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Hi All,
I have been asked to provide evidence regarding the wearing of outside footwear in the operating theatres. A couple of surgeons at our facility have expressed concern that outside footwear is a risk and I am unable find very little evidence to convince them otherwise. Most references do recommend closed in footwear that can be easily cleaned, but this seems to be more OS&E related, rather than infection prevention and control.
The same surgeons don’t seem to think that wearing scrubs outside the complex or the hospital is a risk though!
Does anyone have any thoughts on this one?
Thanks
BarbaraBarbara Elliott I Coordinator Infection Prevention & Control I St John of God Subiaco Hospital
Level 3, 12 Salvado Road SUBIACO WA 6008
P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E: barbara.elliott@sjog.org.auMessages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.
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Barbara,
I know my opinion may not be popular, perhaps “politically incorrect”, but this appears to be a classical case where the onus to provide evidence should be with those who want to change standard, internationally accepted practice. Standard practice is to have footwear that can be easily cleaned or disinfected and is confined to the theatre area.
The question should be: “If anyone would like to change practice and wear outside footwear in operating theatres, then please show me the evidence that wearing outside footwear is NOT associated with an increase in infection rates as opposed to wearing easy-to-clean footwear confined to theatres”.
I am almost certain that some of the US AORN papers and recommendations would have some details on this, as they are usually quite detailed.
It is also a matter of common sense. Outside footwear may have been worn in mud, bring in dirt, etc., and is uncontrolled in that regard, whereas footwear confined to the theatre area has never left it.
Best regards, Matthias.
—
Matthias Maiwald, MD, FRCPA
Consultant in Microbiology
Adj. Assoc. Prof., Natl. Univ. Singapore
Department of Pathology and Laboratory Medicine
KK Women’s and Children’s Hospital
100 Bukit Timah Road
Singapore 229899
Tel. +65 6394 8725 (Office)
Tel. +65 6394 1389 (Laboratory)
Fax +65 6394 1387Hi All,
I have been asked to provide evidence regarding the wearing of outside footwear in the operating theatres. A couple of surgeons at our facility have expressed concern that outside footwear is a risk and I am unable find very little evidence to convince them otherwise. Most references do recommend closed in footwear that can be easily cleaned, but this seems to be more OS&E related, rather than infection prevention and control.The same surgeons don’t seem to think that wearing scrubs outside the complex or the hospital is a risk though!
Does anyone have any thoughts on this one?
Thanks
BarbaraBarbara Elliott I Coordinator Infection Prevention & Control I St John of God Subiaco Hospital
Level 3, 12 Salvado Road SUBIACO WA 6008
P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E: barbara.elliott@sjog.org.au
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Hi Barbara
My thoughts are that any changes in standard practice should have evidence to show the change will NOT increase infection risks. Maybe they would be willing to enter into a long term study (would need to be long term, as to show a rise in overall infection rate would take quite a sample size). Good luck in them getting ethics approval for such a study though! I also doubt the majority of orthopods and cardiothoracic surgeons would support such a study….
There was an old document published in the UK about rituals in theatres, it has some interesting thoughts about some of these things. It is mainly opinion based, but might be worth sending to the questioning surgeons as the basis for some further discussion!
http://www.his.org.uk/_db/_documents/Rituals-02.doc
This document suggests overshoes are actually more problematic than they are worth, but we still need to keep operating room floors clean.
I won’t comment much on the wearing of theatre clothes except to say think there is so little evidence to support this from an surgical site infection prevention perspective. It is mainly about controlling the risk of BBF exposures to other parts of the hospital as far as I am concerned.
Cheers
MichaelMichael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
e: Michael.Wishart@hsn.org.au
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this emailHi All,
I have been asked to provide evidence regarding the wearing of outside footwear in the operating theatres. A couple of surgeons at our facility have expressed concern that outside footwear is a risk and I am unable find very little evidence to convince them otherwise. Most references do recommend closed in footwear that can be easily cleaned, but this seems to be more OS&E related, rather than infection prevention and control.The same surgeons don’t seem to think that wearing scrubs outside the complex or the hospital is a risk though!
Does anyone have any thoughts on this one?
Thanks
BarbaraBarbara Elliott I Coordinator Infection Prevention & Control I St John of God Subiaco Hospital
Level 3, 12 Salvado Road SUBIACO WA 6008
P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E: barbara.elliott@sjog.org.au
[cid:ZVVKAZRJVWXD.IMAGE_22.jpg]
Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of ACIPC.Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
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WARNING : This email contains information, which is CONFIDENTIAL, and that maybe subject to LEGAL PRIVILEGE. This e-mail and any attachments to it (the “Communication”) is confidential and is for the use only of the intended recipient, and may not duplicated or used by any other party without the express consent of the sender. The Communication may contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”), or any of its related entities or of third parties. If you are not the intended recipient of the Communication, please notify the sender immediately by return e-mail, delete the Communication, and do not read, copy, print, retransmit, store or act in reliance on the Communication. Any views expressed in the Communication are those of the individual sender only, unless expressly stated to be those of SVHAC. SVHAC does not guarantee the integrity of the Communication, or that it is free from errors, viruses or interference. Thank-you.Message protected by MailGuard: e-mail anti-virus, anti-spam and content filtering.http://www.mailguard.com.au/mg
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Hi Michael, we were discussing some of these issues at our hospital &
the feedback from one of our operating room nurse educators I thought I
would shareHi
Well we originally started off with canvas boots (not to mention the
cotton mask and boiler suits & starched scrubs), back on track now – the
canvas boot were to conduct the static electricity to the floors which
had copper rods running through them. It was only after the explosive
anaesthetic agent became less common the canvas boot remained in use
without the antistatic strap that ran from inside the boot to the
outside sole of the boot. It was seen as a standard, not really a sacred
cow! Hence we have now moved to dedicated footwear in the OR.The second point is that the beds, in most facilitates travel through
the hospital and into the operating room – one hopes that the bed
haven’t travel through the local farm and transferring organic material
into the OR.Finally, the floor should be acknowledged as the dirtiest area in the
department, therefore what is on the floor should stay on the floor.Regards
David Derrick
Acting Perioperative Educator | Operating Theatre
2nd Floor Crawford House, Hunter St, Lismore. NSW 2480
Tel 02 6620 7534 | Mob 0429 882 819 |
david.derrick@ncahs.health.nsw.gov.auBehalf Of Michael Wishart
Hi Barbara
My thoughts are that any changes in standard practice should have
evidence to show the change will NOT increase infection risks. Maybe
they would be willing to enter into a long term study (would need to be
long term, as to show a rise in overall infection rate would take quite
a sample size). Good luck in them getting ethics approval for such a
study though! I also doubt the majority of orthopods and cardiothoracic
surgeons would support such a study….There was an old document published in the UK about rituals in theatres,
it has some interesting thoughts about some of these things. It is
mainly opinion based, but might be worth sending to the questioning
surgeons as the basis for some further discussion!http://www.his.org.uk/_db/_documents/Rituals-02.doc
This document suggests overshoes are actually more problematic than they
are worth, but we still need to keep operating room floors clean.I won’t comment much on the wearing of theatre clothes except to say
think there is so little evidence to support this from an surgical site
infection prevention perspective. It is mainly about controlling the
risk of BBF exposures to other parts of the hospital as far as I am
concerned.Cheers
Michael
Michael Wishart
CNC Infection Control
Holy Spirit Northside Private Hospital
627 Rode Road, Chermside, Qld 4032
t: (07) 3326 3068 | f: (07) 3326 3523
w:www.holyspiritnorthside.org.au
Please consider the environment before printing this email
Behalf Of Barbara Elliott
Hi All,
I have been asked to provide evidence regarding the wearing of outside
footwear in the operating theatres. A couple of surgeons at our facility
have expressed concern that outside footwear is a risk and I am unable
find very little evidence to convince them otherwise. Most references do
recommend closed in footwear that can be easily cleaned, but this seems
to be more OS&E related, rather than infection prevention and control.The same surgeons don’t seem to think that wearing scrubs outside the
complex or the hospital is a risk though!Does anyone have any thoughts on this one?
Thanks
Barbara
Barbara Elliott I Coordinator Infection Prevention & Control I St John
of God Subiaco HospitalLevel 3, 12 Salvado Road SUBIACO WA 6008
P: 08 9382 6871 F: 08 9382 6785 M: 0413706384 E:
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WARNING : This email contains information, which is CONFIDENTIAL, and
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to it (the “Communication”) is confidential and is for the use only of
the intended recipient, and may not duplicated or used by any other
party without the express consent of the sender. The Communication may
contain copyright material of St Vincent’s Health & Aged Care(“SVHAC”),
or any of its related entities or of third parties. If you are not the
intended recipient of the Communication, please notify the sender
immediately by return e-mail, delete the Communication, and do not read,
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Any views expressed in the Communication are those of the individual
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