Benefits of music on theatre staff in a paediatric theatre setting: a staff survey

Abstract Introduction In the already high-risk, high-stress environment of the operating theatre, operating during Covid-19 has brought its own unique challenges. Communication, teamwork and anxiety related new operating practices secondary to Covid-19 are hypothesised to have a negative impact on patient care. Method We conducted a single-centre online survey of operating theatre staff from 22nd June–6th July 2020. Respondents completed 18 human factors questions related to COVID-19 precautions including communication, teamwork, situational awareness, decision making, stress, fatigue, work environment and organisational culture. Questions consisted of yes/no responses, multiple choice and Likert items. Kruskall-Wallis tests, Chi-Squared, Mann Whitney U tests, Spearman’s correlation coefficient, lambda and Cramer’s V tests were used. Free-text responses were also reviewed. Results 116 theatre staff responded. Visual (90.5%), hearing/ understanding (96.6%) difficulties, feeling faint/lightheaded (66.4%) and stress (47.8%) were reported. Decreased situational awareness was reported by 71.5% and correlated with visors (r = 0.27 and p = 0.03) and FFP2/3 mask usage (r = 0.29 and p = 0.01). Reduced efficiency of theatre teams was reported by 75% of respondents and 21.5% felt patient safety was at greater risk due to Covid-19 precautions in theatre. Conclusions Organisational adjustments are required, and research focused on development of fit-for-purpose personal protective equipment (PPE).

Download Full-text

709 Covid-19 Pandemic: Audit on The Management of Acute Cholecystitis

British Journal of Surgery ◽

10.1093/bjs/znab134.077 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Asarbakhsh ◽

N Lazarus ◽

P Lykoudis

Keyword(s):

Laparoscopic Cholecystectomy ◽

Acute Cholecystitis ◽

Readmission Rate ◽

Adverse Outcomes ◽

Management Option ◽

Management Guidelines ◽

Theatre Staff ◽

The Impact ◽

Definitive Management ◽

Upper Gastrointestinal

Abstract Background The definitive management of acute cholecystitis is laparoscopic cholecystectomy on the same admission if the patient is fit. As the Covid-19 pandemic emerged, evidence suggested adverse outcomes for asymptomatic Covid positive patients undergoing surgery, including increased mortality risk. Risks to theatre staff were also highlighted. This prompted changes in acute cholecystitis management guidelines. Method The audit aim was to assess the impact of guideline change on clinical outcomes and readmission rate for acute cholecystitis. The revised Association of Upper Gastrointestinal Surgeons of Great Britain and Ireland (AUGIS) guidelines were the gold standard. All inpatient admissions for acute cholecystitis during the 4-week peak of the pandemic (17/04/2020 – 14/05/2020) were included. Result 24 patients were admitted with acute cholecystitis. 10 patients (41.7%) were managed with antibiotics alone, 4 patients (16.6%) underwent cholecystostomy. 12 patients (50%) were discharged within 3 days. Lack of clinical progress/ongoing symptoms was the indication for laparoscopic cholecystectomy in 5 cases (20.8%). 5 conservatively managed patients (20.8%) were readmitted with ongoing cholecystitis or pancreatitis. Conclusions 19 patients (80%) were managed non-surgically in accordance with AUGIS guidelines. However conservative management was not always appropriate. We recommend that laparoscopic cholecystectomy should remain a management option for acute cholecystitis during the ongoing Covid-19 pandemic.

Download Full-text

Fire in operating theatres: DaSH-ing to the rescue

Journal of Perioperative Practice ◽

10.1177/1750458918775556 ◽

2018 ◽

Vol 28 (7-8) ◽

pp. 188-193

Author(s):

Liam Wilson ◽

Omer Farooq

Keyword(s):

Patient Care ◽

Fire Safety ◽

Training Session ◽

Operating Theatre ◽

In Situ Simulation ◽

Safe Patient Care ◽

Team Interactions ◽

Operating Theatres ◽

Theatre Staff ◽

Safety Officer

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.

Download Full-text

666 Innovations in ENT Surgery During The COVID-19 Pandemic

British Journal of Surgery ◽

10.1093/bjs/znab134.019 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

M Aziz ◽

M Benamer ◽

S Hany ◽

Y Sahib

Keyword(s):

Healthcare Workers ◽

Sinus Surgery ◽

Healthcare Team ◽

Ear Surgery ◽

The Past ◽

Ent Surgery ◽

Global Pandemic ◽

Theatre Staff ◽

Reduce Risk ◽

Nose And Throat

Abstract Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), is responsible for the coronavirus disease 2019 (COVID – 19) global pandemic. Similar coronavirus epidemics over the past years affected healthcare workers significantly. Aerosol generating procedures (AGPs) presented a unique risk to ear, nose and throat (ENT) Surgeons. We introduce various methods of reducing risk in ENT AGPs. Recommendations During trachesostomies we advocate the adoption of a specialist checklist based on ENT UK guidelines. We also advise the use of a clear drape to create a clear barrier between the patient and staff. For ear surgery we advise suturing 2 microscope pieces together end-to-end so that a clear drape can sperate the patient from surgeon. During nasal and sinus surgery, we advise attaching a clear drape to the sterile camera drape used in rigid nasal endoscopy to create a barrier between patient and surgeon. Discussion Our recommendations will create an extra barrier between the patient and the rest of healthcare team. This should reduce the risks to theatre staff from AGPs. Conclusions COVID 19 is a serious health issue affecting healthcare workers, especially during AGPs in ENT surgery. We recommend several techniques to reduce risk. These can also be used during future epidemics.

Download Full-text

Latex allergy: An emerging health hazard for operating theatre staff

British Journal of Surgery ◽

10.1002/bjs.1800840302 ◽

1997 ◽

Vol 84 (3) ◽

pp. 289-290

Author(s):

P. C. A. Kam ◽

J. F. Thompson

Keyword(s):

Health Hazard ◽

Operating Theatre ◽

Latex Allergy ◽

Theatre Staff

Download Full-text

Growing our own theatre staff: Practice development and education

Journal of Perioperative Practice ◽

10.1177/1750458918769199 ◽

2018 ◽

Vol 28 (5) ◽

pp. 128-132

Author(s):

Becky Cresswell ◽

Corrina Davies ◽

Sue Langlois ◽

Dan Richter

Keyword(s):

Quality Improvement ◽

Student Satisfaction ◽

Quality Improvement Project ◽

Quality And Safety ◽

Improvement Project ◽

Staff Morale ◽

Theatre Staff ◽

Practice Development ◽

Staff Practice ◽

Practice Education

Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust engaged in a quality improvement project aimed at improving quality and safety in theatres. The improvements delivered were recruitment to full staffing template, reduction in agency staffing to zero, and creating a theatre coordinator role to ensure safe staffing. The Practice Education Team was increased fivefold with no extra investment as a result of these improvements. Student satisfaction results amongst ODPs and nurses have increased alongside staff morale and productivity.

Download Full-text

Surgeons in the operating theatre: preparing to lead by example

Bulletin of The Royal College of Surgeons of England ◽

10.1308/147363508x359529 ◽

2008 ◽

Vol 90 (9) ◽

pp. 306-307

Author(s):

K Woo

Keyword(s):

Health Care ◽

Patient Safety ◽

Adverse Events ◽

Operating Theatre ◽

Traditional Practices ◽

Consent Forms ◽

Operative Site ◽

Current Climate ◽

Theatre Staff

Surgeons, anaesthetists and theatre staff have always worked to ensure that no harm comes to their patients, particularly within the operating theatre environment. Patient safety and the prevention of adverse events underlie many of our traditional practices such as the use of identity bracelets, consent forms and marking of the operative site. Perhaps even more so today than ever, unnecessary or avoidable mistakes in the operating theatre cannot be afforded, with the current climate of increasing standards of health care and rising expectations.

Download Full-text

Eye-tunes: role of music in ophthalmology and vision sciences

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211040890 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110408

Author(s):

Shruti Muralidharan ◽

Parul Ichhpujani ◽

Shibal Bhartiya ◽

Rohan Bir Singh

Keyword(s):

Surgical Procedures ◽

Diagnostic Procedures ◽

Well Being ◽

Modern Medicine ◽

Holistic Healing ◽

Operation Theatre ◽

Healing Effect ◽

Theatre Staff

Although the healing effect of music has been recognized since time immemorial, there has been a renewed interest in its use in modern medicine. This can be attributed to the increasing focus on holistic healing and on the subjective and objective aspects of well-being. In ophthalmology, this has ranged from using music for patients undergoing diagnostic procedures and surgery, as well as for doctors and the operation theatre staff during surgical procedures. Music has proven to be a potent nonpharmacological sedative and anxiolytic, allaying both the pain and stress of surgery. This review aims to explore the available evidence about the role of music as an adjunct for diagnostic and surgical procedures in current ophthalmic practices.

Download Full-text

Intraoperative awareness

Handbook of Communication in Anaesthesia & Critical Care ◽

10.1093/oso/9780199577286.003.0023 ◽

2010 ◽

Author(s):

Christel J Bejenke

Keyword(s):

General Anaesthesia ◽

Declarative Memory ◽

Well Being ◽

Striking Similarity ◽

Medical Complication ◽

Psychological Consequences ◽

Intraoperative Awareness ◽

Practice Advisory ◽

Theatre Staff ◽

The Usa

Intraoperative awareness (IOA) represents a range of heterogeneous experiences and is a topic of considerable relevance, not only to anaesthetists, but to all theatre staff. This chapter focuses on communications that the anaesthetist may find helpful in ameliorating or preventing adverse sequelae associated with IOA. This is a well-described, infrequent complication of general anaesthesia which can have serious long-term psychological consequences. First recognized as a medical complication in 1846, there have been numerous reports since the 1950s. Considerable research has been devoted to its understanding and prevention over the past two decades. IOA has increasingly come to the attention of clinicians, patients and the media. It is also a medico-legal issue and high compensation awards have been made. The ASA practice advisory for anaesthesiologists states that, ‘Intraoperative awareness occurs when a patient becomes conscious during a procedure performed under general anaesthesia and subsequently has recall of these events.’ This may include: sensations of weakness; inability to communicate, move or scream; auditory and tactile perceptions; feelings of helplessness; acute fear, panic and pain; believing to have been abandoned and betrayed; and being dead, or about to die. Explicit awareness (declarative memory) permits conscious recall of intraoperative events such as auditory, visual and tactile experiences, paralysis and pain. There is a striking similarity of experiences among patients, but only a minority (35 % ) may inform their anaesthetists. Explicit awareness has been the subject of the majority of investigations related to IOA and is the main topic of this chapter. Implicit awareness (non-declarative memory): information can be recollected but cannot be recalled or consciously retrieved. There is strong evidence for auditory information-processing of material relevant to the patient’s well-being, whether beneficial or threatening. The overall incidence of IOA varies, but has been reported to be between 0.1 and 0.9 % with 30 000–40 000 cases annually in the USA. However, the true incidence of recall is probably underestimated. According to a 2010 report by the ASA closed claims project, IOA occurs in less than 1 in 700 cases. Causes were largely attributed to light anaesthesia and anaesthetic delivery problems.

Download Full-text

To begin …

Handbook of Communication in Anaesthesia & Critical Care ◽

10.1093/oso/9780199577286.003.0007 ◽

2010 ◽

Author(s):

Stavros Prineas ◽

Andrew F Smith

Keyword(s):

Human Dimensions ◽

Pain Clinic ◽

Clinical Settings ◽

Hospital Administrators ◽

High Dependency ◽

The World ◽

Theatre Staff ◽

Anaesthetic Assessment ◽

The Many ◽

Labour Suite

Communication is an innately fascinating and, on occasions, a somewhat mysterious topic. At its heart, it is the means of expressing, both to ourselves and to others, how we perceive the world and how we influence the world around us. It is a tool for exchanging information and meaning, but also a way to connect with others. While obviously a means to an end, it is also an end in itself—without the ability to share with others, life would be greatly impoverished. The many human dimensions of communication— the practical, the social, the linguistic, the lyrical, the subliminal, its ability to soothe and to injure, to inform, to entertain, to terrify—are what make this topic so challenging. Anaesthesia has come a very long way since the 1840s. The advent of safer and more selective drugs, coupled with ever more sophisticated technology, has made the practice of anaesthesia safer, yet also more complicated. The patients that we treat are often older, have multiple co-morbidities, and are undergoing procedures that would have been unthinkable 20 years ago. Yet with the increasingly complex workload have come the additional pressures of time and resource allocation. Patients are admitted on the day of surgery, leaving minimal time for anaesthetic assessment. Anaesthetists are frequently busy, isolated and unavailable when working in theatre, or find themselves working at multiple sites with little opportunity for interaction with colleagues. Similarly, theatre staff rarely work in the same operating room with the same team on a regular basis. The hospital administrators are under constant pressure as they strain to contain costs and reduce length of stay, while wards are increasingly understaffed and overworked. In the midst of all this, patients are left wondering who is actually caring for them, and if anyone is listening to their concerns. Anaesthetists play a crucial role in multi-professional teams in a wide variety of clinical settings of which theatre is only one. There is the high dependency unit (HDU), the labour suite, paediatrics, the chronic pain clinic—to name but a few. In almost every aspect of anaesthetic clinical practice the ability to communicate effectively is a vital component of patient care.

Download Full-text