Safety in OR remains a hot item

News - 29 May 2019 - Webredactie 3ME

We still have an awful lot to learn when it comes to safety in the operating room, according to Frédérique Meeuwsen. She will obtain her PhD on 29 May on this subject at TU Delft.


In her research on safety in the operating room (OR), physician and PhD student Frédérique Meeuwsen focuses in part on electrosurgery. The latter involves the use of a surgical device that uses electrical energy to manipulate tissue. ‘It turns out there are still things that need to be improved,’ Meeuwsen says. ‘Despite its frequent use, things still regularly go wrong. And that’s why good training is extremely important.’

‘We examined the educational training programmes for electrosurgery for surgical residents in various Dutch hospitals. They weren’t satisfied with the setup of the training programme and the theoretical competences acquired by themselves and their supervisors. So we need better education for both residents and their supervisors to enhance patient safety.’

ImprovementsThe poor level of theoretical knowledge also influences the way in which electrosurgery is applied. ‘We have noticed differences in the way electrosurgery is applied by surgeons and residents. And there also differences in approaches among surgeons. This may arise from the complex interplay between settings, choice of electrode, experience and the task at hand.’

‘I think we still have an awful lot to learn in this area.’ In addition to improving training, Meeuwsen believes that it would be wise to make electrosurgical devices less complicated and more standardised, for example.

Meeuwsen examined the surgical workflow in more detail for her PhD work as well, with the aim of improving OR logistics and safety. For example, she developed a track and trace system to monitor the use of surgical devices. In this system, devices are equipped with a sensor (RFID tag) that makes it possible to monitor their use live on a dashboard. Surgeons at the Reinier de Graaf hospital in Delft are currently the first to be testing this technology in the operating room.

‘Monitoring the use of devices makes it possible to see what stage of an operation a surgeon is working in. That enables you to estimate how long the intervention will still take so you can prepare the next patient, for example. And this enables us to improve planning in the operating room.

‘The safe use of medical technology means: a safe product, in the hands of a trained user, in an environment that can guarantee safe use.’ Meeuwsen concludes, ‘But the sole presence of these cornerstones doesn’t constitute safe use yet. All elements have to be properly aligned with each other. By objectively measuring these three cornerstones, my dissertation will hopefully serve as a guide for successful and safe alignment.’

Also read A world first: Reinier de Graaf increases safety and efficiency with track and trace in the operating theatre