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Govt-run eye centre OT shut down againJuly 16, 2015, DHNS:

Patient contracts infection post surgery

The Delhi government-run Guru Nanak Eye Centre was forced to shut down its operation theatre last week after a patient reportedly contracted infection in the post-operative state.

Even though the government officials maintained that all the OTs are operational now, a senior doctor claimed that around five operational tables were not operational even since Monday.

“The operation theatres are fully functional now, according to the official statement that we have received. The OTs were shut down for around three days last week. The OT was fumigated after this. We will inspect the hospital tomorrow and take stock of the situation,” said Rajesh Gupta, Health Parliamentary Secretary.

The government will now investigate if this is a return of last year’s infection at the OT, following which the theatres had to be shut thrice since May, 2014.

Bacterial infection in the operation theatre and contamination of water source had forced the hospital to shut down its operation theatre for long periods last year.

Contamination source

According to hospital sources, the vision of at least five parseons were affected then. For a long time, the team inspecting the hospital was unable to locate the source of contamination.

The government had also identified the faulty structural design of the operation theatre — one entry point and one exit — as one of the causes of the recurring infection.

“Last week, three persons contracted infection in the post-operative state. One of the persons is responding well to treatment. Two others are also under observation,” said a senior doctor, requesting anonymity.

Hospital sources said a few operational tables in the OT are still not functional. “Moreover, only extraocular operations are being conducted. Intraocular operations, like cataract which are more sensitive operations and have higher chances of infection, are being avoided,” said the doctor.

With the ongoing construction work on the campus and staff not maintaining high levels of hygiene standards, the operation theatre has increased chances of infection recurring, said doctors.

Once the OT remains shut for longer period of time, the waiting period for patients gets extended. With Guru Nanak Eye Centre being one of the key government-run eyecare hospitals, patients face a harrowing time with the OTs remaining shut.

In 2013, around 14,000 operations were conducted, said another senior doctor. “The numbers drastically came down to slightly over 5,000 last year,” the doctor added.

Source

http://www.deccanherald.com/content/489567/govt-run-eye-centre-ot.html

Kochi

Hygiene in casualty at medical collegeTNN | Oct 8, 2014, 01.05 PM IST

KOCHI: A day after two operation theatres were shut down by the government medical college, Ernakulam, following cases of infection, authorities have admitted that there is no supervisory mechanism in place to ensure hygiene.

The theatre committee, assigned to monitor safety aspects in operation theatres, has been defunct for quite some time.

However, the incident in which 14 persons allegedly contracted theatre-borne infection seems to have woken up the authorities.

"The theatre committee has been defunct for quite some time. We have convened an urgent meeting of the committee on Wednesday," said medical college principal DrPraveenlalKuttichira.

"The committee will provide guidelines on safety measures to be taken. It is up to the committee to manage and monitor the cleanliness in theatres. They will decide on how many theaters or tables are to be given to each department," he said.

It will take almost a week for the closed theatres to resume functioning. "But we have taken measures to ensure that patients do not suffer much. On Tuesday, we had to postpone 7-8 surgeries. But from Wednesday, we will use operation theatres for emergency cases also for routine cases," Kuttichira said.

The preliminary inquiry, conducted by the college principal, has put the number of post-surgery infections at eight.

"In eight cases, patients had developed fevers after surgery. In all the cases except one, the fever had subsided after we administered a few dose of antibiotics," he said.

Source

http://timesofindia.indiatimes.com/city/kochi/Hygiene-in-casualty-at-medical-college/articleshow/44698025.cms

J Prev Med Hyg. 2013 Sep;54(3):131-7.

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Operating theatre quality and prevention of surgical site infections.Spagnolo AM, Ottria G, Amicizia D, Perdelli F, Cristina ML.

Abstract

Surgical site infections (SSI) account for 14% to 17% of all hospital-acquired infections and 38% of nosocomial

infections in surgical patients. SSI remain a substantial cause of morbidity and death, possibly because of the

larger numbers of elderly surgical patients or those with a variety of chronic and immunocompromising

conditions, and emergence of antibiotic-resistant microorganisms. Factors causing surgical site infection are

multifarious. Several studies have identified the main patient-related (endogenous risk factors) and procedure-

related (external risk factors) factors that influence the risk of SSI. The rate of surgical wound infections is

strongly influenced by operating theatre quality, too. A safe and salubrious operating theatre is an environment

in which all sources of pollution and any micro-environmental alterations are kept strictly under control. This

can be achieved only through careful planning, maintenance and periodic checks, as well as proper ongoing

training for staff Many international scientific societies have produced guidelines regarding the environmental

features of operating theatres (positive pressure, exchanges of filtered air per hour, air-conditioning systems

with HEPA filters, etc.) and issued recommendations on healthcare-associated infection, including SSI,

concerning surveillance methods, intervention to actively prevent SSI and approaches to monitoring the

implementation of such strategies. Therefore, the prevention of SSI requires a multidisciplinary approach and

the commitment of all concerned, including that of those who are responsible for the design, layout and

functioning of operating theatres.

Source

http://www.ncbi.nlm.nih.gov/pubmed/24783890

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