Surgical site infections (SSIs) can lead to increased mortality rates, extended hospital stays, and higher health care costs. Application of an effective operating room (OR) ventilation system is a crucial prevention strategy for SSIs, but standardized assessment tools are lacking.

A mixed-methods sequential exploratory design was used. The qualitative phase included literature and standards review and expert panel discussions to identify key domains and items. The quantitative phase assessed psychometric properties, including content validity and reliability. Sixty-four ORs across 7 hospitals were evaluated.

The ORVSA (Operating Room Ventilation System Assessment) tool comprises 7 domains and 44 items, covering ventilation type, exhaust systems, managerial factors, standard criteria, filtration, air handling units, and anesthetic gas management. The tool demonstrated excellent content validity (mean CVI = 0.959, mean CVR = 0.936) and high reliability (Cohen's Kappa coefficient = 0.963, test-retest reliability = 0.949).

Validation of the tool’s items by a qualified and heterogeneous expert panel, demonstrating high relevance, simplicity, and clarity, and consistent inter-rater correlations confirm the tool's validity in accurately measuring its intended purpose.

The ORVSA tool provides a comprehensive and user-friendly method for assessing OR ventilation systems, ensuring compliance with standards and identifying areas for improvement. Its strong psychometric properties make it a valuable resource for reducing SSIs and enhancing patient safety.