ELECTRICAL SAFETY
Information and training of healthcare staff The personnel must be provided with guidelines on how the alarm system related to the insulation-level monitoring operates in the room. The guidelines must also be displayed on the wall of an operating room for everyone to see. The staff must be able to react and
respond quickly when an IT system gives an alarm. A faulty device in use can cause a serious, even life-threatening, situation for the healthcare person and the patient. The IT system is the responsibility of the hospital’s technical staff, but they are not always present immediately, so the OR staff must handle the situation quickly. There must always be someone in or near the OR who can act. That person might as well be a medical janitor (Figs 2&3).
OR staff must be capable of locating and replacing the faulty device In an OR, a staff member connects a faulty device, which has an insulation fault in the socket. If the system in the operating room sounds an alarm, the personnel unplug the faulty electronic device from the socket. After the failed device is removed, the system automatically resets the alarm. The OR staff replace the failed device with a spare one. After that, the operation can continue with only a tiny delay. In the meantime, the technical staff are notified of the alarm. Our system tells the team which outlet the faulty device is connected to. The technical staff receives information through the automation system and ensures that the defective device is delivered for service. The system also allows technical staff
to see data about when an accident has occurred. This is especially important in cases where the fault is temporary. The
OR staff do not need to understand IT system technology in depth, but they need to respond to an alarm and replace a faulty device with a new one. That way, it is possible to maximise safety.
Checklist for operating room management Below is a list of following tasks to ensure the electrical safety of an operating room: l A modern IT system with an insulation monitoring system.
l A reliable and cooperative supplier who provides design support and training.
l Training, motivating and encouraging the OR staff to understand the purpose and principles of the protective system and to know how to act in emergencies.
l Clear instructions to the OR staff. l Appointment of responsible staff members.
l Electrical equipment should be maintained and tested regularly.
Tips for designing a modern IT system Switchboards are often designed in a way that they are too small to fit the equipment of an advanced IT system. A good IT system should include insulation fault localisation, protective conductor continuity measurement and a fault detection screen in the operating room. In practice, this means that the insulation fault locator indicates the location of the faulty device. Protective conductor continuity measurement ensures that protective earth is used at each socket. It is important to understand that if protective earth is disconnected, these sockets are not earthed. These sockets will then not have insulation monitoring. The ideal situation would be
monitoring at the socket level. The faulty
device could then be quickly localised and replaced. In the old design method, one IT monitoring device monitors all the sockets in the operating room, for example, 50 sockets. In that case, an alarm indicates that one of the 50 connected devices is faulty. Often, the local standard does not require insulation fault localisation but recommends it.
Conclusion Although technology, practices and safety measures have advanced, there is still a long way to go to achieve an adequate level of electrical safety in operating rooms worldwide. In the 2020s, many risk factors will
continue to be identified globally. There is a lot of room for improvement in the following issues: equipment know-how, equipment condition, faulty cables, information flow, training, the operating environment, operating methods and the lack of reliable electrical safety monitoring. Any electrical malfunctions in an
operating room could be fatal. An illicit medical device may lead to death. Therefore, an OR should be protected with an electrical safety system. For that purpose, an IT system with insulation monitoring is the best way to guarantee staff and patient safety. Acquiring a modern IT system with insulation monitoring is a small investment compared to the security and benefits it brings; it is a sustainable solution with a long life cycle. According to surveys, fewer work-
related risks and accidents at work occur at workplaces where employees are introduced to and actively involved in promoting occupational safety and health. Of course, this applies to electrical safety as well. Proper guidance and investment in
training are beneficial in the usability and efficiency of the new technology equipment. When the staff understand the operation of the equipment at a sufficient level, the best possible result is obtained. Regular training provides the necessary skills and knowledge and the ability to use electronic medical devices safely. The existing hazards should be discussed with real examples. When the electrical equipment in an
OR environment works properly, is easy to use, and when integration between different solutions is successful, it increases wellbeing at work and efficiency.
IFHE Figure 3. The defective device is removed from the outlet and returned for service. 70
Reference 1 Fish MR, Geddes LA. Conduction of Electrical Current to and Through the Human body: A Review. Eplasty 2009; 9: e44. Published online 12 Oct 2009. US National Library of Medicine. National Institutes of Health. PMCID: PMC2763825.
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