Stavanger, Norway | 12 - 15 May 2022 10th EORNA Congress Round Table Sessions 33 Round Table: Improved OR practices for young patients RT16 Implementation of an operating room safety checklist in paediatric surgery I. Franconi1, M. Fioretti1, L. Gatti1, P. Orazi1, S. Giacchetti1 1Blocco Operatorio, AOU Ospedali Riuniti Ancona, Ancona, Italy Introduction: Operations on the wrong patient or site are sentinel events that can be linked to several factors, such as lack of preoperative planning, lack of control systems, and inadequate communication between healthcare professionals, and professionals and patients, The “surgical safety checklist” helps the operating team manage and document the activities carried out before, during and after the operation. The checklist adopted by the “A.O.U. Ospedali Riuniti di Ancona’’ made use of the WHO Guidelines for Safe Surgery, and the “Raccomandazione del Ministero della Salute n.3, 2008” for the correct identification of patients, surgical sites and procedures. To promote safe treatments, the Hospital Directorate has decided to implement the “surgical safety checklist” in paediatric surgery. Objective: To guarantee the correct procedure, on the correct patient and site by implementing the “surgical safety checklist” in every surgical procedure. Beneficiaries: The Operating Procedure is aimed at all healthcare professionals involved in surgical activities in the operating room. Area of applicability: The checklist is applied to all patients aged ≤14 years undergoing surgical procedures performed in the operating room in ordinary hospitalisation and Day Surgery. Procedure: The checklist consists of five phases distributed over three distinct periods 1. Period of preparation for surgery (in the days or hours preceding the surgery): it includes the 1st (Acquisition of informed consent) and 2nd phases (Verification and marking of the operative site) 2. Period immediately before entering the operating room: includes the 3rd phase (Identification of the paediatric patient). 3. Period immediately before surgery in the operating room: it includes the 4th (Time out) and 5th phase (Double Check). These activities must be formalised by filling in the “Pre-operative form to correctly identify the patient, surgical site and procedure”. RT17 Best practice recommendations for Sacral Neuromodulation implant in paediatric patients B. Confetto1, C. Scognamiglio1, I. Pannacci1, E.M. Marandola1, M. Maurizi1 1Ospedale Pediatrico Bambino Gesù, Rome, Italy Sacral neuromodulation (SNM) is a treatment that can solve problems related to overactive bladder, retention or urinary incontinence. A small implantable device controls nerves of the sacral area at the s3 level. This device works with permanent electrical stimulation to stimulate the bladder. SNM is utilised, on paediatric patients, as neurogenic bladder therapy. Bambino Gesù Paediatric Hospital (OPBG) is, in this regard, one of the major reference centre in Italy. The aim of this article is to present the best-practice adopted by OPBG regarding intraoperative positioning of the patient during the placement of SNM in order to prevent any adverse events such as pressure injuries, cervical spine injuries, compartment syndrome, neuropraxia, neurotmesis. It has been performed a literature review regarding prone positioning of patients during SNM implantation that returned few studies on this subject. Therefore, articles concerning intraoperative positioning of paediatric patients in general have been selected and analysed to highlight what is the best practice to be preferred. A retrospective study was also performed on the records of patients operated in our hospital between 2019 and 2021: 30 surgeries were performed on patients between 12 and 31 years of age, the neuromodulator had been either implanted, replaced or permanently removed. Among these patients, none of them presented any problems or adverts events mentioned above due to intraoperative positioning. Conclusions: The responsibility of intraoperative positioning of patients with SNM implant lies within the entire surgical team. Since there are currently no clear and defined internal protocols available, the practice adopted by our hospital seems, in this regard, to be effective and highlights the need for guidelines to be clarified and designed in order for the nursing staff to be properly prepared to offer the best intraoperative care to paediatric patients.
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