Optimizing surgical site infection control systems: evaluating operating room ventilation system effectiveness in public hospitals

Adherence to ventilation standards/guidelines in hospital operating rooms is essential for preventing surgical site infections, controlling exposure to anesthetic gases and surgical smoke, and maintaining indoor air quality. This study evaluated the effectiveness of ventilation systems in 64 operating rooms across seven major hospitals. A cross-sectional design was used with stratified random sampling. Data were collected via a standardized checklist covering various aspects of the operating room ventilation system. Statistical methods included descriptive analysis, Kruskal-Wallis tests, parametric and non-parametric Item Response Theory (IRT), and cluster analysis. Effect sizes and reliability measures (Cronbach's Alpha, Mokken's H) were calculated. The mean total score was 18.5 (SD = 5.2), with wide variability among hospitals. High-scoring hospitals like H-4 (M = 25) and H-1 (M = 23) outperformed low-scoring ones like H-6 (M = 9.0). Subscale analysis showed ventilation and air filter deficiencies in low-performing hospitals. Parametric IRT revealed high item discrimination (e.g., QuestionV4, a = 1.2; QuestionE8, a = 1.5), and non-parametric IRT confirmed strong scalability (H = 0.58). Cluster analysis identified four performance groups. Compliance with ventilation standards/guidelines differs significantly among hospitals. Regular assessments and targeted improvements are crucial, particularly in underperforming settings. High-performing hospitals provide valuable benchmarks for identifying best practices.