Did operating theatre staff understand the COVID-19 guidelines for surgery during Victoria's second wave?
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ABSTRACT:
SUBMITTER: Drysdale HRE
PROVIDER: S-EPMC8250072 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundIn many hospitals, operating theatres are not used to their full potential due to the dynamic nature of demand and the complexity of theatre scheduling. Theatre inefficiencies may lead to access block and delays in treating patients requiring critical care. This study aims to employ operating theatre data to provide decision support for improved theatre management.MethodHistorical observations are used to predict long-term daily surgery caseload in various levels of granularity, from emergency versus elective surgeries to clinical specialty-level demands. A statistical modelling and a machine learning-based approach are developed to estimate daily surgery demand. The statistical model predicts daily demands based on historical observations through weekly rolling windows and calendar variables. The machine learning approach, based on regression algorithms, learns from a combination of temporal and sequential features. A de-identified data extract of elective and emergency surgeries at a major 783-bed metropolitan hospital over four years was used. The first three years of data were used as historical observations for training the models. The models were then evaluated on the final year of data.ResultsDaily counts of overall surgery at a hospital-level could be predicted with approximately 90% accuracy, though smaller subgroups of daily demands by medical specialty are less predictable. Predictions were generated on a daily basis a year in advance with consistent predictive performance across the forecast horizon.ConclusionPredicting operating theatre demand is a viable component in theatre management, enabling hospitals to provide services as efficiently and effectively as possible to obtain the best health outcomes. Due to its consistent predictive performance over various forecasting ranges, this approach can inform both short-term staffing choices as well as long-term strategic planning.
| S-EPMC9172609 | biostudies-literature
Project description:OBJECTIVES:Hot environmental conditions can result in a high core-temperature and dehydration which can impair physical and cognitive performance. This study aimed to assess the effects of a hot operating theatre on various performance, physiological and psychological parameters in staff during a simulated burn surgery. METHODS:Due to varying activity levels, surgery staff were allocated to either an Active (n = 9) or Less-Active (n = 8) subgroup, with both subgroups performing two simulated burn surgery trials (CONTROL: ambient conditions; 23±0.2°C, 35.8±1.2% RH and HOT: 34±0°C, 28.3±1.9% RH; 150 min duration for each trial), using a crossover design with four weeks between trials. Manual dexterity, core-temperature, heart-rate, sweat-loss, thermal sensation and alertness were assessed at various time points during surgery. RESULTS:Pre-trials, 13/17 participants were mildly-significantly dehydrated (HOT) while 12/17 participants were mildly-significantly dehydrated (CONTROL). There were no significant differences in manual dexterity scores between trials, however there was a tendency for scores to be lower/impaired during HOT (both subgroups) compared to CONTROL, at various time-points (Cohen's d = -0.74 to -0.50). Furthermore, alertness scores tended to be higher/better in HOT (Active subgroup only) for most time-points (p = 0.06) compared to CONTROL, while core-temperature and heart-rate were higher in HOT either overall (Active; p<0.05) or at numerous time points (Less-Active; p<0.05). Finally, sweat-loss and thermal sensation were greater/higher in HOT for both subgroups (p<0.05). CONCLUSIONS:A hot operating theatre resulted in significantly higher core-temperature, heart-rate, thermal sensation and sweat-loss in staff. There was also a tendency for slight impairment in manual dexterity, while alertness improved. A longer, real-life surgery is likely to further increase physiological variables assessed here and in turn affect optimal performance/outcomes.
| S-EPMC6795495 | biostudies-literature
Project description:BackgroundAdverse surgical incidents affect both patients and health professionals. This study sought to explore the effect of surgical incidents on operating theatre staff and their subsequent behaviours.MethodsEligible studies were primary research or reviews that focused on the effect of incidents on operating theatre staff in primary, secondary or tertiary care settings. MEDLINE, Embase, CINALH and PsycINFO were searched. A data extraction form was used to capture pertinent information from included studies and the Critical Appraisal Skills Programme (CASP) tool to appraise their quality. PRISMA-P reporting guidelines were followed and the review is registered with PROSPERO.ResultsA total of 3918 articles were identified, with 667 duplicates removed and 3230 excluded at the title, abstract and full-text stages. Of 21 included articles, eight focused on the impact of surgical incidents on surgeons and anaesthetists. Only two involved theatre nurses and theatre technicians. Five key themes emerged: the emotional impact on health professionals, organization culture and support, individual coping strategies, learning from surgical complications and recommended changes to practice.ConclusionHealth professionals suffered emotional distress and often changed their behaviour following a surgical incident. Both organizations and individual clinicians can do a great deal to support staff in the aftermath of serious incidents.
| S-EPMC5989958 | biostudies-literature
Project description:BackgroundThe COVID-19 pandemic has greatly affected access to elective surgery, largely because of concerns for patients and healthcare workers. A return to normal surgery workflow depends on the prevalence and transmission of coronavirus in elective surgical patients. The aim of this study was to determine the prevalence of active SARS-coronavirus-2 infection during a second wave among patients admitted to hospital for elective surgery in Victoria.MethodsProspective cohort study across eight hospitals in Victoria during July-August 2020 was conducted enrolling adults and children admitted to hospital for elective surgery or interventional procedure requiring general anaesthesia. Study outcomes included a positive polymerase chain reaction (PCR) test for SARS-CoV-2 in the preoperative period (primary outcome), and for those with a negative test preoperatively, the incidence of a positive PCR test for SARS-CoV-2 in the post-operative period.ResultsWe enrolled 4965 elective adult and paediatric surgical patients from 15 July to 31 August 2020. Four patients screened negative on questionnaire but had a positive PCR test for coronavirus, resulting in a Bayesian estimated prevalence of 0.12% (95% probability interval 0-0.26%). There were no reports of healthcare worker infections linked to elective surgery during and up to 2 weeks after the study period.ConclusionThe prevalence of SARS-CoV-2 in asymptomatic elective surgical patients during a second wave was approximately 1 in 833. Given the very low likelihood of coronavirus transmission, and with existing current hospital capacity, recommencement of elective surgery should be considered. A coronavirus screening checklist should be mandated for surgical patients.
| S-EPMC7753725 | biostudies-literature
Project description: Not available
| S-EPMC7174186 | biostudies-literature
Project description:ObjectiveWe aimed to explore compliance with and barriers to wearing facemasks at the workplace among university teaching staff in Egypt.MethodsAn online survey was shared with teaching staff members at 11 public and 12 private Egyptian universities and high institutes, and 218 responses were received. All participants were asked about beliefs related to wearing facemasks. For participants who taught in-person classes, compliance with and barriers to wearing facemasks at the workplace were assessed. Compliance level was classified into: Non-compliance, inadequate and adequate, based on the degree of adherence to having facemasks on and not taking them off at five main work settings. We compared demographic characteristics, beliefs, and barriers scores across compliance levels.ResultsMost participants (81.7%) believed that facemasks reduce infection risk to others and 74.3% believed facemasks can reduce risk to the wearer. Around 80% of the respondents who taught in-person classes wore facemasks, but only 37.8% met the criteria of adequate compliance. Difficulty breathing and impaired communication were cited as major barriers by 42.2% and 30.3% of in-person class tutors respectively. The risk of reporting COVID-19 like symptoms among non-compliant participants was double the risk among those with adequate compliance (45.9% vs 25.7% respectively). Adequate compliance was significantly associated with higher positive beliefs scores and lower barriers scores.ConclusionAdequate compliance with wearing facemasks at the workplace was low. Addressing negative beliefs may improve compliance. Difficulty breathing, and impaired communication were important barriers, therefore we recommend replacing in-person interactions with online classes whenever applicable.Supplementary informationThe online version contains supplementary material available at 10.1007/s44155-022-00011-3.
| S-EPMC9207867 | biostudies-literature
Project description:India experienced the second wave of SARS-CoV-2 infection from April 3 to June 10, 2021. During the second wave, Delta variant B.1617.2 emerged as the predominant strain, spiking cases from 12.5 million to 29.3 million (cumulative) by the end of the surge in India. Vaccines against COVID-19 are a potent tool to control and end the pandemic in addition to other control measures. India rolled out its vaccination programme on January 16, 2021, initially with two vaccines that were given emergency authorization-Covaxin (BBV152) and Covishield (ChAdOx1 nCoV- 19). Vaccination was initially started for the elderly (60+) and front-line workers and then gradually opened to different age groups. The second wave hit when vaccination was picking up pace in India. There were instances of vaccinated people (fully and partially) getting infected, and reinfections were also reported. We undertook a survey of staff (front line health care workers and supporting) of 15 medical colleges and research institutes across India to assess the vaccination coverage, incidence of breakthrough infections, and reinfections among them from June 2 to July 10, 2021. A total of 1876 staff participated, and 1484 forms were selected for analysis after removing duplicates and erroneous entries (n = 392). We found that among the respondents at the time of response, 17.6% were unvaccinated, 19.8% were partially vaccinated (received the first dose), and 62.5% were fully vaccinated (received both doses). Incidence of breakthrough infections was 8.7% among the 801 individuals (70/801) tested at least 14 days after the 2nd dose of vaccine. Eight participants reported reinfection in the overall infected group and reinfection incidence rate was 5.1%. Out of (N = 349) infected individuals 243 (69.6%) were unvaccinated and 106 (30.3%) were vaccinated. Our findings reveal the protective effect of vaccination and its role as an essential tool in the struggle against this pandemic.
| S-EPMC10081792 | biostudies-literature
Project description:COVID-19 patients in the critical care unit tend to have prolonged hospital stay requiring high doses of sedation and paralysis to treat acute respiratory distress syndrome, resulting in a shortage of these drugs. In our hospital, we have instituted strategies to rationalise drug and oxygen usage. This includes prioritising time-sensitive elective cases, reducing overall elective case load, favouring opioid-reduction strategies and usage of alternative anaesthetic agents not commonly used in ICU. Both intensive care physicians and anaesthesiologists have to cooperate on drug conservation as similar drugs are used in elective operating lists as in the ICU. Patient safety is of utmost importance and we should keep in mind some pitfalls and ethical concerns of these alternative strategies.
| S-EPMC7289710 | biostudies-literature
Project description: Not available
| S-EPMC8244620 | biostudies-literature
Project description:Purpose:To determine the association between preoperative lumbar epidural injections (LEIs) in the operating theater (OR) and the occurrence of surgical site infection (SSI) after posterior lumbar instrumented fusion surgery. Methods:This study was performed from January 2015 to September 2019. We enrolled 2312 patients who underwent lumbar surgery without LEIs (control group) and 469 patients who underwent lumbar surgery after LEIs in the OR. We further separated the patients by the time interval between the LEIs and surgery: 1) for the 0-1 M group, lumbar surgery was performed within 1 month after the LEIs, and 2) for the >1 M group, it was performed more than 1 month after the LEIs. Results:The postoperative infection rate in the 0-1 M group was considerably higher than that in the control group (p = 0.0101). We further subdivided the 0-1 M and >1 M groups into four subgroups: a) the 0-1 MNS group included patients in the 0-1 M group who did not receive steroids; b) the 0-1 MS group who received steroids; c) the >1 MNS group included patients in the >1 M group who did not receive steroids; d) the >1 MS group who received steroids. The postoperative infection rate in the 0-1 MS subgroup was considerably higher than that in the control group (p = 0.0018). However, the infection rate was lower in the >1 MS subgroup (p = 0.1650). There were no statistically significant differences in the postoperative infection rate between the control group and the two non-steroid groups (0-1 MNS group, p = 0.4961; 1 MNS group, p = 0.7381). Conclusion:The administration of LEIs without steroids in the OR before lumbar instrumented fusion does not significantly increase patients' risk of postoperative infection. We recommend avoiding steroid injections administered within 1 month before lumbar instrumented fusion.
| S-EPMC7457848 | biostudies-literature