The presence of personal items in the operating room (OR) raises concerns related to sterility, infection control, and procedural efficiency. Despite strict guidelines aimed at maintaining an aseptic environment, the use of personal items by healthcare professionals in the OR remains a topic of discussion in modern surgical practices. Personal items such as mobile phones, jewelry, and even pens can inadvertently compromise the sterile OR environment and pose risks to patient safety.
Mobile phones, one of the most common personal items in the OR, have been identified as significant reservoirs of microbial contamination. Studies have shown that mobile phones used by healthcare workers frequently harbor pathogenic microorganisms, including Staphylococcus aureus, Escherichia coli, and multidrug-resistant organisms such as MRSA (methicillin-resistant Staphylococcus aureus) (1). The frequent handling of these devices during work and personal time increases the likelihood of contamination. In the OR, where sterility is paramount, even momentary breaches caused by contaminated devices can result in nosocomial infections. This is particularly concerning for patients undergoing invasive procedures, as infections acquired in the OR are associated with increased morbidity, longer hospital stays, and higher healthcare costs.
Personal items like jewelry and watches can also compromise sterility in the OR. Studies have shown that rings, bracelets, and watches can harbor bacteria and create a microenvironment conducive to microbial growth, particularly in moist or occluded conditions (2). Despite the common practice of hand washing and the use of surgical gloves, these items can limit the effectiveness of proper hand hygiene and act as a focus for cross-contamination. Furthermore, jewelry poses a physical hazard as it can inadvertently tear gloves or compromise sterile drapes, potentially increasing the risk of surgical site infections (SSIs). Pens and similar personal accessories, while seemingly innocuous, have also been identified as vectors for microbial transmission. Healthcare workers often use personal pens throughout their shift, inadvertently transferring bacteria between contaminated surfaces and sterile zones. In surgical settings, the habit of placing pens in scrub pockets or on non-sterile surfaces further exacerbates the risk of contamination (2).
Despite the risks to sterility posed by personal items in the OR, the psychological and cultural factors that lead to their usage can be hard to resist. Healthcare workers often rely on their personal devices for communication and access to medical resources. However, this reliance must be balanced with strict adherence to infection control protocols. Technological advances, such as antimicrobial coatings for devices and the development of OR-specific tools, offer promising solutions to mitigate risk. Nonetheless, proper education and adherence to institutional policies remain the cornerstone of effective infection prevention (3).
Institutional policies aimed at minimizing the use of personal items in the OR increasingly emphasize the importance of education and compliance. Guidelines such as those from the Association of Perioperative Registered Nurses (AORN) and the Centers for Disease Control and Prevention (CDC) provide detailed recommendations for maintaining sterility in surgical environments (4). These guidelines discourage the presence of unnecessary personal items in the OR and emphasize the importance of thorough cleaning protocols for essential items. For example, mobile devices approved for use in the OR should be encased in cleanable covers and routinely disinfected to minimize microbial load.
Ultimately, the responsibility for maintaining a sterile OR environment rests with all members of the surgical team. Awareness, adherence to guidelines, and implementation of evidence-based practices can significantly reduce the risks associated with personal items. Ongoing research and advancements in infection prevention strategies will play a critical role in further minimizing the risk of contamination and improving patient safety in the OR.
References
- Ulger F, Esen S, Dilek A, Yanik K, Gunaydin M, Leblebicioglu H. Are we aware how contaminated our mobile phones with nosocomial pathogens? [published correction appears in Ann Clin Microbiol Antimicrob. 2009;8:31]. Ann Clin Microbiol Antimicrob. 2009;8:7. Published 2009 Mar 6. doi:10.1186/1476-0711-8-7
- Kampf G, Löffler H, Gastmeier P. Hand hygiene for the prevention of nosocomial infections. Dtsch Arztebl Int. 2009;106(40):649-655. doi:10.3238/arztebl.2009.0649
- Kneisley M. Guidelines in Practice: A Safe Environment of Care. AORN J. 2024;119(5):340-347. doi:10.1002/aorn.14125
- Centers for Disease Control and Prevention. Disinfection and sterilization. Updated May 24, 2019. Accessed December 14, 2024. Available at: https://www.cdc.gov/infection-control/hcp/disinfection-and-sterilization.