Eating or Drinking in the OR: Another Safety Factor?
Article Outline
Nursing students are taught that no food or beverages are allowed in the OR. More and more often, however, they have reported to me that they see members of the surgical team eating during surgery or anesthesia personnel bringing in coffee or other drinks. This leads them to question the OR's designation as a “no eat, no drink” area.
Rationale against eating and drinking in the OR include patient safety concerns, the potential for accidents, and the negative effect on infection control. If the process of eating or drinking occupies a surgical team member's attention even for a short period, he or she may miss a crucial event during surgery that could affect patient safety and the surgical outcome. If a cup of coffee spills, it could leak into equipment; into the computer; or onto the floor, creating a slip hazard. The biggest problem is the potential impact on infection control. Could eating or drinking soil the person's clothes or hands, the floor, or table surfaces? Could it attract insects? AORN's “Recommended practices for prevention of transmissible infections” states that food and drink should not be present in the restricted and semi-restricted areas of the surgical suite.1(p623)
Why Do People Eat in the OR?
Personnel who eat or drink in the OR say they do so because there is no down time, there is no one to relieve them for breaks or lunches, or they have been on call or working too many days in a row and are eating or drinking to prevent fatigue. One nurse, who has a tendency to become hypoglycemic, told me she has to keep something in her pocket to snack on during long procedures or she runs the risk of becoming faint and sometimes disoriented. Others have told me they keep hard candy to eat or to slip under the mask of the surgeon or scrub person during very long procedures when they notice that the scrubbed team members are getting sluggish. Some procedures last through two shifts, which is much too long for the OR team to go without sustenance.
Finally, because down time has been minimized, personnel often barely get one surgical patient transferred from the OR when another must be assessed and taken to the room, allowing no time between procedures for a brief break. Practitioners who eat in the OR say that the food or drink does not jeopardize the sterile areas, and it is closely controlled so there are no leftovers to attract insects.
Eating and drinking in the OR seems to happen most often in traditional ORs. Ambulatory and office surgery practitioners perform shorter procedures. The surgery most often is scheduled during the day on a weekday, so these personnel are not likely to have worked extended hours or to have been on call. These factors may allow personnel more time for breaks and may account for the fact that eating or drinking in these environments does not appear to be as common.
Recommendations
Most institutions have strict policies against eating and drinking in the OR. All OR managers should review their facility's policy on providing lunches and other breaks for OR personnel during procedures. Anesthesia and surgical personnel should be involved in creating and maintaining these policies.
Surveys or descriptive studies could be used to identify the extent of this problem in the OR, including who is eating and drinking during the procedure, when, and why. This information could be used to address the issue proactively as we strive to make our practice more evidenced based.
Reference
PII: S0001-2092(08)00262-7
doi:10.1016/j.aorn.2008.04.004
© 2008 AORN, Inc. Published by Elsevier Inc All rights reserved.
