title: Attitudes, risk of infection and behaviours in the operating room (the ARIBO Project): a prospective, cross-sectional study.
abstract: BACKGROUND
  Inappropriate staff behaviours can lead to environmental contamination in the operating room (OR) and subsequent surgical site infection (SSI). This study will focus on the continued assessment of OR staff behaviours using a motion tracking system and their impact on the SSI risk during surgical procedures.
  
  
  METHODS
  This multicentre prospective cross-sectional study will include 10 ORs of cardiac and orthopaedic surgery in 12 healthcare facilities (HCFs). The staff behaviour will be assessed by an objective, continued and prolonged quantification of movements within the OR. A motion tracking system including eight optical cameras (VICON-Bonita) will record the movements of reflective markers placed on the surgical caps/hoods of each person entering the room. Different configurations of markers positioning will be used to distinguish between the staff category. Doors opening will be observed by means of wireless inertial sensors fixed on the doors and synchronised with the motion tracking system. We will collect information on the OR staff, surgical procedures and surgical environment characteristics. The behavioural data obtained will be compared (1) to the 'best behaviour rules' in the OR, pre-established using a Delphi method and (2) to surrogates of the infectious risk represented by microbiological air counts, particle counts, and a bacteriological sample of the wound at closing. Statistics will be performed using univariate and multivariate analysis to adjust on the aerolic and architectural characteristics of the OR. A multilevel model will allow including surgical specialty and HCFs effects. Through this study, we will develop an original approach using high technology tools associated to data processing techniques to evaluate 'automatically' the behavioural dynamics of the OR staff and their impact on the SSI risk.
  
  
  BACKGROUND
  Approbation of the Institutional Review Board of Paris North Hospitals, Paris 7 University, AP-HP (no 11-113, 6 April 2012). The findings will be disseminated through peer-reviewed journals, and national and international conference presentations.
authors.affiliation: IAME, UMR 1137, Univ Paris Diderot, Sorbonne Paris Cité, Paris, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Birgand
authors.forename: Christine
authors.initials: C
authors.lastname: Azevedo
authors.forename: Gaelle
authors.initials: G
authors.lastname: Toupet
authors.forename: Roger
authors.initials: R
authors.lastname: Pissard-Gibollet
authors.forename: Bruno
authors.initials: B
authors.lastname: Grandbastien
authors.forename: Eric
authors.initials: E
authors.lastname: Fleury
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lucet
mesh_terms: D001291:Attitude of Health Personnel; D003430:Cross-Sectional Studies; D003697:Delphi Technique; D005602:France; D006801:Humans; D017053:Infection Control / Q000379:methods / Q000458:organization & administration; D009873:Operating Rooms / Q000458:organization & administration / Q000592:standards; D018570:Risk Assessment / Q000379:methods; D013503:Surgery Department, Hospital / Q000458:organization & administration / Q000592:standards; D013530:Surgical Wound Infection / Q000517:prevention & control*; D013647:Task Performance and Analysis