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operating room safety

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https://www.readbyqxmd.com/read/28442950/effect-of-intranasal-dexmedetomidine-on-emergence-agitation-after-sevoflurane-anesthesia-in-children-undergoing-tonsillectomy-and-or-adenoidectomy
#1
Ahmed Mostafa Abd El-Hamid, Hany Mahmoud Yassin
BACKGROUND: Emergence agitation (EA) after sevoflurane anesthesia is common in children during recovery from general anesthesia and may result in postoperative complications. This study investigated safety and effectiveness of intranasal dexmedetomidine in reducing the incidence and severity of EA. METHODS: This prospective, randomized double-blinded controlled trial included 86 patients scheduled for the tonsillectomy and/or adenoidectomy under general anesthesia with sevoflurane...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28436232/safety-performance-and-satisfaction-outcomes-in-the-operating-room-a-literature-review
#2
Anjali Joseph, Sara Bayramzadeh, Zahra Zamani, Bill Rostenberg
OBJECTIVE: This review of empirical literature focuses on the design of operating rooms (ORs) by investigating the physical environmental features of ORs associated with patient and staff outcomes. BACKGROUND: Many ORs built more than 30 years ago remain operational today. However, most are inadequately designed to handle the equipment, processes, and people that a contemporary OR needs to accommodate. However, the evidence base for designing ORs has been sorely lacking, and little guidance exists on how OR design can improve safety and performance outcomes...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/28435283/unlocking-the-black-box-of-practice-improvement-strategies-to-implement-surgical-safety-checklists-a-process-evaluation
#3
Brigid M Gillespie, Kyra Hamilton, Dianne Ball, Joanne Lavin, Therese Gardiner, Teresa K Withers, Andrea P Marshall
BACKGROUND: Compliance with surgical safety checklists (SSCs) has been associated with improvements in clinical processes such as antibiotic use, correct site marking, and overall safety processes. Yet, proper execution has been difficult to achieve. OBJECTIVES: The objective of this study was to undertake a process evaluation of four knowledge translation (KT) strategies used to implement the Pass the Baton (PTB) intervention which was designed to improve utilization of the SSC...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28432189/safety-and-efficiency-of-a-new-generic-package-labelling-a-before-and-after-study-in-a-simulated-setting
#4
Beate Hennie Garcia, Renate Elenjord, Camilla Bjornstad, Kjell Hermann Halvorsen, Sigurd Hortemo, Steinar Madsen
BACKGROUND: Medication errors are frequent and may cause harm to patients and increase healthcare expenses. AIM: To explore whether a new labelling influences time and errors when preparing medications in accordance with medication charts in an experimental setting. METHOD: We carried out an uncontrolled before and after study with 3 months inbetween experiments. Phase I used original labelling and phase II used new generic labelling. We set up an experimental medicine room, simulating a real-life setting...
April 21, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28431426/anesthesiologists-and-disaster-medicine-a-needs-assessment-for-education-and-training-and-reported-willingness-to-respond
#5
Heather K Hayanga, Daniel J Barnett, Natasha R Shallow, Michael Roberts, Carol B Thompson, Itay Bentov, Gozde Demiralp, Bradford D Winters, Deborah A Schwengel
BACKGROUND: Anesthesiologists provide comprehensive health care across the emergency department, operating room, and intensive care unit. To date, anesthesiologists' perspectives regarding disaster medicine and public health preparedness have not been described. METHODS: Anesthesiologists' thoughts and attitudes were assessed via a Web-based survey at 3 major academic institutions. Frequencies, percentages, and odds ratios (ORs) were used to assess self-reported perceptions of knowledge and skills, as well as attitudes and beliefs regarding education and training, employee development, professional obligation, safety, psychological readiness, efficacy, personal preparedness, and willingness to respond (WTR)...
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28430878/cosmetic-liposuction-preoperative-risk-factors-major-complication-rates-and-safety-of-combined-procedures
#6
Christodoulos Kaoutzanis, Varun Gupta, Julian Winocour, John Layliev, Roberto Ramirez, James C Grotting, Kent Higdon
Background: Liposuction is among the most commonly performed aesthetic procedures, and is being performed increasingly as an adjunct to other procedures. Objectives: To report the incidence and risk factors of significant complications after liposuction, and to determine whether adding liposuction to other cosmetic surgical procedures impacts the complication risk. Methods: A prospective cohort of patients who underwent liposuction between 2008 and 2013 was identified from the CosmetAssure database...
April 20, 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28429040/retraction-force-necessary-to-expose-the-mandibular-neck-in-risdon-and-high-cervical-anteroparotid-transmasseteric-approaches-an-anatomic-comparative-study
#7
Jérôme Adnot, Aliosha Feuss, Fabrice Duparc, Olivier Trost
PURPOSE: The purpose of this anatomic study was to compare the retraction force necessary to expose the mandibular neck in the Risdon and the high cervical anteroparotid transmasseteric (HAT) approaches. METHODS: An anatomic study was performed on 18 formalin-embalmed cadavers. We performed a Risdon approach on the left side, and an HAT approach on the right side in all the cases. The subjects were placed in a normative frame and the force necessary to maintain a satisfactory exposure of the condyle was measured with a system of cables, pulleys, and mechanical dynamometer...
April 20, 2017: Surgical and Radiologic Anatomy: SRA
https://www.readbyqxmd.com/read/28422778/ultrasound-as-a-screening-tool-for-central-venous-catheter-positioning-and-exclusion-of-pneumothorax
#8
Rabia Amir, Ziyad O Knio, Feroze Mahmood, Achikam Oren-Grinberg, Akiva Leibowitz, Ruma Bose, Shahzad Shaefi, John D Mitchell, Muneeb Ahmed, Amit Bardia, Daniel Talmor, Robina Matyal
OBJECTIVES: Although real-time ultrasound guidance during central venous catheter insertion has become a standard of care, postinsertion chest radiograph remains the gold standard to confirm central venous catheter tip position and rule out associated lung complications like pneumothorax. We hypothesize that a combination of transthoracic echocardiography and lung ultrasound is noninferior to chest radiograph when used to accurately assess central venous catheter positioning and screen for pneumothorax...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28417890/fire-safety-for-the-oral-and-maxillofacial-surgeon-and-surgical-staff
#9
REVIEW
LisaMarie Di Pasquale, Elie M Ferneini
Fire in the operating room is a life-threatening emergency that demands quick, efficient intervention. Because the circumstances surrounding fires are generally well-understood, virtually every operating room fire is preventable. Before every operating room case, thorough preprocedure "time outs" should address each team members' awareness of specific fire risks and agreement regarding fire concerns and emergency actions. Fire prevention centers on 3 constituent parts of the fire triad necessary for fire formation...
May 2017: Oral and Maxillofacial Surgery Clinics of North America
https://www.readbyqxmd.com/read/28416968/safety-and-efficacy-of-resistive-polymer-versus-forced-air-warming-in-total-joint-surgery
#10
Melanie F Sandoval, Paul D Mongan, Michael R Dayton, Craig A Hogan
BACKGROUND: Forced-air warming is used as a mechanism to prevent hypothermia and adverse outcomes associated with hypothermia among patients undergoing surgery. Patient safety in healthcare includes the use of devices and technology that minimize potential adverse events to patients. The present study sought to compare the capabilities of patient warming between two different devices that use different mechanisms of warming: forced-air warming and non-air warming. METHODS: One hundred twenty patients undergoing total hip or total knee arthroplasty received patient warming via a forced warming device or non-air warming fabric conductive material...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28415147/neurosurgical-laser-ablation-and-mr-thermometry-risks-of-multisite-workflow-pattern
#11
Paul S Larson, Sudhakar Vadivelu, Hooman Azmi-Ghadimi, Amy Nichols, Loretta Fauerbach, Helen Boehm Johnson
Neurosurgical laser ablation is a relatively new but rapidly growing application of stereotactic neurosurgery that allows neurosurgeons to treat many previously untreatable conditions with the added benefit of shorter hospitalizations and recovery times. The vast majority of these procedures, however, are performed using a multisite workflow pattern involving transport of the patient between the operating room (OR), the computed tomography (CT) suite, and the magnetic resonance imaging (MRI) suite, often necessitating patient transfer through public pathways and requiring multiple trips if laser fiber placement is not accurate...
April 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28410289/initial-experience-with-real-time-hybrid-single-photon-emission-computed-tomography-computed-tomography-guided-percutaneous-transthoracic-needle-biopsy
#12
Qian Hua, Xiangyun Zhu, Lei Zhang, Yanjun Zhao, Ping Tang, Jianming Ni
The aim of this study was to explore a technique that uses real-time fusion image of single-photon emission computed tomography/computed tomography (SPECT/CT) to guide percutaneous transthoracic needle biopsy (PTNB) and test its feasibility and safety in patients. Twelve patients with intrathoracic lesions suspicious for malignancy underwent real-time 99m-technetium sestamibi SPECT/CT-guided PTNB. Chest SPECT/CT fusion images were used for biopsy planning and intraprocedure fusion of SPECT with guiding CT was used to adjust the puncture angle and direction...
April 13, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/28409365/troubleshooting-common-endoscopic-malfunctions-a-study-integrating-a-preoperative-checklist-and-troubleshooting-guide-into-surgical-resident-training
#13
Jenny Lam, Kevin Grimes, Adnan Mohsin, Shawn Tsuda
INTRODUCTION: This study assessed the utility of a checklist in troubleshooting endoscopic equipment. Prior studies have demonstrated that performance in simulated tasks translates into completion of similar tasks in the operating room. Checklists have been shown to decrease error and improve patient safety. There is currently limited experience with the use of simulation and checklists to improve troubleshooting of endoscopic equipment. We propose the use of a checklist during a simulated colonoscopy to improve performance during endoscopic troubleshooting...
April 13, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28406846/the-value-of-simulation-based-training-in-the-path-to-laparoscopic-urological-proficiency
#14
Ben S E P Van Cleynenbreugel, Ali S Gözen, Theodoros Tokas
PURPOSE OF REVIEW: Numerous factors have reduced the training opportunities of surgical residents in the operating room. There is also the question of patient's safety. This gives a need for increased training opportunities outside the operating room. We look if there is an added value in simulation-based training (SBT) in the acquisition of laparoscopic skills. RECENT FINDINGS: Incorporating SBT into the medical students curriculum reduces surgical complication rates in the operating room...
April 12, 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/28400685/republication-all-india-difficult-airway-association-2016-guidelines-for-tracheal-intubation-in-the-intensive-care-unit
#15
Sheila Nainan Myatra, Syed Moied Ahmed, Pankaj Kundra, Rakesh Garg, Venkateswaran Ramkumar, Apeksh Patwa, Amit Shah, Ubaradka S Raveendra, Sumalatha Radhakrishna Shetty, Jeson Rajan Doctor, Dilip K Pawar, Singaravelu Ramesh, Sabyasachi Das, Jigeeshu Vasishtha Divatia
Tracheal intubation (TI) is a routine procedure in the Intensive Care Unit (ICU) and is often lifesaving. In contrast to the controlled conditions in the operating room, critically ill patients with respiratory failure and shock are physiologically unstable. These factors, along with under evaluation of the airway and suboptimal response to preoxygenation, are responsible for a high incidence of life-threatening complications such as severe hypoxemia and cardiovascular collapse during TI in the ICU. The All India Difficult Airway Association (AIDAA) proposes a stepwise plan for safe management of the airway in critically ill patients...
March 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28399047/assessing-quality-and-safety-in-pediatric-supracondylar-humerus-fracture-care
#16
Christopher A Iobst, Matthew Stillwagon, Deidre Ryan, Eric Shirley, Steven L Frick
BACKGROUND: Recently, there has been an emphasis on improving quality, safety, and value in the delivery of health care in the United States. The American Board of Orthopedic Surgery (ABOS) has developed a performance improvement questionnaire (PIQ) for orthopaedic surgeons managing pediatric supracondylar humerus fracture (PSCHF). Using the supracondylar PIQ as a guide, this study evaluates the process of measuring the outcomes and variations in care to PSCHF patients among pediatric orthopaedic surgeons...
April 10, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28397541/a-novel-patient-safety-event-reporting-tool-in-otolaryngology
#17
Peter M Vila, Sean Lewis, Gene Cunningham, Jean Brereton, Alexandra G Espinel, David W Roberson, Rahul K Shah
Objective To report the results of a preliminary analysis of a quality improvement initiative aimed to identify potential latent systems defects. Methods A pilot study of an anonymous, voluntary, event reporting system made available to all members of the American Academy of Otolaryngology-Head and Neck Surgery was performed. The National Coordinating Council for Medication Error Reporting and Prevention (NCC MERP) index was used to classify error types. Descriptive statistics were used to summarize submissions to the database...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28391002/paravalvular-regurgitation-after-transcatheter-aortic-valve-replacement-comparing-transthoracic-versus-transesophageal-echocardiographic-guidance
#18
Salim S Hayek, Frank E Corrigan, Jose F Condado, Shuang Lin, Sharon Howell, James P MacNamara, Shuai Zheng, Patricia Keegan, Vinod Thourani, Vasilis C Babaliaros, Stamatios Lerakis
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is increasingly being performed in cardiac catheterization laboratories using transthoracic echocardiography (TTE) to guide valve deployment. The risk of paravalvular regurgitation (PVR) remains a concern. METHODS: We retrospectively reviewed 454 consecutive patients (mean age, 82 ± 8; 58% male) who underwent transfemoral TAVR at Emory Healthcare from 2007 to 2014. Two hundred thirty-four patients underwent TAVR in the cardiac catheterization laboratory with TTE guidance (TTE-TAVR; mean Society of Thoracic Surgeons score, 10%), while 220 patients underwent the procedure in the hybrid operating room with transesophageal echocardiography (TEE) guidance (TEE-TAVR; mean Society of Thoracic Surgeons score, 11%)...
April 6, 2017: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28390771/contemporary-outcomes-of-surgical-revascularization-of-the-lower-extremity-in-patients-on-dialysis
#19
Ajit Rao, Melissa Baldwin, James Cornwall, Michael Marin, Peter Faries, Ageliki Vouyouka
OBJECTIVE: Peripheral arterial disease is a common comorbidity found in up to 38% of patients with end-stage renal disease (ESRD). With an increase in the survival rate of patients with ESRD by >25%, there is a lack of contemporary data on the safety of open surgical revascularization of the lower extremity (OSRLE) in this population of patients. We sought to identify the perioperative morbidity and mortality and independent risk factors of mortality in dialysis patients undergoing OSRLE...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28376609/simulation-training-in-upper-tract-endourology-myth-or-reality-critical-analysis-of-the-literature
#20
Catherine E Lovegrove, Takashige Abe, Abdullatif Aydin, Domenico Veneziano, Kemal Sarica, M Shamim Khan, Prokar Dasgupta, Kamran Ahmed
Surgeons training in the twenty-first century are subject to a myriad of pressures, as has always been the case within surgical training. These include reduced hours available for training and increased threat of litigation against their operating practice. The Halstedian approach of "see one, do one, teach one" has been replaced within surgical training and simulation has become established to enable urology trainees to develop technical and non-technical skills away from the operating room. With the primary focus as patient safety and increasing operating skill, "simulation training" encompasses several modalities...
March 30, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
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