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Reducing the environmental impact of surgery on a global scale : systematic review and co-prioritization with healthcare workers in 132 countries
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National Institute for Health and Care Research Global Health Research Unit on Global Surgery (Including: Lillywhite, Robert). (2023) Reducing the environmental impact of surgery on a global scale : systematic review and co-prioritization with healthcare workers in 132 countries. British Journal of Surgery, 110 (7). pp. 804-817. doi:10.1093/bjs/znad092 ISSN 0007-1323.
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WRAP-reducing-environmental-impact-surgery-global-scale-systematic-review-co-prioritization-healthcare-workers-132-countries-2023.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons: Attribution-Noncommercial 4.0. Download (553Kb) | Preview |
Official URL: https://doi.org/10.1093/bjs/znad092
Abstract
Background:
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods:
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results:
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion:
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries.
Item Type: | Journal Article | ||||||||
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Subjects: | R Medicine > RD Surgery | ||||||||
Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||
Library of Congress Subject Headings (LCSH): | Surgery , Surgery -- Practice, Surgical instruments and apparatus -- Environmental aspects | ||||||||
Journal or Publication Title: | British Journal of Surgery | ||||||||
Publisher: | John Wiley & Sons Ltd. | ||||||||
ISSN: | 0007-1323 | ||||||||
Official Date: | July 2023 | ||||||||
Dates: |
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Volume: | 110 | ||||||||
Number: | 7 | ||||||||
Page Range: | pp. 804-817 | ||||||||
DOI: | 10.1093/bjs/znad092 | ||||||||
Status: | Peer Reviewed | ||||||||
Publication Status: | Published | ||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||
Date of first compliant deposit: | 4 August 2023 | ||||||||
Date of first compliant Open Access: | 7 August 2023 | ||||||||
RIOXX Funder/Project Grant: |
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