OR Traffic Control

Clinical Objective

Minimize airborne and contact contamination within the operating room by controlling personnel movement and door activity during surgery. OR traffic is a modifiable SSI risk factor that is frequently underestimated.

Why This Matters

Each door opening during a procedure displaces clean air and introduces particulates. Studies in human surgery have documented measurable increases in particulate count near the sterile field with each entry.

Critical Control Points

• OR doors closed throughout the procedure

• Single circulating nurse responsible for managing access

• Re-entry restrictions enforced for the duration of the case

Step-by-Step Protocol

1. 1

   Limit OR occupancy to the minimum required for the procedure — count personnel before starting.

2. 2

   Designate a circulating nurse responsible for managing access during the case.

3. 3

   Keep OR doors closed throughout the procedure; each door opening displaces clean air and introduces particulates.

4. 4

   Brief all team members before the procedure: no unnecessary movement, no exit-reentry without necessity.

5. 5

   Track door openings during the case as a quality metric — review at debrief.

6. 6

   Restrict observers and non-essential personnel.

Key Pitfalls

• Propping OR doors open between cases or during procedures — this fundamentally compromises positive pressure.

• Allowing non-essential students, observers, or staff to be present, particularly in small ORs.

• Failing to enforce re-entry restrictions: personnel who leave mid-case and return carry contamination back in.

• Performing OR cleaning cursorily between back-to-back cases.