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Footwear practices and operating room contamination
1Oxford School of Nursing, Academic Centre, John Radcliffe Hospital, Headington, England.
Abstract:
The extent of bacterial transfer into the clean confines of the operating room (OR) was studied by comparing the use of protective footwear (i.e., polypropylene shoe covers and OR restricted shoes) with unprotected street shoes over a 5-week period. The study was divided into two experimental times: (a) early morning (disinfected floor) and (b) midmorning (dirty floor). Data obtained from the early morning experiment showed that OR restricted shoes and shoe covers transferred fewer bacteria onto the disinfected study area than unprotected street shoes; similar findings were obtained from the midmorning experiment for shoe covers, but not for OR restricted shoes. A comparison of changes in bacterial counts obtained from OR restricted shoes and shoe covers worn from the changing room through a common corridor to the disinfected study area did not differ significantly from OR restricted shoes and shoe covers that were put on immediately before walking through the study area at both experimental times. Overall results indicated that protective footwear may act to reduce bacterial contamination on OR floors.
Insights
Protective footwear, including shoe covers and operating room (OR) restricted shoes, significantly reduced bacterial transfer onto OR floors compared to street shoes. This suggests protective footwear is effective in minimizing operating room contamination.
Area of Science:
- Healthcare-associated infections
- Microbiology
- Hospital hygiene
Background:
- Operating rooms (ORs) require stringent contamination control to prevent surgical site infections.
- Bacterial shedding from footwear is a potential source of microbial contamination in sterile environments.
- The efficacy of different types of protective footwear in reducing bacterial transfer to OR floors is not fully elucidated.
Purpose of the Study:
- To compare the bacterial transfer from unprotected street shoes versus protective footwear (polypropylene shoe covers and OR restricted shoes) into the operating room.
- To evaluate the impact of floor cleanliness (disinfected vs. dirty) on bacterial transfer from footwear.
- To assess whether wearing protective footwear from a changing room through a corridor affects bacterial transfer.
Main Methods:
- A 5-week study comparing bacterial transfer from street shoes, shoe covers, and OR restricted shoes.
- Experiments conducted at two times: early morning (disinfected floor) and midmorning (dirty floor).
- Bacterial counts measured on a study area after footwear contact.
Main Results:
- Both OR restricted shoes and shoe covers transferred fewer bacteria than street shoes onto a disinfected floor.
- Shoe covers, but not OR restricted shoes, showed reduced bacterial transfer on a dirty floor compared to street shoes.
- No significant difference in bacterial counts for footwear worn from a changing room versus put on immediately before entering the study area.
Conclusions:
- Protective footwear, particularly shoe covers, can effectively reduce bacterial contamination on OR floors.
- The type of footwear and floor condition influence bacterial transfer.
- Implementing protective footwear policies may enhance operating room hygiene and patient safety.