Comparison of waste anesthetic gases in operating rooms with or without an scavenging system in a Brazilian University Hospital

Background To reduce the ambient concentration of waste anesthetic agents, exhaust gas scavenging systems are standard in almost all operating rooms. The incidence of contamination and the factors that may increase the concentrations of ambient anesthetic gases have not been evaluated fully during routine circumstances, however. Methods Concentrations of nitrous oxide (N2O) in ambient air were monitored automatically in 10 operating rooms in Kagoshima University Hospital from January to March 1997. Ambient air was sampled automatically from each operating room, and the concentrations of N2O were analyzed every 22 min by an infrared spectrophotometer. The output of the N2O analyzer was integrated electronically regarding time, and data were displayed on a monitor in the administrative office for anesthesia supervisors. A concentration of N2O > 50 parts per million was regarded as abnormally high and was displayed with an alarm signal. The cause of the high concentration of N2O was then sought. Results During the 3-month investigation, N2O was used in 402 cases. Abnormally high concentrations of N2O were detected at some time during 104 (25.9%) of those cases. The causes were mask ventilation (42 cases, 40.4% of detected cases), unconnected scavenging systems (20 cases, 19.2%), leak around uncuffed pediatric endotracheal tube (13 cases, 12.5%), equipment leakage (12 cases, 11.5%), and others (17 cases, 16.4%). Conclusions N2O contamination was common during routine circumstances in our operating rooms. An unconnected scavenging system led to the highest concentrations of N2O recorded. Proper use of scavenging systems is necessary if contamination by anesthetic gas is to be limited.

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Evaluation of teamwork in operating rooms in a Tunisian university hospital

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.508 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

H Lamine ◽

O Ammar ◽

W Mrabet ◽

M A Tlili ◽

W Aouicha ◽

...

Keyword(s):

Quality Of Care ◽

Adverse Events ◽

Situation Awareness ◽

Assessment Tool ◽

Operating Rooms ◽

University Hospital ◽

Quality Level ◽

Cross Sectional ◽

The University

Abstract Background Teamwork is fundamental to ensuring the quality of care and patient safety in operating rooms. It has been shown that the occurrence of adverse events is closely linked to a poor quality of teamwork in these settings. Thus, this study aimed to assess teamwork in different operating rooms of the university hospital of Sahloul Sousse (Tunisia). Methods It is a descriptive cross-sectional study with convenience sampling, conducted in operating rooms of the university hospital of Sahloul Sousse (Tunisia) between February and April 2018. The measuring instrument was the validated observation grid 'Communication and Teamwork Skills Assessment Tool (CATS) '. Teamwork is assessed through 4 domains (Situation awareness, Coordination, Communication, Cooperation). Behaviors are marked in rows each time they occur and are rated for quality in columns labeled “Observed and Good,” “Variation in Quality” (meaning incomplete or of variable quality), and “Expected but not Observed.” Results A total of 51 interventions were observed. Good coordination between the team members was noted, as well as good cooperation within the teams. A variation of quality level of communication with the patient was noted in 31.4% of cases, also communication about the context, the situation and recommendation among caregivers is not quite good with a percentage of 39.2%. Moreover, the work environment was rated as good in 84.3% of cases. Conclusions Some failures in teamwork were noted, hence it is important to take corrective measures for better practice and better patient management in such a complex environment, the operating rooms, where there is a strong need for team coordination. Key messages There is a direct relationship between the quality of care and the effectiveness of teamwork. It is necessary to eliminate the barriers to communication, in order to prevent adverse events.

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OCCUPATIONAL GENOTOXIC EFFECTS AMONG A GROUP OF NURSES EXPOSED TO ANESTHETIC GASES IN OPERATING ROOMS AT ZAGAZIG UNIVERSITY HOSPITALS

Egyptian Journal of Occupational Medicine ◽

10.21608/ejom.2018.4942 ◽

2018 ◽

Vol 42 (1) ◽

pp. 105-122 ◽

Cited By ~ 1

Author(s):

Borayek GE ◽

Abou El-Magd SA ◽

El-Gohary SS ◽

El-Naggar AM ◽

Hammouda MA

Keyword(s):

Operating Rooms ◽

University Hospitals ◽

Genotoxic Effects ◽

Anesthetic Gases

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Operating Room Management In Klaipėda University Hospital: Prospective Analysis In 2009

Sveikatos mokslai ◽

10.5200/sm-hs.2016.083 ◽

2016 ◽

Vol 26 (5) ◽

pp. 114-119

Author(s):

Renata Paškevičiūtė ◽

Geda Klimavičiūtė

Keyword(s):

Operating Room ◽

Surgical Procedures ◽

Surgical Procedure ◽

Operating Rooms ◽

Turnover Time ◽

University Hospital ◽

Time Variability ◽

Procedure Time ◽

High Turnover ◽

Scheduled Time

Summary Background: Klaipeda University Hospital performs about 30000 surgical procedures every year. The operating room (OR) is a major production unit in hospital. The OR is very expensive to construct and to operate. The goal might be thought to be full utilization of all operating rooms during all hours that they are staffed and available for scheduling. Management is the ability to apply a diverse body of knowledge to accomplish planning, organizing, staffing, leading, and controling a work group. Methods: We decided accidentally to choose and to analyze OR utilization. We had analyzed central operating department consisting of 9 ORs with regularly scheduled time 8:00 AM to 4:00 PM (8 h), full staffed in 2009 four months period (78 workdays). Four months (78 workdays) of data were collected from the 9 operating rooms surveys. Holidays and weekends were excluded.The data was analyzed using “ Statistica” version 7.Results: There were performed 1982 surgical procedures (elective – 1807 (91,2%), urgent – 99 (5%), cancelled – 76 (3,8%)) during investigated period regularly scheduled time (8 h). Actually utilized OR time of all 9 ORs was 4648 h (82,76%), it was planned to work 5616 h. Our OR utilization was 82,76% during investigated period. Total under – utilized time was 968 h (17,36%). Surgeon estimated surgical procedure time was longer than actual surgical procedure time, variability of case duration between surgical teams was high. Turnover time mean duration was 28 min. Conclusions: Our study demonstrates that our central operating department have been worked efficiently (OR utilization was 82,76%, case cancellation rate was 3,8%, mean turnover time was 28 min, prolonged turnovers were less than 10%) in 2009 (four month period).

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Implementing, Connecting, and Evaluating a Standard-Based Integrated Operating Room within a German University Hospital

ACI Open ◽

10.1055/s-0038-1639604 ◽

2018 ◽

Vol 02 (01) ◽

pp. e10-e20

Author(s):

Raluca Dees ◽

Angela Merzweiler ◽

Gerd Schneider ◽

Martin Kasparick ◽

Lars Mündermann ◽

...

Keyword(s):

Iterative Method ◽

Operating Room ◽

Medical Devices ◽

Clinical Relevance ◽

Additional Data ◽

Operating Rooms ◽

University Hospital ◽

Human Machine Interfaces ◽

It Systems ◽

Integrated Operating Room

Background Digital operating rooms (ORs), when optimally designed and integrated, can reduce the complexity of the surgery suite. However, many integrated ORs are effectively isolated from other IT systems in the hospital because there is little or no connectivity with them. Within the German flagship project OR.NET, concepts and components were developed for a standard-based connection of the OR with hospital IT systems. Objectives The aim of this work was to implement and evaluate OR.NET concepts and components within the existing IT landscape of a German university hospital. This article describes and evaluates the implemented architecture and processes for connecting a demo OR to existing hospital IT systems at Heidelberg University Hospital. Methods For the design, establishment, and evaluation of standard-based connections of the demo OR with hospital IT systems, the iterative method “Design and Creation” with four iterations was applied. Results A generic and a concrete architecture for several standard-based connection concepts of the demo OR were developed. Furthermore, the concrete architecture was implemented and evaluated for its technical and clinical relevance. The main benefits of the project were the establishment of basic requisites for improving the efficiency within the OR, easier operation of medical devices as a result of harmonized human–machine interfaces, and providing additional data for improving healthcare. Conclusion OR.NET concepts for a standard-based connection of the OR with hospital IT systems have proven to be promising. They can serve as a reference for further integration scenarios in other hospitals.

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Sliding doors: how their opening affects particulate matter levels?

European Journal of Public Health ◽

10.1093/eurpub/ckaa166.704 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

A Della Camera ◽

G Spataro ◽

G Cevenini ◽

N Nante ◽

F M De Marco ◽

...

Keyword(s):

Particulate Matter ◽

Turbulent Flows ◽

Air Flow ◽

Surgical Site Infections ◽

Operating Rooms ◽

Laminar Flows ◽

Wilcoxon Test ◽

University Hospital ◽

Door Opening ◽

Particulate Contamination

Abstract Background The operating theatres (OTs) have adequate conditions to perform safe operations and to prevent surgical site infections. Opening doors can compromise these situations. Measurement of particulate contamination is a key point to check the effectiveness of preventive measures in the OTs. We analysed how openings impact in different type of OTs. Methods Between January/February 2020 a transversal study was conducted in 5 different types of OTs in a university hospital. Two had laminar flows, with 55 and 60 air changes/h; three had turbulent flows: OT-A (18 air changes/h, with 4 inlets from the ceiling), OT-B (23 air changes/h and air flow from the ceiling plenum), OT-C (16 air changes/h, air flow directed from one wall to the opposite wall and the main door laterally to the flow). Particulate matter (PM) measurements were carried out in 7 different points in each OT, alternating two conditions: a) doors closed; b) opening/closing the main door twice per minute. For each spot, in each condition, we recorded for several minutes the following parameters: particles (0.3, 0.5, 1, 3, 5, 10µ), room temperature (Ta), Relative Humidity (Rh), airspeed (Va). Comparison with the Wilcoxon test were made using STATA 14. Results In laminar flow, classified with better ISO levels (4), opening and closing the door the PM, for any size, increased not significantly (p > 0.05). The OTs with turbulent flows (ISO 5-6) had a higher particulate level than the laminar ones and greater variations with door openings. OT-A worsened significantly for all particles (p < 0.05) closing/opening the door. In contrast, OT-B and OT-C had a significant reduction of PM (p < 0.05). All 5 OTs had pressure falling to 0 at door opening; Ta, Rh and Va may be affected by different type air flows and design. Conclusions OTs parameters during door openings are influenced by different ventilation systems and room design. Laminar flows OTs are less affected, but innovative turbulent flows OTs can be just as effective. Key messages The operating rooms are affected by the door opening. Laminar flows operating rooms are less influenced by door openings than turbulent flows ones. Turbulent flow rooms have different performance depending on their construction characteristics.

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