Valencia, Spain | 16 - 18 May 2024 11th EORNA Congress Parallel Sessions 21 150 Intraoperative aseptic practices in orthopaedic operations - a Master’s thesis study Ninamari Pitko1 1Laurea University of Applied Sciences Background: According to previous study findings, aseptic and sterile techniques are always not fully adhered to in intraoperative settings and there are improvement areas in the aseptic practices of OR staff during surgery. Objectives: This study evaluated the actualized aseptic practices during sterile field establishment and maintenance phases compared to existing international and national guidelines and evidence-based recommendations during 49 orthopaedic surgeries in Finland. Methods: The study was implemented as a local small-scale observational clinical aseptic practice quality improvement study with statistical data analysis. Data collection was done with the constructed tool in which foci of observation were divided to seven main themes: Availability of hand hygiene products, hand hygiene realisation, preparations of the patient, establishment of sterile field, preparations of sterile personnel, aseptic behaviour and maintenance of sterile field. Results: Results show high adherence to most evaluated categories, but also that there are areas of improvement in sterile field establishment and maintenance, and aseptic behaviour during surgery. Timely antibiotic prophylaxis of 60 minutes before incision or tourniquet inflation was adherent in 97.7%. Preparations of the sterile team members were highly adhered (96.4%), double gloving and protective eyewear were used accordingly in 95.5%. Aseptic behaviour during surgery was adherent in most operations (90.7%), but it appeared that doors were often opened during surgery. The duration of the surgery was noticed to have an association with the number of door openings. Maintenance of sterile areas was adherent in 76.9%, where unscrubbed person did not move between two sterile areas in 81.6%. Eye contact and visible distance to sterile fields were kept in 79.6% when moving near sterile fields. Conclusion: To enable adequate IPC in intraoperative settings, implementation of regular multidisciplinary education, policy development and monitoring of aseptic practices were recommended. 223 Risk factors for position-related injuries in adult surgical patients: a systematic review and metaanalysis Veronica Ramirez Johansson1 2, Ann-Christin von Vogelsang2 3 1Karolinska University Hospital, Perioperative Medicine and Intensive Care, Stockholm, Sweden, 2Karolinska Institutet, Department of Clinical Neuroscience, Stockholm, Sweden, 3Karolinska University Hospital, Heart, Vascular and Neuro Theme, Stockholm, Sweden Background: Pressure- and nerve injuries are well-known complications due to positioning on the operating bed. Depending on the patient’s surgical position, anatomical prerequisites, intrinsic- and extrinsic risk factors, some patients can be more exposed to injuries than others. The length of the surgical procedure, high/low Body Mass Index, and comorbidities are examples of risk factors that affect the development of position-related injuries, but previous studies show varying and sometimes contrary results. The perioperative nurse ensures the patient safety in the operating room and has an important role in positioning the surgical patient. Objectives: To summarize the evidence on risk factors for the development of position-related pressure- or nerve injuries in connection with surgery. Methods: A systematic review and meta-analysis. Studies were identified through PubMed, Web of Science, CINAHL, Embase and Cochrane Library databases. Original articles, published between 1990 and 2022, were screened with the following inclusion criteria; adult patients undergoing surgery, all types of anesthesia, all types of surgical positions and identified risk factors for pressure- or peripheral nerve injuries. The PRISMA guidelines were followed throughout the review process. Results: The database searches resulted in 13 018 publications, whereof 40 studies were included in the review; 26 on pressure injuries and 14 on peripheral nerve injuries. Results from the systematic review and meta-analysis of risk factors will be presented during the conference. Conclusion: Summarized evidence on risk factors for position-related pressure- or nerve injuries in connection with surgery can increase the surgical teams’ awareness of risk for injuries and use of preventive measures during surgical positioning. The results can be used to construct a risk assessment instrument to predict position-related injuries in the surgical context.
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