Wednesday, February 24, 2010

CLOTHING SOLUTION FOR CHILLY OPERATING ROOM ENVIRONMENT



Hugging heated IV bags, layering undergarments and wrapping themselves in blankets - Barry Finegan and his co-workers do what they can to get warm before heading into the surgical theatre.

Hospital operating rooms are traditionally kept chilly, well below standard room temperature, for the comfort of surgeons sweating under the warm lights needed for their work. But that can leave others on the surgical team literally out in the cold.

Such is the plight for support staff in operating rooms everywhere, and Finegan is hoping bright minds at the University of Alberta can solve the dilemma.

Finegan, a professor in the U of A's Department of Anesthesiology and Pain Medicine and an OR team member at the University of Alberta Hospital, was tired of seeing his colleagues shivering as they cared for patients undergoing complex and often lengthy surgeries, and wanted to do something about it. He didn't have far to go.

"I thought, 'we have the expertise here at the university in clothing materials and design. We must be able to improve the technology we are using in our OR garments.'"

His quest turned out to be a great fit for the Department of Human Ecology in the Faculty of Agricultural, Life and Environmental Sciences. Under the guidance of human ecology professors Megan Strickfaden and Rachel McQueen, third-year students Annette Aslund and Alex Pedden are working with master's student Yin Xu to design a garment that will keep OR team members like Finegan more comfortable during surgery.

The trio is working on an improved design for a warm-up jacket that members of surgical teams can wear in the operating room.

"We have a challenging environment in the OR, in that we've got to keep the patient warm but at the same time, we have to make the environment appropriate for the people who work there," Finegan said.

While surgeons and other staff directly involved in an operation are kept warm by their scrubs and the lights over the table, those on the periphery are vulnerable to the cool temperatures that help keep the surgeons comfortable and focused.

Anesthesiologists like Finegan can sit through surgeries that can go on for up to 12 hours while they continuously monitor their patients, which often also means sitting under a vent that pushes cool air into the room. And nurses have to remove their current warm-up jackets to avoid contamination when preparing patients for surgery.

"The people who aren't patients or directly involved in the surgical process are in an uncomfortably cold environment," Finegan noted. And because the room must be kept sterile, homegrown solutions like sweaters or other garments aren't viable.

Aslund, Pedden and Xu conducted field research at the U of A hospital, monitoring room temperature and humidity in the surgical suites, observing medical teams at work and collecting textile samples from existing operating room garb. They also videotaped and photographed the donning and removal of the garments and, using body diagrams, had the staff indicate where they felt hot or cold.

High on the wish list for both groups were garments that were sterile, professional-looking, thermally functional, washable, that fit well and would be approved for use by Alberta Health Services. Nurses wanted less baggy sleeves, anesthesiologists wanted vests and both groups want multiple pockets.

Using their data, the students drew up a prototype design that will be the subject of a pilot study. Securing grants to continue the research is next, Strickfaden said. "We need to do more textile analysis and build on the early concepts we have for a garment design."

The project provided an opportunity not only for Strickfaden and McQueen to collaborate within their department, but also gave their team a chance to view a problem holistically and work directly with those affected-the ideal approach in human ecology. It was an "eye-opener," especially for the undergraduate students, Strickfaden added.

"The OR was a complex environment and they really got to experience a research situation, interviewing people and getting out in the field."

Aslund is studying for a science degree in clothing and textiles, with a minor in product development. She got "a real sense of satisfaction" from her field research, which involved interviewing members of the OR team. "It felt more university-like than sitting in a classroom. And we just scratched the surface of it. I would have liked to go on to the textile testing. But I did gain some knowledge about taking a holistic approach to solving a problem."

She believes her early foray into field work will serve her well, no matter what her future career brings. "If I have to do a focus group in marketing or business I'll be able to talk to a client or conduct different kinds of research."

The experience has been just as rewarding for Finegan, who looks forward to the final outcome.

"I was impressed by the detailed approach the students and the department took to assessing our environment. For me as a medical researcher, it's always illuminating to work with those in other disciplines and realize the strength of cross-disciplinary research. We forget sometimes the importance of human ecology in ensuring that the environment in which we work is optimal. Obviously for us, temperature issues are potential distractions."

(Photo: U. Alberta)

University of Alberta

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