Infection control practices to reduce airborne bacteria during total knee replacement: a hospital survey in four states.

View Abstract

OBJECTIVE

To describe the use of laminar airflow, body exhaust, and ultraviolet lights during total knee replacement (TKR) in four U.S. states.

DESIGN

Survey of healthcare facilities.

SETTING

Hospitals in Illinois, North Carolina, Ohio, and Tennessee that performed TKR during 2000 as identified by Medicare claims data.

PARTICIPANTS

Hospitals responding to a mailed questionnaire.

RESULTS

Two hundred ninety-five (73%) of 405 eligible hospitals that performed 18,374 primary and revision TKR procedures responded to the questionnaire. Among responding hospitals, 30% reported regular use (for > 75% of procedures) of laminar airflow, 42% reported regular use of body exhaust, and 5% reported regular use of ultraviolet lights. Among hospitals providing complete data, 150 (58%) performing 66% of procedures reported regular use of at least one of these techniques. On regression analyses, laminar airflow was used more often by hospitals with a TKR volume greater than 25 procedures per year (odds ratio [OR], 2.0; 95% confidence interval [CI95], 1.1-3.7) and orthopedic residency programs (OR, 2.8; CI95, 1.3-6.3), but its use was not significantly related to hospital setting or ownership status.

CONCLUSIONS

Although these clean air practices are not recommended by any U.S. governmental or professional organization, they are used in nearly two-thirds of TKR procedures. Better information about their impact on current practice and more explicit guidelines may aid decisions about the use of these resource-intensive infection control practices.

Investigators
Abbreviation
Infect Control Hosp Epidemiol
Publication Date
1999-11-30
Volume
26
Issue
12
Page Numbers
910-5
Pubmed ID
16417030
Medium
Print
Full Title
Infection control practices to reduce airborne bacteria during total knee replacement: a hospital survey in four states.
Authors
Miner AL, Losina E, Katz JN, Fossel AH, Platt R