Decreasing Foot Traffic in the Orthopedic Operating Room: A Narrative Review of the Literature

Introduction: Surgical site infections (SSIs) are implicated in poor outcomes in orthopedic surgical patients. Decreasing foot traffic in orthopedic surgical suites is correlated with the reduction of SSI risk. This review aims to understand the background and significance of the problem, isolate factors contributing to the movement in and out of operating rooms, and identify interventions that decrease traffic in procedure areas.

Methods: A comprehensive search was completed using the databases Embase and Medline (Ovid). A PICOT question was used in the literature search to evaluate the efficacy of a standardized guideline on operating room door opening frequency. The Mixed Methods Appraisal Tool was used to appraise the literature critically, and conventional content analysis methodology identified themes within the publications.

Results: The literature search yielded 18 articles providing 3 different themes of evidence: airborne bacterial counts and their association with foot traffic; specific personnel, namely, nurses demonstrating the greatest amount of foot traffic; and interventions aimed at minimizing this foot traffic.

Conclusions: Implementing multiple evidence-based interventions can decrease foot traffic and reduce the risk of SSIs in orthopedic patients. Further studies are needed to directly link airborne bacterial counts to SSIs, increase the level of evidence, and isolate interventions.