Evolving experience of operating theatre staff with the implementation of robotic-assisted surgery in the public sector
Daniel Steffens
A B E , Kate E. McBride C , Rachael Roberts C , Paul G. Bannon C D and Michael J. Solomon A B C
A Surgical Outcomes Research Centre (SOuRCe), Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia. Email: professor.solomon@sydney.edu.au
B Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2050, Australia.
C RPA Institute of Academic Surgery (IAS), Royal Prince Alfred Hospital and University of Sydney, Sydney, NSW 2050, Australia. Email: Kate.McBride@health.nsw.gov.au; Rachael.Roberts@health.nsw.gov.au
D The Baird Institute, Sydney, NSW 2050, Australia. Email: pgbannon@gmail.com
E Corresponding author. Email: Daniel.Steffens@health.nsw.gov.au
Australian Health Review 44(4) 624-629 https://doi.org/10.1071/AH19106
Submitted: 4 May 2019 Accepted: 11 October 2019 Published: 19 June 2020
Abstract
Objectives The use of robotic-assisted surgery (RAS) remains predominantly in the private sector. In the public sector, the effect of the implementation of RAS on theatre staff is unknown. The aim of this study was to examine the knowledge and attitudes of theatre staff before and after implementation of RAS in the public sector.
Methods In all, 250 theatre staff, including nursing, medical and support staff, were invited to participate in the study. A survey investigating the benefits of RAS for patients and staff, concerns towards the workplace environment and facilitators towards the implementation of new technology was administered before (June 2016) and after (February 2019) the implementation of a comprehensive RAS program.
Results The survey was completed by 164 (65.6%) staff before and 200 (80.0%) staff after the implementation of RAS. With time, most nursing (P = 0.002) and medical staff (P = 0.003) indicated that RAS may benefit patients by reducing intraoperative complications, whereas support staff remained uncertain about this benefit (P = 0.594). Before the implementation, most medical staff indicated that RAS would benefit staff, although after they were unsure about this benefit. Overall, before RAS implementation, theatre staff were mostly concerned about workplace safety, but this concern was significantly reduced after RAS implementation (P < 0.010).
Conclusions With time, operating theatre staff considered their RAS program to be associated with enhanced benefits to patients, and their concerns regarding workplace safety were significantly reduced. Conversely, theatre staff were unsure about the benefits of RAS to themselves. It is important for organisations to consider the evolving impact of new technology on their staff and to refine ongoing education and training programs in line with these changes.
What is known about the topic? The implementation of RAS is rapidly evolving in major hospitals. Therefore, it is important to investigate the knowledge, attitudes and experiences of operating theatre staff before and after the implementation of RAS, especially in the public sector.
What does this paper add? This study found that with time theatre staff considered RAS to be beneficial to patients, and their initial concerns about the effect on workplace safety were significantly reduced.
What are the implications for practitioners? It is important for organisations to consider the evolving impact of the implementation of new technology on operating theatre staff and to refine ongoing education and training programs as required.
References
[1] Basto M, Sathianathen N, Marvelde LT, Ryan S, Goad J, Lawrentschuk N, Costello AJ, Moon DA, Heriot AG, Butler J, Murphy DG. Patterns‐of‐care and health economic analysis of robot‐assisted radical prostatectomy in the Australian public health system. BJU Int 2016; 117 930–39.| 26350758PubMed |
[2] Nolan HR, Christie DB, Ashley DW. Comparison of attending and resident surgeons’ opinions of robotic surgery training in general surgery residency. Am Surg 2015; 81 303–5.
| 26215228PubMed |
[3] van Brenk CM. Setting up a robotic surgery program: a nurse’s perspective. Semin Colon Rectal Surg 2009; 20 162–5.
| Setting up a robotic surgery program: a nurse’s perspective.Crossref | GoogleScholarGoogle Scholar |
[4] Francis P. Evolution of robotics in surgery and implementing a perioperative robotics nurse specialist role. AORN J 2006; 83 42
| Evolution of robotics in surgery and implementing a perioperative robotics nurse specialist role.Crossref | GoogleScholarGoogle Scholar |
[5] Luck ES, Gillespie BM. Technological advancements in the OR: do we need to redefine intraoperative nursing roles? AORN J 2017; 106 280–2.
| Technological advancements in the OR: do we need to redefine intraoperative nursing roles?Crossref | GoogleScholarGoogle Scholar | 28958313PubMed |
[6] Farivar BS, Flannagan M, Leitman IM. General surgery residents’ perception of robot-assisted procedures during surgical training. J Surg Educ 2015; 72 235–42.
| General surgery residents’ perception of robot-assisted procedures during surgical training.Crossref | GoogleScholarGoogle Scholar | 25451717PubMed |
[7] McBride KE, Steffens D, Duncan K, Bannon PG, Solomon MJ. Knowledge and attitudes of theatre staff prior to the implementation of robotic-assisted surgery in the public sector. PLoS One 2019; 14 e0213840
| Knowledge and attitudes of theatre staff prior to the implementation of robotic-assisted surgery in the public sector.Crossref | GoogleScholarGoogle Scholar | 30870503PubMed |
[8] Platis C, Zoulias E. Impacts of robotic assisted surgery on hospital’s strategic plan. Proc Soc Behav Sci 2014; 147 321–6.
| Impacts of robotic assisted surgery on hospital’s strategic plan.Crossref | GoogleScholarGoogle Scholar |
[9] Harris PA, Taylor R, Thielke R, Payne J, Gonzalez N, Conde JG. Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform 2009; 42 377–81.
| Research electronic data capture (REDCap) – a metadata-driven methodology and workflow process for providing translational research informatics support.Crossref | GoogleScholarGoogle Scholar | 18929686PubMed |
[10] Steffens D, Thanigasalam R, Leslie S, Maneck B, Young JM, Solomon M. Robotic surgery in uro-oncology: a systematic review and meta-analysis of randomized controlled trials. Urology 2017; 106 9–17.
| Robotic surgery in uro-oncology: a systematic review and meta-analysis of randomized controlled trials.Crossref | GoogleScholarGoogle Scholar | 28336286PubMed |
[11] Prete FP, Pezzolla A, Prete F, Testini M, Marzaioli R, Patriti A, Jimenez-Rodriguez RM, Gurrado A, Strippoli GFM. Robotic versus laparoscopic minimally invasive surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials. Ann Surg 2018; 267 1034–46.
| Robotic versus laparoscopic minimally invasive surgery for rectal cancer: a systematic review and meta-analysis of randomized controlled trials.Crossref | GoogleScholarGoogle Scholar | 28984644PubMed |
[12] Iavazzo C, Papadopoulou EK, Gkegkes ID. Cost assessment of robotics in gynecologic surgery: a systematic review. J Obstet Gynaecol Res 2014; 40 2125–34.
| Cost assessment of robotics in gynecologic surgery: a systematic review.Crossref | GoogleScholarGoogle Scholar | 25255827PubMed |
[13] Gkegkes ID, Mamais IA, Iavazzo C. Robotics in general surgery: a systematic cost assessment. J Minim Access Surg 2017; 13 243–55.
| Robotics in general surgery: a systematic cost assessment.Crossref | GoogleScholarGoogle Scholar | 28000648PubMed |
