Abstract
Conducting a thorough check to ensure that all equipment and personnel are positioned correctly at the start of any operation is essential for both the safety of the surgical team and the patient outcome. Orthopaedic surgery in particular carries a high risk of occupational injury and this group could benefit greatly from ergonomic improvements. This review highlights multiple factors that can influence safety of surgeons, surgical efficiency and patient outcomes.“TULIPS” is a mnemonic that lists six key steps in optimising the surgical procedure through effective positioning of equipment and personnel pre-operatively. This was trialled by distribution amongst orthopaedic registrars regionally and it received excellent feedback, with the majority changing their current practice. Here we report that using this simple and memorable checklist can assist orthopaedic surgeons in setting up the operating theatre, facilitating ergonomic improvements that can reduce the risk of musculoskeletal injury and radiation exposure.
Highlights
Set-up for surgical procedures is essential for the safety of the patient, the surgeon and patient outcomes
We report that using this simple and memorable checklist can assist orthopaedic surgeons in setting up the operating theatre, facilitating ergonomic improvements that can reduce the risk of musculoskeletal injury and radiation exposure
8/14 (57%) registrars reported they had a method of setting up the operating theatre, only 2/14 (14%) reported using a checklist approach to help them set-up. 12/14 (86%) reported having experienced difficulties in surgery directly linked to poor theatre set-up, with 8/14 (57%) all mentioning that image intensifier position had been problematic
Summary
Set-up for surgical procedures is essential for the safety of the patient, the surgeon and patient outcomes. It has been suggested orthopaedic surgeons would benefit most from ergonomic improvements, as they are at risk of occupational injury [1]. Efforts have been made to improve the ergonomic experience and reduce the strain that occurs during surgery, but adherence to these techniques has not been widely adopted. This has been attributed to general lack of awareness of the current recommendations within the surgical specialties [2]. It has been recommended to raise awareness of these injuries and devote institutional resources to help combat these issues in the orthopaedic community [2]
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