11th EORNA Congress Valencia, Spain | 16 - 18 May 2024 Parallel Sessions 14 Methods: The research is a phenomenological, qualitative research. The study was conducted with 9 nurses who working in the operating room. The data were collected using in-depth, face-to-face interview technique with a semi-structured interview form and a personal information form. The data obtained were analyzed using document and content analysis and thematic analysis. Results: As a result of the participants sharing their experiences, the findings consisted of 5 themes. Nurses defined medication labeling in the sterile field as distinguishing medications and identifying who opened/prepared them. Nurses identified antiseptic and irrigation solutions, local anesthetics, antibiotics, steroids, anticoagulants and antifibrinolytics as the drugs/solutions that should be labeled in the sterile field. For this process, practices such as dipping the syringe plunger in antiseptic solution, writing on the syringe with a sterile marker pen, using different sized syringes and needle tips, and localizing the medications in different areas on the table were identified. To use medication labeling in the sterile field as an effective method, it was said that there should be a certain standard and control mechanism in institutions. Conclusion: With the themes obtained, important information regarding the labeling of drugs in the sterile field was provided and it was recommended that nurses providing care in this field should receive the necessary training within the scope of this process and that current practices should be used in hospitals. 286 Local unidirectional airflow above the surgical instruments reduce bacterial contamination of the instrument area during orthopedic implant surgery in an operating room with conventional ventilation Josefin Seth Caous1 2, Karin Svensson Malchau1 3, Max Petzold4, Ylva Fridell3, Henrik Malchau3 5, Linda Åhlström3 6, Peter Grant1, Annette Erichsen3 6 1University of Gothenburg, Department of Orthopedics, Gothenburg, 2RISE Research Institutes of Sweden, Materials and Production, 3Sahlgrenska University Hospital, 4University of Gothenburg, Public Health and Community Medicine, 5Harvard Medical School, Boston, 6University of Gothenburg, Health & Care Sciences Background: Surgical site infection (SSI) is a dreaded complication after implant surgery, often leading to resource demanding treatment and implant replacement. Airborne bacterial contamination of the wound, either directly, or indirectly through air-contaminated instruments or implants, has been described as an important risk factor for SSI in orthopedic implant surgery. Objectives: The aim of this study was to evaluate if instrument and assistant tables equipped with local unidirectional airflow reduce bacterial contamination of the instrument area to ultra clean levels, during orthopedic implant surgery in an operating room (OR) with conventional displacement ventilation. Methods: Local airflow units of instrument and assistant tables were either active or inactive. Colony forming units were sampled intraoperatively from the air above the instruments and from instrument dummies. Three air filtration samples and two-three surface samples from instrument dummies were taken during each surgery. Air filters and surface imprints were incubated on agar for total aerobic bacterial count. The mean air and instrument contamination during each surgery was calculated and used to analyze the difference in contamination depending on use of local airflow or not. All procedures were performed in the same OR. Results: 188 air and 124 instrument samples were collected during 48 orthopedic implant procedures. Analysis showed that local unidirectional airflow above the surgical instruments significantly reduced the bacterial count in the air above the assistant table (p<0.001) and instrument table (p=0.002), as well as on the instrument dummies from the assistant table (p=0.001). Conclusion: Instrumentation tables equipped with local unidirectional airflow protect the surgical instruments from bacterial contamination during orthopedic implant surgery and may therefore reduce the risk of indirect wound contamination.
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