Diathermy awareness among surgeons-An analysis in Ireland

McQuail, Paula; McCartney, Ben; Baker, Joseph F.; Kenny, Paddy

doi:10.1016/j.amsu.2016.10.006

Cited by 16 publications

(16 citation statements)

References 17 publications

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“…This is different from, for example, the USA, where perioperative nurses are very present in scientific publications (see e.g., [27,39,46,51,52]). However, physicians' resistance to their own health protection seems to be frequent [39,41,42], which also plays a certain role in the prevention obstacles mentioned in our study.…”

Section: Discussionmentioning

confidence: 64%

“…Surgeons and assistant staff should be better informed about the possible health risks of surgical smoke and its prevention. Awareness rising can take place through regularly updated instruction and other formalized training such as a facility-based initiative [42] and manufacturers of smoke evacuation devices should be invited to support regular onsite training [55].…”

Section: Discussionmentioning

confidence: 99%

“…This applies both to the existence of such measures and to the adherence of their use in the event of exposure [37][38][39][40][41]. Surgeons, although they do not feel sufficiently informed about the actual health risks [40], often do not use smoke extractors and consider surgical diathermy to be a safe procedure [42]. Hill et al [5] stated, in a UK study, that smoke extraction systems were only available in 66% of 50 plastic surgery units investigated.…”

Section: Hazard Awareness Of Operating Room Staff and Application Of mentioning

confidence: 99%

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Surgical Smoke—Hazard Perceptions and Protective Measures in German Operating Rooms

Michaelis

Hofmann

Nienhaus

et al. 2020

IJERPH

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(1) Background: Hazardous substances in surgical smoke that is generated during laser or electrosurgery pose a potential health hazard. In Germany, the Technical Rules for Hazardous Substances (TRGS 525) have included recommendations for appropriate protective measures since 2014. Up to now, no empirical data has been available on the extent to which recommendations have been implemented in practice. (2) Methods: In 2018, 7089 surgeons in hospitals and outpatient practices were invited by email to participate in an online survey. In addition, 219 technical assistants were interviewed. The questionnaire dealt with knowledge of, and attitudes toward, the hazard potential of surgical smoke, as well as the availability and actual use of protective measures. Furthermore, manufacturers and distributors of smoke extraction devices were asked to give their assessment of the development of prevention in recent years. (3) Results: The survey response rate was 5% (surgeons) and 65% (technical assistant staff). Half of all surgeons assumed that there were high health hazards of surgical smoke without taking protective measures. Operating room nurses were more often concerned (88%). Only a few felt properly informed about the topic. The TRGS recommendations had been read by a minority of the respondents. In total, 52% of hospital respondents and 65% of the respondents in outpatient facilities reported any type of special suction system to capture surgical smoke. One-fifth of respondents from hospitals reported that technical measures had improved since the introduction of the TRGS 525. Fifty-one percent of the surgeons in hospitals and 70% of the surgeons in outpatient facilities “mostly” or “always” paid attention to avoiding surgical smoke. The most important reason for non-compliance with recommendations was a lack of problem awareness or thoughtlessness. Twelve industrial interviewees who assessed the situation and the development of prevention in practice largely confirmed the prevention gaps observed; only slight developments were observed in recent years. (4) Conclusions: The low response rate among surgeons and the survey results both indicate a major lack of interest and knowledge. Among other measures, team interventions with advanced training are needed in the future.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Section: Hazard Awareness Of Operating Room Staff and Application Of mentioning

confidence: 99%

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Surgical Smoke—Hazard Perceptions and Protective Measures in German Operating Rooms

Michaelis

Hofmann

Nienhaus

et al. 2020

IJERPH

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“…Since the smokes caused by vaporization of tissue are both infectious and carcinogenic, they need to be effectively extracted from the environment of surgery before they are inhaled (24). Therefore, the utilization of smoke extraction facilities and high filtration masks in the operating room are highly recommended (25,26). Items 11,13,14,15,16,17,18,19,28, and 32 are related to application instructions meant to minimize the risk of burning the patient's skin; the most serious side effect of ESUs.…”

mentioning

confidence: 99%

Application of Electrosurgical Units by Operating Room Personnel: Development and Psychometric Testing of an Instrument

et al. 2020

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Background: Today, electrosurgical units are an indispensable part of surgeries. Yet, inappropriate application of this equipment can result in dire consequences for both the patient and the surgical team. Objectives: The present study aimed at developing the psychometric properties of a checklist to evaluate the application of electrosurgery units by operating room personnel. Methods: The present methodological study was performed in two stages: first, the items of the checklist were developed based on a literature review and search in relevant websites; and second, the psychometric properties of the checklist were measured using the methods to evaluate face, content, and construct validities. The reliability was measured through an assessment of the internal consistency of the checklist, based on the degree of inter-rater agreement. To assess construct validity, the researchers compared known groups; 40 surgeries were observed in two university hospitals in the intervention and control groups. Results: The content validity index (CVI) of all the items was over 0.79. The average CVI (S-CVI/Ave) of the checklist with 32 items was 0.97. The results of the Wilcoxon test showed that the posttest performance scores of the personnel in the intervention group were significantly higher than their pretest scores (P value = 0.005). The internal consistency (the Kuder-Richardson coefficient) of the checklist was 0.66. Conclusions: Due to the great importance of appropriate application of electrosurgery units, a reliable instrument is needed to assess personnel's performance in this area. The results of the current study showed that the present instrument is sufficiently valid and reliable to evaluate the application of electrosurgical units by the operating room personnel.

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“…Fear of medicolegal ramifications may lead to under‐reporting of these events. Of concern are two studies that demonstrated a lack of awareness of the dangers of diathermy in surgical clinicians of all levels . The introduction of mandatory reporting of surgical fires may alert surgeons and trainees to these very real risks.…”

mentioning

confidence: 99%