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PURPOSE: This study reviews evidence and provides recommendations for the ideal setting of intravitreal injection (IVI) administration of vascular endothelial growth factor (VEGF) inhibitors. METHODS: A multi-step approach was employed, including content analysis of regulations and guidelines, a systematic literature review, and an international survey assessing perioperative complications and endophthalmitis incidence in relation to injection settings. The literature review searched PubMed and Cochrane databases from 2006 to 2022, focusing on studies reporting correlations between complications and treatment settings. The survey utilized a web-based questionnaire distributed to clinical sites and the international ophthalmic community, with data managed using electronic capture tools. RESULTS: We reviewed regulations and guidelines from 23 countries across five continents, finding significant variation in IVI administration settings. In most countries, IVI is primarily administered in outpatient clean rooms (96%) or offices (39%), while in others, it is restricted to ambulatory surgery rooms or hospital-based operating theatres (4%). The literature review found that endophthalmitis risk after IVI is generally low (0.01% to 0.26% per procedure), with no significant difference between office-based and operating room settings. The international survey (20 centers, 96,624 anti-VEGF injections) found low overall incidences of severe perioperative systemic adverse events and endophthalmitis, independent of injection settings. CONCLUSION: No significant differences in perioperative complications were observed among various settings, including operating theatres, ambulatory surgery rooms, offices, hospitals, or extra-hospital environments. Choosing the appropriate clinical setting can optimize patient management, potentially increasing effectiveness, quality, productivity, and capacity.
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Resumen La cancelación de cirugías programadas es un problema latente en Colombia que tiene repercusiones negativas para el paciente (física y psicológicamente), el personal de la salud (bienestar laboral, satisfacción, desempeño) y la institución (costo-eficiencia). La tasa de cancelación varía entre 2,7 - 7,6 %. La mayoría de las cancelaciones son prevenibles y ocurren por errores administrativos o de programación. En este documento se realiza una revisión sobre el estado y vacíos de conocimiento sobre este problema en Colombia, y se plantean algunos puntos para la agenda de investigación.
Summary Cancellation of scheduled surgeries is a latent problem in colombia, which encompasses negative consequences for the patient (physically and psychologically), the health care personnel (well-being, satisfaction, performance) and the institution (cost-effectiveness). The rate of cancellation varies between 2,7 - 7,6 %. Most cancellations are preventable and occur due to administrative or programming issues. In this document, we performed a review on the gaps of knowledge on this problem in colombia, and we highlighted some points for the research agenda.
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Introduction: Laparoscopic surgery is an increasingly used technique, but it requires a high degree of learning, and communication between the operating room crew is considerably difficult. The use of eye tracking has been proposed as a didactic and evaluation tool in several settings, including in laparoscopy in simulators. Objectives: This study aimed to evaluate the usefulness of the use of eye tracking systems (Tobii glasses 2) in laparoscopic surgery as a didactic and assessment tool to improve communication in the operating room and improve patients' security. Methodology: An anonymous survey was sent to the students and medical teachers of a faculty of medicine and practicing doctors and residents. The message contained an explanation about the use of the Tobii glasses, a link to watch the video showing its use in a laparoscopic surgery, and the survey to complete after watching the video. Results: The survey was answered by 113 participants (51.3% medical students, 27.4% medical teachers, 18.6% practicing doctors, and 2.7% medicine residents). Eighty-three percent agreed with the usefulness of the "Tobii glasses" in the operating room for improving communication between the main surgeon and the assistant, for learning complex surgery techniques, for obtaining didactic videos, and for indicating anatomical structures. The item scored worst was the price of the glasses. Conclusions: It is possible to record and project expert gaze patterns in the operating room in real time using the Tobii glasses. This device allows improving communication among the surgical crew and the learning of residents and also improving the security of surgical patients.
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Objective To assess and evaluate attitudes and knowledge regarding ionizing radiation of urology surgery room staff. Methods A questionnaire was sent to urology surgery room personnel of 4 comprehensive hospitals in Changchun from September to October in 2016. The questionnaire included demographic questions and questions regarding radiation exposure and protection. Results In total,127 questionnaires were answered.Of them, 48.8%(62/127)were nurses,40.2%(51/127)were doctors,and 11.0%(14/127)were radiological technicians.In total,44.1%(56/127)had received specific education or training regarding the harmful effects of radiation; 89.0%(113/127)participants had some knowledge of radiation;72.4%(92/127)used lead apron and collar.For the use of radiation dose disc by radiographers, the rate was 14/14,the using rate by nurses was 33.9%(21/62),the using rate by doctors was 25.5%(13/51), the difference was statistically significant (χ2=26.732, P < 0.01); the using rate of lead screen by radiographers was 11/14, 43.5% (27/62) by nurses, and 19.6% (10/51) by doctors, the difference was statistically significant(χ2=17.949,P<0.01);10/14 technicians used the remote operating system,23.5% (12/51) doctors used a remote operating system,and 6.5%(4/62)for nurses,the difference was statistically significant (χ2=30.106, P < 0.01). Conclusions The awareness and protective measures of urology surgery room personnel about the ionizing radiation are not sufficient.However,the training,the cognition and protection ability of ionizing radiation of technical personnel are better than those of nurses and doctors. The training of ionizing radiation should be strengthened to improve the awareness of ionizing radiation among the operation room staff.
