An eye on the air: Settle plate testing to measure air quality in a tertiary care ophthalmology department during fast track vs. regular cataract procedures
Mon statut pour la session
Authors: Aishwarya Sundaram, Joline Head, Ian Davis, Mark Seamone, Daniel M. O'Brien, Audra Russell-Tattrie, Christopher D. Seamone
Abstract Body:
Purpose: With the advent of new technology, the time required to perform cataract surgeries has significantly decreased. In our center, cataract surgeries are scheduled in two ways: traditional manner vs. fast track days. The differences between the two days is threefold, during fast track days: 1) there is no anesthesia coverage in the operating room (OR), 2) patients are brought into the OR in their street clothes, and 3) patients are pre-selected to be healthier with uncomplicated cataracts. Traditionally cataract surgery is performed with an anesthesia technician. As well, patients change into hospital gowns, presumably for infection prevention. The purpose of our study was to measure the impact of this type of fast track procedures on the air quality in the OR.
Study Design: Cohort design
Methods: The 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 each day. Settle plate testing is a passive form of measuring the air quality. Passive methods of sampling the air quality 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: 4 in each corner of the room and 2 in the surgical field (top of the microscope and the phacoemulsification machine). The plates were then analyzed for the number of colonies of bacteria and fungi that grew on the plates and the type of organism was 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 the 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 days (p<0.001 for both), 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 potentially 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.
