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https://www.readbyqxmd.com/read/29030677/safe-surgery-for-all-early-lessons-from-implementing-a-national-government-driven-surgical-plan-in-ethiopia
#1
Daniel Burssa, Atlibachew Teshome, Katherine Iverson, Olivia Ahearn, Tigistu Ashengo, David Barash, Erin Barringer, Isabelle Citron, Kaya Garringer, Victoria McKitrick, John Meara, Abraham Mengistu, Swagoto Mukhopadhyay, Cheri Reynolds, Mark Shrime, Asha Varghese, Samson Esseye, Abebe Bekele
Recognizing the unmet need for surgical care in Ethiopia, the Federal Ministry of Health (FMOH) has pioneered innovative methodologies for surgical system development with Saving Lives through Safe Surgery (SaLTS). SaLTS is a national flagship initiative designed to improve access to safe, essential and emergency surgical and anaesthesia care across all levels of the healthcare system. Sustained commitment from the FMOH and their recruitment of implementing partners has led to notable accomplishments across the breadth of the surgical system, including but not limited to: (1) Leadership, management and governance-a nationally scaled surgical leadership and mentorship programme, (2) Infrastructure-operating room construction and oxygen delivery plan, (3) Supplies and logistics-a national essential surgical procedure and equipment list, (4) Human resource development-a Surgical Workforce Expansion Plan and Anaesthesia National Roadmap, (5) Advocacy and partnership-strong FMOH partnership with international organizations, including GE Foundation's SafeSurgery2020 initiative, (6) Innovation-facility-driven identification of problems and solutions, (7) Quality of surgical and anaesthesia care service delivery-a national peri-operative guideline and WHO Surgical Safety Checklist implementation, and (8) Monitoring and evaluation-a comprehensive plan for short-term and long-term assessment of surgical quality and capacity...
October 13, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29024977/safer-paediatric-surgical-teams-a-5-year-evaluation-of-crew-resource-management-implementation-and-outcomes
#2
Carl Savage, F Andrew Gaffney, Laith Hussain-Alkhateeb, Pia Olsson Ackheim, Gunilla Henricson, Irini Antoniadou, Mats Hedsköld, Karin Pukk Härenstam
Objective: Evaluate longitudinal changes in technical and non-technical skills (teamwork, situation monitoring, communication and leadership), safety culture, and clinical outcomes before and after implementation of a crew resource management (CRM) safety program. Design: A multi-level prospective single case study in accordance with the SQUIRE-guidelines for reporting quality improvement efforts. Setting: Large university paediatric surgical service...
September 7, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29016781/effectiveness-safety-and-long-term-outcomes-of-non-powered-mechanical-sheaths-for-transvenous-lead-extraction
#3
Andrzej Kutarski, Marek Czajkowski, Radoslaw Pietura, Bogdan Obszanski, Anna Polewczyk, Wojciech Jachec, Maciej Polewczyk, Krzysztof Mlynarczyk, Marcin Grabowski, Grzegorz Opolski
Aims: To analyse the effectiveness, safety and long-term outcomes of conventional non-powered mechanical systems for transvenous lead extraction (TLE) performed by experienced first operators. Outcomes were assessed according to lead location and type of operating room in which the procedure was performed. Methods and results: Data from 2049 patients (mean age: 65 years), with infectious (40%) or non-infectious (60%) indications, were analysed over a mean of 3...
August 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29016380/comparison-of-del-nido-cardioplegia-with-blood-cardioplegia-in-adult-combined-surgery
#4
Raphael Hamad, Anthony Nguyen, Éric Laliberté, Denis Bouchard, Yoan Lamarche, Ismail El-Hamamsy, Philippe Demers
OBJECTIVE: del Nido solution (DNS) is a single-dose cardioplegia designed for pediatric use proposed to offer superior myocardial protection in adults. However, few data support this claim. We hypothesized that DNS and modified blood cardioplegia solution (BS) provide equivalent safety in combined adult valve surgery. METHODS: Between November 2014 and December 2015, 25 patients underwent primary aortic valve replacement and concomitant coronary artery bypass grafting (CABG) with DNS...
October 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28985800/the-application-of-a-6s-lean-initiative-to-improve-workflow-for-emergency-eye-examination-rooms
#5
Samir Nazarali, Jaspreet Rayat, Hilary Salmonson, Theodora Moss, Pamela Mathura, Karim F Damji
BACKGROUND: Ophthalmology residents on call at the Royal Alexandra Hospital identified workplace disorganization and lack of standardization in emergency eye examination rooms as an impediment to efficient patient treatment. OBJECTIVE: The aim of the study was to use the "6S Lean" model to improve workflow in eye examination rooms at the Royal Alexandra Hospital. METHODS: With the assistance of quality improvement consultants, the "6S Lean" model was applied to the current operation of the emergency eye clinic examination rooms...
October 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28984638/the-future-of-nonoperating-room-anesthesia-in-the-21st-century-emphasis-on-quality-and-safety
#6
Steven D Boggs, Sheila R Barnett, Richard D Urman
PURPOSE OF REVIEW: Nonoperating room anesthesia (NORA) has grown from an insignificant percentage of total anesthesia cases into a major percentage of anesthesia workload over the past 30 years. This trend evidences no signs of abating. RECENT FINDINGS: With the rapid development of novel interventional techniques in cardiology, radiology, gastroenterology and pulmonary medicine and other areas, the core responsibilities of the anesthesia provider will no longer be confined to delivering care in traditional operating rooms...
October 3, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28973637/complications-of-head-immobilization-devices-in-children-contact-mechanics-and-analysis-of-a-single-institutional-experience
#7
Mohamed A Zaazoue, Mostafa Bedewy, Liliana C Goumnerova
BACKGROUND: Head immobilization devices (HIDs) are a staple of neurosurgical procedures, including in the intraoperative magnetic resonance imaging (iMRI) operating rooms (ORs) where material modifications were necessary for compatibility with the magnets utilized. OBJECTIVE: To present the experience in this OR environment and discuss the multifactorial nature of the observed adverse events. METHODS: A retrospective chart review was performed, utilizing the Department of Neurosurgery and iMRI OR databases to identify patients who suffered complications related to HIDs between November 2007 and March 2016...
June 20, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971414/musculoskeletal-problems-among-greek-perioperative-nurses-in-regional-hospitals-in-southern-peloponnese-musculoskeletal-problems-in-perioperative-nurses
#8
Helen Bakola, Sofia Zyga, Apostolos Stergioulas, George Kipreos, George Panoutsopoulos
The surgery unit is a particularly labor-intensive environment in the hospital. Studies reflect the correlation of labor risk factors for musculoskeletal injuries among nurses but few have investigated the relationship to perioperative nurses. The purpose of this study is the identification and definition of ergonomic risk factors in the operating room and their connection with musculoskeletal disorders in perioperative nurses in regional hospitals in Greece. Forty four Greek perioperative nurses working in regional hospitals in southern Peloponnese participated...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28967607/reduction-and-standardization-of-surgical-instruments-in-pediatric-inguinal-hernia-repair
#9
Martin A Koyle, Naif AlQarni, Rakan Odeh, Hissan Butt, Mohammed M Alkahtani, Louis Konstant, Lisa Pendergast, Leah C C Koyle, G Ross Baker
AIM: To standardize and reduce surgical instrumentation by >25% within a 9-month period for pediatric inguinal hernia repair (PIHR), using "improvement science" methodology. METHODS: We prospectively evaluated instruments used for PIHR in 56 consecutive cases by individual surgeons across two separate subspecialties, pediatric surgery (S) and pediatric urology (U), to measure actual number of instruments used compared with existing practice based on preference cards...
September 8, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28963302/building-a-collaborative-culture-in-cardiothoracic-operating-rooms-pre-and-postintervention-study-protocol-for-evaluation-of-the-implementation-of-teamstepps-training-and-the-impact-on-perceived-psychological-safety
#10
Aaron Benjamin Dahl, Arbi Ben Abdallah, Hersh Maniar, Michael Simon Avidan, Mara L Bollini, George Alexander Patterson, Aaron Steinberg, Katie Scaggs, Brenda V Dribin, Clare H Ridley
INTRODUCTION: The importance of effective communication, a key component of teamwork, is well recognised in the healthcare setting. Establishing a culture that encourages and empowers team members to speak openly in the cardiothoracic (CT) operating room (OR) is necessary to improve patient safety in this high-risk environment. METHODS AND ANALYSIS: This study will take place at Barnes-Jewish Hospital, an academic hospital in affiliation with Washington University School of Medicine located in the USA...
September 27, 2017: BMJ Open
https://www.readbyqxmd.com/read/28958053/single-stage-localization-and-removal-of-small-lung-nodules-through-image-guided-video-assisted-thoracoscopic-surgery
#11
Ming-Ju Hsieh, Hsin-Yueh Fang, Chien-Cheng Lin, Chih-Tsung Wen, Huan-Wu Chen, Yin-Kai Chao
OBJECTIVES: This case series illustrates the feasibility of single-stage image-guided video-assisted thoracoscopic surgery for simultaneous localization and removal of small solitary pulmonary nodules (SPNs). The procedure was performed in a hybrid operating room using C-arm cone-beam computed tomography equipped with a laser-guided navigation system. METHODS: Between October 2016 and January 2017, 12 consecutive patients presenting with SPNs underwent image-guided video-assisted thoracoscopic surgery...
August 23, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/28954456/evolving-safety-practices-in-the-setting-of-modern-complex-operating-room-role-of-nurses
#12
L Niu, H Y Li, W Tang, S Gong, L J Zhang
Operating room (OR) nursing previously referred to patient care provided during the intra-operative phase and the service provided within the OR itself. With the expansion of responsibilities of nurses, OR nursing now includes pre-operative and post-operative periods, therefore peri-operative nursing is accepted as a nursing process in OR in the contemporary medical literature. Peri-operative nurses provide care to the surgical patients during the entire process of surgery. They have several roles including those of manager or a director, clinical practitioner (scrub nurse, circulating nurse and nurse anesthetist), educator as well as researcher...
July 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28950992/what-factors-influence-attending-surgeon-decisions-about-resident-autonomy-in-the-operating-room
#13
Reed G Williams, Brian C George, Shari L Meyerson, Jordan D Bohnen, Gary L Dunnington, Mary C Schuller, Laura Torbeck, John T Mullen, Edward Auyang, Jeffrey G Chipman, Jennifer Choi, Michael Choti, Eric Endean, Eugene F Foley, Samuel Mandell, Andreas Meier, Douglas S Smink, Kyla P Terhune, Paul Wise, Debra DaRosa, Nathaniel Soper, Joseph B Zwischenberger, Keith D Lillemoe, Jonathan P Fryer
BACKGROUND: Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. METHODS: We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure...
September 23, 2017: Surgery
https://www.readbyqxmd.com/read/28940392/a-novel-approach-to-improving-efficiency-and-cost-saving-in-preoperative-blood-preparation
#14
Sephalie Y Patel, David A Edwards, David C Boulware, Andrew Serdiuk, Susan J Cook, Kaaron Benson, Mark J Rice
BACKGROUND: Preoperative ordering of blood products has been an area of optimization due to considerable variability among physicians; overpreparation can lead to extra costs and underpreparation of blood can potentially compromise patient safety. STUDY DESIGN AND METHODS: We examined the potential cost savings of extending the storage interval of a presurgical type-and-screen sample from 7 to 14 days, thereby reducing the need for a new specimen on the day of surgery...
September 23, 2017: Transfusion
https://www.readbyqxmd.com/read/28937469/outcome-of-a-resident-spine-surgical-skills-training-program
#15
Brian P Calio, Christopher K Kepler, John D Koerner, Jeffrey A Rihn, Paul Millhouse, Kris E Radcliff
STUDY DESIGN: Cadaver training lab. OBJECTIVE: To determine if a technical cadaver skills training lab for spinal surgery increases resident confidence, satisfaction in training, and perception of operating room safety. SUMMARY OF BACKGROUND DATA: Resident training is an important topic in the setting of work hour reform. The use of supplemental materials such as videos, sawbones, and simulators may become important to adequately train orthopedic residents...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28928554/study-to-compare-the-effect-of-oral-rectal-and-intravenous-infusion-of-paracetamol-for-postoperative-analgesia-in-women-undergoing-cesarean-section-under-spinal-anesthesia
#16
Lakshmi Mahajan, Vaishali Mittal, Ruchi Gupta, Himani Chhabra, Jyoti Vidhan, Ashreen Kaur
BACKGROUND: Effective pain relief therapy after caesarean section is essential for the parturient's comfort and early ambulation. Paracetamol has an excellent safety profile when compared to opioids. AIM: To assess and evaluate the effect of oral, rectal, and intravenous infusion of paracetamol for post-operative analgesia in women undergoing caesarean section under spinal anaesthesia. SETTINGS AND DESIGN: We conducted a prospective, randomized controlled study (18-35 years of age) of the ASA- I and II parturient scheduled for lower segment caesarean section were included...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28926391/medical-team-training-improves-team-performance-aoa-critical-issues
#17
James E Carpenter, James P Bagian, Rebecca G Snider, Kyle J Jeray
Effective teamwork and communication can decrease medical errors in environments where the culture of safety is enhanced. Health care can benefit from programs that are based on teamwork, as in other high-stress industries (e.g., aviation), with crew resource management programs, simulator use, and utilization of checklists. Medical team training (MTT) with a strong leadership commitment was used at our institution to focus specifically on creating open, yet structured, communication in operating rooms. Training included the 3 phases of the World Health Organization protocol to organize communication and briefings: preoperative verification, preincision briefing, and debriefing at or near the end of the surgical case...
September 20, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28926159/randomized-controlled-feasibility-trial-of-intranasal-ketamine-compared-to-intranasal-fentanyl-for-analgesia-in-children-with-suspected-extremity-fractures
#18
Stacy L Reynolds, Kathleen K Bryant, Jonathan R Studnek, Melanie Hogg, Connell Dunn, Megan A Templin, Charity G Moore, James R Young, Katherine Rivera Walker, Michael S Runyon
OBJECTIVE: We compared the tolerability and efficacy of intranasal sub-dissociative ketamine to intranasal fentanyl for analgesia of children with acute traumatic pain and investigated the feasibility of a larger non-inferiority trial that could investigate the potential opioid sparing effects of intranasal ketamine. METHODS: This randomized controlled trial compared intranasal ketamine 1 mg/kg to intranasal fentanyl 1.5 μg/kg in children 4-17 years old with acute pain from suspected, isolated extremity fractures presenting to an urban level II pediatric trauma center from December 2015 to November 2016...
September 19, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28924559/fire-in-the-operating-room-during-hypospadias-repair
#19
Alessandro Boscarelli, Simone Frediani, Silvia Ceccanti, Alice Cervellone, Maria Vittoria Pesce, Denis A Cozzi
Fire in the operating room (OR) is a very distressful and shocking occurrence with potential dramatic consequences. Despite safety rules and rigorous recommendations, such unintentional events do occur every so often. Notably, the vast majority of cases have been reported in the adult population, with very few pediatric cases described to date. Herein, we report on a 16-month-old boy undergoing reconstructive surgery for penoscrotal hypospadias, who experienced an OR fire most likely related to the use of alcohol-based solution ignited by monopolar electrocautery...
November 2017: Urology Case Reports
https://www.readbyqxmd.com/read/28924429/administration-safety-of-blood-products-lessons-learned-from-a-national-registry-for-transfusion-and-hemotherapy-practice
#20
Thomas Frietsch, Daffyd Thomas, Michael Schöler, Birgit Fleiter, Martin Schipplick, Michael Spannagl, Ralf Knels, Xuan Nguyen
BACKGROUND: Compared to blood component safety, the administration of blood may not be as safe as intended. The German Interdisciplinary Task Force for Clinical Hemotherapy (IAKH) specialized registry for administration errors of blood products was chosen for a detailed analysis of reports. METHODS: Voluntarily submitted critical incident reports (n = 138) from 2009 to 2013 were analyzed. RESULTS: Incidents occurred in the operation room (34...
August 2017: Transfusion Medicine and Hemotherapy
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