Operating Room Personnel Research Articles

Whole lung lavage: considerations from the anesthesiology perspective.

Whole lung lavage (WLL) remains the standard treatment for pulmonary alveolar proteinosis (PAP). The procedure involves meticulous preparation, including a multidisciplinary team and appropriate facilities, to ensure patient safety and procedural success. Effective anesthesia management is essential to allow for successful completion of the procedure and prevent complications. Effective anesthesia management, including total intravenous anesthesia (TIVA) and careful intraoperative monitoring, is essential to prevent complications such as hypoxemia and fluid overload. Proper airway control with a double-lumen tube, careful positioning, and continuous monitoring during the lavage phase are key to minimizing risks. Challenges such as fluid spillage and ventilation-perfusion mismatch must be managed proactively with techniques such as fiberoptic bronchoscopy and recruitment maneuvers. In cases of severe hypoxemia, advanced options like extra-corporeal membrane oxygenation (ECMO) or sequential lavage may be required. WLL is a pivotal treatment for PAP, offering significant relief and improvement for many patients despite the challenges in standardizing the procedure due to the rare nature of the condition. Involvement of a multidisciplinary team involving pulmonologist, anesthesiologist, critical care personnel, operating room personnel and in some cases and centers, cardiothoracic surgeon and perfusionist is critical to the success of the procedure.

Occupational Radiation Exposure During Intraoperative 3-Dimensional Fluoroscopy in Pelvis and Acetabular Surgery.

To quantify the occupational radiation exposure with a 3-dimensional (3D) fluoroscopic machine during routine use in pelvic and acetabular surgery and to determine whether the additional radiation exposure encountered with the 3D fluoroscopic spin is within previously accepted limits. Prospective cohort study. Level I trauma center. All patients undergoing 3D fluoroscopy intraoperatively during pelvis (OTA/AO 61B,C) or acetabular (OTA/AO 62A-C) surgery between April 2021 and July 2021. Radiation dose at standardized locations around the operating room during the spin portion of the 3D fluoroscopy. Seventy-six 3D spins were performed on 69 patients during the study period. The average emitted radiation dose from the machine for the routine fluoroscopy portion of the case was 74.5 mGy. The average displayed radiation dose in the air for the spin portion of the case was 39.9 mGy, an average of 53.6% less radiation than the routine fluoroscopy portion. For the spin portion, the average radiation exposure seen by the patient was 3.42 mGy (centered on the patient) and the average maximal exposure in the room was 0.062 mGy. Minimal radiation was detected outside the operating room doors. The radiation exposure encountered by operating room personnel with 3D fluoroscopy appears to be within safe occupational limits. The marginal increase in radiation exposure during pelvic and acetabular surgery should not discourage the use of 3D imaging intraoperatively. Level IV, Case Series.

Bibliometric analysis of occupational exposure in operating room from 1973 to 2022

ObjectiveThe purpose of this study is to identify and visualize from different perspectives the topic on occupational exposure in operating room (OEOR).MethodsIn the Web of Science Core Collection (WoSCC), all the half-century data were retrieved from January 1st, 1973 to December 31st, 2022. CiteSpace, VOSviewer and Excel 2019 were employed to analyze and visualize data, based on publications, countries, institutions, journals, authors, keywords.ResultA total of 336 journal papers were found. The increase of publications virtually started in 1991, peaked in 2020 and has been slowing down ever since. USA played most significant part among all the 49 countries/regions, while Universidade Estadual Paulista out of 499 institutions published the most papers. International Archives of Occupational and Environmental Health bears the most documents and citations in all the 219 retrieved journals. There are 1847 authors found, among whom Hoerauf K is the most influential one. "Occupational exposure”, “nitrous oxide” and “operating room personnel” are the top 3 co-occurrences keywords.ConclusionThe trend in the field lies in “anaesthetic gas”, “blood borne pathogen”, “radiation” and “aerosol”, while “surgical smoke” and “occupational safety” are the recently researching hot spots in this study. Accurate recognize and effective protection are always essential subjects for researchers.

A Novel, Autonomous, Module-Based Surgical Lighting System

Optimal illumination of the surgical site is crucial for successful surgeries. Current lighting systems, however, suffer from significant drawbacks, particularly shadows cast by surgeons and operating room personnel. We introduce an innovative, module-based lighting system that actively prevents shadows using an array of swiveling, ceiling-mounted light modules. The intensity and orientation of these modules are autonomously controlled by novel algorithms utilizing multiple depth sensors mounted above the operating table. This paper presents our complete system, detailing the algorithms for autonomous control and the initial optimization of the light module setup. Unlike prior work that was largely conceptual and based on simulations, this study introduces a real prototype featuring 56 light modules and three depth sensors. We evaluate this prototype through measurements, semi-structured interviews (n=4), and an extensive quantitative user study (n=11). The evaluation focuses on illumination quality, shadow elimination, and suitability for open surgeries compared to conventional OR lights. Our results demonstrate that the novel lighting system and optimization algorithms outperform conventional OR lights for abdominal surgeries, according to both objective measures and subjective ratings by surgeons.

Evaluating performance: a scoping review on video-based assessments of non-technical skills in the operating room

Background: Patient safety remains a critical concern in the high-stakes environment of the operating room (OR). Human factors and non-technical skills (NTS) play pivotal roles in surgical performance and in preventing errors. Various assessment tools and methodologies have been developed to evaluate NTS among OR personnel, reflecting the growing recognition of their importance. Objectives: To map and analyze NTS among OR personnel during real-life surgeries using medical video recording systems and to evaluate NTS assessment tools described in existing literature. Methods: Four databases, PubMed, Web of Science, Medline and Embase, were searched for relevant studies. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol was followed. Eligibility criteria included studies focusing on video recordings providing an overview of the entire OR with a focus on NTS. Results: Twenty-four articles were included in this scoping review. A total of eight NTS were assessed, most frequently communication (79%), leadership (54%), teamwork (50%) and situational awareness (50%). Observational methods varied, ranging from one or more cameras to more sophisticated medical data recorders, such as the OR Black Box (ORBB). Additionally, a wide variety of assessment methods were used, mostly validated tools (NOTSS, SPLINTS, ANTS), but also broader systems-based frameworks (SEIPS) or self-developed tools. Conclusions: This scoping review highlights the diverse methodologies used to measure NTS in the OR using medical video recordings, indicating a need for further research to address challenges and standardize practices. Despite the proven potential benefits of video recording in the OR, legal, ethical and logistical challenges may serve as possible barriers to actual implementation.

Virus and viral components transmitted through surgical smoke; a silent danger in operating room: a systematic review

BackgroundDuring surgical procedures, heat-generating devices are widely used producing surgical smoke (SS). Since the SS can transmit infectious viruses, this systematic review was designed to investigate the potential viruses transmitted through SS.MethodsPubMed, Scopus, Web of Science, ProQuest, and Embase databases, along with Cochran Library, and Google Scholar search engine were searched systematically (by April 21, 2024). No language, place, and time restrictions were considered. All studies evaluating the SS and virus transmission, and whole investigations regarding the viral infections transmitted through SS were totally considered inclusion criteria. Besides, non-original, qualitative, case reports, case series, letters to the editor, editorial, and review studies were excluded from the analysis. This study was conducted in accordance with the PRISMA 2020 statement.ResultsTwenty-six eligible studies were selected and reviewed for data extraction. The results showed that the SS contains virus and associated components. Six types of viruses or viral components were identified in SS including papillomavirus (HPV, BPV), Human Immunodeficiency Virus (HIV), varicella zoster, Hepatitis B (HBV), SARS-CoV-2, and Oral poliovirus (OPV), which are spread to surgical team through smoke-producing devices.ConclusionsSince the studies confirm the presence of viruses, and viral components in SS, the potential risk to the healthcare workers, especially in operating room (OR), seems possible. Thus, the adoption of protective strategies against SS is critical. Despite the use of personal protective equipment (PPE), these viruses could affect OR personnel in surgical procedures.

Knowledge, attitudes, and practices of orthopedic operating room personnel regarding the use of pneumatic tourniquets.

Pneumatic tourniquets (PTs) play a crucial role in hemostasis during orthopedic surgery. This study aimed to investigate the current knowledge, attitudes, and practices (KAP) of orthopedic operating room personnel concerning the use of PTs. This cross-sectional study was conducted from Jul. 2023 to Aug. 2023. An online questionnaire was used to collect demographic information and KAP score data of the orthopedic operating room personnel from Hangzhou Regional Hospitals. A total of 336 participants included orthopedic physicians (37.8%), orthopedic nurses (31.5%), anesthesiologists (8.9%), operating room nurses (19.9%) and medical students (1.8%). The median knowledge score was 28.5 (24, 32), with a maximum score of 38; the median attitude score was 31 (28, 35), of a maximum of 35; the median practice score was 41 (36, 44), of a maximum of 45. Correlation analysis showed links between knowledge and attitude (r = 0.388, p<0.001), knowledge and practice (r = 0.401, p<0.001), and attitude and practice (r = 0.485, p<0.001). Multivariate logistic regression analysis confirmed that female gender (OR = 0.294, 95% CI: 0.167-0.520; p<0.001), working in a specialized hospital (OR = 0.420, 95% CI: 0.219-0.803; p = 0.009), and occupation as a surgical anesthesiologist (OR = 3.358, 95% CI: 1.466-7.694; p = 0.004) were associated with better knowledge scores. A higher educational degree (OR = 0.237, 95% CI: 0.093-0.608; p = 0.003) was associated with better practice scores. No previous training was associated with lower knowledge (OR = 0.312, 95% CI: 0.187-0.520; p<0.001) and practice (OR = 0.325, 95% CI: 0.203-0.521; p<0.001) scores. Orthopedic personnel in this study had acceptable knowledge, attitude, and practice concerning the use of PTs; additional training and guidance might enhance proficiency.

Prevalence of Low Back Pain and Association Factors Among Operating Room Personnel of Ahvaz Hospitals: A Cross-Sectional Study

Background: Low back pain is a common musculoskeletal disorder among healthcare specialty nurses. Operating room staff are particularly susceptible to experiencing low back pain due to the nature of their work. Objectives: We conducted a study to investigate the prevalence of low back pain and the factors associated with it. Methods: A cross-sectional study was conducted on 323 operating room staff from five hospitals affiliated with Ahvaz Jundishapur University of Medical Sciences. Data was collected using a questionnaire developed by Tavakol et al. This questionnaire included demographic information and assessed the prevalence and dimensions of low back pain. The data was analyzed using IBM SPSS v.26. Results: The results showed that the prevalence of low back pain (LBP) was 74.3%. In this study, 64.8% of the personnel were women, 63.5% were married, and 72.4% had a bachelor's degree. Additionally, 87% had no history of smoking. The average age was 33.83 ± 7.02 years. There was a significant relationship between the prevalence of LBP and gender (P = 0.044), marital status (P = 0.0001), BMI (P = 0.008), age (P = 0.0001), shift work (P = 0.001), work experience (P = 0.0001), and the average number of shifts (P = 0.037). Conclusions: We found a high prevalence of LBP among operating room personnel, which is related to both individual and occupational factors. Our recommendations for nursing managers include modifying work shifts, allocating less physically demanding tasks to senior personnel and females, and implementing educational programs that focus on improving ergonomics and reducing physical strain.

Assessment of knowledge, attitude, and practice regarding medical waste management among operation room personnel in a tertiary hospital.

Medical waste management (MWM) is of concern to the medical and surgical communities in the hospital. Adequate knowledge, attitude, and practice regarding the management of healthcare waste are important for the proper handling and disposal by physicians and healthcare workers. The aim of this study was an assessment of knowledge, attitude, and practices regarding medical waste management among operation room personnel in a tertiary hospital. This study was a descriptive cross-sectional survey conducted at a single-center government Comprehensive Specialized Hospital operation room from 1-30 September 2022. All specialty operation room healthcare personnel consenting to cooperate and participate were included in the study. The data were collected using a self-administered questionnaire. The collected data were analyzed using SPSS. The results were presented in texts, tables and graphs. From 130 operation room personnel, the results revealed that the majority of the total respondents were male (83.1%). Only 30 (23.1%) of the respondents were involved in training, whereas 100 (76.9%) of the study participants have not participated in training. It was found that 86 (66.2%) of the respondents had good knowledge, 113 (86.9%) of the respondents had a good attitude, and 27 (20.8%) of the respondents had good practice. The authors' study reveals that the majority of study participants have a moderate level of knowledge, a good level of attitude, and poor levels of practice, according to Bloom's cut-off point. The institution should more fully implement the training for operation room personnel to improve their level of knowledge and practice of medical waste management.

Peri-anesthetic Environmental and Occupational Exposure to Desflurane Waste Anesthetic Gas in a Large Animal Veterinary Hospital.

The goals were to determine the environmental levels of desflurane waste anesthetic gas and the desflurane occupational exposure of operating room staff during the anesthesia of large animal veterinary patients. Active environmental sampling was performed using single-beam infrared spectrophotometry. Passive sampling with dosimeter badges was used to measure the occupational exposure of anesthesia and operating room staff. Higher concentrations of desflurane (n = 16) were measured at all recovery timepoints relative to the concentrations measured at all locations and timepoints at the start of anesthesia and surgery ( P < 0.05). Time-weighted average desflurane concentrations from dosimeter badges (n = 310) were higher for anesthesia staff than for other operating room personnel ( P < 0.0001). The anesthetic recovery of large animal patients is a period of increased exposure to desflurane waste anesthetic gas for veterinary staff.

Ethical climate and its relationship with attitude to teamwork in operating room nurses: A cross-sectional study

IntroductionIn the nursing profession, ethical climate is considered to be an important element of the work environment. Nurses are exposed to moral tension due to the volume and high work pressure; on the other hand, the stressful nature of this profession can have many negative effects on nurses and, as a result, the quality of care. Therefore, improving the conditions and ethical climate becomes very important. In the operating room, due to the special working conditions and the variety of available specialties, team work is of great importance among the operating room staff. Improving teamwork in the operating room reduces stress and anxiety, increases work efficiency, improves the quality of care, and increases the patient safety. ObjectiveThis study was conducted with the aim of determining the relationship between the ethical climate and the attitude towards teamwork of operating room nurses in hospitals affiliated with Shiraz University of Medical Sciences. MethodThis research was a cross-sectional study conducted in 2022. The study involved a sample of 310 operating room nurses from hospitals affiliated with Shiraz University of Medical Sciences, selected using convenient and purpose-based sampling methods. In order to collect data, the questionnaires of demographic information, Olsan's ethical climate and attitude towards teamwork baker were used. The collected data were analyzed by SPSS V20. FindingsThe average score of the operating room staff from the ethical climate was 94.12±14.96, and that of the overall attitude towards teamwork was 121.92±11.74, which indicates a favorable attitude towards teamwork. There was a significant relationship between the scores of the ethical climate and the attitude toward teamwork among the operating room personnel (r = 0.339,p < 0.0001). ConclusionThe results showed that there is a significant relationship between the attitude towards teamwork and the ethical climate of operating room nurses. Managers of hospitals and operating rooms can strengthen the spirit of teamwork and create a suitable atmosphere in the operating room by holding training courses and increase safety and productivity there.

Long-Term Disinfection in Operating Rooms Affects Skin Microbiota and Metabolites of Medical Personnel

Introduction: Disinfectants play a critical role in reducing healthcare-associated infections by eliminating microorganisms on surfaces. However, prolonged use of disinfectants may adversely affect the skin microflora, essential for skin health and infection prevention. This study investigates the impact of disinfection on the skin microbiota and metabolites of medical personnel in operating rooms, aiming to provide a scientific foundation for safeguarding their skin health. Methods: We conducted 16S sequencing and metabolomic analysis to assess the effects of disinfection on the skin microbiota and metabolites of medical personnel. Samples were collected from operating room personnel after disinfectant exposure to identify changes in microbial communities and metabolite profiles. Results: Our analysis revealed that prolonged use of disinfectants led to alterations in skin microbial communities and microbial metabolites. These alterations included the production of harmful metabolites that could potentially promote skin infections and other health issues among medical personnel. Conclusion: The findings underscore the importance of minimizing disruptions to skin microbiota and metabolites caused by long-term disinfectant use to preserve the overall health of medical personnel. This study provides valuable insights into the relationship between disinfectant use, skin microbiota, and metabolites, highlighting the necessity for further research in this area.

Comparative analysis of combined spinal–epidural anesthesia and general anesthesia in percutaneous nephrolithotomy: a prospective study on surgical team and operating room personnel satisfaction

ObjectiveWe aimed to investigate the efficacy and complications of combined spinalepidural anesthesia and general anesthesia in percutaneous stone surgery prospectively.Materials and methodsThe study prospectively included patients who underwent percutaneous nephrolithotomy with general anesthesia (Group.1) or combined spinal–epidural anesthesia (Group.2) at the Department of Urology, Training and Research Hospital, Karabuk University. between December 2018 and December 2019. The effect of the anesthesia technique on the comfort and satisfaction of the operating room personnel, surgeon and anesthesia team were prospectively evaluated and recorded.ResultsDuring the postoperative period, the spinal anesthesia group had a significantly lower visual analog score than the general anesthesia group. No patient in either group required narcotic analgesics during the postoperative period. In terms of overall satisfaction scores, the surgeon performing the surgical procedure had a significantly higher satisfaction score in the general anesthesia group than in the CSEA group. The score was considered good in the general anesthesia group and moderate in the CSEA group. Personnel satisfaction was higher in the patient group that underwent CSEA. In the general anesthesia group, the score was considered to be average. In the CSEA group, the satisfaction score was considered good, with a statistically significant difference (p < 0.05). The anesthesia team’s satisfaction score was moderate, with no significant difference between the CSEA and general anesthesia groups (p > 0.05).ConclusionPCNL under CSEA can be performed safely in certain individuals. Different anesthetic techniques may have varied levels of satisfaction among the surgical team.

Radiation dosage is related to changes in lymphocyte count, interleukin-6, and c-reactive protein levels during C-arm use in closed femoral nailing surgery

Introduction: Although the C-arm allows real-time image capture and intensification to allow accurate placement of implants and fixation devices with minimal incisions, these advantages have the disadvantage of the amount of radiation exposure to operating room personnel, especially surgical operators. The exposure mainly was low dose (&lt;1 Sv). However, the effects of low-dose exposure may be accurate and should be considered seriously. Methods: This research was an observational prospective cohort study. A total of 30 residents who met the inclusion criteria had blood samples taken before and after femoral nailing surgery. Then, the blood sample underwent a complete blood count, IL-6, and CRP levels examination. During surgery, C-arm radiation will be measured using a personal dosimeter. The statistical tests used were descriptive statistics, proportion comparison analysis with the dependent t-test, and simple linear regression tests. Results: Univariate analysis using paired t-test proved changes in lymphocyte count, IL-6, and CRP levels of orthopedic residents before and after femoral nailing surgery with c-arm guiding with a statistically significant difference, based on p-values respectively: p=0.001; p=0.001; p=0.002. Simple linear regression test proved that radiation dosage of c-arm during operation is associated with a change in lymphocyte count, IL-6 and CRP levels before and after femoral nailing surgery with R squared values respectively: 0.474 (p=0.001), 0.694 (p=0.001) and 0.701 (p=0.001). Conclusion: Radiation dosage of c-arm during femoral nailing surgery is related to changes in lymphocyte count, interleukin-6, and c-reactive protein levels among orthopedics and traumatology residents.

Evaluation of Oxidative Stress Induced by Occupational Inhalation Exposure to N2O, an Anesthetic Gas

Introduction: Nitrous oxide (N2O) is the most common anesthetic gas used in operating rooms. The major objective of this investigation is to measure N2O values in two modes: first, when the ventilation system is on, and second, when it is off; and to determine the biomarkers of oxidative stress associated with this exposure among operating room personnel.&#x0D; Materials and Methods: A cross-sectional study was conducted on 60 operating room personnel as the N2O exposed group, and on 60 nurses as the referent group. N2O concentrations were determined according to NIOSH method 6600. Total antioxidant capacity (TAC) levels, malondialdehyde (MDA), and superoxide dismutase (SOD) activities were also measured.&#x0D; Results: The concentrations of N2O in the presence and absence of ventilation systems were significantly higher than the recommended exposure limit (REL) of 25 ppm recommended by NIOSH. The levels of TAC and SOD were significantly lower in participants exposed to N2O in comparison with the referent group. Adjusted for age, work experience, and sex, exposure to N2O was found to be an occupational risk factor for low levels of TAC and SOD, so that exposure to N2O reduced TAC and SOD levels by 0.16 mM and 0.75 U/ml, respectively.&#x0D; Conclusion: The present study shows that the operating room personnel are exposed to levels of N2O several times more than the REL of this gas and this heavy exposure is associated with a significant increase in oxidative stress.

Phase 1 trial of same day cytology to guide the use of HIPEC.

Peritoneal metastases from gastrointestinal or gynecologic malignancy are a prominent part of the natural history of these diseases. Peritoneal metastases, if not effectively treated, will result in a decreased survival and cause an impaired quality of life. Hyperthermic intraperitoneal chemotherapy (HIPEC) is a treatment specifically designed to combat peritoneal metastases. A group of patients who, from a theoretical perspective, may benefit from HIPEC are those patients with a positive peritoneal cytology. In order to identify these patients at the time of a surgical intervention, a same day cytology is to be performed. The result of this test is to be available at or before the completion of the cancer resection. If the cytology is positive, the patient immediately becomes a candidate for HIPEC. The HIPEC will be of maximal value if a complete cytoreduction, as judged by the surgeon, has been possible. This phase 1 trial is to demonstrate that the Surgical Oncology Service, the Department of Pathology, the Pharmacy and the Operating Room personnel can co-ordinate a phase 1 protocol to successfully complete the same day cytology with an efficient delivery of HIPEC. A standardized plan for consent, cytology collection, preparation of the specimen, reading of the specimen, reporting the results in a timely manner facilitates the administration of HIPEC in peritoneal cytology positive patients. Successful completion of these requirements is a positive result for this study and allows for future protocols to be generated. Successful completion of the same day cytology phase 1 protocol will allow the efficacy, safety, and efficiency of this plan of patient management to be evaluated.

Operating room technologists' knowledge, attitude, and preparedness for disaster management of a Zahedan: Implications for nursing disaster education.

During the occurrence of accidents and disasters, the role of hospitals and healthcare centers is very sensitive and they are among the first units that with their quick, optimal, and timely healthcare services provision can reduce mortality and increase the number of survivors. For this purpose, this study was conducted to investigate the knowledge, attitude, and level of preparedness of operating room technologists of educational hospitals of Zahedan University of Medical Sciences in relation to disasters. The present research is a cross-sectional descriptive study that was conducted with the participation of 60 operating room technologists of Zahedan educational hospitals from January 2022 to December 2022. The sampling was performed by the census method. The data collection tool was a demographic characteristic and a researcher-made questionnaire for the assessment of attitude, knowledge, and preparation against the occurrences of accidents and disasters was completed during 2 months by referring the researcher to the hospitals. For the data analysis, descriptive statistics and analytical statistical tests were used. The data were analyzed using IBM SPSS Statistics 26. Corp., Armonk, NY, USA. The significance level was considered P < 0.05. The results showed that the average scores of attitude, preparation, and knowledge are 9.3 ± 6.1, 75.8 ± 9.9, and 5.7 ± 4.1, respectively, and the majority of operating room technologists have a favorable level towards attitude and have relatively favorable level towards preparation and knowledge during the occurrence of disasters. The average score of knowledge and attitude of operating room technologists with work history had a significant difference from each other (P < 0.05). technologists with less work experience have more knowledge and a more positive attitudedisaster. Measuring the level of knowledge, attitude, and preparedness of surgical technologists to deal with disasters as one of the ways of receiving feedback from employee training can be a useful reflection of the success of training programs in creating the necessary capabilities in various fields of disaster preparedness, and it can be a powerful tool for increasing individual and group dynamics and organizing individual learning in coping training. Furthermore, disaster education should be incorporated into the operating room curriculum, which would play a seminal role in preparing them for future disaster management. It is also suggested to investigate the impact of intelligent training on the level of knowledge, attitude, and preparation of operating room personnel regarding disasters and obstacles in this regard in future research.

Infection Prevention and the Protective Effects of Unidirectional Displacement Flow Ventilation in the Turbulent Spaces of the Operating Room.

Unidirectional displacement flow (UDF) ventilation systems in operating rooms are characterized by a uniformity of velocity ≥80% and protect patients and operating room personnel against exposure to hazardous substances. However, the air below the surgical lights and in the surrounding zone is turbulent, which impairs the ventilation system's effect. We first used the recovery time (RT) as specified in International Organization for Standardization 14644 to determine the particle reduction capacity in the turbulent spaces of an operating room with a UDF system. The uniformity of velocity was analyzed by comfort-level probe grid measurements in the protected area below a hemispherical closed-shaped and a semi-open column-shaped surgical light (tilt angles: 0°/15°/30°) and in the surrounding zone of a research operating room. Thereafter, RTs were calculated. At a supply air volume of 10,500 m3/h, the velocity, reported as average uniformity ± standard deviation, was uniform in the protected area without lights (95.8% ± 1.7%), but locally turbulent below the hemispherical closed-shaped (69.3% ± 14.6%), the semi-open column-shaped light (66.9% ± 10.9%), and in the surrounding zone (51.5% ± 17.6%). The RTs ranged between 1.1 and 1.7 min below the lights and 3.5 ± 0.28 min in the surrounding zone and depended exponentially on the volume flow rate. Compared to an RT of ≤20 min as required for operating rooms with mixed dilution flow, particles here were eliminated 12-18 times more quickly from below the surgical lights and 5.7 times from the surrounding zone. Thus, the effect of the lights was negligible and the UDF's retained its strong protective effect.

Assessment of Knowledge, Attitude and Practice regarding Patient’s Perioperative Pressure Injury Prevention among the Operating Room Personnel of Medical Teaching Institutions, Peshawar

Background: Pressure injuries (PIs), particularly perioperative pressure injuries (ORPIs), pose significant challenges in patient care, leading to increased morbidity, extended hospital stays, and elevated healthcare costs. Despite established guidelines, the incidence of ORPIs remains a concern, underlining the need for improved prevention strategies within the operating room setting. Objective: This study aimed to assess the knowledge, attitudes, and practices (KAP) regarding perioperative pressure injury prevention among operating room personnel in medical teaching institutions in Peshawar, Pakistan, to identify knowledge gaps and areas for intervention. Methods: A cross-sectional descriptive study was conducted over four months, from June to October 2023, involving 264 operating room personnel from three major medical teaching institutions in Peshawar. Participants included nurses, surgeons, and surgical technicians/technologists. Data were collected using structured questionnaires and the KoboCollect mobile application, covering sociodemographic information, and KAP related to perioperative pressure injury prevention. The study employed descriptive statistics, chi-square tests, and Pearson correlation coefficients for data analysis, utilizing IBM-SPSS version 27 and Microsoft Excel 365. Results: The study revealed a mean knowledge score of 66.02% (SD = 18.99), with 44.3% of participants displaying low knowledge levels (&lt;69%). Attitudes towards pressure injury prevention were predominantly positive, with an average score of 78.17% (SD = 10.38). Practice levels were moderate, with an average score of 79.43% (SD = 10.59), and 54.9% of respondents engaging in high-level practices (≥80%). Significant associations were found between knowledge levels and education (p=&lt;0.001), and between practice levels and both age (p=0.01) and professional role (p=0.006). Conclusion: The study highlights a critical gap in knowledge regarding perioperative pressure injury prevention among operating room personnel, despite positive attitudes and moderately high practice levels. Addressing this gap through tailored educational programs and policy interventions is crucial for enhancing patient care and preventing ORPIs.

Safe Surgery Checklist Implementation: Associations of Management Practice and Safety Culture Change.

Designing and developing safe systems has been a persistent challenge in health care, and in surgical settings in particular. In efforts to promote safety, safety culture, i.e., shared values regarding safety management, is considered a key driver of high-quality, safe healthcare delivery. However, changing organizational culture so that it emphasizes and promotes safety is often an elusive goal. The Safe Surgery Checklist is an innovative tool for improving safety culture and surgical care safety, but evidence about Safe Surgery Checklist effectiveness is mixed. We examined the relationship between changes in management practices and changes in perceived safety culture during implementation of safe surgery checklists. Using a pre-posttest design and survey methods, we evaluated Safe Surgery Checklist implementation in a national sample of 42 general acute care hospitals in a leading hospital network. We measured perceived management practices among managers (n = 99) using the World Management Survey. We measured perceived preoperative safety and safety culture among clinical operating room personnel (N = 2,380 (2016); N = 1,433 (2017)) using the Safe Surgical Practice Survey. We collected data in two consecutive years. Multivariable linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following Safe Surgery Checklist implementation.