Operating Theatre Temperature & Humidity Guidelines For Patient Safety and Infection Control

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Good air ventilation is an integral part of effective infection control in operating theatres. But while it’s important to keep the air circulated, it’s equally important to ensure the air is at the optimum temperature and humidity.

Why is Temperature and Humidity Important in an Operating Theatre?

For temperature and humidity levels to be right, there are three crucial needs:

  1. To avoid humidity levels that could cause risks with the anaesthetic.
  2. To ensure that operating theatre staff can work comfortably and efficiently.
  3. Perhaps most crucially, to ensure the patient’s not so cold that they risk developing hypothermia or cardiac arrhythmia, but not so hot that they experience heat stress.

Both staff and patients will potentially spend many hours in an operating theatre environment. And while in the theatre, the staff will be undertaking intensive, high-pressure work, while the patient will be in a profoundly vulnerable state. So the temperature and humidity in an operating theatre needs to be just right.

Operating Theatre Temperature and Humidity Guidelines UK

The Association for Perioperative Practice (AfPP) and The National Institute for Health and Care Excellence (NICE) have both issued guidelines for temperature and humidity control in operating theatres.

To best suit the needs of both staff and patient:

  • The temperature should be maintained between 18 and 25°C, varied within this range depending on the patient and the procedure.
  • The relative humidity should be 50%, to allow for tolerable working conditions for the long-term with no risk of anaesthetic issues.

NICE also outlines that theatre staff should measure a patient’s temperature every 30 minute during their operation, and that their temperature should be at least 21°C at any times when they’re not covered.

Other Safety Measures in Operating Theatres

Maintaining the correct temperature and humidity in the operating theatre is essential for both staff and patient safety.

But this is just one aspect of a safe and productive operating theatre. In addition to temperature control, the following measures are crucial:

Zoning for Infection Control

The theatre complex should be zoned based on cleanliness levels, the presence of microorganisms, and the types of procedures carried out. There must also be separate areas for all the key processes – preparation, disposal, scrubbing, gowning, and equipment storage, sterilisation, and washing.

Operating Theatre PPE

Staff should use the appropriate PPE for the procedure. They should apply their PPE in the correct order, and in a dedicated area, while thoroughly washing their hands at key points throughout the procedure. Also, any PPE they use should be properly fitted to ensure its effectiveness.

Equipment Cleaning

Any reusable surgical equipment should be thoroughly cleaned before use. And once processed, all surgical equipment must be correctly stored in a sterile environment, and not handled until it’s ready to be used on patients. Absorbent mats can also be used to capture fluids during procedures for quick disposal afterwards.

For more, you can read our complete guide to cleaning for infection control in operating theatres.

Support For Infection Control in Operating Theatres

It’s up to your hospital management and your theatre teams to maintain the optimum temperature and humidity settings in your theatre environments. But we can help you with many other aspects of infection prevention and control, helping you to meet all relevant standards while keeping your staff and patients as safe and as comfortable as possible.

Our services include:

  • Air purification consultations and solutions.
  • Face-fit testing.
  • Fluid management and washroom hygiene solutions.
  • Comprehensive infection control solutions, such as cleaning equipment and sanitising chemicals.

Get in touch to talk to our friendly team of expert infection control consultants and we’ll help you find a solution that works for you.

 

Why Is PPE So Important in Healthcare?

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Personal protection equipment (PPE) is vital for effective infection prevention and control in healthcare. PPE protects both staff and patients from infection through acting as an effective barrier against common sources of infection such as coughs, sneezes, and bodily fluids.

PPE Protocols

But it’s not just the PPE itself that works to prevent infection. There are also key protocols associated with PPE, all of which are designed to reduce the risks of contamination. These include:

  • Storing all PPE in a clean and dry area, close to the point of use.
  • Ensuring all PPE is single-use only, unless specified by the manufacturer.
  • Putting on and taking off PPE in a specific order, with thorough hand-washing between each step.
  • Changing PPE immediately after seeing each patient, and immediately after each task or procedure.
  • Correctly disposing of all PPE immediately after use.

An Essential Introduction to PPE in Healthcare

Though certain medical procedures will call for specialist protective equipment, usually when we talk about PPE we’re referring to the following:

  • Scrubs
  • Gowns and aprons
  • Gloves
  • Footwear
  • Head covers for facial and head hair
  • Masks and face shields

There are specific guidelines for what type of PPE to use for each task. And as we mentioned above, there are separate guidelines for storing PPE, disposing of it, and putting it on and taking it off.

You’ll find many guides to PPE and its related protocols on our site:

What Is The Most Important PPE?

As different types of PPE are designed for different tasks, then really, no single piece of PPE is more or less important than any other. Some might argue that masks and face shields are the most important, as they can protect you from accidently ingesting bodily fluids during certain procedures, which can be a key source of infection. But if you’re handling caustic chemicals in the lab, a face covering won’t be as immediately useful as a good pair of gloves. So who’s to say which is the most important?

The importance of any given piece of PPE depends entirely on the task at hand. It’s also fair to say that any piece of PPE is only as good as the person using it.

If the equipment doesn’t fit properly, or if the person doesn’t follow the essential infection control protocols, then they might as well not have bothered wearing any PPE in the first place.

How Effective is PPE for Healthcare Workers?

In December 2021, the UK’s National Institute for Health Research released the results of a study into the effectiveness of PPE for healthcare workers.

The study specifically looked at PPE’s effectiveness in reducing the transmission of Covid-19 in health and social care settings. PPE might offer different levels of effectiveness when used to reduce the transmission of other pathogens.

The study accounted for numerous variables, including full-PPE use compared to partial use, the frequency and consistency of PPE use, and the impact of infection control training and education on transmission rates.

You can read the key findings of the study.

How Else Can You Prevent Infection in a Healthcare Setting?

PPE, and the protocols associated with its use, is just one of many standard infection control precautions in a healthcare setting. Other vital precautions include good hand hygiene, respiratory and cough etiquette, patient placement, and the correct management of equipment, linen, and waste.

You can read our complete guide to the standard infection control precautions.

How to Manage Infection Control

We offer many services and solutions that can help you manage infection prevention and control in your healthcare setting.

Our services include:

  • Air purification
  • Face-fit testing for PPE effectiveness
  • Workplace exposure monitoring services
  • Washroom hygiene solutions
  • Fluid management solutions
  • Cleaning equipment, disposal containers, and sanitising chemicals

So if you’d like some guidance on infection control, or a free quote for any of our services, get in touch to talk to an expert today.

 

When & What Type of PPE Should Be Used: NHS & Healthcare

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The NHS introduced new guidelines for personal protective equipment (PPE) in April 2020. They said:

“Any clinician working in a hospital, primary care or community care setting within two metres of a suspected or confirmed Covid-19 patient should wear an apron, gloves, surgical mask and eye protection.”

The guidelines also stipulated that clinicians should wear “a higher level of protective equipment” when carrying out aerosol generating procedures (AGPs).

These guidelines stipulated that healthcare workers essentially wore personal protective equipment round the clock. But this was during a global pandemic, when people from all walks of life took special measures to reduce the risk of infection.

So what are the PPE guidelines for NHS and healthcare workers during “normal times”, when we’re not fighting to contain a new virus?

A Brief Introduction to PPE

When we talk about PPE, we’re mainly referring to the following equipment:

  • Head covers, for facial and head hair
  • Masks and face shields
  • Scrubs
  • Gowns and aprons
  • Gloves
  • Footwear

All PPE fulfils the same essential function: to prevent the spread of viruses and bacteria, and to protect both staff and patients from contamination and infection.

Certain specialist procedures might call for specialist PPE precautions. For example, many healthcare settings have specific PPE guidelines for staff involved in chemotherapy treatments.

But by and large, when we refer to PPE, we’re referring to the above equipment.

When & What Type of PPE Should Be Used – Latest NHS Guidance

The NHS published the latest National Infection Prevention and Control (IPC) manual in June 2022. Though these guidelines apply to healthcare settings in England, the guidelines in Scotland, Wales and Northern Ireland will be broadly similar.

These guidelines reinforce the important role PPE plays as a standard infection control precaution (SICP).

Healthcare workers should assess the risks associated with any procedure before deciding what PPE to use:

“Before undertaking any procedure, staff should assess any likely exposure to blood and/or other bodily fluids, non-intact skin or mucous membranes and wear personal protective equipment (PPE) that protects adequately against the risks associated with the procedure.”

Basic PPE Principles in Healthcare

Regardless of the patient and the procedure, the latest NHS guidelines say that all PPE must be:

  • Stored close to the point of use in a clean, dry area
  • Single-use only, unless specified by the manufacturer
  • If reusable, decontaminated after use according to the manufacturer’s instructions
  • Changed immediately after seeing each patient, or after completing a procedure or task
  • Disposed of immediately after use in the correct waste stream – domestic, non-infectious, or clinical
  • Discarded immediately if it gets damaged or contaminated.

Read our full guide to the factors to consider when choosing PPE.

Beyond this, there are specific guidelines for each type of PPE.

NHS Glove Guidelines

The NHS advises that gloves must be worn when there’s any chance that a procedure will involve exposure to blood, other bodily fluids, non-intact skin or mucous membranes. Though it’s not recommended for routine clinical care, some exposure-prone procedures may require double gloving – such as gynaecological or orthopaedic operations, and major trauma incidents.

Do I Need to Wear Gloves When Using the Phone or Computer in a Hospital?

Gloves are not necessary for administration tasks, even if you perform them near patients – such as using telephones or computers, distributing or collecting food, writing in the patient chart or giving oral medication.

When to Change Gloves in Healthcare?

You must change your gloves immediately after seeing each patient, and after performing any task or procedure – even if it’s with the same patient. You must also change your gloves immediately if you suspect they have a perforation or a puncture.

NHS & Healthcare Apron and Gown Guidelines

Wear aprons to protect your uniform or clothes when you anticipate contamination – such as when in direct care contact with a patient. And like gloves, you must change your apron after seeing each patient, or after completing each task or procedure.

When to Wear Gowns instead of an Apron?

Wear gowns or coveralls instead of aprons when there’s a risk of extensive splashing of blood or bodily fluids, such as in the operating theatre or the intensive care unit. Gowns too must be changed between patients and procedures. And any gowns or coveralls worn in an operating theatre must be sterile.

NHS Face Protection Guidelines

You must wear eye or face protection, such as a full-face visor, whenever you anticipate any blood or bodily fluid contamination to the eyes or face. This includes during surgical procedures, and “always during aerosol generating procedures.”

The guidelines stipulate that regular corrective spectacles do not count as eye protection, and that any protection you wear should not be impeded by piercings, false eyelashes or other accessories.

NHS Mask Guidelines

When it comes to masks, the guidelines only cover fluid-resistant surgical face masks (FRSM). They recommend using these as a means of source control – to protect the patient during sterile procedures, such as surgery. They also recommend using them whenever there’s a risk of splashing or spraying of blood or other bodily fluids.

Like all PPE, the guidelines stipulate that you should remove or change your mask regularly – at the end of each task or procedure, and if the mask’s integrity gets breached (by moisture build-up, for example).

The guidelines also make it clear that face protection is only effective it it’s well-fitting. A specialist face-fit testing service will help you ensure that all of your PPE is fit for purpose.

NHS Footwear Guidelines

While the guidelines don’t specify what specific type of footwear to use for general clinical work, they do stipulate that all footwear must be “visibly clean, non-slip, and well-maintained.” What’s more, any shoes you wear must be supportive, and they must cover the whole foot to avoid contamination and injury.

In areas where dedicated footwear is required, such as the operating theatre, you must remove the footwear before leaving the designated care area.

NHS Headwear Guidance

Unlike most PPE, headwear is not routinely required in clinical areas. It’s only required when it’s necessary to prevent contaminating the environment, such as in operating theatres, central decontamination units, and clean rooms.

But like all PPE, any headwear must be changed or disposed of between clinical procedures or tasks. And it must be removed before leaving the sterile environment. The headwear must completely cover the hair, and if you have any facial hair, you must cover this too, with a snood.

There are separate guidelines for headwear worn for religious regions, including turbans and headscarves. While staff do not have to remove this headwear, they must ensure they do not compromise patient care and safety. So any headwear must be washed or changed daily, and removed immediately if it gets contaminated. And staff must still comply with additional attire in operating theatres and other controlled environments.

Other Standard Infection Prevention Procedures

PPE is vital, but it’s just one part of the infection prevention jigsaw. Other important factors include hand hygiene, cough and respiratory hygiene, waste disposal, and fluid management.

You can read the latest NHS national IPC manual for England.

You can also read our guide to cleaning for infection control in operating theatres.

If you need extra advice and support, we specialise in infection prevention and control.

Our services include:

  • Air purification consultations and solutions
  • Face-fit testing
  • Fluid management and washroom hygiene solutions
  • Comprehensive infection control solutions, such as cleaning equipment and sanitising chemicals

Get in touch to talk to our friendly team of expert infection control consultants and we’ll help you find a solution that works for you.

Health & Safety in Operating Theatres – Hazards & Precautions

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Just like any other working environment, working in an operating theatre comes with numerous occupational hazards. However, in an operating theatre, these hazards can mean life or death. Even the smallest accident could seriously jeopardise the patient’s safety.

The question of health & safety in operating theatres is a deep one. Organisations such as the National Institute for Health and Care Excellence (NICE) regularly produce extensive documents advising on theatre safety on both an operational and a managerial level.

So in this post, we’ll provide an essential overview of the sort of hazards theatre staff may face, and the sort of precautions that could help them manage risk. Please note that in this post we’ll focus on staff safety rather than patient safety.

Also be sure to check out our introduction to improving quality and efficiency in operating theatres.

Common Hazards in Operating Theatres

Speaking as broadly as possible, we might categorise the common hazards staff face in operating theatres as follows:

  • Accidents, including slips, trips, and falls.
  • Exposure to hazardous substances.
  • Contamination and infection.

Let’s look at each of these hazards in turn, along with some of the precautions that could help prevent accidents.

Accidents in Operating Theatres – Slips, Trips and Falls

Just like in any other workplace, operating theatre staff can slip on spilled fluids, or trip and fall on a loose wire or a misplaced bit of equipment.

One of the many recommendations made in the NHS Productive Operating Theatre strategy concerns the layout of operating theatres. They advise removing any non-essential items from the area, and assigning each object a set place in the room.

These recommendations are primarily in place to ensure operational efficiency. If everyone knows where everything is, then operations can proceed with fewer interruptions.

But a well-ordered operating theatre is also a much safer operating theatre. If there are no non-essential items in the area, and if everything is in its right place, then in theory there’ll be no obstacles for theatre staff to trip over as they carry out their work.

The Importance of Good Theatre Hygiene

The guidelines also recommend regularly cleaning and maintaining the operating theatre environment. This is mainly for patient safety, to reduce the risks of infection. But it can also contribute to staff safety. Promptly cleaning any fluids spilled on the floor makes it less likely that anyone will slip and fall.

The right equipment can make a huge difference here. For example, non-drip absorbent operating theatre floor mats can soak up any spilled fluids before they become a health and safety hazard. Then, after the operation, they can simply be picked up, discarded and replaced. This will reduce the turnaround time between operations while also removing the need to mop, so staff won’t have to worry about wet and slippery surfaces.

Exposure to Hazardous Substances

Operating theatre procedures make use of a number of substances which can pose a health hazard  if staff are exposed to them for long periods.

A key culprit in the operating theatre is Isoflurane, which anaesthetists use to maintain a state of general anaesthesia. If inhaled in its vapor form, Isoflurane can cause headaches, dizziness, and fatigue. But long-term exposure can lead to chronic health conditions, including renal, hepatic, and reproductive disorders.

Like all potentially hazardous substances, so long as it’s properly stored, and so long as your equipment is properly maintained, then Isoflurane should pose no problems. But as the substance is so volatile, even the smallest spillage or leak poses a health hazard.

Prevention, and the Cure

Another key recommendation in the NHS Productive Operating Theatre strategy is to stay on top of your equipment maintenance. Again, this is primarily to ensure patient safety, as you cannot depend on faulty equipment to do the job you need it to do. But it’s also to ensure staff safety, to ensure that, for example, any leaks are fixed before they pose a problem.

Wearing adequate PPE when handling or cleaning substances will also help you manage this hazard. But for total peace of mind, get a workplace exposure monitoring report for any area of your hospital where staff are exposed to hazardous substances.

A comprehensive report will include clear and actionable recommendations, so you’ll know exactly where the risks lie and exactly what to do to protect your staff.

Contamination and Infection in Operating Theatres

Infection control measures in operating theatres put the patient’s needs first, as surgical site infections (SSIs) account for around 20% of all hospital-acquired infections.

But of course, any measure that protects patients from infection will also protect staff from infection.

Operating theatres must be aseptic, highly-sterile, and restricted environments. Achieving this requires good air ventilation, strategic zoning, and numerous infection control precautions.

You can read our full guide to cleaning for infection prevention and control in operating theatres here.

PPE also plays a huge part in protecting both staff and patient from infection. It’s not just a question of selecting the right PPE for the task at hand. Just as important is applying and removing the PPE in the correct order.

Health and Safety in Operating Theatres – Essential Support, Solutions, and Guidance

We offer many services and solutions that can help you stay on top of health and safety in the operating theatre.

Our services include:

  • Air purification
  • Face-fit testing for PPE effectiveness
  • Workplace exposure monitoring services
  • Washroom hygiene solutions
  • Fluid management solutions, including absorbent floor mats
  • Cleaning equipment, disposal containers, and sanitising chemicals

Our experts are always on-hand to discuss your needs. So if you’d like some guidance health and safety in operating theatres, get in touch to talk to an expert today.

 

Improve Quality & Efficiency in Operating Theatres

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Improving quality and efficiency in operating theatres brings a range of benefits in both the short-term and the long-term:

  • Reduced turnaround time between procedures.
  • Improved patient care and infection control.
  • Happier and more motivated staff.
  • Huge financial savings – The NHS Institute for Innovation and Improvement estimates that a more productive operating theatre can help the average trust save more than £7 million.

How Much Do Operating Theatres Cost to Run?

Various sources suggest that operating theatres cost between £560 and £1,200 an hour to run. However, there is no recent data available and most sources date back to around 2015. Costs are likely to have risen significantly since then, especially when you take increases in energy costs into account. Improving quality and efficiency in operating theatres comes down to making the absolute most out of all available time and resources. It’s also about understanding the costs associated with downtime.

How to Create a More Productive Operating Theatre

A productive operating theatre is optimised to improve a patient’s experience and outcomes. There are three key areas to focus on to achieve this:

  • Team performance and staff wellbeing
  • Safety and reliability of care
  • Value and efficiency

First, you need to assess how your operating theatre is managing right now.

How to Audit your Current Operating Theatre Practices

Start with a comprehensive audit of your operating theatre practices. The NHS Productive Operating Theatre strategy recommends that financial leaders should commit to a walk-around of their operating theatres to better understand the issues that frontline staff face every day.

The aim is to assess the operational status of each theatre in your trust. Here are some areas to focus on:

  • Is all the necessary equipment available and working?
  • Are the right staff in the right place at the right time?
  • Do operating lists start on time? If not, how often are they delayed, and by how much time are they delayed on average?
  • How often does the theatre face cancellations and delays?
  • Do operating lists finish on time?

Obviously, all theatres will encounter unexpected issues from time to time. But when they do, the operating team should be equipped to identify and escalate issues in a timeless and efficient manner. And when faced with a problem, all plans should be flexible enough that you can make small adjustments to get the day back on schedule.

What Does a Well-Organised Theatre Look Like?

In a well-organised operating theatre, everything and everyone is in the right place at the right time, and ready to go whenever needed.

To work towards a well-organised theatre, the NHS Institute for Innovation and Improvement recommends a system called 5S: Sort, set, shine, standardise, sustain.

  • Sort – Remove any non-essential items from the area.
  • Set – Assign each object an ideal area in the room and organise all the necessary materials and equipment so that it’s easy to access.
  • Shine – Regularly clean and maintain the operating theatre environment.
  • Standardise – Once you establish procedures for maintaining orderly, clean and functional work areas, decide how similar areas can be arranged in the same way.
  • Sustain – Commit to regular audits to ensure that everyone maintains the high standards you set.

How to Reduce Waste in Operating Theatres

The NHS Institute for Innovation and Improvement identifies seven key sources of waste in operating theatres:

  • Defects and rework. If you don’t provide the correct information in the first place, or if your processes are faulty, the operating team will have to repeat certain procedures to ensure they’re done right.
  • If things are not within easy reach, or if they’re not easily accessible, operating teams will have to spend more time than necessary searching for what they need. Also, if the operating theatre isn’t properly organised, people will have to move, walk, and travel much more than necessary.
  • Either people produce more than what is needed, or they produce things earlier than necessary for the next process.
  • Are you moving any materials that really don’t require moving?
  • If staff don’t get the equipment, information, or support they need when they need it, they’ll have no choice but to wait. And when they’re waiting, they’re not working.
  • In an inefficient operating theatre, there’ll be more stock than necessary, too many processes taking place at once, and too many patients waiting in a queue.
  • Over-processing. Everything every member of the team does in an operating theatre should add value. In an inefficient operating theatre, there’ll be an excess of unnecessary steps that don’t add value, they only serve to waste time, motion, and resources.

Improving Patient Preparation and Turnaround

Poor patient preparation can cause a lot of stress, anxiety and uncertainty for both the patient and their relatives. But on an operational level, poor patient preparation can also result in late starts, costly changes to the list order, multiple delays, and even potentially harmful errors and mistakes.

In a well-organised operating theatre, every patient will arrive in the theatre prepared for surgery:

  • At exactly the right time.
  • With an identity band in place, and with all their notes complete and accessible.
  • Fully-informed and consented.
  • With their operation site marked.

Efficient patient turnaround means that not a single second is wasted between the end of one surgical procedure and the start of the next. This can involve several processes occurring at the same time, including:

  • Handing over the patient to recovery staff.
  • Clearing away instruments and cleaning the operating theatre environment.
  • Setting up all instruments and equipment for the next procedure, including the anaesthetic equipment.
  • Performing the check-in and sign-in procedures for the next patient.

Operating Theatre Consumables and Equipment

As we’ve seen, a crucial aspect of a productive operating theatre is that everyone needs to be able to access the equipment they need, when they need it. Nobody should ever have to stop a process to search for the necessary equipment, and nobody should ever find that their equipment is broken, faulty, or out of date just when they’re about to use it.

Also, the theatre team should always have all the equipment they need to cover the number of scheduled procedures. And there should never be any issues concerning skills and competency when using new equipment.

The choice of equipment in an operating theatre can also make a huge difference to efficiency. For example, the right sort of absorbent operating theatre floor mats can help manage health and safety risks while simultaneously improving operational efficiency. As non-drip mats can be picked up and discarded, doing away with the need to mop floors, operating teams can significantly reduce the turnaround times between procedures without compromising on hygiene standards.

Improving Quality and Efficiency in Operating Theatres – Full Guidance

The Productive Operating Theatre is a series of modules designed to help theatre teams work together to improve the quality of the patient experience and the safety of surgical services. The resource outlines ways in which theatres can make best use of available time and expertise.

You can download a suite of modules covering every aspect of a productive operating theatre, including equipment and consumables, patient preparation and turnaround, the handover procedure, and effective teamwork and procedure scheduling.

Head here to access the full suite of Productive Operating Theatre resources.

Whether you want a consultation on effective infection control, or some advice on improving operational effectiveness in the theatre, our experts are here to help.

Get in touch to talk to one of our experts today.

 

Current Issues in Operating Theatres

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Operating theatre teams around the world face fresh challenges every year. In this post we’ll explore some of the current issues in operating theatres, and examine the ways in which operating theatre teams are rising to meet these challenges.

Infection Control and Ventilation

The pandemic caused severe disruption to all surgical specialties. UK operating theatres cancelled elective surgical procedures while avoiding aerosol generating procedures (AGPs).

A recent paper in the Royal College of Surgeons annals reported on how operating theatres across the world had used negative pressure environments to reduce the spread of infectious airborne particles during AGPs. This paper went on to present an overview on how operating theatre ventilation systems can work to reduce both virus transmissions and surgical site infections (SSIs).

The paper concludes that, while there is not yet enough evidence to recommend that all operating theatres convert to negative pressure environments, all health settings should have negative pressure rooms available for high-risk patients.

Head here to read the latest research on operating theatre ventilation in the Royal College of Surgeons annals.

You can also read our guide to cleaning for infection prevention and control in operating theatres.

Improving Operating Room Efficiency

One of the current issues in operating theatres is how to improve efficiency while reducing turnaround time between procedures. A recent paper in Folio 3 Digital Health explored the possibilities of using Internet of Things (IOT) devices to improve operating room efficiency best practices.

“Smart” medical equipment allows for predictive maintenance, so teams can address any potential issues long before they become problems. IOT devices can also help reduce medical errors during surgical processes through allowing for faster and more powerful data sharing among the operating team.

Head here to read the full paper on the possibilities of IOT devices in operating theatres.

In June 2020, the NHS England Improvement Hub published a resource entitled The Productive Operating Theatre. This is a series of modules designed to help theatre teams work together to improve the quality of the patient experience and the safety of surgical services. The resource outlines ways in which theatres can make best use of available time and expertise.

Head here to access the full suite of Productive Operating Theatre resources.

Consumables and Equipment Management

A key focus area for improving operating theatre efficiency is good management of consumables and equipment. Investing in connected IOT devices might be a good long-term goal. But lower-tech solutions can help operating theatre teams make huge improvements to efficiency in the short-term too.

For example, we stock a range of absorbent floor mats designed to capture fluids during surgical procedures. They can help you to optimise your fluid management, which won’t just improve health and safety – it’ll also optimise your turnaround times between procedures.

Communication and Working Together to Overcome Challenges

The Association for Perioperative Practice recently ran an online survey asking theatre nurses to share their experiences of work, and the challenges they face in the theatre environment.

The charity aimed to highlight issues such as bullying, pressure, and support from senior members. As in an operating theatre environment, these issues don’t just result in unpleasant working environments. The working environment can affect patient safety and outcomes.

The WHO Surgical Safety Checklist, first published in 2010, contains numerous measures to help operating theatres foster a supportive environment based on mutual respect. For example, it outlines that all surgical procedures should start with a briefing, during which senior staff members should actively welcome queries and concerns from junior staff members.

Head here to read our full guide to the WHO Surgical Safety Checklist.

Improving the Running of Your Operating Theatre

At Cairn Technology, we’re here to help you run your operating theatre more efficiently and effectively. We have a number of products and services to help you do that, and a team of experts on hand to give you the advice you need.

For example, our absorbent floor mats can help you to optimise your fluid management to help your health and safety and turnaround times, as well as other surgical supplies for infection control and high-level performance.

Do You Have a Question About Current Issues in Operating Theatres?

Whether you want a consultation on effective infection control, or some advice on improving operational effectiveness in the theatre, our experts are here to help.

Get in touch to talk to one of our experts today.

 

 

Introduction to the WHO Surgical Safety Checklist – 5 Steps

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The World Health Organisation (WHO) first published their Surgical Safety Checklist in 2010. It’s a series of five critical steps that surgical teams should perform before and after surgical procedures to reduce the risk of certain adverse events.

The WHO claims that the Surgical Safety Checklist has reduced surgical complications and mortality by over 30%. Any surgical team around the world can perform the checklist in under two minutes. It’s designed to be affordable and sustainable, so that even surgical teams in low and middle income countries can adopt it.

What Are The 5 Steps to Safer Surgery?

The 2008 WHO Surgical Safety Checklist is essentially a process for improving communication between surgical teams. It involves five steps:

  1. Briefing
  2. Sign in
  3. Time out
  4. Sign out
  5. Debriefing

Step 1 – Briefing

The aim of the briefing is to confirm the order of the operating list, to delegate tasks and to confirm that everyone knows their role during the procedure.

The whole surgical team should receive a thorough, focused and supportive briefing before any procedure. They should feel free to ask any questions and raise any concerns they might have. Senior staff members should actively welcome queries from junior staff members.

The briefing should take place in a quiet room with a closed door, so as to ensure patient confidentiality. Any member of the team can lead the briefing, and they must encourage an atmosphere of open communication.

The briefing should begin with all members of the team introducing themselves. When discussing the patient, they should be referred to by name. Next should be an overview of the operating list – and all members of the team should have received a copy of this before the briefing. In this way, they can consider any questions or concerns in advance.

Step 2 – Sign In

The aim of the sign in is to ensure that all necessary preparations for surgery have been made, and that it’s safe to introduce anaesthesia. So all other activity must stop before the sign in, to allow the anaesthetist and Operating Department Practitioner (ODP) to give it their full attention.

The sign in process is a series of questions:

  • Has the patent confirmed their identity, site, procedure and consent?
  • Is the site marked?
  • Is the anaesthesia machine and medication check complete?
  • Does the patient have a known drug allergy?
  • Does the patient have a difficult airway, or an aspiration risk?
  • Is there any risk of blood loss?

These questions should be read aloud, and where necessary, the patient should be involved in the discussion. If any item in the list needs clarifying, then it must be done immediately, and the sign in process should be repeated from the beginning.

Anaesthesia should only commence once the sign in is complete, with all discrepancies resolved.

Step 3 – Time Out

The aim of the time out is to ensure that the surgical team is undertaking the correct procedure on the correct patient, and that all the correct measures are in place to prevent harm.

As with the sign in, all activity must stop to allow the team to focus on the time out. It should begin once the patient has been safely positioned with all necessary monitoring attached.

This is another series of questions which, again, should be read aloud – from the list, and not from memory:

  • Confirm that all team members are present, and that all have been introduced by name and role.
  • Confirm the patient’s name, procedure, and incision site.
  • Anticipate critical events for the surgeon, the anaesthetist, and the nursing team.
  • Ensure that all essential imaging is displayed, including X-rays, CT scans, and MRI, to reduce the risk of wrong-site surgical marking.

Surgery should only commence once the time out process has been successfully completed.

Step 4 – Sign Out

The aim of the sign out is to ensure that the surgical procedure has been completed in its entirety and documented accordingly. This step also ensures the patient’s ongoing safety beyond the theatre.

Again, all activity must stop to allow the whole team to focus on the sign out, and the sign out must be completed before any member of the team leaves the operating theatre. The patient should also remain in the theatre until any discrepancies have been resolved.

It’s once again a case of reading a series of questions aloud from a list. A surgical nurse should begin by verbally confirming the name of the procedure, before conducting thorough instrument, sponge and needle counts.

Then comes the specimen labelling process, and the nurse should read all specimen labels aloud, including the patient’s name. They should also confirm whether there are any equipment problems to address.

Finally, the surgeon, anaesthetist and nurse should confirm the key concerns for the patient’s ongoing recovery and management.

Step 5 -Debrief

The aim of the debrief is to allow the surgical team to review their performance, to identify achievements along with any areas that may need improvement.

Like the initial briefing, the debriefing should be attended by everyone. The atmosphere should be professional yet open, welcoming, and supportive.

If any actions are identified, there should be a clearly identified person appointed to deal with it. This way, everyone will know their responsibilities, which will make it much more likely that any problems will be addressed.

More Resources for Safer Surgeries

You can download a copy of the Surgical Safety Checklist from the WHO’s website. The WHO’s site also has a number of instructional videos outlining how to use the checklist, and how not to use it.

We also have a guide to standard infection control precautions in healthcare settings, and a guide to cleaning for infection prevention and control in operating theatres.

Finally, head here to read our guide to selecting the correct surgical instrument for procedures.

Want to talk about how we can help you ensure operational effectiveness in the theatre? Get in touch to talk to one of our experts today.