1. Short summary / abstract
This report is from the working party set up by HIS in 1999, to examine best practice on operating theatre practice, environmental monitoring and optimal theatre facilities. This report is from sub-group 2 of that working party and aims to provide clear and practical guidelines for infection control practitioners and other healthcare staff working in operating theatres on rational, feasible and applicable guidance for the environmental monitoring (including bacteriological air sampling) of operating theatre facilities.
It looks at where monitoring is indicated, how it should be carried out and what action should follow if abnormal results found. The group reviewed literature where available and consulted with healthcare professionals and others as appropriate and achieved consensus where scientific evidence was not available.
Draft documents were widely circulated to professional groups and comments incorporated before posting on the HIS website in early 2001.
The report includes: -
· Overall principles of prevention of airborne microbial contaminants
· Commissioning of operating theatres to include conventionally-ventilated theatres and ultraclean ventilated (UCV) theatres
o interiors, ventilation engineering, air change rates, pressure differentials and airflow, microbiological sampling
· Monitoring of conventional and UCV theatres
o Routine, in a working theatre and the air handling unit
· Appendices include problems and actions, air filters, airflow indictors, examples of air samplers, model letter, certificate and guidance for completion of certificate for conventionally ventilated theatre and supplementary certificate of compliance for UCV theatres and guidance on completion.
The document provides clear guidance for the first time on monitoring operating theatres, will enable healthcare staff to understand the importance of the operating theatre environment and ventilation systems and as importantly recognise when something goes wrong
2. What question is the document addressing?
This report aims to provide clear and practical guidelines for infection control practitioners and other healthcare staff working in operating theatres on rational, feasible and applicable guidance for the environmental monitoring (including bacteriological air sampling) in both conventionally and ultraclean ventilated theatres.
3. Type of study
Review, best practice
4. Methods valid & appropriate?
Yes
Comments:
Reports from subgroup 1 and 3 can also be found on the HIS website. (see references)
5. Results / recommendations reliable?
Yes
6. Any major problems and biases?
Report was published 2001 any new research and technology which has been published or evolved since that time will not be included in this document.
7. Any other important / relevant studies which confirm or contradict?
1. Behaviours and Rituals in the Operating Theatre (2001) A Report from the Hospital Infection Society (HIS) Working Group on Infection Control in the Operating Theatres http://www.his.org.uk/
2. NHS Estates. Health Facilities Note (HFN) 30 – Infection Control in the Built Environment: design and planning. Knowledge and Information Portal http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/EstatesAndFacilitiesManagement/EstatesAndFacilitiesArticle/fs/en?CONTENT_ID=4118956&chk=gz0VFG
3. Department of Health. Winning Ways: Working together to reduce healthcare associated infection in England (2003) ) http://www.dh.gov.uk/assetRoot/04/06/46/89/04064689.pdf
4. The epic project: developing national evidence-based guidelines for preventing healthcare associated infections. Phase 1: guidelines for preventing hospital acquired infections. Journal of Hospital infection (2001) 47 (Supplement): S1-S82 http://www.dh.gov.uk/assetRoot/04/07/73/68/04077368.PDF
5. Infection Control: prevention of healthcare-associated infection in Primary and Community Care. Pellow CM, Pratt RJ, Harper P, Loveday HP, Robinson N, Jones S, MacRae ED, and the Guideline Development Group. (2003). Journal of Hospital Infection 55(Supplement 2): 1-127
http://www.nice.org.uk/pdf/CG2fullguidelineinfectioncontrol.pdf
6. The epic project. Updating the evidence-base for national evidence-based guidelines for preventing healthcare-associated infections in the NHS hospitals in England: a report with recommendations. Pellow CM, Pratt RJ, Loveday HP, Robinson N, Jones SRLJ> British Journal of Infection Control, December 2004, Vol 5 No 6
http://www.epic.tvu.ac.uk/PDFFiles/epic%201/epic%20update.pdf
7. NHS Estates. Health Technical Memorandum 2025: Ventilation in Healthcare Premises. 1994; Knowledge and Information Portal http://www.dh.gov.uk/PolicyAndGuidance/OrganisationPolicy/EstatesAndFacilitiesManagement/EstatesAndFacilitiesArticle/fs/en?CONTENT_ID=4118956&chk=gz0VFG
8. Keywords
Operating theatre commissioning theatre theatre ventilation air sampling ultra clean ventilation
Reviewer's Details:
| Name: | Sue Wiseman |
| Post: | Nurse Consultant –Infection Control, DH |
Affiliations
(Society / Organisation / Advisory Committee): | Member Advisory Committee on Dangerous Pathogens
Health Protection Adviser Royal College of Nursing P/T
Member Infection Control Nurses Association |
*** Note: These are the views of a professional expert rather than an official statement from his or her society, organisation or advisory committee.