Operating Room Personnel Research Articles

Evaluation of Knowledge and Practice of Radiographers and Operating Room Personnel about Radiation Protection: Importance of Training Courses

Purpose: Awareness of personnel who are professionally involved with ionizing radiation on the principles of radiation protection is very important; especially for operation room personnel, because they do not receive radiation protection training during their university education in Iran. The aim of this study was to evaluate knowledge and practice of radiographers and operating room personnel about the principles of radiation protection. Materials and Methods: A validated researcher-made questionnaire was used and the study was conducted on 328 medical staff in 2021. Factors such as age, gender, university degree, working years, occupation, and knowledge and practice about radiation protection were recorded. The collected data were analyzed by independent t-test and Pearson correlation analysis using SPSS software. Results: The results of the study showed that age, gender and university degree have no significant effect on the knowledge and practice of radiographers and operating room personnel (p > 0.05). The knowledge and practice of radiographers were significantly higher than operating room personnel (p < 0.05). With regard to working years, there were significant relationships with the knowledge of personnel (p= 0.034), and with practice (p= 0.038). There was a significant correlation between passed training courses of radiation protection and knowledge (p=0.012), and practice (p=0.033). There was a significant correlation between knowledge about radiation protection and practice (p=0.002). Conclusion: It is necessary to encourage staff with lower working years and operating room personnel to participate in radiation protection courses and workshops. It can be suggested to add training programs about radiation protection in university education or in-service education for operating room personnel.

BIOMONITORING OF SEVOFLURANE EXPOSURE IN ANESTHESIOLOGIST

ABSTRACTSevoflurane is used by anesthetists for the induction and maintenance of general anesthesia. This causes the anesthetist to get daily exposures. This will be a potential hazard for exposed operating room personnel, especially anesthetists. The adverse health effects of sevoflurane as hepatotoxic, nephrotoxic and neurotoxic in the human body can be a risk for anaesthetists. Biological monitoring can be done by measuring the levels of sevoflurane and its metabolites or by looking at biomarkers for their effects on health effects. The aim of this study was to seek a literature review on the biomonitoring of sevoflurane exposure in anaesthetists. We searched the literature review using the PRISMA method in PubMed and Google scholar using the following keywords "occupational disease" "chronic effects" "anaesthetist" "sevoflurane exposure" "inorganic fluoride" "biomarkers" previously using the term MeSH and combined with Boolen "OR" and AND". We obtain 75 articles taken from the database, excluded 35 articles, and selected 5 articles. The results of the review articles showed that there were health effects, especially on liver and kidney function in chronic exposure. Biological monitoring can be undertaken by detecting sevoflurane and its metabolites in the urine during work and function of the liver and kidneys. The evidence for biological monitoring as surveillance in anaesthesiologists remain inconsistent due to limited studies. We recommend to measure sevoflurane in ambient air using a hierarchy of controls, such as elimination, replacement, engineering, administrative and personal protective equipment. We need to undertaken environmental and biological monitoring in order to acquire a safe and healthy work environment. Keywords: sevoflurane exposure, occupational health, anesthesiologist

Effects of Inhalation Aromatherapy With Rosa damascena (Damask Rose) on the State Anxiety and Sleep Quality of Operating Room Personnel During the COVID-19 Pandemic: A Randomized Controlled Trial

PurposeAlthough aromatherapy with damask rose can reduce anxiety and improve sleep quality in different conditions, no study has yet addressed its effects among operating room (OR) personnel. Considering the high level of workload among Iranian OR personnel during the COVID-19 pandemic which can affect their anxiety and sleep quality, this study evaluated the effects of damask rose aromatherapy on state anxiety and sleep quality among a population of Iranian OR personnel during the COVID-19 pandemic. DesignA randomized, nonblinded, parallel-group controlled trial. MethodsEighty OR personnel were divided into the two groups of damask rose and placebo (paraffin oil) using the stratified randomization method. In the first aromatherapy session, the participants inhaled two drops of either damask rose oil or paraffin oil for 10 minutes at the beginning of their morning shift. Then, they attached an absorbent cloth napkin impregnated with 5 drops of products to the side of their pillow for 30 consecutive nights. The Spielberger state anxiety inventory (SAI) and the Pittsburgh sleep quality index (PSQI) were completed before random allocation (T1) and on the 31st day of the study (T3). Also, the SAI was completed 90 minutes after the end of the first aromatherapy session (T2). FindingsThe mean changes in the SAI score were significant compared to T1 both at T2 and T3 in favor of the damask rose group (P < .001 in two cases). Similarly, the mean change in PSQI score was significant compared to T1 at T3 in favor of the damask rose group (P < .001). ConclusionsDamask rose can be effective in reducing state anxiety and improving sleep quality of OR personnel. Further studies are needed to determine the generalizability of the findings.

Measuring the awareness of the predisposing factors of low back pain among the operating room personnel

BackgroundLow back pain is the most common type of work-related musculoskeletal disorders and one of the costliest health problems. This study aimed to design a tool to measure the awareness of the predisposing factors of low back pain among the operating room personnel and to evaluate its psychometric properties MethodsThis methodological study aimed to design a psychometric tool for assessing the operating room personnel's awareness of predisposing factors and dimensions of low back pain in. In the first step, the main dimensions and concepts were developed by reviewing the literature and consulting with professors and experts. In the second step, the initial items of the questionnaire were formulated. Finally, the psychometric properties of the questionnaire were determined using face, content and construct validity, internal consistency, and test-retest reliability. ResultsIn the first phase of the study, the concept of low back pain and its risk factors were determined, and then the initial items of the tool were developed. In the next step, face and content validity of the instrument were determined both qualitatively and quantitatively (content validity ratio=0.91 and content validity index=0.95). Indeed, construct validity was assessed by convergent and divergent validity using chronic pain and general health questionnaires, respectively (correlation coefficient in convergent validity=0.70 and correlation coefficient in divergent validity=-0.37). Finally, the reliability of the instrument was determined using internal consistency (α=0.60) and test-retest reliability (0.77). ConclusionConsidering the design, validity, and reliability of the instrument for measuring the awareness of predisposing factors and dimensions of low back pain in operating room personnel, we suggest that it should be used for evaluation of the awareness and different dimensions of low back pain among the operating room personnel.

Clarifying Values of Surgical Providers to Improve Care for Transgender Patients Undergoing Gender-Affirming Surgery

<h3>Study Objective</h3> Minimal literature exists addressing surgical providers' own personal views in the context of caring for transgender patients. We created a pilot Values Clarification survey administered to operating room personnel with the objective of engaging participants in a process of self-examination to better elucidate their values, unconscious biases, and concerns that ultimately impact care for this patient population. <h3>Design</h3> An anonymized survey created consists of 23 questions with a series of 5-point Likert Scale statements pertaining to participants' understanding, biases, comfort and attitudes towards transgender individuals and gender affirming surgery. <h3>Setting</h3> Questionnaires were developed through Qualtrics online program and distributed to participants through a secure institutional email platform. <h3>Patients or Participants</h3> Pilot survey was sent to operating room staff including nursing, scrub technicians, and administrative staff at one academic hospital. Inclusion criteria comprised of personnel that would have peri-operative clinical interactions with patients undergoing gender-affirming surgery. <h3>Interventions</h3> N/A. <h3>Measurements and Main Results</h3> There were 18 respondents to the survey. There were ambivalent beliefs surrounding gender-affirming surgeries with 27%(N=5) who "neither agree nor disagree" to surgery being medical necessary. 39% (N=7) of participants were neutral and 16% (N=3) "disagreed" that patients under the age of 25 are certain of their own gender identity. 50% (N=9) "neither agreed nor disagreed" and 11% (N=2) "agreed" there is an increased risk of regret after undergoing gender-affirming surgery under the age of 25. 77% of participants reported overall comfort with directly participating in gender affirming surgery cases. <h3>Conclusion</h3> Preliminary data suggests the need to improve the knowledge of transgender issues, explore provider values towards individuals undergoing gender affirming surgery and whether age is a component for concerns, and promote increased comfort in caring for this patient population. Our goal is to utilize this data to finalize our Values Clarification Curriculum in which we can later educate surgical providers to expand awareness and improve care for transgender individuals.

Effect of Operating Room Personnel Generation on Perceptions and Responses to Surgeon Behavior.

Little is known regarding the impact of operating room (OR) personnel generation on their perceptions to various surgeon behaviors. We aimed to characterize these relationships by evaluating their responses to 5 realistic intraoperative scenarios. Operating room personnel were asked to assess surgeon OR behavior across a standardized set of 5 scenarios via an online survey. For each scenario, respondents were asked to identify the behavior as either acceptable, unacceptable but would ignore, unacceptable and would confront the surgeon, or unacceptable and would report to management. Chi-squared analyses were used to compare responses to surgeon behavior with respondent generation. There were 3101 respondents, of which 41% of respondents were baby boomers (n = 1280), 31% were generation (Gen) X (n = 955), and 28% were Gen Y (n = 866). Overall, when compared to Gen X or Gen Y, baby boomers were significantly more likely to find surgeon behaviors of impatience (P < .001), being late for a case (P < .001), swearing in the OR (P < .001), and shouting with a bleeding patient (P = .001) to be inappropriate and would talk to the surgeon. Alternatively, Gen Y respondents were more likely to find fault with surgeon behaviors that deviate from rules and regulations, such as forgetting a time-out (P = .001), when compared to baby boomers and Gen X respondents. Results of our study demonstrate that OR personnel generation affects their perceptions and response to surgeon behavior. Understanding these tendencies can guide efforts to improve OR interactions among team members.

Living on the EDGE: Canadian Experience With EUS-directed Transgastric ERCP (EDGE) in Patients With Roux-en-Y Gastric Bypass Anatomy.

IntroductionRoux-en-Y gastric bypass (RYGB) surgery imposes anatomic barriers to endoscopic retrograde cholangiopancreatography (ERCP). Potential options for biliary access in these patients include laparoscopic-assisted ERCP or balloon enteroscopy. However, these approaches require specialized equipment and/or operating room personnel and are associated with high rates of failure and adverse events compared to conventional ERCP. A recently described technique, EDGE, is an endoscopic approach which involves accessing the excluded stomach to facilitate ERCP.ObjectiveThe objective of this study is to describe the results of EDGE procedures performed in Canada.MethodsData were collected from patient cases who had undergone an EDGE procedure across centers in Canada. All patients had a history of RYGB bariatric surgery. In each procedure, a 20-mm diameter lumen-apposing metal stent (LAMS) was deployed under EUS guidance to allow access from the gastric remnant/proximal jejunum to the excluded stomach. Subsequently, during a separate procedure, a duodenoscope was passed through the LAMS to perform ERCP. Following ERCP, the LAMS was replaced with a pigtail stent or APC was used to facilitate closure of the gastro-jejunal/gastro-gastric fistula.ResultsThe indication for EDGE in the seven included cases was for the treatment of choledocholithiasis (six) or gallstone pancreatitis (one). The technical success rate of the EDGE procedure in these cases was 100%. Clinical success, defined by normalization of bilirubin and symptomatic relief, was observed in all cases. There were no adverse events reported.ConclusionThe results of this series support EDGE as a safe and minimally invasive approach to biliary access and therapy in patients with previous RYGB surgery.

Anaesthetic Effects of Propofol, Ketamine and their Combination (Ketofol) as Total Intravenous Anaesthesia (TIVA) in Pigs

Background: Endotracheal intubation for inhalation anaesthesia in pigs is not considered a good anaesthetic method as it is technically difficult because of oral anatomy and the presence of excess tissues in the oropharyngeal region. Moreover, the major limitation of inhalation anaesthesia is that it requires the use of a cumbersome and costly anaesthetic machine, including a suitable breathing system and vaporizer and is the exposure of operating-room personnel to the pollution in the ambient air. Therefore, the present study was undertaken to evaluate the effect of propofol, ketamine and their combination ‘Ketofol’ as a TIVA in pigs. Methods: The study was conducted in eighteen piglets of either sex. The piglets were randomly divided into three groups with six animals in each group. All the three groups were premedicated with Atropine sulphate @ 0.04mg/kg body weight and Xylazine Hydrochloride @ 1mg/kg body weight I.M. and Medazolam @ 0.5mg/kg body weight I.M. with minimum forcible restraint as pre-anaesthetic. In group-I, propofol @ 5mg/kg body weight, in group-II, ketamine @ 5mg/kg body weight and in group-III, ketofol @ 4mg/kg body weight was administered intravenously for induction after 15 minutes of pre-anaesthetic administration. Surgical anaesthesia was maintained for 90 minutes in all three groups viz. group-I, group-II and group-III with propofol @ 2.5mg/kg, ketamine @ 2.5mg/kg and ketofol @ 2mg/kg body weight respectively by intermittent bolus injection (IBI) technique. Clinical and cardiopulmonary profiles were evaluated before administration of the anaesthetic agent (0 minutes) then at 15, 30, 60 and 90 minutes during and after administration of anaesthetic agents to evaluate their anaesthetic effect. Result: The study revealed that induction time (IT), duration of analgesia (DOA), duration of recumbency (DOR) and recovery time (RT) interval showed better result in the combination of ketamine and propofol group as compared to propofol and ketamine-induced individual group. The temperature and respiration rate was significantly decreased in all the groups at 30 minutes during TIVA whereas heart rate was significantly increased in all the groups at 15 minutes. The combination of ketamine and propofol group showed a consistent diastolic pressure and systolic pressure during the entire period of anaesthesia. The SPO2 in the ketamine-induced group showed a significant decrease (P less than 0.01) as compared to the propofol and ketofol group. It was concluded that the anaesthetic drug combinations resulted in smooth and uneventful induction with mild cardiopulmonary depressions and rapid recovery.

Perceptions on music and noise in the operating room: a cross-sectional study

Objectives. Noise in operating rooms (ORs) during surgery may affect OR personnel and pose a threat to patient safety. The sources of noise vary depending on the operation. This study aimed to investigate how OR staff perceived noise, whether music was considered noise and what its perceived effects were. Methods. Surgeons, anaesthesiologists, residents and nurses were interviewed. iPads were placed in the ORs to gather noise-level data. Results. Ninety-one interviews were conducted. Most participants (60.5%) reported the presence of noise and 25% the presence of music in the OR. Noise data from iPads registered levels ranging between 59.52 and 85.60 dB(A). analyses yielded significant results between participants’ role and the perceived effects of noise (p = 0.02). Responses to open-ended questions were thematically categorized. Conclusions. Surgeons generally chose the music played in ORs and were likely positively inclined to its effects, while anaesthesiologists and nurses minded the lack of choice and were more likely to consider it as noise.

Improving Wellness of Operating Room Personnel: A Light-Based Intervention on Perceived Nursing-Related Stress

Background: Nursing is an emotionally demanding and physically draining occupation. Well-being of health care workers is essential to achieve success in care and have good cooperation relationships with other health professionals.Objective: The purpose of this study was to evaluate the effectiveness of a light-based intervention on perceived nursing-related stress in health care personnel working in an operating room environment.Methods: A total of 84 nurses participated in this randomized, cross-over controlled study. Intervention consisted of 4 weeks of bright blue-enriched light exposure using a LED head-mounted portable device (n = 42) or no light exposure (n = 42) separated by a 2-week washout period in a crossover fashion. Participants completes questionnaires for the Nursing Stress Scale (NSS).Results: Intervention and control groups were comparable in terms of demographics, with a median age of 34 (IQR: 27–49) and 69 (82%) female. The mean baseline NSS score was similar in both groups before intervention. The NSS score of the intervention group was significantly lower after intervention than the baseline score: the NSS score difference before and after intervention was 15.1 (SD 7.6) (p < 0.001) and 19.7 (SD 7.5) (p < 0.001) during the two successive periods of intervention, respectively. The cross-group comparison after intervention showed a significantly higher NSS score difference after intervention in the intervention group than the control group: 15.1 (SD 7.6) vs. 1.4 (SD 8.4) (p < 0.001) and 19.7 (SD 7.5) vs. 1.7 (SD 8.9) (p < 0.001) during the two successive periods of intervention, respectively.Conclusion: Alternative person-directed initiatives should be considered to improve the well-being of the health workforce in operating rooms, especially during the coronavirus pandemic.

MP18-11 ENDOUROLOGICAL PROCEDURES UNDER LOCAL ANESTHESIA, DURING SARS COV 2 PANDEMIA.

INTRODUCTION AND OBJECTIVE: Endourological procedures are generally performed under general anesthesia, presenting a high risk of viral infection during intubation in SARS Cov2 positive patients. During the Covid 19 pandemic, an attempt was made to reduce the exposure of operating room personnel, so a protocol was started with local anesthesia for these surgeries1. The objective of this work is to evaluate the feasibility of performing these procedures with local anesthesia, analyzing pain through the Visual Analogue Scale (VAS), the stone-free rate, and the correct position of the double j stent. METHODS: Descriptive prospective study conducted between March 2020 and January 2021, all patients undergoing endoscopic procedures were included. Patients who were admitted for outpatient surgery for placement or replacement of a double-j stent, or ureteroscopy for ureteral lithiasis were selected. Patients with previous pathologies such as diabetes, hypertension, neuropathies, neurological pathologies, hypersensitivities, trauma and psychiatric disorders were excluded. The local anesthesia protocol consisted of placing a urinary catheter, instilling 40 ml of lidocaine 2% solution without epinephrine 20 minutes before starting the procedure, associated with analgesia with Ketorolac 30 mg (IV) and Dexamethasone 8 mg (IV), prior to the same2. The visual analog pain scale was performed after the procedure. Its assessment is mild if the patient scores pain less than 3. Moderate pain if the assessment is between 4 and 7, and severe pain if the assessment is equal to or greater than 8 points on the scale. The stone-free rate and the correct position of the double j catheters were analyzed with a simple radiograph of the urinary tree. The patients were asked if they would recommend the procedure and would undergo it again, if necessary. RESULTS: Eighteen patients were included, with an average age of 39.6 years (≥ 12.4 years), 11 (61%) female, submitted to 19 endoscopic procedures in our institution;URS were performed in 4 (22.2%) patients, 5 (27.7%) required URS = double j catheter, 4 (22.2%) patients received double j catheter only, 3 (16.6%) patients had double j catheter exchange and 1 (5.5%) required bilateral exchange. The average VAS value was 6.4 (≥ 1.5, mode=7), 16 patients reported moderate pain (VAS 4-7), and only 2 referred severe pain (VAS ≥ 8), which had to be suspended due to pain intolerance (1 URS and 1 double jot), for which they required general anesthesia. The stone-free rate was 90% for the URS, and 100% of the double j catheters were normally positioned in the radiological control. The procedures were completed with a success rate of 88%. 14 patients would recommend repeating the procedure to others, 7 patients answered that they would not repeat the procedure, if necessary. CONCLUSIONS: Endourological procedures such as URS and placement of a ureteral catheter under local anesthesia were well tolerated by the patients. It had a high success rate and acceptance.

Catching Fire: Are Operating Room Fires a Concern in Orthopedics?

Operating room (OR) fires are considered "never events," but approximately 650 events occur annually in the United States. Our aim was to detail fires occurring during orthopedic procedures via a questionnaire because of the limited information present on this topic. A 25-question survey on witnessing surgical fires, hospital policies on surgical fires, and surgeons' perspective on OR fires was sent to 617 orthopedic surgeons in 18 institutions whose residency program is a member of the Collaborative Orthopaedic Educational Research Group. The response rate was 28%, with 172 surgeons having completed the survey. Twelve of the 172 orthopedic surgeons surveyed reported witnessing at least 1 surgical fire in an OR setting. Electrocautery was the leading ignition source, causing fires in 7 events. A saw, laser, and light source were reported to have caused 1 fire each. Regarding fuel source for the fires, bone cement was a common culprit (n = 4), followed by gauze (n = 3). Oxygen delivery to patients was via a closed system in most cases (n = 9). No patient harm was reported in any of these cases.Just under half of the respondents (47.7%) reported not receiving any formal OR fire prevention or response training. The most common answer for frequency of concern about a surgical fire was "never" (42.4%). Fires pose a risk in surgery, even in an orthopedics setting. Room oxygen can supply enough oxidizing power for a fire to occur, especially with the ubiquitous nature of ignition sources and fuels in the OR. Prevention is key with these events. Operating room personnel education must be sought, and surgeons should be mindful of the fire components in the OR.

A STUDY OF WARMING DEVICES AND PERIOPERATIVE FACTORS POTENTIALLY CONTRIBUTING TO SURGICAL FIELD CONTAMINATION IN SMALL ANIMAL PATIENTS

Bacterial contamination on surgical drapes may increase the risk of surgical site infection (SSI). This preliminary investigation analyzed the relationship between forced-air warming devices and bacterial contamination on surgical drapes in small animal soft tissue surgery settings. The subjects of this study were canine and feline patients enrolled in clean surgical procedures at the National Taiwan University Veterinary Hospital. Bacterial colonies on surgical drapes were sampled on agar plates immediately prior to and 1[Formula: see text]h after skin incision. Cases with bacteria growth on the post-incision sampled agar were considered with surgical field contamination (SFC). Intraoperative warming methods (forced-air warming systems or circulating water blankets) and other factors that potentially contribute to SFC (drape material, patient features, surgical procedure types, surgeons, and number of operating room personnel) were recorded. The study comprised 57 operations, 28 cases belonged to the circulating water blanket group and 29 belonged to the forced-air warming system group. No differences in contamination rate were detected among intraoperative warming methods, drape materials, patient characteristics, surgical procedure types, or number of operating room personnel. However, a significant difference in contamination rate was detected among surgeons.

Observance of preventive standards against COVID-19 transmission in operating rooms: A cross-sectional study

BackgroundDue to the highly contagious innate of the novel coronavirus, the surgical team is exposed to the disease during surgical care of patient with confirmed covid-19. Therefore, the necessary measures should be taken to protect surgical caregivers. This study was conducted to determine the status of compliance with the preventive standards against covid-19 transmission in the operating room. MethodsThis cross-sectional descriptive study was conducted on 183 surgical team members working in hospitals affiliated to Tabriz university of medical sciences in 2020. Participants were selected by stratified random sampling. The required data were collected by a researcher-made questionnaire according to the standard protocols of SAGES, EAES and AORN. In the first part of this questionnaire, the level of compliance with the standards of using personal protective equipment (PPE) was evaluated and in the second part, the level of compliance with the preventive strategies in the operating room was evaluated in three phases of Pre, Intra and Post-operative. The data was analyzed using SPSS16. Resultspreventive standards observance against COVID-19 was in moderate (55.3 ± 10.5) level and The level of compliance with the standards of using PPE by the surgical team was favorable (61.8 ± 8.1). There was a statistically significant relationship between the level of compliance with the standards of using PPE and the type of specialty (P = 0.004). ConclusionAccording to the results, the level of compliance with the principles of standards in applying protective measures against covid-19 was not favorable, so the operating room personnel is exposed to COVID-19 and the necessary measures and improvements should be considered in compliance with standards in operating room.

OPERATING ROOM AND PATIENT SAFETY: AN OVERVIEW

Safety in the operating room (OR) has always been a major public health concern. It refers tothe safety of both the patient and the working personnel. Improving patient safety is anincreasing priority for surgeons and hospitals as sentinel events can be catastrophic for patients,caregivers, and institutions. Although patient safety in the operating room (OR) has improvedin last decades, significant risks remain. Adverse events may be subtle and delayed (as a centralline-associated bloodstream infection due to poor hand hygiene) or dramatic and immediate(e.g., a fire). All operating room personnel must have certain knowledge and skills to providesafety and quality care to patients before, during and after surgery. Review focused on thescience of safety principles and efforts to improve safety in the OR.

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

Safety culture, shared values with regard to safety management, is a key driver of high-quality health care delivery. The Safe Surgery Checklist (SSC) is an innovative tool for improving surgical care safety, but evidence about SSC effectiveness is mixed. While a structured implementation and management commitment are considered important, limited evidence exists about what managerial practices support safety culture, and how SSC implementation can impact the organization’s managerial practices and safety culture. We examined the relationship between management practices and perceived safety culture and the way checklist implementation induces change in both. Using a pre-posttest design and survey methods, we evaluated the implementation of SSC in a national sample of 42 general acute care hospitals affiliated with a leading hospital system. We measured perceived management practices among management (n=99) using the World Management Survey. We administered the Safe Surgical Practice Survey to clinical operating room personnel to measure perception of pre-operative safety and safety culture (N= 2380 in 2016 and N= 1433 in 2017). Data was collected in two consecutive years. Linear regression analysis demonstrated a significant relationship between changes in management practices and overall safety culture and perceived teamwork following SSC implementation.

Exploration of the Operating Room Personnel From Components and Examples of Interprofessional Collaboration: A Phenomenological Study

Background and Objectives: Inter-professional collaboration is one of the most important components of patient safety.Understanding the components of interprofessional collaboration is essential. So far, few studies have been conducted on interprofessional cooperation in the operating room, worldwide and in Iran.The aim of this study was to explain the experiences of operating room staff from the components and examples of interprofessional collaboration using the phenomenological approach by Colaizzi method (1978). The aim of this study was to explain the experiences of operating room staff from the components and examples of interprofessional collaboration using the phenomenological approach by Colaizzi method (1978). The aim of this study was to explain the experiences of operating room staff from the components and examples of interprofessional collaboration using the phenomenological approach Colaizzi method (1978). Methods: 12 employees working in different professions in the operating room of Qom hospitals were included.The study was conducted in a qualitative phenomenological manner with the Colaizzi method and structured goal-based interviews. Results: From the analysis of the obtained data, 6 Emergent Them and 20 Theme Clusters were obtained as follows: “Organization” (goal setting and shared resources), “Professional Identity” (commitment,mutual‏respect, synergy‏ and clear role), ”Communication” (Collaboration, Trust, Information Sharing, and Conflict Management “Team Characteristics (Flexibility, Experience, Participation, Teamwork, and responsibility،accountability)”, Leadership and Management (Operating Room Leadership, Hierarchy Structure, Climate, Working Conditions, and Capacity) “Coordination” (planning) Conclusion: Staff training and explaining the experience of other operating room staff about the components of Inter-professional collaboration, could be considered as one of the main steps to achieve inter- Inter-professional collaboration and patient safety. The results of this study can be helpful education officials in improving and improving the quality of joint inter-professional training programs.

The compliance with radiation protection and knowledge about radiation exposure among the orthopedic operating room personnel in Saudi Arabia

Objectives: There is a rapid advancement in surgical techniques requiring real-time visualization and intraoperative X-ray utilization, leading to a higher radiation exposure among operating room (OR) staff. Taking preventive measures and reducing the unnecessary radiation exposure for the patient and the OR staff is essential. The study aimed to assess the compliance with using radiation protection equipment, as well as assessing the level of knowledge about radiation exposure among the orthopedic OR staff. Methods: This is a cross-sectional study that was conducted in Saudi Arabia. A 19-Item questionnaire that was developed and validated by Jentzsch et al. was sent to the emails of all the registered members of the Saudi Orthopedic Association, orthopedic physicians, OR nurses, and radiology technicians were included in the study. A Correlation procedure was performed to determine the relationship between knowledge and compliance scores. Results: We recruited 242 orthopedic OR personnel, 110 (45.5%) showed good knowledge and 120 (49.5%) showed good compliance. Lead apron was the most commonly used equipment, lead goggles use was the least. Females, radiology technicians, and sports and/or arthroplasty surgeons showed better compliance scores. Conclusion: The study reveals inadequate knowledge and compliance among OR staff regarding radiation protection. Therefore, we recommend providing training programs to minimize radiation hazards.

A 5-YEAR RETROSPECTIVE ANALYSIS OF IONIZING RADIATION DOSE TO HYBRID OPERATING ROOM PERSONNEL IN SAUDI ARABIA.

The annual average effective dose (ED) for operating room personnel (ORP) in Saudi Arabia was estimated from the period of 2015-2019 using thermoluminescent dosemeters. A retrospective analysis was conducted on annual EDs for 7530 ORP working across 52 hospitals. These workers were only exposed to radiation in the operating room. The annual average ED over the period of 5years was found to be 0.59mSv with no incidence of a dose above the annual dose limit of 20mSv. The maximum annual ED reported was 15mSv for an operating room worker in 2019. More than 88% of the workers received an annual ED of <1mSv. The study concluded that the work environment in hybrid operating rooms across Saudi Arabia is safe. However, it is always recommended that workers take every protective measure when dealing with ionization radiation.

Operating Room Drugs and, Consumables Distribution Systems: Knowledge, Attitude and, Practice among Operating Room Workforce in a Tertiary Hospital in the Developing World

Drug and consumables distribution system in the operating room is key to the smooth running of the operating room in any hospital. Technological advancements have led to the development of newer and more efficient distribution systems. We aim to assess the knowledge, attitude and, practice of drug and consumable distribution systems among operating room workforce of a tertiary hospital in Nigeria. The study was a questionnaire-based cross-sectional study among the various categories of professionals of the operating room workforce. Two sets of questionnaires with structured questions on the knowledge, attitude and practice of operating room drug and consumables distribution system were administered one after the other on the operating room personnel. 282 of 363 operating room workforce consented and responded to the questionnaires. The workforce is made up of surgeons 198 (70%), physician anaesthetists 28 (10%), nurse anaesthetists 25 (9%) and, perioperative nurses 31 (11%). Their mean age was 42.61+8.74 years, 175 (64%) aged between 30 and 49 years with male to female ratio of 2.9:1. The majority 243 (86%) of respondents did not know the meaning of an operating room drug and consumable distribution system. After explanation, it was discovered that 228 (81%) had experienced the individual prescription order system with its associated wastages 195 (69%), medication errors 130 (46%,) and, delay or scheduling of cases 183 (65%). This study revealed poor knowledge of drug and consumables distribution system among operating room workforce in our institution. The study centre uses individual prescription order system with significant untoward effects. We recommend improved awareness of the theatre workforce on drug and consumable distribution systems.