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Climate change represents one of the gravest threats to health. Surgical activities mobilize a large number of resources which contribute to increased emission of CO2 and anesthetic gases in the environment. The objective of this study was to assess the level of knowledge of surgeons and the practical stances of healthcare establishments toward sustainable development. This was a descriptive cross-sectional study, lasting 2 months. From 1 May 2021 to 30 June 2021, surgeons were asked via an online questionnaire to participate. A total of 131 out of the 457 contacted surgeons responded. A majority practiced in the private sector, 48.9% knew little about the rules of sustainable development in operating theaters, and 43.5% had an average level. The sustainable development charter was available in only 23% of establishments, while 19% had a sustainable development committee, and specific sustainable development actions were carried out in 27%. The level of knowledge of surgeons in Île-de-France on sustainable development was low. In general, surgical units were not complying with the rules of good practice on CO 2 reduction. It is necessary to find strategies to reduce the impact of operating theaters on the environment. [ABSTRACT FROM AUTHOR]

Objectives: An operating room pharmaceutical unit centralizes medical devices and drugs for various surgical specialities. The aim of this work is to present the methodology used in our establishment to set up the operating room pharmaceutical unit., Methods: This approach involved the formation of multi-professional working groups. The needs of operating theatres were defined based on an analysis of healthcare product consumption and stock inventories. Material sheets were defined for each procedure. On the basis of simulations, material supply arrangements were selected, specifying material flows, equipment, workstations and information systems., Results: Over 3200 healthcare product references were identified and 862 equipment files were created. Local stocks have been limited to medical trolleys for nursing staff. Emergency operating packs have been deployed for unforeseen operations. Cabinets have been dedicated to transporting re-sterilizable medical devices, and carts have been purchased for programmed operating packs. The equipment is made available by logistics agents and pharmacy assistants under pharmaceutical responsibility., Conclusions: This innovative approach is a model for facilities desiring to centralize and secure the logistics of healthcare products in the operating room. Ongoing adjustments will be required to meet new operating rooms needs., (Copyright © 2024 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.)

Abstract: Objectives: Implementation of the checklist “Safe surgery saves live” (CL) is associated with reduction of perioperative morbidity and mortality. In France, CL is mandatory in operating rooms (OR) since January 2010. The objective of this work was to evaluate the level of the roll out of the CL in our institution, a French universitary hospital. Methods: Evaluation of the level of use of the CL and completion of each item of the CL during three periods of 15 days during the first year of development, live evaluation of the process of filling the CL form and opinion survey of the OR nurses who were CL coordinators in our institution. Results: Use of CL was 88, 89 and 76%. Completion of preinduction, preincision and postoperative items was respectively 90, 90 and 75%. Only 4% of the analyzed CL was properly filled with communication in the OR at the three phases. Four out of five OR nurses recognized meeting difficulties with CL completion. Half of them felt CL was a communication tool and two out of three OR nurses felt CL was a security tool. Conclusion: CL evaluation restricted to levels of use is limited and should be extended to a qualitative evaluation. Communication in the OR remains insufficient and represents an important quality improvement aim to improve security in the OR. [Copyright &y& Elsevier]

Complications related to energy sources in the operating room are not well-recognized or published, despite occasionally dramatic consequences for the patient and the responsible surgeon. The goal of this study was to evaluate the risks and consequences related to use of energy sources in the operating room., Patients and Methods: Between 2009 and 2015, 876 adverse events related to health care (AERHC) linked to energy sources in the operating room were declared in the French experience feedback data base "REX". We performed a descriptive analysis of these AERHC and analyzed the root causes of these events and of the indications for non-elective repeat operations, for each energy source., Results: Five different energy sources were used, producing 876 declared AERHC: monopolar electrocoagulation: 614 (70%) AERHC, advanced bipolar coagulation (thermofusion): 137 (16%) AERHC, ultrasonic devices: 69 (8%) AERHC, traditional bipolar electrocoagulation: 32 AERHC, and cold light: 24 AERHC. The adverse events reported were skin burns (27.5% of AERHC), insulation defects (16% of AERHC), visceral burns or perforation (30% of AERHC), fires (11% of AERHC), bleeding (7.5% of AERHC) and misuse or miscellaneous causes (8% of AERHC). For the five energy sources, the root causes were essentially misuse, imperfect training and/or cost-related reasons regarding equipment purchase or maintenance. One hundred and forty-six non-elective procedures (17% of AERHC) were performed for complications related to the use of energy sources in the operating room., Conclusion: This study illustrates the risks related to the use of energy sources on the OR and their consequences. Most cases were related to persistent misunderstanding of appropriate usage within the medical and paramedical teams, but complications are also related to administrative decisions concerning the purchase and maintenance of these devices., (Copyright © 2017 Elsevier Masson SAS. All rights reserved.)

Objective: Assessing neuroradiologists' skills in the operating room (OR) is difficult and often subjective. This study used a workflow time-based task analysis approach while performing cerebral angiography., Methods: Eight angiographies performed by a senior neuroradiologist and eight performed by a junior neuroradiologist were compared. Dedicated software with specific terminology was used to record the tasks. Procedures were subdivided into phases, each comprising multiple tasks. Each task was defined as a triplet, associating an action, an instrument and an anatomical structure. The duration of each task was the metric. Total duration of the procedure, task duration and the number of times a task was repeated were identified. The focus was on tasks using fluoroscopy and for moving the X-ray table/tube., Results: The total duration of tasks to complete the entire procedure was longer for the junior operators than for the seniors (P=0.012). The mean duration per task during the navigation phase was 86s for the juniors and 43s for the seniors (P=0.002). The total and mean durations of tasks involving the use of fluoroscopy were also longer for the juniors (P=0.002 and P=0.033, respectively). For tasks involving the table/tube, the total and mean durations were again longer for the juniors (P=0.019 and P=0.082, respectively)., Conclusion: This approach allows reliable skill assessment in the radiology OR and comparison of junior and senior competencies during cerebral diagnostic angiography. This new tool can improve the quality and safety of procedures, and facilitate the learning process for neuroradiologists., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Introduction: The use of the World Health Organization surgical safety checklist, mandatory in operating rooms (OR) in France, significantly reduces morbidity and mortality. Our objective was to evaluate the use of this checklist in the OR of a French military hospital in Djibouti (Horn of Africa)., Methods: The study was performed in three stages: a retrospective evaluation of the checklist use over the previous two months, to assess the utilization and completeness rates; provision of information to the OR staff; and thereafter, prospective evaluation for a one-month period of checklist use, the reasons for non-compliance, and the cases in which the checklist identified errors and thus prevented serious adverse events., Results: The initial utilization rate was 49%, with only 24% complete. After staff training and during the study these rates reached 100% and 99%. The staff encountered language difficulties in 53% of cases, and an interpreter was available for 81% of them. The capacity of the surgical safety checklist to detect serious adverse events was highlighted., Conclusion: The utilization and completeness rates were initially worse than those observed in metropolitan French ORs, but a simple staff information program was rapidly effective. Language difficulties are frequent but an interpreter is often available, unlike in developed countries where language problems are uncommon and the availability of interpreters difficult. Moreover, this study illustrates the ability of the checklist to detect and therefore prevent potentially serious adverse events.