ABSTRACT
In 2019, the North East Anaesthesia Sustainable Healthcare (NEASH) Network was formed. Its aim is to encourage coordinated sustainability efforts. We comprise over 80 anaesthetists with representatives in every Trust in our region. The NHS accounts for 4% of UK carbon emissions. Two per cent of NHS emissions come solely from anaesthetic gases. In late 2020, we began a region-wide project to raise awareness of the environmental impact of general anaesthesia (GA) with the aim of reducing emissions throughout our geographical area. Methods NEASH performed a snapshot audit of 1 full week's GA data in early 2021. Consumed volatile agent, nitrous oxide (N2O) and total intravenous anaesthesia (TIVA) were converted into kilograms of carbon dioxide equivalents (kg CO2e) [1, 2]. Each Trust's emissions were divided by total GA time giving kg CO2e per hour (kg CO2e.h-1), allowing efficiency comparison between sites. We presented our results and the following messages to each Trust. Firstly, stop using desflurane and use N2O only when essential as these agents have the highest global warming potential (GWP). Secondly, we encouraged sevoflurane use as it has the lowest GWP of volatiles (followed by isoflurane);low fresh gas flows are essential. Thirdly, consider TIVA, as its GWP is lower than volatile GA. Although outside the scope of our audit, we reminded colleagues that local or regional anaesthesia have a lower CO2e than GA. In early 2022, we re-audited to assess the impact of our messages. Results The results of 5340 h of GA data are displayed in the table below. Discussion Due to increased operating post-COVID-19 and the inclusion of a hospital that was unable to participate in round 1, round 2 contained 787 more hours of data. Despite this, emissions of CO2e were 12.83 t lower, demonstrating an average hourly emission reduction of 61.1%. This was mainly driven by reduced desflurane and N2O use. Two hospitals in our region have since decommissioned N2O manifolds and two others are undertaking this process. Region-wide procurement data obtained by NEASH showed that three hospitals have ceased ordering desflurane. TIVA use remained broadly the same, which may be due to a lack of availability of equipment. This region-wide project is easily reproducible nationwide and could make significant contributions towards NHS net zero. (Table Presented).
ABSTRACT
Background & Objective: Every operating room has been associated with a variety of occupational hazards, but not many studies have been conducted to assess and address these hazards. We used a qualitative approach to explore operating room personnel's experiences of workplace hazards and how these hazards threaten their occupational safety and health (OSH). Methodology: This qualitative study was conducted in five teaching hospitals in the south-west of Iran from February 2019 to March 2021. The sample was 24 operating room personnel who were selected under convenient sampling technique. Data were collected using semi-structured, individual interviews, document review and non-participant observation. The collected data were analyzed according to the qualitative content analysis method using MAXQDA v. 2020. Results: After prolonged analysis of the data, the researchers extracted 644 codes, 13 subcategories, 4 categories, and 1 main theme. The main theme of the study was working in a context of occupational hazards. Conclusions: Operating rooms are full of potential dangers, which, when combined with the personnel's negligence and management inefficiencies, increase the risk of occupational health and safety. Therefore, making working conditions safe by providing adequate personal protective equipment (PPE), in-service training, and identifying and managing the causes of personnel negligence are recommended. Moreover, strategies should be introduced to manage stress and conflicts among the healthcare personnel, thus controlling psychological hazards.