American journal of infection control · 2025
Operating room mixing of irrigation solutions "OR-MISS" survey: A look at "homebrew" OR practices in the United States.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Weber David J, Della Valle Craig J, Eby Jonathan M
Аннотация
BACKGROUND: Antiseptic wound irrigation is supported by clinical guidelines as a standard intraoperative practice. This survey of operating room (OR) personnel assessed OR-mixed or compounded (homebrew) irrigation solution practices to identify standardization opportunities, expose regulatory noncompliance, and improve patient safety and outcomes.
METHODS: A US national survey was conducted among 401 surgical personnel (216 OR nurses; 185 OR technicians) responsible for preparing irrigation solutions.
RESULTS: Findings showed 90% of solutions were made with nonsterile ingredients, though 69% believed they were sterile. During OR‑mixing, gloves were nonsterile or absent 45% of the time. In 50.2% of mixtures, the concentration was different than intended. Inexact measuring was used by 38% of respondents and 53% of the time solutions were not used within institutional policy time limits. Training was deficient in 22% of respondents and only 24% of facilities required competency assessment of irrigation mixing.
CONCLUSIONS: Serious concerns were identified with OR‑mixed irrigation solutions, including unknown/unintended concentrations, inadequate training and competency evaluations, using non-sterile ingredients, and nonsterile practices. Findings revealed noncompliance with recommended standards and a lack of standardization. Using a clinical practice guideline‑aligned ready‑to‑use irrigation solution instead of OR‑mixed ones may enhance compliance and potentially reduce wound contamination from the irrigation solutions.
METHODS: A US national survey was conducted among 401 surgical personnel (216 OR nurses; 185 OR technicians) responsible for preparing irrigation solutions.
RESULTS: Findings showed 90% of solutions were made with nonsterile ingredients, though 69% believed they were sterile. During OR‑mixing, gloves were nonsterile or absent 45% of the time. In 50.2% of mixtures, the concentration was different than intended. Inexact measuring was used by 38% of respondents and 53% of the time solutions were not used within institutional policy time limits. Training was deficient in 22% of respondents and only 24% of facilities required competency assessment of irrigation mixing.
CONCLUSIONS: Serious concerns were identified with OR‑mixed irrigation solutions, including unknown/unintended concentrations, inadequate training and competency evaluations, using non-sterile ingredients, and nonsterile practices. Findings revealed noncompliance with recommended standards and a lack of standardization. Using a clinical practice guideline‑aligned ready‑to‑use irrigation solution instead of OR‑mixed ones may enhance compliance and potentially reduce wound contamination from the irrigation solutions.