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postoperative recovery audit

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https://www.readbyqxmd.com/read/27820740/enhanced-recovery-after-bariatric-surgery
#1
Adrian Alvarez, Basavana G Goudra, Preet Mohinder Singh
PURPOSE OF REVIEW: Enhanced recovery after surgery (ERAS) methodology has demonstrated consistent benefits in patients undergoing colorectal, urological and thoracic surgeries. Principles of these protocols and their advantages are expected to extend into other surgical specialties such as bariatric surgery. In this review, we summarize the components of ERAS protocols for bariatric surgery and present the evidence on the emerging role of ERAS principles in obese patients. RECENT FINDINGS: Many recent trials have evaluated ERAS protocols for bariatric surgery...
November 4, 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27764047/the-future-of-postoperative-quality-of-recovery-assessment-multidimensional-dichotomous-and-directed-to-individualize-care-to-patients-after-surgery
#2
Andrea Bowyer, Colin F Royse
PURPOSE OF REVIEW: Recovery after surgery is a complex interplay of the patient, the surgery, and the perioperative anaesthesia management. Assessment of recovery should address the needs of multiple stakeholders, including the institutions and healthcare providers, but primarily should be focused on the patients and their perception of quality of recovery and return to normalcy. This review will summarize the development of assessment of recovery to a multidimensional dichotomous construct that requires a real-time assessment tool validated for repeat measures and containing cognitive assessment...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/27730406/enhanced-recovery-implementation-in-colorectal-surgery-temporary-or-persistent-improvement
#3
David Martin, Didier Roulin, Valérie Addor, Catherine Blanc, Nicolas Demartines, Martin Hübner
PURPOSE: Enhanced recovery after surgery (ERAS) implementation has proven to reduce complication rate and length of hospital stay. Little is known about the sustainability of these results over time. The study aim was to assess the application of ERAS pathway over the first 4 years after initial implementation. METHODS: This retrospective study analyzed data collected prospectively from 482 consecutive elective colorectal patients operated in 2011 during the ERAS implementation process (n = 66), and after initial implementation in 2012 (n = 136), 2013 (n = 152), and 2014 (n = 128)...
October 11, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27709725/exploring-canadian-surgeons-decisions-about-postoperative-weight-bearing-for-their-hip-fracture-patients
#4
Leslie Carlin, Kathryn Sibley, Richard Jenkinson, Pia Kontos, Rhona McGlasson, Hans J Kreder, Susan Jaglal
For older adults with osteoporosis, a fall resulting in hip fracture is a life-changing event from which only one-third fully recover. Current best evidence argues strongly for elderly patients to bear weight on their repaired hip fracture immediately after their surgery to maximize their chances of full or nearly full recovery. Patient stakeholders in Canada have argued that some surgeons fail to issue "weight-bearing-as-tolerated" (WBAT) orders in all eligible cases, protecting their bony repair but contributing to increased mortality and long-term disability rates...
October 6, 2016: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/27638322/large-scale-implementation-of-enhanced-recovery-programs-after-surgery-a-francophone-experience
#5
J Veziant, O Raspado, A Entremont, J Joris, B Pereira, K Slim
INTRODUCTION: Enhanced recovery after surgery program (ERP) has now surpassed the stage of clinical research in certain specialties and currently poses the problematic of large-scale implementation. The goal of this study was to report the experience during the first year of implementation in three French-speaking countries. MATERIAL AND METHODS: This is a prospective study in which 67 healthcare centers, all registered in the Grace-Audit databank, participated...
September 13, 2016: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/27246933/perioperative-management-of-patients-treated-with-angiotensin-converting-enzyme-inhibitors-and-angiotensin-ii-receptor-blockers-a-quality-improvement-audit
#6
A Vijay, A Grover, T G Coulson, P S Myles
Previous studies have shown that patients continuing angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers on the day of surgery are more likely to have significant intraoperative hypotension, higher rates of postoperative acute kidney injury, and lower incidences of postoperative atrial fibrillation. However, many of these studies were prone to bias and confounding, and questions remain over the validity of these outcomes. This observational, before-and-after quality improvement audit aimed to assess the effect of withholding these medications on the morning of surgery...
May 2016: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/27146925/analgesic-management-after-thoracotomy-for-decortication-in-children-a-retrospective-audit-of-83-children-managed-with-a-paravertebral-infusion-based-regime
#7
Tim Murphy, Alan McCheyne, Jacob Karlsson
BACKGROUND: It is important that postoperative analgesic management after thoracotomy is very effective in order to optimize postoperative recovery. A regional technique such as an epidural or a paravertebral catheter with an infusion of local anesthetic may be supplemented with systemically administered analgesic drugs in order to achieve satisfactory analgesia. OBJECTIVE: The objective of this observational study was to evaluate whether a paravertebral infusion of local anesthetic delivered via a surgically placed catheter together with systemic analgesics is associated with low pain scores and satisfactory analgesia after thoracotomy for decortication in children...
July 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26990683/pulmonary-aspiration-under-ga-a-13-year-audit-in-a-tertiary-pediatric-unit
#8
Zihui Tan, Shu Ying Lee
INTRODUCTION: Pulmonary aspiration is a known risk of general anesthesia. We aim to find out the incidence, risk factors, and outcome of pulmonary aspiration in our pediatric population. METHODS: Since 2000, all critical incidents are reported on a standardized audit form. All cases with pulmonary aspiration being reported as a critical incident were identified and their case notes traced to look at the perioperative details. RESULTS: From 2000 to 2013, a total of 102 425 pediatric cases were done in our hospital...
May 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26843724/the-effects-of-drinking-coffee-while-recovering-from-colon-and-rectal-resection-surgery
#9
Mirela Piric, Fuad Pasic, Zijah Rifatbegovic, Ferid Konjic
AIM: Resection surgery on the colon and rectum are changing both anatomical and physiological relations within the abdominal cavity. Delayed functions of the gastrointestinal tract, flatulence, failure of peristalsis, prolonged spasms and pain, limited postoperative recovery of these patients increase the overall cost of treatment. Early consumption of coffee instead of tea should lead to faster restoration of normal function of the colon without unwanted negative repercussions. METHOD: This study is designed as a prospective-retrospective clinical study and was carried out at the Surgery Center Tuzla, during the year 2013/ 2014...
December 2015: Medical Archives
https://www.readbyqxmd.com/read/26734429/postoperative-analgesia-for-enhanced-recovery-in-joint-replacement-audit-of-a-new-electronic-prescribing-order-set
#10
Jonathan Wright, Benjamin Cullinger, Ian Bacarese-Hamilton
Enhanced recovery in joint replacement has been shown to reduce length of inpatient stay, reduce re-admission rates, and can improve early functional recovery. Postoperative analgesia is an important component of the group of interventions required to form a holistic enhanced recovery protocol. The introduction of electronic prescribing provides the opportunity to introduce some standardisation, where clinically appropriate, in the prescription of an evidence based postoperative analgesia protocol. Enhanced recovery following joint replacement has been used at this institution since 2011...
2015: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/26688719/perioperative-intravenous-fluid-prescribing-a-multi-centre-audit
#11
Benjamin Harris, Christian Schopflin, Clare Khaghani, Mark Edwards
BACKGROUND: Excessive or inadequate intravenous fluid given in the perioperative period can affect outcomes. A number of guidelines exist but these can conflict with the entrenched practice, evidence base and prescriber knowledge. We conducted a multi-centre audit of intraoperative and postoperative intravenous fluid therapy to investigate fluid administration practice and frequency of postoperative electrolyte disturbances. METHODS: A retrospective audit was done in five hospitals of adult patients undergoing elective major abdominal, gastrointestinal tract or orthopaedic surgery...
2015: Perioperative Medicine
https://www.readbyqxmd.com/read/26673045/the-use-of-urological-hospital-services-by-nonagenarians
#12
S Pridgeon, E Nagarajan, G Ellis, J S Green
INTRODUCTION: The super-elderly population is a small but expanding group of patients who will pose a significant challenge to future healthcare resources. A snapshot audit was completed of all emergency and elective urological nonagenarian activity in a UK general hospital, including surgical outcomes in this group of patients. METHODS: Prospective and retrospective databases and clinical records were examined to identify all patients aged 90-99 years who had patient episodes between January 2006 and August 2012...
March 2016: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/26514704/successful-implementation-of-an-enhanced-recovery-pathway-the-nurse-s-role
#13
Karen M Brady, Deborah S Keller, Conor P Delaney
Enhanced recovery pathways (ERPs) are standardized, multidisciplinary approaches to caring for patients with a goal of decreasing length of stay and care costs without negatively affecting patient outcomes. One facility successfully implemented ERPs for patients undergoing abdominal surgery. For implementation to be successful, nurses were found to be key in providing education, perioperative care, and postoperative evaluation, as well as cost containment. The implementation team collaborated to define, design, implement, and audit an ERP for surgical services...
November 2015: AORN Journal
https://www.readbyqxmd.com/read/26509324/current-issues-in-postoperative-pain-management
#14
REVIEW
Narinder Rawal
Postoperative pain has been poorly managed for decades. Recent surveys from USA and Europe do not show any major improvement. Persistent postoperative pain is common after most surgical procedures, and after thoracotomy and mastectomy, about 50% of patients may experience it. Opioids remain the mainstay of postoperative pain treatment in spite of strong evidence of their drawbacks. Multimodal analgesic techniques are widely used but new evidence is disappointing. Regional anaesthetic techniques are the most effective methods to treat postoperative pain...
March 2016: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/26385659/programmes-guidelines-and-protocols-the-antithesis-of-precision-medicine
#15
EDITORIAL
M O Columb, P M Hopkins
No abstract text is available yet for this article.
October 2015: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/26351156/long-term-outcome-of-open-plantar-fascia-release
#16
Alasdair MacInnes, Sam C Roberts, Jessica Kimpton, Anand Pillai
BACKGROUND: Plantar fasciitis is thought to be a self-limiting condition best treated by conservative measures, but despite this many patients have a prolonged duration of symptoms and surgery may be indicated. Partial plantar fascial release is reported to have a short-term success rate of up to 80%, but anecdotally this was not thought to represent our local experience. METHODS: An audit of long-term patient-reported outcomes following open partial plantar fascia release was performed...
January 2016: Foot & Ankle International
https://www.readbyqxmd.com/read/26183086/successful-implementation-of-an-enhanced-recovery-after-surgery-programme-for-elective-colorectal-surgery-a-process-evaluation-of-champions-experiences
#17
Lesley Gotlib Conn, Marg McKenzie, Emily A Pearsall, Robin S McLeod
BACKGROUND: Enhanced recovery after surgery (ERAS) is a multimodal evidence-based approach to patient care that has become the standard in elective colorectal surgery. Implemented globally, ERAS programmes represent a considerable change in practice for many surgical care providers. Our current understanding of specific implementation and sustainability challenges is limited. In January 2013, we began a 2-year ERAS implementation for elective colorectal surgery in 15 academic hospitals in Ontario...
2015: Implementation Science: IS
https://www.readbyqxmd.com/read/26160285/-major-surgery-in-two-days-of-hospitalization
#18
Pascal Alfonsi
A reduction to 2 days the length of stay after a major surgery is possible by enhancing patient empowerment and decreasing morbidity. A rapid patient's empowerment is obtained by the use of means that reduce the impact of the surgical stress and facilitate the recovery. The decrease in postoperative morbidity is obtained by improving the perioperative quality of care. All of these means are gathered in enhanced recovery programs that are clinical pathways designed by a multidisciplinary and multiprofessional team...
September 2015: La Presse Médicale
https://www.readbyqxmd.com/read/26055003/mid-term-follow-up-of-tapp-hernia-repair-without-staples-and-glue-an-audit-of-the-data
#19
Giuseppe Piccinni, Giuseppe Massimiliano De Luca, Alessandro De Luca, Simone Giungato, Mario Testini
Groin hernia repair by using the laparoscopic transabdominal preperitoneal (TAPP) repair approach presents lower post-operative pain with a quicker return to normal patient activity compared to the open technique. Nevertheless, the long learning curve, general anaesthesia, and increased costs due to devices are the arguments against TAPP. Currently, the only mesh fixation techniques are those using glue or tacks. We report the audit of two years follow-up about our experience using a self-gripping lightweight mesh Parietex ProGrip™ (Covidien, Trevoux, France)...
May 2015: Surgical Technology International
https://www.readbyqxmd.com/read/26041851/the-impact-of-obesity-on-the-outcome-of-total-ankle-replacement
#20
Maryse Bouchard, Amit Amin, Ellie Pinsker, Ryan Khan, Erisa Deda, Timothy R Daniels
BACKGROUND: Obese patients have a slightly higher proportion of revision and infection following knee or hip replacement, but functional improvement is equivalent to that of normal-weight patients. We compared outcomes of total ankle replacement for end-stage ankle arthritis in obese and normal-weight patients. METHODS: This retrospective cohort study compared thirty-nine obese patients (those with a body mass index of ≥30 kg/m(2)) at a mean follow-up time of 3...
June 3, 2015: Journal of Bone and Joint Surgery. American Volume
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