OR Traffic Control & Environmental Management

Clinical Objective

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

Protocol Steps

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

   Maintain OR temperature between 18–24°C and relative humidity 40–60% per HVAC standards.

6. 6

   Ensure proper positive-pressure ventilation is functioning before beginning the procedure.

7. 7

   Conduct post-case cleaning with approved disinfectants before the next patient enters.

Key Pitfalls to Avoid

• 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.