Operating Rooms have become the most important areas in hospitals because of the scarcity and cost of resources. The present study investigates Operating Room scheduling and rescheduling considering the priority of surgical patients in a specialized hospital. The ultimate purpose of scheduling is to minimize patient waiting time, surgeon idle time between surgeries, and penalties for deviations from Operating Room preferences. A mathematical programming model is presented to solve the problem. Because the problem is strongly NP-hard, two heuristic algorithms are presented. A heuristic algorithm based on a mathematical programming model with local search obtains near-optimal solutions for all the samples. The average relative deviation of this algorithm is 0.02%. In continuous, heuristic algorithms performance have been investigated by increasing the number of patients and reduce the number of recovery beds. Next, a rescheduling heuristic algorithm is presented to deal with real-time situations. This algorithm presents fewer changes resulting from rescheduling in comparison with the scheduling problem.

Introduction: Self-efficacy is the belief in one's ability and ability to perform the task. One way to enhance employees' job self-efficacy is the manager's leadership style. The purpose of this study was to determine the correlation between leadership style of Operating Room supervisors and Operating Room technologists' selfefficacy in teaching hospitals of Iran University of Medical Sciences in 2017-2018. Methods: The present study is a descriptive-correlational study which was performed on 220 Operating Room technologists of hospitals of Iran University of Medical Sciences by stratified random sampling. Data were collected using two questionnaires: "Multifactor Leadership Questionnaire" and "Job Self-Efficacy Questionnaire. " The content validity of the questionnaires was confirmed in previous studies, and their reliability was tested by the retest method. Data were analyzed using SPSS 21 software. Results: Most Operating Room supervisors (65. 5%) had a transformational leadership style. The majority of Operating Room technologists (71. 4%) had high self-efficacy. There was a direct and significant correlation between transformational, exchangeable, and non-interference leadership styles of Operating Room supervisors with occupational self-efficacy (P < 0. 05). Also, the mean score of self-efficacy in transformational and exchangeable leadership styles was higher than non-interventionist leadership styles. Conclusions: There is a direct relationship between job self-efficacy with all three types of leadership styles, but the mean score of self-efficacy in transformational and exchangeable leadership styles is higher than the non-intervention style. Therefore, it is recommended that supervisors use transformational or transactional leadership styles, or a combination of these two leadership styles, depending on the situation in the Operating Room.

Introduction: The Operating Room internship is associated with stress and anxiety and using simulations may reduce this anxiety. The aim of this study was to determine the effect of Operating Room simulation on students’ hidden anxiety during Operating Room internship. Methods: This study was a quasi-experimental research. All students of a class (n=17) were simple randomly assigned to a simulation and a control group. The students in the simulation group were trained by simulation method prior to the internship program. The control group received routine and traditional training. The students’ anxiety level was measured before the intervention, the first and the last day of the internship using Spielberger's hidden anxiety questionnaire. Data were analyzed by Mann-Whitney U and Friedman tests at a significance level of 0. 05. Results: Mean anxiety scores (total=80) before the intervention, the first and the last day of internship were 43. 7± 75. 64, 41. 5± 00. 12, and 37. 62± 2. 32 in the simulation group and 42. 11± 6. 23, 40. 88± 6. 8 and 42. 55± 5. 07 in the control group, respectively. There was no significant difference between the two groups (P=0. 321) in the anxiety scores before the intervention and the first day of internship, while a significant difference was found between the two groups in the anxiety scores on the last day of the internship program (P=0. 021, t=-2/078). Conclusion: Exposing the Operating Room students to a simulated environment before the internship cannot reduce their anxiety on the first day of internship, but it can lower their anxiety during the internship period and significantly reduce anxiety at the end of this period.

Introduction. Long term exposure to trace amounts of anesthetic vapors and gases may produce hematologic and hepatic disorders in human. Since Operating Room (OR) staffs are exposed to these agents, we decided to study their hematopoietic and hepatic systems in comparison with ordinary ward staffs.Methods. Seventy staffs from OR were compared with a matched similar number of ward staffs about their hematologic and hepatic laboratory findings in a historical cohort study.Findings. Mean of leukocyte and platelet counts were significantly lower in OR staffs, but in normal range. Mean of monocyte count was significantly higher in OR staffs. No significant differences were found between two groups for other hepatic and hematologic tests. Fatigue and headache were reported in OR staffs more than others.Conclusion. These findings may warn a risk to OR staffs but, it is not clear and requires further controlled studies.

Background: A review of Operating Room sterilization and disinfection methodsObjectives: Explain various methods of Operating Room sterilization and disinfectionMethods: A literature review using various publications related to Operating Room sterilization and disinfectionResults: An Operating Room is a restricted location in a hospital where surgery is performed. The history of Operating Room construction as a specialized facility for performing surgery dates back to the 18th century. Before that, surgeries were usually performed at patient's or surgeon's place of residence. Early Operating Rooms did not have ideal structural conditions and were mostly built as a place to demonstrate surgical operations. With the identification of microorganisms, especially bacteria, as the causative agents of postoperative infections, the design of Operating Rooms was altered to control these infections. Surgery is an invasive treatment method and exposes the patient to surgical site infections. These infections are caused by contamination of the surgical wound by microorganisms, especially bacteria. Natural flora of the patient, surgical equipment, surgical team and physical environment of the Operating Room are considered as sources of infective bacteria. Operating Rooms can be contaminated by unfiltered air, ventilation systems, disinfectants, discharges from infected wounds, transport of patients and collection bags, excessive traffic in the Operating Room, clothes, shoes, hands and gloves of surgical team members, non-sterile surgical equipment and contaminated surfaces. Therefore, to prevent surgical site infections, apart from the surgical site, surgical equipment and surgical team, the physical environment of the Operating Room must also be designed, maintained and disinfected using appropriate methods. This review article describes general principles of Operating Room design and ventilation along with daily cleaning, disinfection and sterilization methods.Conclusions: Daily cleaning and disinfection of the Operating Room is mandatory as one of the most important aspects of prevention of surgical site infections and should be conducted by experienced and trained staff.

Although there are numerous studies about the effects of music on patient's recovery, less evidence is available about the effects of music on the physicians and hospital staff. It is generally believed that silence and tranquility should prevail in Operating Rooms and any extra noise is regarded as a distraction and can interfere with verbal communication among personnel. Do the harmonic and pleasant sounds have the same effect? In their latest study published in Injury, Ulmann, et al indicated that tranquility in Operating Room does not mean strict silence and even the sound of music can help to bring about the intended tranquility in Operating Room. In order to evaluate the influence of music on surgeons, anesthesiologists and nurses working in the Operating Room, a questionnaire was designed and 300 copies were distributed among the doctors and nurses at five different hospitals in Urmia. The collected data were analyzed 70.2% of participants believed that light music improves verbal communication between personnel and 90.3% of responders claimed that music in the Operating Room improves their concentration. Anesthesiologists and older personnel had a tendency for low volume music. The obtained data revealed that music in low volume could improve verbal communication and concentrating ability of surgeons, anesthesiologists, and other personnel working in Operating Rooms. An interventional study can be designed to reassess the results obtained from this questionnaire-based study.

Introduction: Fire is one of the fearful and morbid accident for each of members in the Operating Room team and important destructive accidents for each surgery patient that may occur during surgery. This study has been carried out to evaluate awareness of Operating Room staff about fire sources and its prevention methods in Operating Room.Methods and Materials: In this cross-sectional study a number of 48 persons of Operating Room staff from Shahroud Imam Hossein and Fatemiyeh hospitals were chosen and their awareness about fire sources (ignition Sources, oxygen sources and fuel sources) and ways of fire prevention in Operating Room were assessed using designed questionnaire related to prevention and fire safety in the Operating Room.  Mean of participation’s awareness about above-mentioned fields, upon 0-100 was divided to three levels: poor, intermediate and good. The data were analyzed using SPSS, software.Results: Based on the results, 97.9% of participants declare that educational program related to prevention and fire safety in Operating Room is necessary and all of them told these programs are useful and important. 85.4% of participants declare that never passed any educational course related to prevention and fire safety in Operating Room. Mean of participation’s awareness about prevention and fire safety in Operating Room was estimated 15.7 in anesthesiologist, 13.1 Operating Room technicians, 12.4 anesthesia technicians and 10.9 surgeons. In general 60.4% of Operating Room staff had intermediate awareness, 33.3% poor awareness and 6.3% good awareness about fire and its prevention in Operating Room.Conclusion: According to the results, unfortunately majority of Operating Room staff are not aware of fire sources and its prevention methods in Operating Room. Thus further research for improving awareness of Operating Room staff about prevention and control of fire in Operating Room is recommended.

Background: Privacy is one of the basic human needs and is considered one of the most important rights of patients. There is little information about respecting the privacy of patients undergoing surgery in the Operating Rooms of educational hospitals in Zanjan Iran. Objectives: Determine the status of respect for privacy in Operating Room from the perspectives of patients and staff. Methods: This is a descriptive cross sectional study. Participants in the study included 204 Operating Room staff and 323 patients undergoing surgery who were selected by convenience sampling. Patients and staff viewpoints were gathered through combining Serenko Fan privacy questionnaires and Noorian in three physical, informational, and psychological dimensions using self-reporting method for staff and interviewing for patients. Data analysis was performed using descriptive statistics and SPSS software version 16. Results: The findings of this study showed that the rate of total respect for privacy from the patients’ perspective was 13. 6% moderate and 86. 4% good. In physical, informational and psychological dimensions, 77. 1%, 72. 8% and 12. 7% of patients, respectively, assessed the status of privacy as good. From the perspectives of the Operating Room staff, respect for privacy was generally poor in 0. 5% of cases, moderate in 5. 4% of cases, and good in 94. 1% of cases. In physical, informational and psychological dimensions, 89. 7%, 95. 1% and 71. 1% of Operating Room staff, respectively, assessed the status of privacy as good. Conclusion: The findings showed that the evaluation of respect for privacy from the perspectives of staff was better than that of patients. The lowest score given by patients and staff was related to the psychological dimension of respect for privacy. Despite the total favorable status of respect for privacy from the perspectives of patients and staff, taking the necessary strategies is required to improve the current status.