LAUSR

Purpose Nowadays, it is impossible to imagine hospitals without medical technology. Many devices have become part of everyday practice, such as electrosurgical units. Electrosurgery uses electricity to gain a surgical effect. The risk of working with this technique is often underestimated by healthcare professionals. This makes the technique potentially hazardous for patient, surgeons and assistants. A safe and effective use of the technique requires theoretical knowledge and practical skills. In this abstract, we describe the initiative to formulate competence requirements for using electrosurgery that are general applicable and can be used as input for training and examination. Methods A group of medical physicists located in eight Dutch hospitals used educational methods to analyze the use of electrosurgery in the operation room and determine competence requirements. Additionally, the group investigated resources like the Dutch risk profile for electrosurgery, risk analyses of individual hospitals, supplier manuals, user protocols, (nearly) incident reports and available local training materials. For each requirement, an explanation was given and it was pointed out if the requirement is verifiable in practice. The result was presented to users of electrosurgery such as urologists and surgeons. Furthermore, a member consultation of the association of general medical physicists took place. Outcomes of consultations were used to improve and complete the requirements. Results The final requirements are clustered in electricity, technology, tissue effect, instruments and their use, settings, minimal invasive surgery, risks (patient electrode patches, alternative current flow, fire, long term use, contamination of electrode) and surgical smoke. It appeared to be important for physicians to have a good perception of the behavior of electrical current in the human body, without elaborating in too much physics and mathematical equations. Best results are obtained applying a combination of theoretical explanation followed by practicing in a skills lab. Conclusions Safe patient care requires qualified medical staff. The approach which combined physical knowledge and educational methods successfully resulted in competence requirements. These requirements are used by hospitals as input for teaching materials and to state a minimum level of qualification for using electrosurgery safely and effectively in patient care.