Eye最新文献

Background: Theatre activity is a major source of hospital waste, accounting for 21-30% of total output, and is 3-6 times more energy-intensive than any other hospital department. Cataract remains the leading cause of blindness worldwide, and cataract surgery is the most commonly performed surgical procedure worldwide, but to date has received little analysis in this field. The aim of this study was to evaluate the carbon impact of streamlining single-use packs, and transitioning from single-use items, to reusable equivalents in cataract surgery.

Methods: A focus group and prospective audit was carried out to identify single-use pack items for streamlining. A bottom-up, process-based carbon footprint analysis was conducted of single-use items and reusable alternatives using activity data provided by the suppliers and greenhouse gas (GHG) conversion factors from the UK Government GHG Conversion Factors for Company Reporting database.

Results: Total carbon savings from streamlining was 935 kgCO2e/year, and switching, was 309 kgCO2e/year. Single-use items had a 27 times greater carbon footprint than reusable equivalents (322 kgCO2 vs. 12 kgCO2e respectively). A net carbon saving was achieved from 19 or more re-uses of the reusable items compared to single-use equivalents.

Conclusions: This study provides evidence of carbon emissions savings both from streamlining disposable instruments in cataract surgical packs, and from switching from single-use to reusable instruments. Mitigation strategies targeting hotspots in resource intensive areas will be an important aspect of reducing the climate burden of surgery. Change in practice and policy is required in all surgical specialities to realize net zero carbon healthcare.

Background/objectives: Patient safety is a global health priority, yet there is limited research into how ophthalmology is responding to this. There is evidence that a review of patient harm related to eye care and the associated patient safety incidents is needed. We aimed to characterise patient safety incidents involving eye care by: identifying the most frequently reported incidents involving clinical care; and characterising the nature of incidents leading to severe vision loss.

Methods: The data comprised patient safety incidents reported between 2018 and 2022 to the National Reporting and Learning System and the NHS England Learn from Patient Safety Events system. Reports were searched for eye-related terms (ICD-11) and those reports relating to implementation of care and clinical assessment were included. A descriptive analysis was undertaken to characterise the most frequent incident types and their contributory factors, followed by a thematic analysis of incidents relating to severe vision loss.

Results: Of the 836 reports identified, insufficient care (n = 416) and delayed diagnosis (n = 234) featured most. Patient harm occurred related to vision loss (n = 449), delays in treatment (n = 182), and disease progression (n = 121). Among 220 reports that resulted in severe vision loss, patients with Glaucoma and Age-related Macular Degeneration were impacted by delays in monitoring and management, loss to follow-up, disease progression due to insufficient care and system failures.

Conclusions: In this characterisation of eye-related incident reports in a national population, potential areas of interest toward safer eye care include addressing delays in patients receiving care and insufficient care such as inconsistent monitoring in glaucoma.