Research hotspots and theme analysis of infection management in operating room based on Nvivo software.

Objective To analyze the research hotspots and theme in the field of infection prevention and control（infection control) management in operating room in recent six years in China, so as to provide reference for further research on infection control management in operating room. Methods The articles related to infection control management in operating room published in China National Knowledge Infrastructure（CNKI), Wanfang and VIP databases from 2015 to 2021 were selected as the research objects, and Nvivo software query, coding and cluster analysis were adopted as the main methods to visually present the research hotspots and theme groups in the field of infection management in operating rooms. Results A total of 128 literatures with 30 high-frequency keywords were included. After free coding, 8 parent nodes, 28 child nodes, 60 secondary nodes and 1 736 coding reference points were formed. Six theme groups had been formed, which were the guidelines for infection control of COVID-19 infection, construction and management of clean operating rooms, management of relevant personnel in operating rooms, management of surgical supplies, operating room environment control, theoretical support and occupational exposure control. Conclusion The research content related to infection control management in operating rooms is becoming increasingly mature, and is constantly improving in line with the development of the times. The research direction and theory are also showing a trend of diversification. In response to the huge challenge of COVID-19 situation, it is supposed to preparing for surgery protection in general hospitals actively, ensure the safety of patients and medical staff, and prevent hospital infection events. (English) [ FROM AUTHOR] 目的 分析国内近6年手术室感染预防和控制(感控)管理领域的研究热点和主题内容, 为手 术室感控管理的进一步研究提供借鉴。方法 选取2015-2021年中国知网、万方和维普等数据库刊出的手术 室感控管理相关内容的期刊论文作为研究对象, 主要采用 Nvivo软件查询、编码、聚类分析等研究方法, 以可视 化方式呈现手术室感控管理领域的研究热点和主题类团。结果 共纳入128篇文献, 30个高频关键词;经自由 编码形成8个树状节点、28个子节点、60个次节点、1736个编码参考点;形成6个主题类团, 分别为新型冠状 病毒(新冠病毒)感染疫情感染防控指引、洁净手术室建设与管理、手术室相关人员管理、手术用品管理、手术室 环境管控、理论支持与职业暴露管控。结论 手术室感控管理相关研究内容日渐成熟, 且紧扣时代发展不断完 善, 研究方向和理论也呈多元化趋势。在应对新冠病毒感染疫情的巨大挑战下积极做好综合医院的手术防护 准备工作, 保障患者和医务人员安全, 防止医院内感染事件的发生。 (Chinese) [ FROM AUTHOR] Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Metrics of efficient use of operating rooms during the SARS-CoV-2 (COVID-19) pandemic

Introduction: the COVID-19 pandemic has induced a transformation in the way hospitals function, causing a decrease in the time and efforts dedicated to surgical activity, which in turn has caused delays in the surgery schedule of most hospitals. This represents a major public health problem, significantly compromising the principle of equity that inspires public health systems throughout the world. To address this problem, it would be of the utmost importance to put in place initiatives to measure and improve surgical efficiency. Objective: evaluate indicators of efficiency in the use of operating rooms during the COVID-19 pandemic. Material and methods: a descriptive, longitudinal retrospective study was conducted on 3554 patients scheduled for surgery during a one-year period of the COVID-19 pandemic. Indicators of efficiency in they use of operating rooms were measured. The data was processed using SPSS v-25.0. Results: a total of 3,554 surgeries were scheduled, 1,309 of them emergency surgeries, 1,979 elective surgeries, and 266 deferred surgeries. The following parameters were estimated: Starting time of the procedure (42.32 ± 37.04 min);opportunity for emergency surgeries (104.69 ± 102.55 min);starting time of anesthesia (10.11 ± 9.85 min);starting time of surgery (40.03 ± 24.68 min);time of admission to post-anesthesia care unit/intensive care unit (PACU/ICU) (15.35 ± 29.94 min);turnover or replacement time (177.97 ± 174.33 min);active surgery time (27.70%). Conclusions: the COVID-19 pandemic negatively impacted the indicators of efficient use of operating rooms, posing new challenges for the management and organization of surgical work. (English) [ FROM AUTHOR] Introducción: la pandemia por COVID-19 ha emplazado una transformación hospitalaria, esto acarreó un decremento de la actividad quirúrgica e implicó un aplazamiento en la programación, lo que representó un problema, ya que comprometió sensiblemente el principio de equidad que inspira a los sistemas sanitarios. Así, resultó imperativa la implementación de iniciativas para medir y mejorar la eficiencia quirúrgica. Objetivo: medir los indicadores de uso eficiente del quirófano durante la pandemia por COVID-19. Material y métodos: se realizó un análisis descriptivo, longitudinal y retrospectivo en 3,554 pacientes programados para cirugía, durante la pandemia en un período de un año, además se midieron los indicadores de uso eficiente del quirófano. Los datos fueron procesados en SPSS v-25.0. Resultados: se programaron 3,554 cirugías, 1,309 urgencias, 1,979 electivas, 266 diferidas. Se estimó un tiempo de inicio del procedimiento 42.32 ± 37.04 min, oportunidad para urgencias quirúrgicas 104.69 ± 102.55 min, tiempo de inicio de anestesia 10.11 ± 9.85 min, tiempo de inicio de cirugía 40.03 ± 24.68 min, tiempo para la admisión en la unidad de cuidados postanestésicos/unidad de terapia intensiva (UCPA/UTI) 15.35 ± 29.94 min, tiempo de rotación o recambio 177.97 ± 174.33 min y tiempo quirúrgico activo 27.70%. Conclusiones: la pandemia por COVID-19 impactó negativamente en los indicadores de uso eficiente del quirófano, lo que implicará nuevos retos en la gestión y organización de la jornada quirúrgica para su mejora. (Spanish) [ FROM AUTHOR] Copyright of Revista Mexicana de Anestesiologia is the property of Colegio Mexicano de Anestesiologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Research hotspots and theme analysis of infection management in operating room based on Nvivo software

Objective To analyze the research hotspots and theme in the field of infection prevention and control（infection control) management in operating room in recent six years in China, so as to provide reference for further research on infection control management in operating room. Methods The articles related to infection control management in operating room published in China National Knowledge Infrastructure（CNKI), Wanfang and VIP databases from 2015 to 2021 were selected as the research objects, and Nvivo software query, coding and cluster analysis were adopted as the main methods to visually present the research hotspots and theme groups in the field of infection management in operating rooms. Results A total of 128 literatures with 30 high-frequency keywords were included. After free coding, 8 parent nodes, 28 child nodes, 60 secondary nodes and 1 736 coding reference points were formed. Six theme groups had been formed, which were the guidelines for infection control of COVID-19 infection, construction and management of clean operating rooms, management of relevant personnel in operating rooms, management of surgical supplies, operating room environment control, theoretical support and occupational exposure control. Conclusion The research content related to infection control management in operating rooms is becoming increasingly mature, and is constantly improving in line with the development of the times. The research direction and theory are also showing a trend of diversification. In response to the huge challenge of COVID-19 situation, it is supposed to preparing for surgery protection in general hospitals actively, ensure the safety of patients and medical staff, and prevent hospital infection events. (English) [ FROM AUTHOR] 目的 分析国内近6年手术室感染预防和控制(感控)管理领域的研究热点和主题内容, 为手 术室感控管理的进一步研究提供借鉴。方法 选取2015-2021年中国知网、万方和维普等数据库刊出的手术 室感控管理相关内容的期刊论文作为研究对象, 主要采用 Nvivo软件查询、编码、聚类分析等研究方法, 以可视 化方式呈现手术室感控管理领域的研究热点和主题类团。结果 共纳入128篇文献, 30个高频关键词;经自由 编码形成8个树状节点、28个子节点、60个次节点、1736个编码参考点;形成6个主题类团, 分别为新型冠状 病毒(新冠病毒)感染疫情感染防控指引、洁净手术室建设与管理、手术室相关人员管理、手术用品管理、手术室 环境管控、理论支持与职业暴露管控。结论 手术室感控管理相关研究内容日渐成熟, 且紧扣时代发展不断完 善, 研究方向和理论也呈多元化趋势。在应对新冠病毒感染疫情的巨大挑战下积极做好综合医院的手术防护 准备工作, 保障患者和医务人员安全, 防止医院内感染事件的发生。 (Chinese) [ FROM AUTHOR] Copyright of Journal of Modern Medicine & Health is the property of Journal of Modern Medicine & Health and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

A Lean Approach for Reducing Downtimes in Healthcare: A Case Study

Lean Management is considered one of the most successful management paradigms for enhancing operational performance in the manufacturing environment. However, it has been applied throughout the years to several sectors and organisational areas, such as service, healthcare, and office departments. After the Covid-19 outbreak, increasing attention has been given to potential performance improvements in healthcare organisations by leveraging Lean. This paper intends to add further knowledge to this field by presenting a case study in a hospital. In this paper, a pilot project is presented carried out in a healthcare organisation. Lean methods were used to improve the operating room performance, particularly by reducing the operating room changeover time. The A3 template was used to drive the project and implement a new procedure using the Single Minute Exchange of Die (SMED) method. With the implementation of the new procedure, the changeover time between two different surgeries in the operating room was significantly reduced, together with a more stable and reliable process. © 2023, IFIP International Federation for Information Processing.

A comparative study looking at trauma and orthopaedic operating efficiency in the COVID-19 era.

BACKGROUD: COVID-19 has led to a reduction in operating efficiency. We aim to identify these inefficiencies and possible solutions as we begin to pursue a move to planned surgical care. METHODS: All trauma and orthopaedic emergency surgery were analysed for May 2019 and May 2020. Timing data was collated to look at the following: anaesthetic preparation time, anaesthetic time, surgical preparation time, surgical time, transfer to recovery time and turnaround time. Data for 2019 was collected retrospectively and data for 2020 was collected prospectively. RESULTS: A total of 222 patients underwent emergency orthopaedic surgery in May 2019 and 161 in May 2020. A statistically significant increase in all timings was demonstrated in 2020 apart from anaesthetic time which demonstrated a significant decrease. A subgroup analysis for hip fractures demonstrated a similar result. No increase in surgical time was observed in hand and wrist surgery or for debridement and washouts.Although the decrease in anaesthetic time is difficult to explain, this could be attributed to a reduction in combined anaesthetic techniques and possibly the effect of fear. The other increases in time demonstrated can largely be attributed to the PPE required for aerosol generating procedures and other measures taken to reduce spread of the virus. These procedures currently form a large amount of the orthopaedic case load. CONCLUSION: COVID-19 has led to significant reductions in operating room efficiency. This will have significant impact on waiting times. Increasing frequency of regional anaesthesia concurrently with non-aerosol generating surgeries may improve efficiency.

Cardiac surgeons between apprehension and ethical duty in the COVID-19 pandemic.

BACKGROUND: Cardiothoracic surgeons are facing a big challenge in their surgical practice in the era of the COVID-19 pandemic. The attitude towards performing surgery is influenced by the pandemic. Setting special recommendations for safe cardiothoracic surgery is of extreme importance. METHODS: This was an observational cross-sectional survey that included 77 Egyptian cardiothoracic surgeons. The survey consisted of a self-administered constructed questionnaire with six sections, and was delivered as a Google Forms questionnaire (https://www.google.com/forms/about) that was sent to individuals via social networks and email. RESULTS: More than 80% of Egyptian cardiothoracic surgeons believe they and their patients are at risk. Out of all participants, none had actually been infected with COVID-19 but 26% had encountered a positive COVID-19 person in their surgical team. Although 51% were testing patients before surgery, they reported 9 confirmed cases postoperatively. Computed tomography was the most recommended investigation prior to surgery (by 69%). Most had postponed elective surgeries and only one-third of all surgeons recommended performing elective surgeries cautiously with pretesting for COVID-19 and maximizing protective measures, while more than 40% recommended not performing high-risk elective surgeries. CONCLUSION: We are committed to the safety of our patients, ourselves, our staff, and our families. Planning for the new phase of reopening, whether total reopening or step-by-step reopening, should carefully consider how we should utilize our resources, respect social distancing, and prevent exposure to untested patients or health workers who might turn out to be an undetected positive case.

The Experiences of Operating Room Nurses During COVID-19 Pandemic: A Qualitative Study.

PURPOSE: The aim of this study was to determine the changes in the physical, mental, and social conditions of operating room nurses and their personal experiences during the COVID-19 pandemic. DESIGN: The study applied a qualitative research design that included the content analysis method. METHODS: Face-to-face interviews were conducted online with 26 operating room nurses. Analysis of the data was completed in six steps using the content analysis method. FINDINGS: Four main themes emerged from the interviews: physical effect of the COVID-19 pandemic on operating room nurses, psychological effect of the COVID-19 pandemic on operating room nurses, operating room nurses' perceptions on the training given to them during the COVID-19 pandemic, and effects of the COVID-19 pandemic on health care worker and patient safety and nursing care. CONCLUSIONS: This study contributes new findings on the experiences of operating nurses during the COVID-19 pandemic to the relevant literature. The results of the study indicated that the nurses were negatively affected both physically and psychologically during this period, and that this directly affected patient care.

Comparing the Need for Recovery in the Operating Room Practitioners with and Without Covid-19 Infection History

Background: Healthcare staff are at the heart of the covid-19 pandemic and play an important role in controlling this disease. Operating room practitioners could be contaminated by a coronavirus, which imposes a high pressure on them, affecting their need for recovery from work. This study aimed to compare the need for recovery in the operating room practitioners with and without covid-19 infection history. Methods: This cross-sectional study was conducted in the operating room department of a public hospital on 217 operating room practitioners, including Operating room technicians, anaesthesiologists, and service staff. The data collection tools were a demographics questionnaire and the need for recovery scale. Descriptive statistics, independent sample t-test, and one-way ANOVA were used for data analysis. Results: The mean and standard deviation of the need for recovery score in the studied population were 71.30±21.40. The practitioners with covid-19 infection history had a significantly higher need for recovery (P=0.001) than those without covid-19 history. In addition, the service staff had a higher percentage of covid-19 infection and had more need for recovery than operating room technicians (P=0.014). Conclusion: The operating room practitioners with a history of covid-19 infection had a significantly higher need for recovery than those without a history of infection. Therefore, protecting the operating room practitioners against covid-19 infection is the first step in preventing the excessive need for recovery levels. In addition, increasing the number of operating room staff, reducing the number of working hours, and paying more attention to their work-life quality can help reduce their need for recovery. © 2022 The authors.

Impact of the COVID-19 pandemic on the planning of operating theatres: Case of the Department of Orthopedic Surgery B4 of Hassan II University Hospital in Fez, Morocco

Background: The COVID-19 pandemic has forced the cessation of all non-urgent surgical activity in Morocco. In order to reschedule the delayed interventions, a quantification of the decline in activity is necessary. The aim of this work was to evaluate compared to 2019 the reduction in trauma and orthopedic surgical activity during 2020. Methods: This is a retrospective analytical study performed in the orthopedic surgery department B4 of the Hassan II University Hospital of Fez, comparing the surgical activity of the department in 2020 with the reference year 2019. Including all patients operated in the department during these two years. The data collected were: dates of interventions, surgical indications, type of intervention, type of hospitalization and time of occupation of the operating room. The comparison was made by calculating the variation between the two years according to months, type of surgery and surgical categories. The data received were entered and processed in Excel 2013. Different proportions were compared using a Chi2 test. Results: We observed a decrease in the overall activity of the service of 46% between 2019 and 2020 (1022 and 551 interventions respectively). The oncology activity recognized the largest drop of 72%. Ambulatory and orthopedic activities decreased by 64% and 62%. Approximately 1109 hours of surgery will need to be rescheduled to make up for the canceled operating program. Conclusion: Surgical activity has clearly decreased after the decision to confine and postpone any non-urgent activity, in favor of the care of patients with Covid-19. To cope with this critical situation, a massive and balanced reprogramming is necessary, taking into consideration the new patients. © 2022 IEEE.

The defects of lace-up surgical masks and related solutions in operating rooms.

BACKGROUND: It is difficult to make a lace-up surgical mask fit tightly to the face with conventional wearing methods because of the strings' poor tension, resulting in some air flowing through the gap. We introduced two feasible new wearing methods and obtained satisfactory experimental results. METHODS: The wearing of surgical masks by staff was investigated through observation and interview in operation rooms. The required time to don, close-fitting rates, and satisfaction of the conventional method and the two new recommended methods were counted and compared, according to the subjects' experience. The differences between the three wearing methods on the microbial contamination of the sterile area were explored in a mock operation. RESULTS: In the subjects' experience, the close-fitting rates were 47.0%, 92.0% and 100.0% in the conventional, Three Knots, and Elastic Band groups, respectively (P<0.001); the satisfaction scores evaluated by numerical rating scale from 0 to 10 were 5.06 ± 2.22, 6.89 ± 1.86 and 7.10 ± 1.72, respectively (P<0.001); the required times were 14.32 ± 2.20, 25.76 ± 5.13 and 27.37 ± 5.11 s, respectively (P<0.001). In the mock operation, there were significant differences between the conventional and Three Knots groups (37.5 (13) vs 18 (8) cfu, P<0.001), as well as between the conventional and Elastic Band groups (37.5 (13) vs 17(10) cfu, P<0.001). CONCLUSIONS: The recommended new wearing methods had the advantages of closer fit, higher satisfaction rates, were more comfortable, and resulted in lower contamination of the sterile area; however, the recommended two methods required more time.

[Recommendations for reopening elective surgery services during the SARS-CoV-2 pandemic]. / Recomendaciones para la reapertura de servicios de cirugía electiva durante la pandemia por SARS-CoV-2.

Given the uncertainty that accompanies the SARS-CoV-2 pandemic and the need to respond to multiple chronic and acute health problems affecting the general population, including those requiring surgical intervention, the recommendations implemented in clinics and hospitals in Colombia are presented as a guide to achieve a reopening of elective surgery services in a safe, staggered and monitored manner in accordance with the dynamics imposed by the pandemic, national and international guidelines and the speed of production of scientific evidence related to COVID-19.

Air exchanges, climate change, and severe acute respiratory coronavirus virus 2 (SARS-CoV-2): Results from a survey of the Society of Healthcare Epidemiology of America Research Network (SRN).

In this cross-sectional survey, we assessed knowledge, attitudes and behaviors regarding operating room air-change rates, climate change, and coronavirus disease 2019 (COVID-19) pandemic implications. Climate change and healthcare pollution were considered problematic. Respondents checked air exchange rates for COVID-19 and ∼25% increased them. Respondents had difficulty completing questions concerning hospital heating, ventilation and air conditioning (HVAC) systems.

COVID19 epidemic outbreak: operating rooms scheduling, specialty teams timetabling and emergency patients' assignment using the robust optimization approach.

The health care system is characterized by limited resources, including the physical facilities as well as skilled human resources. Due to the extensive fixed cost of medical facilities and the high specialization required by the medical staff, the problem of resource scarcity in a health care supply chain is much more acute than in other industries. In the pandemic of the Coronavirus, where medical services are the most important services in communities, and protective and preventive guidelines impose new restrictions on the system, the issue of resource allocation will be more complicated and significantly affect the efficiency of health care systems. In this paper, the problem of activating the operating rooms in hospitals, assigning active operating rooms to the COVID-19 and non-COVID-19 patients, assigning specialty teams to the operating rooms and assigning the elective and emergency patients to the specialty teams, and scheduling their operations is studied by considering the new constraints of protective and preventive guidelines of the Coronavirus. To address these issues, a mixed-integer mathematical programming model is proposed. Moreover, to consider the uncertainty in the surgery duration of elective and emergency patients, the stochastic robust optimization approach is utilized. The proposed model is applied for the planning of operating rooms in the cardiovascular department of a hospital in Iran, and the results highlight the role of proper management in supplying sufficient medical resources effectively to respond to patients and scheduled surgical team to overcome the pressure on hospital resources and medical staff results from pandemic conditions.

Swab test in biological fluids as predictor of COVID-19 transmission risk during surgery: a prospective cross-sectional study from an Italian COVID center.

BACKGROUND: The contamination of body fluids by Severe Acute Respiratory Syndrome Coronavirus 2 during surgery is current matter of debate in the scientific literature concerning CoronaVIrus Disease 2019. Surgical guidelines were published during the first wave of the COVID-19 pandemic and recommended to avoid laparoscopic surgery as much as possible, in fear that the chimney effect of high flow intraperitoneal gas escape during, and after, the procedure would increase the risk of viral transmission. AIM: The aim of this study was to evaluate the possibility of SARS-CoV-2 transmission during surgery by searching for viral RNA in serial samplings of biological liquids. METHODS: This is a single center prospective cross-sectional study. We used a real-time reverse transcriptase (RT) polymerase chain reaction (PCR) test to perform swab tests for the qualitative detection of nucleic acid from SARS-CoV-2 in abdominal fluids, during emergency surgery and on the first post-operative day. In the case of thoracic surgery, we performed a swab test of pleural fluids during chest drainage placement as well as on the first post-operative day. RESULTS: A total of 20 samples were obtained: 5 from pleural fluids, 13 from peritoneal fluids and two from biliary fluid. All 20 swabs performed from biological fluids resulted negative for SARS-CoV-2 RNA detection. CONCLUSION: To date, there is no scientific evidence of possible contagion by laparoscopic aerosolization of SARS-CoV-2, neither is certain whether the virus is effectively present in biological fluids.

On the COVID effect for OT-ICU systems

How does the COVID-19 pandemic influence the congestion probability of the ICU? In this paper two models are given to capture the interaction and effect of COVID to non-COVID patients at the ICU and its possible effect on postponed surgeries for a single hospital. Particularly a coordinate convex interdependence is allowed. So-called product form expressions are derived that can be used to compute Bt, the patient dependent congestion probabilities. It enables, as illustrated with real data, to calculate the congestion probabilities for the different patient types. © 2021 Samo Drobne – Lidija Zadnik Stirn – Mirjana Kljajić Borštnar – Janez Povh – Janez Žerovnik

Is a Video Worth a Thousand Words? Educating Preclinical Medical Students on Sterile Scrubbing, Gowning, and Gloving Virtually and In-Person.

INTRODUCTION: Programs that offer early exposure to surgery for medical students foster interest in and positive perceptions of surgery. The COVID-19 pandemic led to suspension of these activities at our institution, the University of Kansas School of Medicine. In response to the lack of virtual alternatives, a pilot virtual surgery enrichment program was implemented for first-year students in place of in-person surgical exposure. The aim of this study was to compare the efficacy of in-person and virtual-based surgical education programs to expose preclinical medical students about the surgical realm of medicine. METHODS: First-year medical students participated in either a virtual (Group A) or in-person (Group B) week-long surgical enrichment program. Group assignments were dictated by COVID restrictions on each of our three medical school campuses: Salina, Wichita, and Kansas City. Pre- and post-surveys with a 14-question multiple-choice assessment of surgical knowledge were distributed to participants. Paired Wilcoxon Signed Rank tests and Mann-Whitney-U tests were used for statistical analysis. RESULTS: There were 14 participants in Group A and 7 participants in Group B. Both groups improved significantly from pre- to post-assessment score. (Group A, p = 0.01; Group B, p = 0.04). There was no difference between groups in the magnitude of score improvement from pre- to post-assessment (p = 0.59). CONCLUSIONS: This pilot program demonstrated that virtual platforms can be a method to provide meaningful clinical experiences in surgery to preclinical medical students restricted from clinical activities. Further development of mentorship in virtual surgical programs and assessment of subjective experience is needed.

Effects of Inhalation Aromatherapy With Rosa damascena (Damask Rose) on the State Anxiety and Sleep Quality of Operating Room Personnel During the COVID-19 Pandemic: A Randomized Controlled Trial.

PURPOSE: Although aromatherapy with damask rose can reduce anxiety and improve sleep quality in different conditions, no study has yet addressed its effects among operating room (OR) personnel. Considering the high level of workload among Iranian OR personnel during the COVID-19 pandemic which can affect their anxiety and sleep quality, this study evaluated the effects of damask rose aromatherapy on state anxiety and sleep quality among a population of Iranian OR personnel during the COVID-19 pandemic. DESIGN: A randomized, nonblinded, parallel-group controlled trial. METHODS: Eighty OR personnel were divided into the two groups of damask rose and placebo (paraffin oil) using the stratified randomization method. In the first aromatherapy session, the participants inhaled two drops of either damask rose oil or paraffin oil for 10 minutes at the beginning of their morning shift. Then, they attached an absorbent cloth napkin impregnated with 5 drops of products to the side of their pillow for 30 consecutive nights. The Spielberger state anxiety inventory (SAI) and the Pittsburgh sleep quality index (PSQI) were completed before random allocation (T1) and on the 31st day of the study (T3). Also, the SAI was completed 90 minutes after the end of the first aromatherapy session (T2). FINDINGS: The mean changes in the SAI score were significant compared to T1 both at T2 and T3 in favor of the damask rose group (P < .001 in two cases). Similarly, the mean change in PSQI score was significant compared to T1 at T3 in favor of the damask rose group (P < .001). CONCLUSIONS: Damask rose can be effective in reducing state anxiety and improving sleep quality of OR personnel. Further studies are needed to determine the generalizability of the findings.

Operating-Room Procedures Do Not Increase Risk of COVID-19 Infection.

BACKGROUND AND OBJECTIVES: Operating-room procedures canceled due to the COVID-19 pandemic depleted hospital revenue and potentially worsened patient outcomes through disease progression. Despite safeguards to resume elective procedures, patients remain apprehensive of contracting COVID-19 during hospitalization and recovery. We investigated symptomatic COVID-19 infection in patients undergoing operating-room procedures during the spring 2020 outbreak in Fairfield County, CT, a heavily affected New York Metropolitan area. METHODS: We retrospectively analyzed 419 operating-room patients in Danbury and Norwalk Hospitals between 3/16/20 and 5/19/20. COVID-19 infection was assessed through test results or documented well-being within 2 weeks postdischarge. Variables studied were procedure classification, length of stay, and discharge disposition. Postprocedural COVID-19 infection was analyzed using binomial tests comparing rates to state-mandated infection data. RESULTS: Six patients developed COVID-19 after 212 urgent-elective and 207 emergent procedures. Overall postprocedural infection risk was equivalent to community infection risk (P > .05). No infections occurred in 1-2 day stays or urgent-elective procedures with discharge home (both P < .05). Discharges home reduced the risk to one-sixth of community spread (P = .03). Risk of infection doubled in hospitalizations > 5 days (P = .05) and quadrupled in discharges to extended care facilities (P = .01). DISCUSSION: Operating-room procedures did not increase the risk of symptomatic COVID-19 infection during an outbreak. Urgent-elective and emergent procedures during further outbreaks appear safe when anticipating short stays with discharges home. When anticipating prolonged hospitalization or discharges to facilities, appropriate delay of urgent-elective procedures may minimize risk of infection.

Negative pressure rooms and COVID-19.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes 2019 novel coronavirus disease (COVID-19), has rapidly developed into a global pandemic and public health emergency. The transmission and virulence of this new pathogen have raised concern for how best to protect healthcare professionals while effectively providing care to the infected patient requiring surgery. Although negative pressure rooms are ideal for aerosol-generating procedures, such as intubation and extubation, most operating theatres are generally maintained at a positive pressure when compared with the surrounding areas. This article compares negative and positive pressure rooms and the advantages of a negative pressure environment in optimising clinical care and minimising the exposure of patients and health care professionals to SARS-CoV-2.