Abstract：
Anesthesia contributes significantly to a hospital\'s carbon footprint. Climate-smart actions have the potential to reduce greenhouse gas emissions. Prerequisites for sustainable behavior of providers are knowledge and awareness. We aimed to assess the change in anesthesiologists\' climate-friendly behavior before and after educational interventions in three areas that every anesthesiologist can address in their daily clinical routine: 1) energy use; 2) recycling opportunities; 3) consumption of volatile anesthetics.
We performed a cross-sectional before-and-after single center sub-study within the multicenter \"Provider Education and Evaluation Project\" at the Department of Anesthesiology, RWTH Aachen University hospital from May3 2021 to May 1 2022. Educational interventions consisted of stickers, posters and a presentation on climate-smart actions in anesthesiologists\' work routine between the first and the second assessment. For each cross-sectional assessment, all central 28 ORs were observed for one week. During the before-and-after comparison we analyzed: 1) energy wasted in unoccupied ORs because of running computers and turned-on lights at 9 p.m.; 2) feasibility of recycling preoperative anesthesia plastic packaging by determining the difference between calculated weight of unseparated preoperative plastic waste in the first assessment and the weight of actual separated waste in the second assessment; 3) fresh gas flow in balanced anesthesia cases in steady state at 9 a.m., and purchased hypnotics converted to bottles/1000 general anesthesia cases in 2018-2022.
We observed a reduction of wasted energy by 44% in unoccupied ORs. Usage of low fresh gas flow settings increased from 55% to 75%. The average of purchased desflurane in 2018-2020 decreased by 72% in 2022. We calculated 10.33 kg of preoperative plastic waste per week but were unable to implement waste separation for infrastructural and logistical reasons.
We found that environment-friendly working behaviors increased after the implementation of educational interventions. The causality between the interventions and the observed improvements remains to be proven.
We performed a cross-sectional before-and-after single center sub-study within the multicenter \"Provider Education and Evaluation Project\" at the Department of Anesthesiology, RWTH Aachen University hospital from May3 2021 to May 1 2022. Educational interventions consisted of stickers, posters and a presentation on climate-smart actions in anesthesiologists\' work routine between the first and the second assessment. For each cross-sectional assessment, all central 28 ORs were observed for one week. During the before-and-after comparison we analyzed: 1) energy wasted in unoccupied ORs because of running computers and turned-on lights at 9 p.m.; 2) feasibility of recycling preoperative anesthesia plastic packaging by determining the difference between calculated weight of unseparated preoperative plastic waste in the first assessment and the weight of actual separated waste in the second assessment; 3) fresh gas flow in balanced anesthesia cases in steady state at 9 a.m., and purchased hypnotics converted to bottles/1000 general anesthesia cases in 2018-2022.
We observed a reduction of wasted energy by 44% in unoccupied ORs. Usage of low fresh gas flow settings increased from 55% to 75%. The average of purchased desflurane in 2018-2020 decreased by 72% in 2022. We calculated 10.33 kg of preoperative plastic waste per week but were unable to implement waste separation for infrastructural and logistical reasons.
We found that environment-friendly working behaviors increased after the implementation of educational interventions. The causality between the interventions and the observed improvements remains to be proven.
摘要：
背景：麻醉对医院的碳足迹有重要影响。气候智慧型行动有可能减少温室气体排放。提供者可持续行为的先决条件是知识和意识。我们旨在评估麻醉医师在教育干预之前和之后气候友好行为的变化，每个麻醉医师都可以在其日常临床常规中解决三个方面：1）能量使用；2）回收机会；3）挥发性麻醉剂的消耗。
方法：我们在麻醉科的多中心“提供者教育和评估项目”中进行了横向前后单中心子研究，亚琛工业大学医院，2021年5月3日至2022年5月1日。教育干预包括贴纸，在第一次和第二次评估之间，在麻醉师的工作程序中张贴关于气候智能行动的海报和演讲。对于每个横截面评估，所有中心28个ORs均观察一周.在前后比较中，我们分析了：1）由于运行计算机和晚上9点打开的灯而在未占用的OR中浪费的能量；2）通过确定第一次评估中未分离的术前塑料废物的计算重量与第二次评估中实际分离废物的重量之间的差异来回收术前麻醉塑料包装的可行性；3）上午9点处于稳定状态的平衡麻醉病例中的新鲜气体流量，并在2018-2022年购买了催眠药转换为瓶子/1000例全身麻醉病例。
结果：我们观察到在未占用的OR中浪费的能量减少了44％。低新鲜气体流量设置的使用从55%增加到75%。2018-2020年购买地氟烷的平均值在2022年下降了72%。我们计算了每周10.33千克的术前塑料废物，但由于基础设施和后勤原因无法实施废物分离。
结论：我们发现，实施教育干预措施后，环境友好型工作行为增加。干预措施与观察到的改进之间的因果关系仍有待证明。
方法：我们在麻醉科的多中心“提供者教育和评估项目”中进行了横向前后单中心子研究，亚琛工业大学医院，2021年5月3日至2022年5月1日。教育干预包括贴纸，在第一次和第二次评估之间，在麻醉师的工作程序中张贴关于气候智能行动的海报和演讲。对于每个横截面评估，所有中心28个ORs均观察一周.在前后比较中，我们分析了：1）由于运行计算机和晚上9点打开的灯而在未占用的OR中浪费的能量；2）通过确定第一次评估中未分离的术前塑料废物的计算重量与第二次评估中实际分离废物的重量之间的差异来回收术前麻醉塑料包装的可行性；3）上午9点处于稳定状态的平衡麻醉病例中的新鲜气体流量，并在2018-2022年购买了催眠药转换为瓶子/1000例全身麻醉病例。
结果：我们观察到在未占用的OR中浪费的能量减少了44％。低新鲜气体流量设置的使用从55%增加到75%。2018-2020年购买地氟烷的平均值在2022年下降了72%。我们计算了每周10.33千克的术前塑料废物，但由于基础设施和后勤原因无法实施废物分离。
结论：我们发现，实施教育干预措施后，环境友好型工作行为增加。干预措施与观察到的改进之间的因果关系仍有待证明。
