Assessment of infection prevention practices in office-based surgery: a multicentre regional audit

Abstract

Abstract Background Office-based surgery (OBS) is increasingly used due to organizational constraints and perceived benefits. However, data on infection prevention and control (IPC) practices in OBS settings remain limited. This study aimed to assess the conditions in which OBS are performed, focusing on IPC measures. Methods A regional audit was conducted between July 2023 and January 2024. Healthcare facilities with at least one room dedicated to OBS were eligible. Four domains were assessed: architecture and organization, cleaning procedures, patient pathways, and professional practices. Data were collected during on-site visits by IPC professionals using standardized checklists based on direct observation and interviews. Individual and composite criteria were analysed. Results Forty OBS rooms from 15 centres (two university hospitals, eight public hospitals, and five private clinics) were included. A total of 173 procedures from 17 specialties were identified, mainly ophthalmology (33%), Ear, Nose and Throat (27%), dermatology (20%), and urology (15%). Mechanical ventilation was used in 80% of rooms and operating room-like ventilation (ISO Class 8 or 7 cleanroom) in 20%. Protocols for surgical hand disinfection by the surgeon before each procedure was present in 33% of teams. IPC training was reported by 67% of teams; 56% were trained in skin preparation and 40% in circulator roles. Skin preparation was explained to patients in 72% of pathways and documented in 44%. Public facilities scored significantly higher than private facilities for ventilation, room equipment, and patient pathway criteria (all p < 0.01). Conclusion OBS includes diverse procedures across varied settings and is performed by teams with heterogeneous awareness regarding IPC measures. Strengthening IPC training, standardization, and documentation could improve patient safety.