THEATRE SAF E T Y


taken to make sure that safety remains the highest priority. Laparoscopy and other fields of operations have already begun demonstrating that with the necessary prevention methods, clear processes, and utilising equipment which limits the need for human-to-human interaction, hospital theatres can be made safer.


The pandemic has also revealed what adaptations should be taken if theatres are faced with a second wave of COVID-19, or a future pandemic, and the importance of clear communications.


While measures, such as using single- person equipment have been deployed solely for the COVID-19 pandemic, there is no reason why they cannot continue to be effective once the spread eases. Such devices may prove to be essential as hospitals start returning to near-full capacity


but with reduced staffing, ensuring optimum management of hospital resources.


References 1 Prin, M. and Bartels, K. Social distancing: implications for the operating room in the face of COVID-19, Can J Anaesth. 2020 Apr 14: 1–9. doi: 10.1007/s12630-020-01651-2 [Epub ahead of print] Accessed at: https://www.ncbi.nlm.nih.gov/ pmc/articles/PMC7155950/


2 OneTogether, Surgical Environment Quality Improvement Resource 2018 Version 1. Accessed at: https://www.onetogether.org.uk/downloads/ OneTogether%20Surgical%20Environment%20 Guide.pdf


3 Morris, S.N. et al, Understanding the ‘Scope’ of the Problem: Why Laparoscopy Is Considered Safe during the COVID-19 Pandemic, The Journal of minimally invasive gynaecology. April 03, 2020DOI: https://doi.org/10.1016/j.jmig.2020.04.002


Returning to elective surgery: the barriers activity that is needed.”


The Royal College of Surgeons recently surveyed 1,741 surgeons and surgical trainees on the challenges associated with a return to elective surgery, in the wake of the COVID-19 crisis. The survey findings have highlighted a number of key issues – including slow access to test results, continuing difficulty accessing COVID-light facilities and a lack of interdependent services such as diagnostics. Respondents identified the following barriers: l46% cited lack of access to interdependent services (such as diagnostics, anaesthesia and sterile processing).


l35% cited lack of staff. l33% cited lack of access to testing or swift results.


l21% cited lack of sufficient PPE.


Of particular concern was the finding that one in six (17%) said that they did not have a sufficient supply of PPE to do their job safely. In addition, just 10% of surgeons said that they could get test results for surgical patients within 8 hours, with a further 31% saying test results were available in 24 hours. The RCS states: “COVID-19 will be around for the foreseeable future and infection rates may fluctuate as public health measures relax. A significant backlog of surgical work is being created in addition to those patients on waiting lists before the present crisis. “Retaining an expanded workforce and resources to deal with all of these patients is essential, but illness, fatigue and social issues among healthcare workers all threaten the necessary increase in surgical


The RCS has developed two tool kits for theatre teams to help manage return to surgery safely: Tool 1 is a ‘checklist for restarting elective surgical services’ and Tool 2 includes ‘safety considerations and risk assessment’. In addition, RCS has issued the following recommendations: lThe speed at which test results can be returned is a crucial factor in enabling more elective surgery to take place safely. The aim should be for surgeons to have access to same-day test results, so they can test patients both before and upon admission, and again upon discharge.


lSurgical staff working in COVID-light sites should be tested regularly - up to twice a week where practical.


lSurgical teams in every part of the UK need access to COVID-light sites for their patients, so that people waiting for time-sensitive operations can safely be treated again.


lA quarter of surgical teams depend on the independent sector to provide COVID- light facilities, so contracts with the independent sector need to be extended and include opportunities for surgical trainees to progress their training.


lGood use must continue to be made of recently retired surgeons who have returned to support the NHS through the crisis, with extension of the temporary registers which underpin this.


For more information and guidance visit: https://www.rcseng.ac.uk/coronavirus/ recovery-of-surgical-services/


60 l WWW.CLINICALSERVICESJOURNAL.COM


CSJ


volume 27, issue 4, p789-791, 1 May 2020, Accessed at: https://www.jmig.org/article/S1553- 4650(20)30171-0/fulltext


4 Joint RCOG / BSGE Statement on gynaecological laparoscopic procedures and COVID-19, accessed at: https://mk0britishsociep8d9m.kinstacdn. com/wp-content/uploads/2020/03/Joint-RCOG- BSGE-Statement-on-gynaecological-laparoscopic- procedures-and-COVID-19.pdf


5 Nepogodiev, D, National Institute for Health Research Global Health Research Unit on Global Surgery, BJS Society. Accessed at: https://bjssjournals. onlinelibrary.wiley.com/doi/abs/10.1002/bjs.11646


6 Gynaecological laparoscopy in the time of Coronavirus, accessed at: https://www.bsge.org.uk/ news/laparoscopy-in-the-time-of-coronavirus/#


7 University of Birmingham, COVID-19 disruption will lead to 28 million surgeries cancelled worldwide, 15 May 2020, accessed at: https://www.birmingham. ac.uk/news/latest/2020/05/covid-disruption-28- million-surgeries-cancelled.aspx


8 Ben Clover, Urgent cancer treatment down 60 per cent in April, Health Service Journal, 11 June 2020. Accessed at: https://www.hsj.co.uk/quality-and- performance/urgent-cancer-treatment-down-60- per-cent-in-april/7027823.article


9 The NHS faces a slow road to recovery, Health Business, 10 June 2020. Accessed at: https:// healthbusinessuk.net/news/10062020/nhs-faces- slow-road-recovery


10 COVID-19: Supplying vital medical equipment in uncertain times and managing regulatory, contractual and reputational risk, Accessed at: https://www.linklaters.com/en/insights/ publications/2020/april/supplying-vital-medical- equipment-in-uncertain-times


About the author


Gemma Rower has been with Aquilant- HC21 for more than 18 months. In a career spanning nearly three decades, Gemma has developed detailed insight into the latest generations of medical devices and works closely with a network of clinicians to ensure best practice can be maintained across all levels.


AUGUST 2020


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