Interventions to achieve environmentally sustainable operating theatres: an umbrella systematic review using the behaviour change wheel.

Autor:	Almukhtar A; Department of General Surgery, Imperial College Healthcare NHS Trust, St Mary's Hospital.; Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building., Batcup C; Dyson School of Design Engineering, Imperial College London., Bowman M; Department of Breast Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK., Winter Beatty J; Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building., Leff D; Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building.; Department of Breast Surgery, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK., Demirel P; Dyson School of Design Engineering, Imperial College London., Judah G; Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, 10th Floor Queen Elizabeth Queen Mother Building., Porat T; Dyson School of Design Engineering, Imperial College London.
Jazyk:	angličtina
Zdroj:	International journal of surgery (London, England) [Int J Surg] 2024 Nov 01; Vol. 110 (11), pp. 7245-7267. Date of Electronic Publication: 2024 Nov 01.
DOI:	10.1097/JS9.0000000000001951
Abstrakt:	Introduction: The healthcare sector is a major contributor to the climate crisis and operating theatres (OTs) are one of the highest sources of emissions. To inform emissions reduction, this study aimed to (i) compare the outcomes of interventions targeting sustainable behaviours in OTs using the Triple Bottom Line framework, (ii) categorise the intervention strategies using the five Rs (reduce, recycle, reuse, refuse, and renew) of circular economy, and (iii) examine intervention functions (IFs) using the Behaviour Change Wheel (BCW). Methods: Medline, Embase, PsychInfo, Scopus, and Web of Science databases were searched until June 2023 using the concepts: sustainability and surgery. The review was conducted in line with the Cochrane and Joanna Briggs Institution's recommendations and was registered on PROSPERO. The results were reported in line with Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) (Supplemental Digital Content 1, http://links.lww.com/JS9/D210 ) guidelines. Results: Sixteen reviews encompassing 43 life-cycle analyses, 30 interventions, 5 IFs, and 9 BCW policy categories were included. 28/30 (93%) interventions successfully led to sustainability improvements; however, the environmental outcomes were not suitable for meaningful comparisons due to their using different metrics and dependence on local factors. The 'reduce' strategy was the most prolific and commonly achieved through 'education' and/or 'environmental restructuring'. However, single-session educational interventions were ineffective. Improving recycling relied on 'environmental restructuring'. More intensive strategies such as 'reuse' require multiple intervention functions to achieve, either through a sustainability committee or through an intervention package. Conclusion: Policymakers must examine interventions within the local context. Comparing the outcomes of different interventions is difficult and could potentially be misleading, highlighting the need for a tool integrating diverse outcomes and contextual factors. 'Reduce' strategy guarantees environmental and financial savings, and can be achieved through 'Education' and/or 'environmental restructuring'. (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
Databáze:	MEDLINE
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