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Journal articles on the topic 'Operating theatre management'
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Hodgson, E. "Airway management outside the operating theatre." Saudi Journal of Anaesthesia 2, no. 2 (2008): 35. http://dx.doi.org/10.4103/1658-354x.51853.
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Tavare, Abhijeet, and Jaideep J. Pandit. "Does anyone know how much NHS operating rooms cost? A survey of operating room managers' knowledge of costs and data." British Journal of Healthcare Management 27, no. 12 (December 2, 2021): 1–11. http://dx.doi.org/10.12968/bjhc.2020.0054.
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Background/Aims Operating theatres represent a large proportion of NHS healthcare resources, so there has been focus on reducing costs in this area. This, in part, relies on managers having knowledge of the relevant costs in operating rooms. This study aimed to gauge the level of familiarity regarding costs among the various tiers of managers of NHS operating theatres, and if this information informed their decision making. Methods A semi-structured interview was administered to 12 finance managers, theatre managers and board members across 16 separate hospitals, representing six NHS trusts. Responses were reviewed through qualitative analysis by the authors. Findings The respondents showed very limited knowledge of operating theatre costs, with nearly all being unable to use cost data to inform either daily or longer-term strategic decision making. In particular, the costs of under- or over-running operating lists were not known. Conclusions The study suggests that heuristics of operating theatre management are, in practice, not influenced by costs. Instead, the resulting cost balance appears to be a passive consequence of decision-making based on other factors. This has significant implications for cost reduction initiatives and suggests an urgent need for improvement.
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Guinet, Alain, and Sondes Chaabane. "Operating theatre planning." International Journal of Production Economics 85, no. 1 (July 2003): 69–81. http://dx.doi.org/10.1016/s0925-5273(03)00087-2.
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Wichsova, Jana, and Jana Škvrňáková. "Key Skill Management in Operating Room – Results of ERASMUS+ project." Revista Romaneasca pentru Educatie Multidimensionala 13, no. 2 (July 2, 2021): 78–89. http://dx.doi.org/10.18662/rrem/13.2/411.
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The Key Skills Management in Operating Room (KSMOR) was a project that assessed key skills, knowledge, procedures and the degree of adaptation of perioperative nurses in operating theatres in the countries of the European Union (EU). Five EU countries participated in data collection. The respondents were perioperative nurses divided into two groups (with experience in operating rooms up to 2 years and over 2 years). The third group consisted of operating theatre managers who participated in the data collection and subsequently evaluated the user-friendliness of the questionnaires used for the data collection. The user-friendliness of the questionnaires was also assessed by all the perioperative nurses participating in the data collection. The majority of respondents from the Czech Republic rated the level of knowledge/skills at a good level, i.e. 2 points ("You are independent, you manage the procedure normally in your daily routine"), even for the group of the respondents with the length of experience in operating rooms up to 2 years. Both the managers and the perioperative nurses assessed the user-friendliness of the questionnaire on skills and knowledge of perioperative nurses positively. The output of the KSMOR project is an electronic version of the questionnaire on skills and knowledge of perioperative nurses, which enables evaluation and training of perioperative nurses not only in basic skills but also in very specific ones according to the particular field. It is also a suitable tool for the operating theatre manager for the management and evaluation of perioperative nurses, planning and support of educational activities and its subsequent integration into the operation of operating theatres.
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Samah, Norlaila Abu, Norimah Said, Norhafizatul Akma Shohor, and Emad Adel Al-Shadat. "Knowledge and Attitude of Operating Theatre Nurses towards Pain Management." Environment-Behaviour Proceedings Journal 7, no. 19 (March 31, 2022): 413–19. http://dx.doi.org/10.21834/ebpj.v7i19.3197.
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Background: Pain Management is a medical approach that draws on science and alternative healing disciplines to study the prevention, diagnosis, and treatment of pain. Operating theatre nurses play the leading role in pain management and require thorough knowledge and skill in managing pain. Significant: Nurses, especially those working in a palliative setting, are considered to demonstrate a high level of knowledge regarding pain management principles with adequate understanding on matters such as a vital sign of patients in response to pain and type of analgesic drugs available. Aim: This study aims to determine the knowledge and attitude regarding pain management among operating theatre nurses in Hospital Melaka. Objective To determine the knowledge and attitude towards pain management among operating theater nurses in Hospital Melaka. Methods: A descriptive, cross-sectional survey was employed to determine operating theatre nurses' knowledge and attitude towards pain management in Hospital Melaka. The total sampling method was used to draw the respondents. An adapted version of The Nurses' Knowledge and Attitudes Survey Regarding Pain (NKASRP) tool was used to test the knowledge and attitude of operating theatre nurses in Hospital Melaka. Normality tests were used to determine the normality of data distribution, and descriptive statistics were used to analyze the data to present quantitative descriptions of variables in this study. Limitations: Although this study was carefully prepared, there were some unavoidable limitations. There is a lack of time for this study because during this study was performed, and it is a pandemic COVID-19, most of the nurses do not have enough time to answer the questionnaire because of their workload. Findings: This study showed that 77.9% of operating theatre nurses in Hospital Melaka had a high level of knowledge, and 88.4% had a high attitude regarding pain management. Nurses specializing in the perioperative course have a slightly higher level of knowledge (78.2%) and attitude (87.3%) than respondents who specialized in the perioperative course. In general, all operating theatre nurses in Hospital Melaka had adequate knowledge and attitude toward pain management. Pain management is effectively managed by operating theatre nurses in the hospital. Implications: However, all nurses need to adhere to best practices in pain management by increasing their theoretical and practical knowledge to improve pain management procedures in the future. Keywords: Knowledge, Attitude, Pain Management, Nurses. eISBN 978-1-913576-05-9 © 2022. The Authors. Published for AMER ABRA cE-Bs by e-International Publishing House, Ltd., U.K. This is an open access publication under the CC BYNC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies), Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.
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Khan, Bushra Alizah, Muhammad Arif, Ahson Memon, and Atif Sharjeel. "Operation room conflicts and management." International Journal of Endorsing Health Science Research (IJEHSR) 10, no. 4 (October 22, 2022): 398–403. http://dx.doi.org/10.29052/ijehsr.v10.i4.2022.398-403.
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Background: This study is based on management issues within the healthcare sector in Karachi. Specifically, it is focused on managing conflicts in the operation rooms, whereby team performance of Operation Theatre staff directly impacts patients' speedy recovery.
Methodology: A quantitative survey was conducted involving the surgeons and Operation Theatre staff in Karachi's community hospitals. A closed-ended questionnaire was used in this study, and the questions mainly focused on the conflicts and management of doctors and staff in the operation theatre. Only those doctors and staff members included in the study who is currently working in the operation theatre division of the hospital. a Pearson correlation analysis was performed to assess the relationships between the factors affecting conflicts in the hospital's operating room.
Results: The results indicated that the extent of conflict management is high. Factors include communication, leadership, training, adequate compensation, and role identification as perceived by employees. After performing OLS regression tests, the study found that the variable of miscommunication, the communication gap, plays a crucial role in accelerating disagreements of conflicts in Operation Theatre.
Conclusion: A significant positive association between the factors and conflict management is observed. It suggests that operation theatre-related factors are improving with better conflict management practices.
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Wilson, Liam, and Omer Farooq. "Fire in operating theatres: DaSH-ing to the rescue." Journal of Perioperative Practice 28, no. 7-8 (May 4, 2018): 188–93. http://dx.doi.org/10.1177/1750458918775556.
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Operating theatres are dynamic environments that require multi professional team interactions. Effective team working is essential for efficient delivery of safe patient care. A fire in the operating theatre is a rare but potentially life threatening event for both patients and staff. A rapid and cohesive response from theatre and allied staff including porters, fire safety officer etc is paramount. We delivered a training session that utilised in situ simulation (simulation in workplace). After conducting needs analysis, learning objectives were agreed. After thorough planning, the date and location of the training session were identified. Contingency plans were put in place to ensure that patient care was not compromised at any point. To ensure success, checklists for faculty were devised and adhered to. A medium fidelity manikin with live monitoring was used. The first part of the scenario involved management of a surgical emergency by theatre staff. The second part involved management of a fire in the operating theatre while an emergency procedure was being undertaken. To achieve maximum learning potential, debriefing was provided immediately after each part of the scenario. A fire safety officer was present as a content expert. Latent errors (hidden errors in the workplace, staff knowledge etc) were identified. Malfunctioning of theatre floor windows and staff unawareness about the location of an evacuation site were some of the identified latent errors. Thorough feedback to address these issues was provided to the participants on the day. A detailed report of the training session was given to the relevant departments. This resulted in the equipment faults being rectified. The training session was a very positive experience and helped not only in improving participants’ knowledge, behaviour and confidence but also it made system and environment better equipped.
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Karachalios, Theofilos, Katre Maasalu, and Li Felländer-Tsai. "Personal protection equipment for orthopaedic and trauma surgery during the COVID-19 pandemic: The results of an EFORT survey initiative." EFORT Open Reviews 7, no. 2 (February 1, 2022): 122–28. http://dx.doi.org/10.1530/eor-21-0120.
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Orthopaedic and trauma surgeons performing surgery in the COVID-19 pandemic environment faced problems with availability, use, rationing, modification, compliance and recycling of personal protection equipment (PPE). Orthopaedic and trauma surgeons were not well informed concerning the use of PPE for aerosol-generating orthopaedic and trauma procedures. Scientific bodies, health authorities and management have provided insufficient guidelines for the use of PPE in aerosol-generating orthopaedic and trauma procedures. The availability of specific PPE for orthopaedic and trauma operating theatres is low. Hospital management and surgeons failed to address the quality of operating theatre ventilation or to conform to recommendations and guidelines. Operating theatre PPE negatively affected surgical performance by means of impaired vision, impaired communication, discomfort and fatigue. Existing PPE is not adequately designed for orthopaedic and trauma surgery, and therefore, novel or modified and improved devices are needed.
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Veling, Sanket, and Neha Ahire. "Assessment of operation theatre complex efficiency and utilization at a 750 bedded multispeciality hospital, Mumbai, India." Journal of Complementary Medicine Research 13, no. 4 (2022): 121. http://dx.doi.org/10.5455/jcmr.2022.13.04.23.
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Introduction: The operation theatre complex of a hospital represents an area of considerable spending in a hospital budget and requires utmost utilization to guarantee optimum cost benefit. Operating room (OR) functions with a lot of resources. Thus, any form of inappropriate functioning will cause revenue loss as well as decreased quality of patient care and satisfaction. Any delaying the operation theatre detrimental to the image and overall functioning of the hospital and any ways to reduce the delays are key to improve patient care and to maximize consumption of the resources in the operating room. Objective: To determine OR utilization and efficiency in the OT complex. Methodology: A prospective study was done from 1st May 2019 to 15th May 2019 in the OT complex of a 750 bedded Multispeciality Hospital in Mumbai, India . OT utilization and efficiency over a time period of two months was studied with respect to number of operation theaters, working hours in that particular study period, OR working capacity, Utilized hours. Results: Collected data showed that ORs were serviceable for 52 days through the study period and in that period 726 cases were operated. Total OR utilization time was 1820 hours for the study period. Collected data showed that in a two month period from 1st May 2019 to 30th June 2019 there was the highest utility of 58% (OR 2) whereas there was the lowest utility of 27 % (OR 3) in the 5th floor OT complex. However considering the entire 5th floor OT complex, actual utilized OT hours were only 655 out of the available 1820 hours during the study period. Thus a utility of 36% only was seen. Conclusion: Integrated time management and time utilization will result in a cost reduction, increase in hospital revenues with improved quality and patient satisfaction. Improving the performance of operating theatres is key to achieving shorter waiting times for treatment, implementing booking of elective operations and reducing cancelled operations. Change can only be implemented successfully if employees are fully engaged in the change process and are able and willing to make the changes required. Subjects: Science and Medical Education, Human Resources, Statistics Keywords: Operation theater utilization, OT cancellations, OT efficiency
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Grimes, C., and L. Horgan. "A New Algorithm for the Management of Critical Events in the Theatre." Bulletin of the Royal College of Surgeons of England 94, no. 2 (February 1, 2012): 1–2. http://dx.doi.org/10.1308/147363512x13189526438756.
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Patients may be subject to risk during surgery as a result of nontechnical as well as technical error. Effective surgical teams have been shown to have fewer problems per operation, higher intra-operative performance and shorter operating times. There is increasing evidence that interventions that improve teamwork, leadership, decision making, communication and situational awareness within operating teams also improve technical performance and patient outcome. In addition, briefings and debriefings before and at the end of operating lists have been shown to improve teamwork and communication, thereby improving patient safety.
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Hall, N. "The Rise of Inventory Management in Operating Theatre Departments." Journal of Perioperative Practice 26, no. 10 (October 2016): 221–24. http://dx.doi.org/10.1177/175045891602601002.
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Shehu, Bello B., and Emmanuel A. Ameh. "Time Management in the Operating Theatre in Developing Countries." Tropical Doctor 34, no. 4 (October 2004): 256–57. http://dx.doi.org/10.1177/004947550403400434.
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Harrison, Sanjay, Omar Nugud, and Harrison Benziger. "Operating theatre management: do we lack a mathematician's perspective?" ANZ Journal of Surgery 83, no. 1-2 (January 2013): 5–6. http://dx.doi.org/10.1111/ans.12029.
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Meredith, James O., Amy L. Grove, Paul Walley, Fraser Young, and Mairi B. Macintyre. "Are we operating effectively? A lean analysis of operating theatre changeovers." Operations Management Research 4, no. 3-4 (July 12, 2011): 89–98. http://dx.doi.org/10.1007/s12063-011-0054-6.
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Saadani, Nour El Houda, and Alain Guinet. "Heuristics for Operating Theatre Scheduling: Following the Patient." Supply Chain Forum: An International Journal 13, no. 1 (January 2012): 38–49. http://dx.doi.org/10.1080/16258312.2012.11517286.
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Booij, L. H. D. J. "Anaesthetic management of the trauma patient in the operating theatre." Current Anaesthesia & Critical Care 7, no. 3 (June 1996): 125–38. http://dx.doi.org/10.1016/s0953-7112(96)80082-2.
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Souki, Mejdi, and Abdelwaheb Rebai. "Heuristics for the Operating Theatre Planning and Scheduling." Journal of Decision Systems 19, no. 2 (January 2010): 225–52. http://dx.doi.org/10.3166/jds.19.225-252.
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Fitzgerald, Anneke, and Yong Wu. "Beyond clinical priority: what matters when making operational decisions about emergency surgical queues?" Australian Health Review 41, no. 4 (2017): 384. http://dx.doi.org/10.1071/ah16009.
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Objective This paper describes the perceptions of operating theatre staff in Australia and The Netherlands regarding the influence of logistical or operational reasons that may affect the scheduling of unplanned surgical cases. It is proposed that logistical or operational issues can influence the priority determination of queue position of surgical cases on the emergency waiting list. Methods A questionnaire was developed and conducted in 15 hospitals across The Netherlands and Australia, targeting anaesthetists, managers, nurses and surgeons. Statistical analyses revolved around these four professional groups. Six hypotheses were then developed and tested based on the responses collected from the participants. Results There were significant differences in perceptions of logistics delay factors across different professional groups when patients were waiting for unplanned surgery. There were also significant differences among different groups when setting logistical priority factors for planning and scheduling unplanned cases. The hypotheses tests confirm these differences, and the findings concur with the paradigmatic differences mentioned in the literature. These paradigmatic differences among the four professional groups may explain some of the tensions encountered when making decisions about scheduling emergency surgical queues, and therefore should be taken into consideration for management of operating theatres. Conclusions Queue positions of patients waiting for unplanned surgery, or emergency surgery, are determined by medical clinicians according to clinicians’ indication of clinical priority. However, operating theatre managers are important in facilitating smooth operations when planning for emergency surgeries. It is necessary for surgeons to understand the logistical challenges faced by managers when requesting logistical priorities for their operations. What is known about the topic? Tensions exist about the efficient use of operating theatres and negotiating individual surgeon’s demands, especially between surgeons and managers, because in many countries surgeons only work in the hospital and not for the hospital. What does this paper add? The present study examined the logistical effects on functionality and purports the notion that, while recognising the importance of clinical precedence, logistical factors influence queue order to ensure efficient use of operating theatre resources. What are the implications for practitioners? The results indicate that there are differences in the perceptions of healthcare professionals regarding the sequencing of emergency patients. These differences may lead to conflicts in the decision making process about triaging emergency or unplanned surgical cases. A clear understanding of the different perceptions of different functional groups may help address the conflicts that often arise in practice.
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Baxendale, Bryn, and Bryony Lovett. "Making the Operating Theatre a 'High-Reliability' Environment." Bulletin of the Royal College of Surgeons of England 94, no. 5 (May 1, 2012): 159–61. http://dx.doi.org/10.1308/147363512x13311314195574.
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The public, healthcare commissioners and regulators rightly seek assurances about delivery of reliable, high-quality surgical care. The Department of health's 'never events' framework 1 specifically lists patient misidentification, wrong-site surgery and retained swabs and instruments as unacceptable occurrences. Professional conversations reveal many seemingly inconsequential daily occurrences that have an impact on patient outcome and ongoing management. Unfortunately, many of these incidents are not reported formally by those involved, which limits the opportunity for professionals and organisations to learn from subsequent analysis.
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Stuart, Kari, and Erhan Kozan. "Reactive scheduling model for the operating theatre." Flexible Services and Manufacturing Journal 24, no. 4 (August 4, 2011): 400–421. http://dx.doi.org/10.1007/s10696-011-9111-6.
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Lum, Brandon, Hong Muay Png, Hock Lan Yap, Cindy Tan, Bixian Sun, and Yen Hoon Law. "Streamlining workflows and redesigning job roles in the theatre sterile surgical unit." BMJ Open Quality 8, no. 3 (September 2019): e000583. http://dx.doi.org/10.1136/bmjoq-2018-000583.
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The theatre sterile surgical unit (TSSU) is an essential core to support the operating theatres in National University Hospital. Surgical instruments and supplies are processed, packaged and sterilised safe for surgical procedures. A rapid improvement event adopting lean methodology was conducted with the TSSU team to streamline the workflows in this area.The project aimed to identify TSSU work processes that can be streamlined or automated, improving timeliness while identifying potential for role redesign and maximising human resource.The team successfully implemented initiatives to eliminate unnecessary workflows and achieve workload levelling. This reduced instrument processing time by 5%, while replenishment times of surgical supplies to the operating theatres decreased by 29%. The team successfully redesigned the TSSU job roles, converting several nursing staff to non-nursing roles. Long-term initiatives such as the use of disposables and an improved theatre instrument management system were planned for as well.Initiatives derived from this project can be spread to other sterile supply units within the hospital, further optimising the use of resources at a hospital level. The concept of role redesign was found to be applicable to healthcare, highlighting its potential in other areas of the hospital.
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McMahon, Orlaith. "Practical Operating Theatre Management: Measuring and Improving Performance and Patient Experience." Canadian Journal of Anesthesia/Journal canadien d'anesthésie 67, no. 4 (January 8, 2020): 502–3. http://dx.doi.org/10.1007/s12630-020-01566-y.
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Rufai, S. R., P. L. Cronbach, P. Alexander, and S. C. Lash. "A management dashboard to boost operating theatre utilisation, productivity and profitability." International Journal of Surgery 20 (August 2015): 26–27. http://dx.doi.org/10.1016/j.ijsu.2015.06.021.
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Guerriero, Francesca, and Rosita Guido. "Operational research in the management of the operating theatre: a survey." Health Care Management Science 14, no. 1 (November 20, 2010): 89–114. http://dx.doi.org/10.1007/s10729-010-9143-6.
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Mewburn, Judy. "Safer surgery: analysing behaviour in the operating theatre Rhona Flin Safer surgery: analysing behaviour in the operating theatre and Lucy Michell(Eds) Ashgate£75482pp97807546753659780754675365." Nursing Management 17, no. 8 (December 8, 2010): 9. http://dx.doi.org/10.7748/nm.17.8.9.s12.
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Baines, Rw, Gary Colquhoun, Nathan Jones, and Richard Bateman. "The Benefits of Using Customised Procedure Packs." British Journal of Perioperative Nursing (United Kingdom) 11, no. 1 (January 2001): 34–39. http://dx.doi.org/10.1177/175045890101100105.
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Discrete item purchasing is the traditional approach for hospitals to obtain consumable supplies for theatre procedures. Although most items are relatively low cost, the management and co-ordination of the supply chain, raising orders, controlling stock, picking and delivering to each operating theatre can be complex and costly. Customised procedure packs provide a solution.
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Kim, Young, Mackenzie C. Morris, and Ryan E. Earnest. "Surgical management of post-traumatic transvaginal herniation of small intestine in a third-world country." BMJ Case Reports 12, no. 5 (May 2019): e228330. http://dx.doi.org/10.1136/bcr-2018-228330.
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We present a case of a 26-year-old woman with a small bowel herniating from her vagina following traumatic injury from a road traffic accident. The patient was taken immediately to operating theatre for repair of her uterine defect and small bowel resection. The patient required eventual return to theatre for subtotal hysterectomy and recovered well after her surgeries. She was discharged home without any further complications and in good condition.
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Lande-Marghade, Pallavi. "Operating Theatre Mannerisms & Etiquette: Revisited!" Journal of Anaesthesia and Critical Care Reports 4, no. 2 (2018): 1–3. http://dx.doi.org/10.13107/jaccr.2018.v04i02.088.
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The operating theatre in a hospital is a highly critical and complex area which requires high hygienic standards. A certain code of conduct must be followed at all times to maintain a pedagogical model of excellence. There is indeed a very narrow margin for errors and critical incidents are waiting to happen with any lapses in the standard of care. The core idea of possessing certain etiquettes and mannerisms is therefore quintessential for excellence and safety in patient care and a good outcome. We as anesthetists play a pivotal role in maintaining the requisite standards. Let us revisit these sequentially to better equip ourselves in our temple of work- The Operating Theatre (OT) Basic house rules mandate entering the OT in a well laundered clean two piece scrub suit, cap, disposable mask and proper footwear to minimize cross infection. The scrub suit is made up of cotton with a high weave density that minimizes the risk of bacterial strike- through. These should be changed immediately if soiled or contaminated. Long sleeves are not allowed and bare below elbows must be strictly followed in all clinical areas. Proper footwear has ridged rubber soles to make it antistatic and anti skid to prevent slip and falls. (1) Our next portal of contact is the patient which has to be impactful! This is a game changing opportunity and one must make the most of it! Through each and every step of anesthesia, one must be courteous, empathetic, reassuring and communicate adequately with the patient. (2) This would set the patient at ease and half the battle will be won! Vigilance with multitasking must be reflected at every step with positive communication. Dutt-Gupta et al have shown that negative communication during intravenous cannulation is known to have increased analgesic requirements in one study. (3) Leave apart the humour, sattire, sarcasm but the best surgeon – anesthetist relationship actually is a symbiotic one which thrives on professionalism, punctuality, discipline, mutual respect and assertiveness. We all do possess technical skills with great dexterity but one must possess non technical skills which sets us apart from others. Arrive before time for performing the blocks. One must turn their penchant off for people pleasing and maintain integrity at all times. Strong work ethics is a must for success. Mistakes do happen and one must apologize and explain them. Perfect documentation of all events in the OT is essential as the law is very clear about it, if it is not mentioned in the anesthetic chart-it has not happened! In the recently concluded FIFA world cup 2018, the Croatian team taught us lessons for a lifetime. They did an unmitigated display of non-technical skills which are equally important for our working in theatre. These nontechnical skills are none other than task management, team work, situation awareness and decision making. Flin et al in their excellent article on Anesthetists’ and non-technical skills have pointed out that deficiencies in these can contribute to medical error and adverse events.(4) Ghodki et al has demonstrated these non-technical skills with day to day examples in her editorial on soft skills for anesthetists.(5) Quality Communication Quality communication should be the key element of the OT milieu. Gawande et al documents 43% of adverse events to be due to communication failure. Lingard et al has noted 30% of adverse events due to lack of standardization and team integration. Reluctance to interrupt, fear of embarrassment, and concern of being misjudged or inability to verbalize thoughts are the most common causes of communication failure. The challenge is to overcome the barriers and speak up. (6) Two challenge rule of advocacy and curiosity practiced in aviation has been strongly recommended in OT and critical care setting as well. While advocacy means deliberate practice to express your concern without being offensive, curiosity is to understand others point of view. The bottom-line of effective communication is to give clear precise instructions and ensure that the loop is closed and correct action executed. Non verbal clues like facial expressions, body language and above all the ability to listen to others make a whole lot of difference. (7) Infection Control Another important area which definitely needs our valuable contribution is infection control. Practice your 5 moments of hand hygiene religiously. Use personal protection equipment (PPE) and sterile aseptic precautions while doing any invasive procedures like central neuraxial blockade (CNB) and central venous cannulation. There has been a lot of apathy regarding the use of face masks while performing CNB’s. An observational study found that most cases of meningitis after CNB were due to Streptococcus, a commensal in the respiratory tract. Let’s see what the CDC (Centre for Disease Control and prevention) has to say in this respect; facemasks should always be used when injecting any material or inserting a catheter into the epidural or subdural space, aseptic technique and other safe injection practices should always be followed for all spinal injection procedures. Excellent protection from an appropriate mask lasts for ∼15 minutes. A proper large, soft, pleated, pliable mask (as opposed to a cloth mask) remains a good bacterial filter for up to 8 hrs. It is prudent to change mask after each procedure. The correct segregation of healthcare waste on site is vital and we as anesthetists have our share of responsibility too! As a matter of fact during my training in England, I learnt by observing my seniors and consultants to dispose the sharps after use myself into the sharps can. Any contaminated or infectious disposables should be discarded in the yellow bag for further disposal. Black bag is meant only for non contaminated packaging, tissues, and disposable cups. (1) Mobile Menace The only word which comes to mind when I think of smartphones is menace. However, these have become an integral part of the healthcare sector responsible for innovation, teaching and education, data entry and many others. It’s difficult to dissociate smartphones but we can try to minimize its use in the OT. Apart of being a significant source of nosocomial infections due to handling of mobiles by healthcare professionals by contaminated hands, they are a potent source of distraction. Although anesthetists are trained in multitasking while maintaining situational awareness, it may sometimes result in lack of concentration. Sterile cockpit rules followed in aviation industry apply to OT environment as well. To prevent interference with medical equipment a safe 1m rule is followed although most of the equipments are not affected due to electromagnetic radiation. It would be a good idea to store mobiles in plastic bag to prevent cross contamination. Restricted use of mobiles is highly recommended with regulation of ring tones. (8) Needless to mention that use of unparliamentary language is strictly prohibited as it can lead to dire consequences. With the use of smartphones, use of social media has become inevitable with a variety of websites and groups on facebook where patient information is shared for discussion and knowledge sharing. It is our singular responsibility to obtain patient’s consent, hide PID (Patient Identifiable Data) to protect security and privacy and maintain confidentiality all the time. “Unnecessary noise is the most cruel absence of care which can be inflicted either on sick or on well.” —Florence Nightingale, 1859 Specifically within hospitals, average noise levels of 45 dBA or less are recommended. Both National Institute for Occupational safety and Health and Occupational safety and Health Administration guidelines agree that the peak level for impulsive noise (characterized by a steep rise in the sound level to a high peak followed by a rapid decay) should not exceed 140 dBA. (9) The most common source of noise is loud chatter and music followed by arranging metal instruments, suction apparatus, monitor alarms, air warming units, various mobile ringtones. The most commonly reported short term healthcare consequences are distraction leading to serious communication gaps, negative impact on anesthetist and surgeon performance, increased chances of surgical site infection especially when junior surgical staff is closing the wound with music playing in background. Thus, noise prevention is a collective responsibility to be shared by entire staff in OT for an error free surgery. Strict adherence to sterile cockpit rules during surgery as well anesthetic critical moments like induction, extubation and administering CNB’s and regional blocks. (9) What you do has far more impact that what you say!- Stephen Covey. Anesthetist being the team leader, MUST WALK THE TALK! The team members don’t listen to what you say but follow what you do. The future is definitely bright for anesthetists with the introduction of non-technical skills in undergraduate curriculum. Neurolinguistic programming and simulation training will further enhance our situational awareness and response to crisis moments. Acknowledgment: I owe this editorial to all the members of TAS (The Anaesthetist Society) and especially Dr Shiv Kumar Singh whose posts and discussions have given me ideas galore and inspired me to think laterally and compose them
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Teodorescu, Marius-Alexandru. "The Theatrical System’s Reform as the Aim of the Theatre Director’s Education in Romania." Studia Universitatis Babeş-Bolyai Dramatica 67, no. 2 (December 13, 2022): 81–94. http://dx.doi.org/10.24193/subbdrama.2022.2.05.
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"This article emphasizes the profound interdependence between the theatre directing educational system and the cultural system, taking into account the specifics of the situation in Romania. Identifying the theatre director as a pillar who defines the status quo in the cultural system and that oversees the implementation of a given global vision in theatres, the article argues that the director’s educational process naturally results in defining tomorrow’s theatre practices. In this context, the article identifies the key skills that the young director should have when entering the cultural system and argues in favour of their importance starting from practical situations in the institutional theatre system in Romania. These basic skills are: a deep understanding of all the compartments of a theatre and how each compartment functions, being able to further educate actors about the basic concepts of theatrical art, the ability to conduct a profound text analysis and, lastly, a commitment to use a directing notebook as starting point for their shows. The article concludes that the main reasons why the education system currently fails to develop these skills are the lack of time allocated to theatrical practice, but also the prevalence of the desire to train a small number of exceptional directors to the detriment of training al student directors to become capable of operating in the cultural market. Keywords: director, theatre, pedagogy, practice as research."
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Connolly, D., RR McGookin, A. Gidwani, and MG Brown. "Inflamed Solitary Caecal Diverticulum – It is Not Appendicitis, What Should I Do?" Annals of The Royal College of Surgeons of England 88, no. 7 (November 2006): 672–74. http://dx.doi.org/10.1308/003588406x149336.
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We describe three cases that presented with symptoms suggestive of appendicitis but were found at operation to have an inflamed solitary caecal diverticulum. All were treated successfully with diverticulectomy or inversion of the diverticulum. We wish to highlight this diagnosis and its surgical management so that informed decisions can be made if this is first encountered in the operating theatre.
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Roffe, L., R. Peterson, G. Smith, R. Penumarthy, N. Atkinson, M. Ross, L. Singelton, C. Bodian, and S. Timoko-Barnes. "NEW ZEALAND PROVINCIAL ORTHOPAEDIC TRAUMA STUDY (NZPOTS): THE EFFECTS OF INCREASING TRAUMA ON ELECTIVE ORTHOPAEDIC SURGERY IN PROVINCIAL NEW ZEALAND." Orthopaedic Proceedings 105-B, SUPP_3 (February 2023): 2. http://dx.doi.org/10.1302/1358-992x.2023.3.002.
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Trauma and elective orthopaedic demands in New Zealand are increasing. In this study, prospective and retrospective data has been collected at Nelson Hospital and across New Zealand to identify the percentage of elective theatre time lost due to cancellation for acute patient care. Data has been collected from theatre management systems, hospital data systems and logged against secretarial case bookings, to calculate a percentage of elective theatre time lost to acute operating or insufficient bed capacity.Data was collected over a five-month period at Nelson Hospital, with a total of 215 elective and 226 acute orthopaedic procedures completed. A total of 95 primary hip or knee arthroplasties were completed during this trial while 53 were cancelled. The total number of elective operative sessions (one session is the equivalent of a half day operating theatre time) lost to acute workload was 47.9. Thirty-three percent of allocated elective theatre time was cancelled - an equivalent of approximately one-full day elective operating per week.Over a five-week period data was collected across all provincial hospitals in New Zealand, with an average of 18% of elective operating time per week lost due to acute workload. Elective cancellations were due to acute operating 40% of the time and bed shortages 60% of the time. The worst effected centre was Palmerston North which had an average of 33% of elective operating cancelled per week to accommodate acute surgery or due to bed shortages.New Zealand's provincial orthopaedic surgeons are under immense pressure from acute operating that impedes provision of elective surgery. The New Zealand government definition of an ‘acute case’ does not reflect the nature of today's orthopaedic burden. Increasing and aging populations along with staff and infrastructure shortages have financial and societal impacts beyond medicine and require better definitions, further research, and funding from governance.
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Lam, C., S. Cleland, H. Lee, B. Subramanian, and M. Saunders. "Effective management is key in providing a productive day case operating theatre." International Journal of Surgery 10, no. 8 (2012): S26. http://dx.doi.org/10.1016/j.ijsu.2012.06.140.
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Magasich-Airola, N., Q. Souberbielle, L. L’Hotel, M. Momeni, and R. Tircoveanu. "Waste management in Belgian operating rooms: A narrative review." Acta Anaesthesiologica Belgica 75, no. 2 (May 2024): 149–54. http://dx.doi.org/10.56126/75.2.47.
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Climate change is caused by the accumulation of greenhouse gases (GHG) that trap heat in the atmosphere, resulting in rising temperatures. The healthcare sector is a significant contributor to GHG emissions, accounting for a global average of 4.4% of total emissions, rising to 5.5% in Belgium. The operating room (OR) is disproportionately responsible for 40% of these emissions. The carbon footprint of the OR is mainly composed of waste production, energy consumption, and the emission of anesthetic gases. It is estimated that the OR generates 20 to 30% of hospital waste. Therefore, anesthesiologists have shown an increased interest in sustainable healthcare, particularly in waste management. This narrative review aims to explain healthcare waste management in the Belgian operating theatre and to explore evidence-based approaches to a more sustainable practice based on the waste hierarchy “reduce, reuse, recycle”.
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Healy, Kathy, Anne O’Sullivan, and Lavinia McCarthy. "A nurse-led audit on the incidence and management of inadvertent hypothermia in an operating theatre department of an Irish hospital." Journal of Perioperative Practice 29, no. 3 (July 31, 2018): 54–60. http://dx.doi.org/10.1177/1750458918793295.
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Inadvertent perioperative hypothermia (IPH) is a common problem associated with perioperative patients which can have significant consequences for them during surgery and in the immediate postoperative period. Recognising and managing IPH remains an important aspect of perioperative nursing and is a significant factor in maintaining patient safety, achieving positive surgical outcomes and patient satisfaction. A nurse-led clinical audit was undertaken in the operating theatre department of a major teaching hospital in Ireland to establish the incidence and management of IPH in the department. One hundred (n = 100) patients were included in the audit, both children and adults. Results of the audit were used to inform quality improvement initiatives, with the purpose of improving patient care standards in the operating theatre department in that hospital.
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Key, Thomas, Gavin Reid, Nicola Vannet, John Lloyd, and David Burckett-St. Laurent. "‘Golden Patient’: A quality improvement project aiming to improve trauma theatre efficiency in the Royal Gwent Hospital." BMJ Open Quality 8, no. 1 (February 2019): e000515. http://dx.doi.org/10.1136/bmjoq-2018-000515.
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The efficiency of trauma lists when compared with elective orthopaedic lists is a frustration of many orthopaedic departments. At the Royal Gwent Hospital, late start times affecting total operating capacity of the trauma list were recognised as a problem within the department. The design team aimed to improve the start time of the list with the introduction of the ‘golden patient’ initiative. A protocol was agreed between the orthopaedic, anaesthetic and theatre staff where a ‘golden patient’ was selected for preoperative anaesthetic assessment by 14:00 the day before surgery and sent for at 08:15 as the first case on the trauma list. Baseline data was collected over a month. Two Plan-Do-Study-Act (PDSA) cycles were completed, one on the month the ‘golden patient’ initiative was implemented and one 4 months after the change. All data was collected from the Operating Room Management Information Service theatre system for the trauma theatre at the Royal Gwent Hospital. Results demonstrated significant improvement in patient arrival time in the theatre suite; PDSA1 by 33 min (p≤0.001) and PDSA2 by 29 min (p≤0.001) and an earlier start of the first procedure; PDSA1 by 19 min (p=0.018) and PDSA2 by 26 min (p≤0.001). There was also increased mean operating time per list (PDSA1 +16 min and PDSA2 +33 min), increased total case number (PDSA1 +20 cases and PDSA2 +36 cases) and reduced cancellations (PDSA1 −2 cases and PDSA −5 cases) compared with our baseline data. We demonstrated that the introduction of a ‘golden patient’ to the trauma theatre list improved the start time and overall operating capacity for the trauma list. Continuing this project, we plan to introduce assessment of all patients with fractured neck of femur in a similar way to the ‘golden patient’ to continue improving trauma theatre efficiency and reduce case cancellations.
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Webb, JA, and J. Stothard. "Cost Minimisation Using Clinic-Based Treatment for Common Hand Conditions – A Prospective Economic Analysis." Annals of The Royal College of Surgeons of England 91, no. 2 (March 2009): 135–39. http://dx.doi.org/10.1308/003588409x359385.
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INTRODUCTION The purpose of this study was to compare the cost of treatment of Dupuytren's disease, ganglia and trigger digits in the out-patient department with the operating theatre. PATIENTS AND METHODS All patients seen in a new patient hand clinic with a diagnosis of Dupuytren's disease, trigger digit or ganglion of the wrist or hand requiring treatment were prospectively identified over a 6-month period. The numbers undergoing a procedure in the out-patient clinic or theatre were recorded. Costings of theatre time and out-patient time, as well as national tariff income, were obtained from the hospital management. RESULTS Over the 6-month period, 80, 26, and 52 patients were treated with regard to Dupuytren's disease, ganglia and trigger digits, respectively. Of these, 37, 23, and 44 were treated by an out-patient procedure, and 43, 3 and 8 underwent a formal operation. The total cost of the out-patient procedures was calculated at £1560 over 6 months. To perform these as formal operations would have cost £64,896. The cost savings were, therefore, £63,336, or £126,672 per annum. CONCLUSIONS Out-patient interventions for Dupuytren's disease, ganglia and trigger digits result in significant cost savings over formal surgical treatment.
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Brinkman, Peter, Christine Seipel, and Alison Juers. "Prosthetic inventory management." Australian Health Review 24, no. 1 (2001): 120. http://dx.doi.org/10.1071/ah010120.
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An improved approach to inventory management in the Operating Theatre has been initiated at Princess AlexandraHospital. A Clinical Resource Co-ordinator (CRC) position was created to provide access to expertise in purchasingand materials management at the clinical level. A review of existing inventory management practices conducted bythe CRC revealed reporting inadequacies, lack of product specialisation and inadequate control over pricing, stocklevels and product usage. Through liaison with key stakeholders, a competitive tendering process was introduced whichresulted in a standing offer arrangement being installed for three specialty orthopaedic areas. Outcomes of thisarrangement are discussed. The importance of raising the area of prosthetic inventory management for debate in theAustralian literature is also highlighted.
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Ang, King Sin, Zhao Kai Low, Bryan Su Wei Ng, and Pei Kee Poh. "Developing a quality improvement project to tackle the desflurane problem." BMJ Open Quality 12, no. 1 (March 2023): e002132. http://dx.doi.org/10.1136/bmjoq-2022-002132.
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Anaesthesia is associated with the routine use of volatile anaesthetic agents, all of which are potent greenhouse gases in varying degrees. Desflurane, in particular, has a high global warming potential and in recent years, there has been a global movement to reduce or remove its usage entirely from operating theatres. We work in a large tertiary teaching hospital in Singapore with deeply entrenched practices of using desflurane to facilitate high turnover of operating theatre cases. We launched a quality improvement project to (1) reduce the median usage of desflurane by 50% (by volume), and (2) reduce the number of theatre cases administering desflurane by 50% over a period of 6 months.We collected baseline data to determine departmental monthly median usage of desflurane. We then deployed sequential quality improvement methods to educate staff and to eliminate misconceptions, as well as to promote a gradual cultural change.We successfully reduced monthly median desflurane usage from 31.5 L to 12.2 L per month (61.3% reduction) within our targeted time frame. We also achieved a reduction in the number of theatre cases using desflurane by approximately 80%. This translated to significant cost savings of US$195 000 per year and over 840 tonnes of carbon dioxide equivalents saved.Healthcare is a resource intensive industry. Anaesthetists are well placed to play an important role in reducing healthcare-related carbon emissions by choosing anaesthetic techniques and resources responsibly. Through multiple Plan-Do-Study-Act cycles and a persistent, multifaceted campaign, we achieved a sustained change in our institution.
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Hoyland, K., M. Sinnott, P. Greig, and N. Nguyen-Lu. "P.120 Ergonomics in the interventional radiology operating theatre for placenta accreta management." International Journal of Obstetric Anesthesia 50 (May 2022): 65. http://dx.doi.org/10.1016/j.ijoa.2022.103416.
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Winter, George. "Time to make surgery greener: waste reduction in the operating theatre." British Journal of Healthcare Management 26, no. 8 (August 2, 2020): 1–3. http://dx.doi.org/10.12968/bjhc.2020.0011.
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Sustainability persists as a key issue in all aspects of society, with increasing urgency. George Winter discusses the environmental impact of operating theatres and the initiatives being implemented to reduce surgical waste output.
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O'Connell, Robert Michael, Ishwarya Balasubramanian, Fionn Barron, Chris Kelly, Eoin O'Brien, and Shona Tormey. "Novel approach to recording theatre utilisation data using Pinpoint: a wearable real-time location services device." BMJ Innovations 6, no. 4 (June 22, 2020): 239–42. http://dx.doi.org/10.1136/bmjinnov-2019-000380.
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IntroductionInefficient theatre utilisation is costly for patients, staff and healthcare organisations. Active management projects have proven effective at identifying and streamlining delays in the perioperative patient journey.AimThe aim of this study is to assess whether a novel, wearable, autonomous, Wi-Fi-based real-time location services (RTLS) device could be used to accurately record and process theatre utilisation data.MethodsA novel RTLS device was employed in our theatre department between June and September 2017. Data were collected pertaining to time of arrival and departure from the surgical day ward, operating theatre and recovery using this device, and compared with our institution’s existing written record of theatre data.Results101 patients were enrolled, but manually recorded data were unavailable on 18 patients. Among the remaining 83 patients, mean difference in recorded start times was 0.43 min (p=0.64). Mean difference in theatre end times was 1.63 min (p=0.41). Mean difference recorded in overall time in theatre was 1.19 min (p=0.59).ConclusionThe RTLS device provided a reliable record of theatre utilisation, without requiring manual input, with potential as a tool to identify and improve inefficiencies in the theatre department.
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Edwards, Peggy. "The National Patient Safety Agency and Theatre Practitioners." British Journal of Perioperative Nursing (United Kingdom) 15, no. 10 (October 2005): 428–33. http://dx.doi.org/10.1177/175045890501501002.
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Theatre practitioners have been involved in patient safety for years. Each time you check a patient into the department you are using a risk management tool: the check-list. Each time you check the position of a patient on the operating table, check their consent form, ensure the sterile field is maintained and that the instrument count is correct, you are intrinsically involved in patient safety.
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Ābele, Ilona, Laura Vīksna, Dagnija Gulbe, and Līga Skuja-Petruševiča. "SELF-ASSESSMENT OF OPERATING THEATRE NURSE COMPETENCE IN PERIOPERATIVE CARE." SOCIETY. INTEGRATION. EDUCATION. Proceedings of the International Scientific Conference 1 (May 19, 2022): 710–20. http://dx.doi.org/10.17770/sie2022vol1.6820.
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Assessment of competence level of operating theatre nurses (OTN) has a significant role in ensuring patient safety, continuity of perioperative care, and positive care environment, allowing to identify shortcomings and address them. The competence level describes quantitatively the competence in perioperative care — a set of skills, attitudes, and knowledge required for effective and safe perioperative care. A simple method to assess the competence level is a self-assessment scale; however, this method has not been used in Latvia to establish the OTN competence levelThe goal of this work is to determine the perceived level of competence in the perioperative care of OTN in a multi-profile hospital in Latvia. For this purpose, a modified perioperative competence self-assessment scale was used, based on Gillespie’s (2012) Perceived Perioperative Competence Scale-Revised (PPCS-R). The results show that OTN have a high perceived level of competence. However, the leadership subscale (which includes coordination and management) displayed lower levels of perceived competence, which shows the insufficiency of training. The results also show that certified OTN, those with more work experience, and OTN with a Bachelor’s degree have a higher perceived competence level. The scale adapted to Latvian exhibits equally good internal consistency as other versions of PPCS-R.
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Poudel, S. C., A. J. Rayamajhi, P. R. Bhattarai, and R. K. Yadav. "Role of Lung Scan for Detection of Pneumothorax in Operation Theatre." Birat Journal of Health Sciences 1, no. 1 (March 31, 2017): 75–77. http://dx.doi.org/10.3126/bjhs.v1i1.17105.
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Iatrogenic pneumothorax is life threatening complication that an anesthesiologist may encounter in operating room while performing various procedure such as central venous catheterization brachial plexus block paravertebral block or during surgery like pyelolithotomy, laparoscopic cholecystectomy, percutaneous nephrolithotomy. Ultrasound can be the diagnostic tool for prompt diagnosis and managementof these situations. As there is overwhelm use of ultrasound in emergency department and ICU setting, by understanding few ultrasonic terms like lines, modes, signs and points of lung scan it can be easily utilized in operation room. Likewise, lung ultrasounds in emergency (BLUE) and fluid administration by lung ultrasound (FALL) are recently being recommending to be used in emergency and ICU. We report two cases where lung scan was beneficial for management of pneumothorax in our operation theater.Birat Journal of Health Sciences 2016 1(1): 75-77
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Goel, Raghav, Harsh Kanhere, and Markus Trochsler. "The 'Surgical Time': a myth or reality? Surgeons' prediction of operating time and its effect on theatre scheduling." Australian Health Review 44, no. 5 (2020): 772. http://dx.doi.org/10.1071/ah19222.
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ObjectiveIn Australia, 2.7 million surgical procedures were performed in the year 2016–17. This number is ever increasing and requires effective management of operating theatre (OT) time. Preoperative prediction of theatre time is one of the main constituents of OT scheduling, and anecdotal evidence suggests that surgeons grossly underestimate predicted surgical time. The aim of this study is to assess surgeons’ accuracy at predicting OT times across different specialties and effective theatre scheduling. MethodsA database was created with de-identified patient information from a 3-month period (late 2016). The collected data included variables such as the predicted time, actual surgery time, and type of procedure (i.e. Emergency or Elective). These data were used to make quantifiable comparisons. ResultsData were categorised into a ‘Theatre list’ and ‘Scopes list’. This was further compared as ‘Actual–Predicted’ time, which ranged from an average underestimation of each procedure by 19min (Ear Nose and Throat surgeons) to an average overprediction of 13.5min (Plastic Surgery). Urgency of procedures (i.e. Emergency and Elective procedures) did not influence prediction time for the ‘Theatre list’, but did so for the ‘Scopes list’ (P<0.001). Surgeons were poor at predicting OT times for complex operations and patients with high American Society of Anaesthesiologists grades. Overall, surgeons were fairly accurate with their OT prediction times across 1450 procedures, with an average underestimation of only 2.3 min. ConclusionsIn terms of global performance at The Queen Elizabeth Hospital institution, surgeons are fairly accurate at predicting OT times. Surgeons’ estimates should be used in planning theatre lists to avoid unnecessary over or underutilisation of resources. What is known about the topic?It is known that variables such as theatre changeover times and anaesthesia time are some of the factors that delay the scheduled start time of an OT. Furthermore, operating time depends on the personnel within the operating rooms such as the nursing staff, anaesthesiologists, team setup and day of time. Studies outside of Australia have shown that prediction models for OT times using individual characteristics and the surgeon’s estimate are effective. What does this paper add?This paper advocates for surgeons’ predicted OT time to be included in the process of theatre scheduling, which currently does not take place. It also provides analysis of a wide range of surgical specialties and assesses each professions’ ability to accurately predict the surgical time. This study encompasses a substantial number of procedures. Moreover, it compares endoscopic procedures separately to laparoscopic/open procedures. It contributes how different variables such as the urgency of procedure (Emergency/Elective), estimated length of procedure and patient comorbidities affect the prediction of OT time. What are the implications for practitioners?This will encourage hospital administrators to use surgeons’ predicted OT time in calculations for scheduling theatre lists. This will facilitate more accurate predictions of OT time and ensure that theatre lists are not over or underutilised. Moreover, surgeons will be encouraged to make OT time predictions with serious consideration, after understanding its effect on theatre scheduling and associated costs. Hence, the aim is to try to make an estimation of OT time, which is closer to the actual time required.
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Bem, Chris. "Thinking about violence: do surgeons have a role outside the operating theatre?" Bulletin of the Royal College of Surgeons of England 90, no. 8 (September 1, 2008): 276–77. http://dx.doi.org/10.1308/147363508x339800.
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All surgical subspecialties involve the management of trauma. Surgeons meet trauma in many guises, mostly as accidents involving vehicles or falls. They also meet the trauma of violence. Violence is defined by the World Health Organisation (WHO) as the intentional use of physical force or power against oneself, another person, or against a group or community, that results in or has a high likelihood of resulting in injury, death, psychological harm, maldevelopment or deprivation.
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Potts, N., DSE Martin, and L. Hoy. "Critical Incident Analysis: Equip to Avoid Failure." Journal of Perioperative Practice 27, no. 4 (April 2017): 77–82. http://dx.doi.org/10.1177/175045891702700403.
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This work is set in the context of perioperative practice in difficult airway management. It integrates a root cause analysis and fish bone technique to investigate a critical incident in temporary yet crucial equipment failure. Risk management and incident reporting is analysed alongside human factors in the operating theatre environment. Finally, recommendations for risk reduction, vigilance and checking vital airway equipment are made in anaesthetic practice.
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Mathieu, Laurent, Michel Levadoux, Emmanuel Soucany de Landevoisin, Tarun J. McBride Windsor, and Sylvain Rigal. "Digital replantation in forward surgical units: a cases study." SICOT-J 4 (2018): 9. http://dx.doi.org/10.1051/sicotj/2018004.
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Introduction: Noncombat-related hand injuries are common in current theatres of operations. Crushing is one of the most frequent mechanisms that may cause traumatic amputations of digits. In the military setting, management of these digital amputations is challenging regarding limitation in microsurgical means in medical treatment facilities and aeromedical evacuation delays out of the combat zone. Methods: Two cases of digital replantation performed in French forward surgical units are described. The first case was a complete distal amputation of the medius which was successfully replanted in the operating theatre of an aircraft carrier. No complication was observed after evacuation. Functional and aesthetic results were excellent. The second case was a ring finger avulsion revascularized in a role 2 facility in Central African Republic. Unfortunately, revascularization failed due to arterial thrombosis during evacuation. Results: Digital, hand or more proximal upper extremity replantation may be considered for isolated amputations due to work-related accidents within the combat zone. For a surgeon trained to microsurgery, a microsurgical set and magnification loupes enable to attempt such procedures in austere conditions. Discussion: The authors propose an algorithm of management in the field according to the type and level of amputation.
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Gazal, Giath. "Evaluation of the effectiveness of early or delayed treatment upon healing of mandibular fractures: A retrospective study." European Journal of Dentistry 09, no. 01 (January 2015): 087–91. http://dx.doi.org/10.4103/1305-7456.149650.
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ABSTRACT Objectives: This study was aimed to assess the impacts of delay treatment of mandibular fracture and its complications. In addition risk variables related such as time to repair, fracture types, substance abuse, causes, surgical management, muddling or complications and duration of clinic stay were also evaluated. Materials and Methods: The data of patients attending the Newcastle General Hospital, UK for the management of mandibular fractures were probed. This retrospective clinical trial conducted over 6 months, included 91 patients attending trauma operating theatre during weekdays or weekends. Data were analyzed for time to admission and treatment and its relationships to various factors using SPSS version 20 (SPSS Inc., Chicago, IL). Results: Time to treatment from the point of admission was 31.50 ± 3.83 h during week days that has been significantly more for patients attending the hospital at weekends or nights. Similar trend was observed for total summative time from the incident to treatment analysis. Conclusions: This investigation has demonstrated that the rate of infection and postoperative complications following surgical treatment of mandible fractures can be eased off by reducing the waiting time from presentation to the emergency and to the operating theater.
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Bian, Leina, Jianhua Li, Wang Li, Xiaoyan Hu, and Ming Dai. "Analysis of the Effect of Holistic Nursing in the Operating Room Based on PDCA and Evidence-Based Nursing in the Otorhinolaryngology Operating Room: Based on a Retrospective Case-Control Study." Contrast Media & Molecular Imaging 2022 (May 21, 2022): 1–9. http://dx.doi.org/10.1155/2022/4514669.
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Objective. Based on a retrospective case-control study, this study aims to explore the effect of holistic nursing in operating room based on PDCA (plan, do, check, and action) process and evidence-based nursing (EBN) in a ear, nose, and throat operating room. Methods. About 200 patients who underwent otorhinolaryngology surgery in our hospital from January 2019 to September 2021 were enrolled. According to the difference of nursing mode, patients were assigned into a control group and study group; holistic nursing in operating room was included in control group, and holistic nursing in the operating room based on PDCA and EBN was included in study group. Nursing satisfaction, hypothermia, chills, restlessness, related indexes of operating room, nursing quality scores of operating room, and individual quality control scores were compared. Results. First of all, we compared the nursing satisfaction, the study group was very satisfied in 69 cases, satisfactory in 30 cases, general in 1 case, the satisfaction rate was 100.00%, while in the control group, 46 cases were very satisfied, 34 cases were satisfied, 13 cases were general, and 7 cases were dissatisfied, the satisfaction rate was 93.00%. The nursing satisfaction of the study group was higher compared to the control group ( P < 0.05 ). Second, we compared the incidence of hypothermia, chills and restlessness. The incidence of hypothermia, chills, and restlessness in the study group was lower compared to the control group ( P < 0.05 ). The time of tracheal tube extubation, PACU stay time, postoperative hospitalization time, hospitalization cost, and operation time in the study group was significantly lower compared to the control group ( P < 0.05 ). In terms of the scores of nursing quality in the operating room, the instruments and equipment management, equipment preparation, nurses’ cooperation skills, disinfection and isolation quality, and total score in the study group were higher compared to the control group ( P < 0.05 ). Finally, we compared the scores of individual quality control examination. The scores of ward management, rescue, therapeutic articles, drug management, first-level nursing, nursing documents, and head nurse management in the study group were higher compared to the control group ( P < 0.05 ). Conclusion. Incorporating the concepts of PDCA and EBN into the overall care of the operating theatre is effective for patients in the ENT operating theatre. Our results show that this care can be effective in improving patients’ surgical indicators, reducing the incidence of postoperative infections, shortening postoperative resuscitation and length of stay, reducing hospital costs, and promoting surgical patient satisfaction. While further multicenter studies are necessary, this series of nursing interventions remains worthy of replication in the clinical setting.