial load and surgical site infection (SSI) risk.
• Reducing OR traffic is a potential strategy to mitigate SSI risk in TJA.

Purpose of the Study:

• To evaluate the effectiveness of "restricted access" signs in reducing OR door openings during primary TJA.
• To quantify the impact of signage on OR traffic flow.

Main Methods:

• A prospective, two-phase study design was employed.
• An independent observer blinded to the intervention collected data on OR door openings per case.
• Phase 1: baseline data without signs. Phase 2: data collection with "restricted access" signs posted.

Main Results:

• The average number of OR door openings per primary TJA case decreased from 75 to 40.
• The rate of door openings per minute reduced from 0.59 to 0.28.
• A significant reduction of 47% in openings per case and 53% per minute was observed.

Conclusions:

• The use of "restricted access" signs effectively and significantly reduces OR traffic during primary TJA.
• This straightforward intervention has the potential to decrease the incidence of surgical site infections.
• Implementing signage is a practical method for enhancing operating room safety and infection control.