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operating room safety

Davide Ferorelli, Fiorenza Zotti, Silvio Tafuri, Angela Pezzolla, Alessandro Dell'Erba
The study aims to evaluate the use of Patient Safety Walkaround (SWR) execution model in an Italian Hospital, through the adoption of parametric indices, survey tools, and process indicators.In the 1st meeting an interview was conducted to verify the knowledge of concepts of clinical risk management (process indicators). One month after, the questions provided by Frankel (survey tool) were administered.Each month after, an SWR has been carried trying to assist the healthcare professionals and collecting suggestions and solutions...
October 2016: Medicine (Baltimore)
Ariane Roemer, Ulrike Köhl, Omid Majdani, Stephan Klöß, Christine Falk, Sabine Haumann, Thomas Lenarz, Andrej Kral, Athanasia Warnecke
BACKGROUND: The success of cochlear implantation may be further improved by minimizing implantation trauma. The physical trauma of implantation and subsequent immunological sequelae can affect residual hearing and the viability of the spiral ganglion. An ideal electrode should therefore decrease post-implantation trauma and provide support to the residual spiral ganglion population. Combining a flexible electrode with cells producing and releasing protective factors could present a potential means to achieve this...
October 7, 2016: Stem Cell Research & Therapy
Abigail C Mancuso, Kelsey Lee, Ran Zhang, Elizabeth A Hoover, Colleen Stockdale, Abbey J Hardy-Fairbanks
OBJECTIVES: Safety of outpatient dilation and evacuations with intravenous (iv) sedation without intubation has been demonstrated, but there is a paucity of data on deep iv sedation on an inpatient second trimester surgical termination population. The purpose of this study is to evaluate complications of deep sedation with propofol without the use of intubation during second trimester surgical terminations in an inpatient teaching institution. STUDY DESIGN: A retrospective chart review of all obstetrical and anesthetic data from inpatient dilation and evacuations between gestational ages 15 0/7 and 24 0/7 during the years 2002 to 2015...
October 3, 2016: Contraception
Tatsuya Norii, Adam Plate
BACKGROUND: Electronic cigarettes have seen a drastic increase in use. A lithium-ion battery is often used as the rechargeable battery of the electronic cigarette device and has recently received much attention in terms of safety. There are several recent case reports in the scientific literature of injuries due to electronic cigarette explosions that involved soft-tissue injuries. CASE REPORT: We report a significant spinal fracture from an electronic-cigarette explosion in a 27-year-old male...
October 3, 2016: Journal of Emergency Medicine
Tanya Keough, David Wilson, Ivan Wong
Over the past 2 decades, hip arthroscopy has developed as a surgical technique, with more orthopaedic surgeons attempting to become proficient in performing this surgical procedure as indications and surgical skills evolve. The hip joint presents unique arthroscopic challenges because of its anatomic location, and it can be challenging to safely and confidently establish portal sites. Ultrasound-guided hip arthroscopy portal placement is not yet common practice for orthopaedic surgeons. The potential advantages of ultrasound-guided hip arthroscopy portal placement are the lack of radiation exposure to the patient and operating room personnel, direct visualization of the hip joint and surrounding soft-tissue structures, and lack of bulky fluoroscopic equipment in the operative field...
August 2016: Arthroscopy Techniques
Rashid Haidarimoghadam, Reza Kazemi, Majid Motamedzadeh, Rostam Golmohamadi, Alireza Soltanian, Mohamad Reza Zoghipaydar
INTRODUCTION: The aim of this study was to evaluate the effects of consecutive night shifts (CNS) and shift length (SL) on cognitive performance and sleepiness. MATERIALS AND METHODS: This study evaluated the sleepiness and performance of 30 control rooms operators (CROs) working in a 7 nights, 7 days, 7 days off (7N7D7O) and 30 CROs working in a 4 nights, 7 days, 3 nights, 7 days off (4N7D3N7O) shift pattern in a petrochemical complex in the last night shift before swinging into the day shift...
October 4, 2016: International Journal of Occupational Safety and Ergonomics: JOSE
Matthew E Gitelis, Adelaide Kaczynski, Torin Shear, Mark Deshur, Mohammad Beig, Meredith Sefa, Jonathan Silverstein, Michael Ujiki
BACKGROUND: In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses...
August 16, 2016: American Journal of Surgery
Robert C Rennert, Kate T Carroll, Mir Amaan Ali, Thomas Hamelin, Leon Chang, Brian P Lemkuil, Clark C Chen
OBJECTIVE Stereotactic laser ablation (SLA) is typically performed in the setting of intraoperative MRI or in a staged manner in which probe insertion is performed in the operating room and thermal ablation takes place in an MRI suite. METHODS The authors describe their experience, in which SLA for glioblastoma (GBM) treatment was performed entirely within a conventional MRI suite using the SmartFrame stereotactic device. RESULTS All 10 patients with GBM (2 with isocitrate dehydrogenase 1 mutation [mIDH1] and 8 with wild-type IDH1 [wtIDH1]) were followed for > 6 months...
October 2016: Neurosurgical Focus
Aaron Heller, John Dollerschell, Joshua Burk, Hailey Haines, Jonathan Kozinn
BACKGROUND: In the past decade, the rate and utilization of veno-venous extracorporeal membrane oxygenation (VV-ECMO) has increased dramatically. A single catheter technique has recently come into favour for providing VV-ECMO. Although it has been shown that intensivists can safely place these catheters, the safety of decannulation by intensivists has not been reported. OBJECTIVE: We describe a technique for safely decannulating the Avalon Elite VV-ECMO catheter at the bedside and assess the safety of this technique, as compared with the standard technique of decannulation in the operating room by a surgeon...
September 30, 2016: Anaesthesiology Intensive Therapy
T Ott, I Schmidtmann, T Limbach, P F Gottschling, H Buggenhagen, S Kurz, G Pestel
BACKGROUND: Simulation-based training (SBT) has developed into an established method of medical training. Studies focusing on the education of medical students have used simulation as an evaluation tool for defined skills. A small number of studies provide evidence that SBT improves medical students' skills in the clinical setting. Moreover, they were strictly limited to a few areas, such as the diagnosis of heart murmurs or the correct application of cricoid pressure. Other studies could not prove adequate transferability from the skills gained in SBT to the patient site...
September 27, 2016: Der Anaesthesist
Joana Chaves Gonçalves Rodrigues de Carvalho, Francisco Javier Tercero Machin, Luis San Roman Manzanera, Jordi Blasco Andaluz, Sílvia Herrero Nogués, Núria Peix Soriano, Victor Obach Baurier, Enrique Jesus Carrero Cardenal
BACKGROUND AND OBJECTIVES: Dural arteriovenous fistulas are anomalous shunts between dural arterial and venous channels whose nidus is located between the dural leaflets. For those circumstances when invasive treatment is mandatory, endovascular techniques have grown to become the mainstay of practice, choice attributable to their reported safety and effectiveness. We describe the unique and rare case of a dural arteriovenous fistula treated by transarterial embolization and complicated by an intraventricular hemorrhage...
September 24, 2016: Revista Brasileira de Anestesiologia
Jonathan D Katz
There is a direct relationship between the quality of the environment of a workplace and the productivity and efficiency of the work accomplished. Components such as temperature, humidity, ventilation, drafts, lighting, and noise each contribute to the quality of the overall environment and the sense of well-being of those who work there.The modern operating room is a unique workplace with specific, and frequently conflicting, environmental requirements for each of the inhabitants. Even minor disturbances in the internal environment of the operating room can have serious ramifications on the comfort, effectiveness, and safety of each of the inhabitants...
September 23, 2016: Anesthesia and Analgesia
A Duclos, J L Peix, V Piriou, P Occelli, A Denis, S Bourdy, M J Carty, A A Gawande, F Debouck, C Vacca, J C Lifante, C Colin
BACKGROUND: The application of safety principles from the aviation industry to the operating room has offered hope in reducing surgical complications. This study aimed to assess the impact on major surgical complications of adding an aviation-based team training programme after checklist implementation. METHODS: A prospective parallel-group cluster trial was undertaken between September 2011 and March 2013. Operating room teams from 31 hospitals were assigned randomly to participate in a team training programme focused on major concepts of crew resource management and checklist utilization...
September 19, 2016: British Journal of Surgery
Douglas A Hardesty, Sean Doerfler, Sukhmeet Sandhu, Robert G Whitmore, Patricia Ford, Scott Rushton, Peter D LeRoux
BACKGROUND: Jehovah's Witnesses (JW) are a Christian faith with > 1 million members in the United States who do not accept autologous blood transfusions. The optimal management of these patients undergoing neurosurgical procedures is not well defined. Here, we examined the feasibility and safety of JW undergoing neurosurgery in a blood management program. STUDY DESIGN AND METHODS: Sixty-eight JW patients including 23 males and 45 females (mean age 53 +/- 12 years) who underwent a variety of cranial (n=19) and spinal (n=49) neurosurgical procedures over a 5-year period were identified retrospectively and their hospital charts, anesthetic records and operative reports reviewed...
September 15, 2016: World Neurosurgery
D Arnal Velasco, E Romero García, G Martínez Palli, L Muñoz Corsini, M Rey Martínez, S Postigo Morales
INTRODUCTION: There is an increasing and more complex demand for sedation for procedures out of the operating room. For different reasons, nowadays the administration of sedation varies considerably. We believe that a patient safety approach rather an approach out of corporate or economic interests is desirable. METHOD: We created a working group of experts within the Spanish Anaesthesia and Reanimation Incident Reporting System (SENSAR) to prepare a series of recommendations through a non-systematic review...
September 15, 2016: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
Shalini Subramanian, Blessy Mathew, Anil Thakur
No abstract text is available yet for this article.
July 2016: Journal of Anaesthesiology, Clinical Pharmacology
Tehsina F Devji, Arin L Madenci, Elizabeth Carpino, Izabela C Leahy, Mihail Samnaliev, Jennifer L Dearden, Brent R Weil, Christopher B Weldon, Joseph Cravero
PURPOSE: The current emphasis on fiscally responsible health spending in the era of the Affordable Care Act and other health care reform necessitates cost-conscious delivery of care. "Value" in health care is defined as the quality of care divided by the cost. As such, health systems optimize value by providing the most cost-effective care possible without sacrificing safety or outcomes. Elective, minimal risk surgical procedures in children may be value-enhanced by moving from an operating room (OR) to a more cost-efficient setting...
November 2016: Journal of Pediatric Surgery
Samuel R Heaton, Zoe Little, Kash Akhtar, Manoj Ramachandran, Joshua Lee
AIM: To enhance non-technical skills and to analyse participant's experience of a course tailored for orthopaedic surgeons. METHODS: A Delphi technique was used to develop a course in human factors specific to orthopaedic residents. Twenty-six residents (six per course) participated in total with seven course facilitators all trained in Crisis Resource Management providing structured feedback. Six scenarios recreated challenging real-life situations using high-fidelity mannequins and simulated patients...
August 18, 2016: World Journal of Orthopedics
Scott L Spear, Courtney N Coles, Braden K Leung, Matthew Gitlin, Mousam Parekh, David Macarios
BACKGROUND: For years, the safety and effectiveness of autologous fat grafting (AFG) for breast reconstruction have been in question, with particular concern over fat necrosis, calcifications, cyst formation, and interfering with the detection of breast cancer. However, increasing evidence suggests that the complication rates and clinical results are generally acceptable to both clinicians and patients. The emerging challenge is the numerous AFG techniques and systems, where there are limited knowledge and data...
August 2016: Plastic and Reconstructive Surgery. Global Open
Junya Zhu, Liping Li, Zehui Zhou, Qingqing Lou, Albert W Wu
OBJECTIVES: Patient safety climate is associated with patient outcomes in hospitals around the world. A better understanding of how safety climate varies within and across hospitals will help identify improvement opportunities. We examined variations in safety climate by work area and job category in Chinese hospitals. METHODS: We administered the Chinese Hospital Survey on Patient Safety Climate in 2011 to workers in 6 hospitals in China, with completed surveys from 1464 (86% response)...
September 9, 2016: Journal of Patient Safety
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