Abstract
Purpose :
In our center, cataract surgeries are scheduled in two ways: regular vs. fast track days. The differences between the two days is threefold; during fast track days: 1) patients are brought into the operating room (OR) in their street clothes, 2) no anesthesia coverage in the OR, and 3) patients are preselected to be healthier with uncomplicated cataracts. Traditionally, cataract surgery is performed with patients in hospital gowns presumably for infection prevention and with an anesthesia technician. The purpose of our study was to measure the impact of fast track procedures on the air quality in the OR.
Methods :
Air quality in the OR was measured using settle plate testing during three time periods each week: inactive period (when OR was not in use) vs. fast track vs. regular cataract days for 8.5 hours/day. Settle plate testing is a passive form of air quality testing. Passive methods of sampling the air is presumed to be more representative of the microbes that settle on patients during surgery. Six chocolate and sabouraud plates were placed in the operating room: 1 in each corner of the room (4 total) and 2 in the surgical field (top of the microscope and the phacoemulsification machine). These plates were analyzed for the number of colonies and the specific organisms were also identified.
Results :
The average number of bacteria that grew on the plates near the door were higher during fast track cataract days compared with plates placed near the door on regular cataract days. However, there was no significant difference in the number of colonies and type of bacteria and fungi that grew in the surgical fields of the fast track and regular cataract days (p=0.41). There was a significant difference when comparing the inactive period with the regular and fast-track cataract days (p<0.001), suggesting that human factors likely play a role in the air quality of the operating room.
Conclusions :
Our study suggests that fast track procedures, such as having the patient in their street cloths and quick turn-over protocol with nursing staff, does not affect the air quality in the surgical field. These findings support safe methods for quicker cataract turnover in the OR, which could potentially help reduce long cataract surgery wait lists with the increased efficiency of OR turnaround procedures.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.