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Autonomy quality surgery

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https://www.readbyqxmd.com/read/29697444/potential-impact-of-take-the-volume-pledge-on-access-and-outcomes-for-gastrointestinal-cancer-surgery
#1
Ryan C Jacobs, Shawn Groth, Farhood Farjah, Mark A Wilson, Laura A Petersen, Nader N Massarweh
OBJECTIVE: To quantify the number of US hospitals that would meet "Take the Volume Pledge" (TVP) volume thresholds and compare outcomes at hospitals meeting and not meeting TVP thresholds. SUMMARY BACKGROUND DATA: TVP aims to regionalize complex cancer resections to hospitals meeting established annual average volume thresholds. There is little data describing the potential impact on patient access if this initiative were broadly implemented or the relationship between these volume thresholds and quality of oncologic care...
April 24, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29525118/fellows-perspective-of-hpb-training-programs-in-north-america-results-of-a-survey
#2
Imran A Siddiqui, Amit V Sastry, John B Martinie, Dionisios Vrochides, Erin H Baker, David A Iannitti
BACKGROUND: Sixteen hepatopancreatobiliary fellowship programs in North America are accredited by the Fellowship Council. This study aims to assess fellows' perceptions of their training program. METHODS: A multiple-choice questionnaire was sent to 35 fellows to assess how they perceived their training: academics, research, operative experiences, autonomy, mentorship, program quality and weaknesses. The survey was developed using the SurveyMonkey® tool. RESULTS: Twenty-four of 35 fellows completed the survey...
March 7, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
https://www.readbyqxmd.com/read/29464756/impact-on-quality-of-life-and-sexual-satisfaction-of-continent-cystostomy-with-enterocystoplasty-in-an-adult-neurologic-population
#3
Ornella Lam Van Ba, Laurent Soustelle, Laurent Wagner, Nicolas Siegler, Michel Boukaram, Kamel Ben Naoum, Stéphane Droupy, Armand Chevrot, Pierre Costa
AIMS: To evaluate long-term general and urinary quality of life (QOL) and sexual satisfaction in adult neurologic patients undergoing continent cystostomy surgery associated with a bladder enlargement to treat neurogenic lower urinary tract dysfunction. METHODS: Monocentre, retrospective series of adult neurologic patients who underwent continent cystostomy with bladder enlargement and followed-up in the long-term. We assessed during follow-up, urinary and renal function and patients filled QOL questionnaires on general QOL, sexuality and urinary (short form Qualiveen) disability...
April 2018: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/29436708/nursing-wound-care-practices-in-haiti-facilitators-and-barriers-to-quality-care
#4
B A Timmins, C Thomas Riché, M W Saint-Jean, J Tuck, L Merry
AIM: To describe the facilitators and barriers for nurses to perform quality wound care in three surgical wards of a hospital in Port-au-Prince, Haiti. BACKGROUND: Up to a quarter of patients in low- and middle-income countries may acquire at least one infection while hospitalized. There is a paucity of research investigating nursing wound care practices in low- and middle-income countries regarding the prevention of hospital-acquired infections. METHODS: The design was qualitative descriptive...
February 13, 2018: International Nursing Review
https://www.readbyqxmd.com/read/29433878/the-effect-of-resident-involvement-on-bariatric-surgical-outcomes-an-acs-nsqip-analysis
#5
Ivy N Haskins, Jihad Kudsi, Kathleen Hayes, Richard L Amdur, Paul P Lin, Khashayar Vaziri
BACKGROUND: Surgical residency training programs in the United States are modeled on the principle of graduated responsibility. Residents are given greater responsibility and autonomy in the operating room and during perioperative care as they gain surgical skills and progress through their training. The impact of this method of surgical training on patient outcomes remains unknown. The purpose of this study is to compare early patient morbidity and mortality after bariatric surgery in cases with and without resident participation using the American College of Surgeons National Surgical Quality Improvement Program database...
March 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29393875/professional-well-being-of-practicing-physicians-the-roles-of-autonomy-competence-and-relatedness
#6
Oksana Babenko
This study investigated the roles of basic psychological needs-autonomy, competence, and relatedness-in physicians' professional well-being, specifically satisfaction with professional life, work-related engagement, and exhaustion. Using an online survey, quantitative data were collected from 57 practicing physicians. Overall, 65% of the participants were female; 49% were family medicine (FM) physicians, with the rest of the participants practicing in various non-FM specialties (e.g., internal medicine, pediatrics, surgery); and 47% were in the early-career stage (≤10 years in practice)...
February 2, 2018: Healthcare (Basel, Switzerland)
https://www.readbyqxmd.com/read/29199087/primary-total-knee-arthroplasty-for-acute-fracture-around-the-knee
#7
REVIEW
S Parratte, M Ollivier, J-N Argenson
Relatively poor results have been reported with open reduction and internal fixation of complex fractures around the knee in elderly osteoporotic patients, and primary total knee arthroplasty (TKA) has been proposed as an alternative solution. While limiting the number of procedures, it meets two prerequisites: (1) to save the patient's life, thanks to early weight-bearing, to limit decubitus complications; and (2) to save knee function and patient autonomy, thanks to early knee mobilization. There are 3 main indications: complex articular fractures in elderly patients with symptomatic osteoarthritis prior to fracture; complex articular fractures of the tibial plateau in elderly patients whose bone quality makes internal fixation hazardous; and major destruction of the distal femur in younger patients...
February 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29157836/elevated-neopterin-levels-predict-early-death-in-older-hip-fracture-patients
#8
Martin Larsen, Charles Bayard, Hélène Lepetitcorps, Judith Cohen-Bittan, Victor Appay, Jacques Boddaert, Delphine Sauce
Our society faces a major challenge concerning management of the health and socio-economic burden caused by acute physical stress in the older population (+75years). In particular, hip-fracture surgery (HFS) represents a major health care preoccupation, affecting 1.6 million patients worldwide, resulting in a significant drop in life quality and autonomy. The trauma is associated with 20-30% one-year mortality in the elderly. In the present study, we aim to identify factors, which influence and/or predict the outcome of elderly hip- fracture patients (HFP) post-surgery...
December 2017: EBioMedicine
https://www.readbyqxmd.com/read/28974875/parental-satisfaction-with-pediatric-day-care-surgery-and-its-determinants-in-a-tertiary-care-hospital
#9
Cenita James Sam, Pavai A Arunachalam, Sivamani Manivasagan, T Surya
OBJECTIVE: The objective is to assess the level of parental satisfaction of pediatric day-care surgery and its different determinants. MATERIALS AND METHODS: This is a descriptive study performed in a tertiary care hospital in India among parents of pediatric day-care surgery patients from June 2013 to March 2015. The core questionnaire for the assessment of patient satisfaction for general day care (COPS-D) was used. Variables related to surgery, overall satisfaction, one open-ended question, and socio-demographic data were also collected...
October 2017: Journal of Indian Association of Pediatric Surgeons
https://www.readbyqxmd.com/read/28967577/progressive-surgical-autonomy-observed-in-a-hand-surgery-resident-clinic-model
#10
Kristopher M Day, Evon S Zoog, Chase T Kluemper, Jillian K Scott, Caleb M Steffen, James Woodfin Kennedy, David Marshall Jemison, Jason P Rehm, Mark A Brzezienski
OBJECTIVE: Resident clinics (RCs) are intended to catalyze the achievement of educational milestones through progressively autonomous patient care. However, few studies quantify their effect on competency-based surgical education, and no previous publications focus on hand surgery RCs (HRCs). We demonstrate the achievement of progressive surgical autonomy in an HRC model. DESIGN: A retrospective review of all patients seen in a weekly half-day HRC from October 2010 to October 2015 was conducted...
September 26, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28881069/person-centred-discharge-education-following-coronary-artery-bypass-graft-a-critical-review
#11
Melanie Rushton, Michelle Howarth, Maria J Grant, Felicity Astin
AIMS AND OBJECTIVES: To examine the extent that individualised education helps reduce depression and anxiety and improves self-care for people who have undergone coronary artery bypass graft surgery. BACKGROUND: Individualised discharge planning is increasingly important following cardiac surgery due to recurrent admissions as well as the issue of anxiety and depression, often due to lack of preparation. The hospital to home transition is fundamental in the recovery process...
December 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28837507/intestinal-rehabilitation-programs-in-the-management-of-pediatric-intestinal-failure-and-short-bowel-syndrome
#12
Russell J Merritt, Valeria Cohran, Bram P Raphael, Timothy Sentongo, Diana Volpert, Brad W Warner, Praveen S Goday
Intestinal failure is a rare, debilitating condition that presents both acute and chronic medical management challenges. The condition is incompatible with life in the absence of the safe application of specialized and individualized medical therapy that includes surgery, medical equipment, nutritional products, and standard nursing care. Intestinal rehabilitation programs are best suited to provide such complex care with the goal of achieving enteral autonomy and oral feeding with or without intestinal transplantation...
November 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28806342/cognitive-abilities-and-quality-of-life-after-cochlear-implantation-in-the-elderly
#13
Marie-Hortense Sonnet, Bettina Montaut-Verient, Jean-Yves Niemier, Michel Hoen, Laurence Ribeyre, Cécile Parietti-Winkler
OBJECTIVE: To evaluate quality of life (QoL) and cognitive function in elderly patients with cochlear implants relative to auditory improvement, using geriatric validated scales. STUDY DESIGN: Prospective observational study. SETTING: A tertiary referral center for cochlear implantation (CI) and a geriatric center in Nancy, France. PATIENTS: Sixteen consecutive patients were included, from 65 to 80 years old, with postlingual severe-to-profound deafness...
September 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/28781132/-taking-training-to-the-next-level-the-american-college-of-surgeons-committee-on-residency-training-survey
#14
Richard B Damewood, Patrice Gabler Blair, Yoon Soo Park, Linda K Lupi, Rachel Williams Newman, Ajit K Sachdeva
OBJECTIVE: The American College of Surgeons (ACS) appointed a committee of leaders from the ACS, Association of Program Directors in Surgery, Accreditation Council for Graduate Medical Education, and American Board of Surgery to define key challenges facing surgery resident training programs and to explore solutions. The committee wanted to solicit the perspectives of surgery resident program directors (PDs) given their pivotal role in residency training. DESIGN: Two surveys were developed, pilot tested, and administered to PDs following Institutional Review Board approval...
November 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28767456/effects-of-anaesthesia-and-analgesia-on-long-term-outcome-after-total-knee-replacement-a-prospective-observational-multicentre-study
#15
Dario Bugada, Massimo Allegri, Marco Gemma, Andrea L Ambrosoli, Giuseppe Gazzerro, Fernando Chiumiento, Doriana Dongu, Fiorella Nobili, Andrea Fanelli, Paolo Ferrua, Massimo Berruto, Gianluca Cappelleri
BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28639296/pathways-to-professionalism-quality-improvement-care-pathways-and-the-interplay-of-standardisation-and-clinical-autonomy
#16
Graham P Martin, David Kocman, Timothy Stephens, Carol J Peden, Rupert M Pearse
Care pathways are a prominent feature of efforts to improve healthcare quality, outcomes and accountability, but sociological studies of pathways often find professional resistance to standardisation. This qualitative study examined the adoption and adaptation of a novel pathway as part of a randomised controlled trial in an unusually complex, non-linear field - emergency general surgery - by teams of surgeons and physicians in six theoretically sampled sites in the UK. We find near-universal receptivity to the concept of a pathway as a means of improving peri-operative processes and outcomes, but concern about the impact on appropriate professional judgement...
June 21, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28486892/cardiopulmonary-resuscitation-from-the-patient-s-perspective
#17
S Wee, Z Y Chang, Y H Lau, Yky Wong, Cym Ong
With increasing emphasis on patient autonomy, patients are encouraged to be more involved in end-of-life issues, including the use of extraordinary efforts to prolong their lives. Being able to make anticipatory decisions is seen to promote autonomy, empower patients and optimise patient care. To facilitate shared decision-making, patients need to have a clear and accurate understanding of cardiopulmonary resuscitation (CPR). This study aims to understand the knowledge and perspectives of the local community regarding resuscitation options and end-of-life decision-making and to explore ways to improve the quality of end-of-life discussions...
May 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28398629/treatment-experiences-of-latinas-after-diagnosis-of-breast-cancer
#18
Steven J Katz, Lauren P Wallner, Paul H Abrahamse, Nancy K Janz, Kathryn A Martinez, Dean A Shumway, Ann S Hamilton, Kevin C Ward, Kenneth A Resnicow, Sarah T Hawley
BACKGROUND: The authors examined racial/ethnic differences in patient perspectives regarding their breast cancer treatment experiences. METHODS: A weighted random sample of women newly diagnosed with breast cancer between 2013 and 2015 in Los Angeles County and Georgia were sent surveys 2 months after undergoing surgery (5080 women; 70% response rate). The analytic sample was limited to patients residing in Los Angeles County (2397 women). RESULTS: The pattern of visits with different specialists before surgery was found to be similar across racial/ethnic groups...
August 15, 2017: Cancer
https://www.readbyqxmd.com/read/28196497/comparison-of-visual-outcomes-spectacles-dependence-and-patient-satisfaction-of-multifocal-and-accommodative-intraocular-lenses-innovative-perspectives-for-maximal-refractive-oriented-cataract-surgery
#19
COMPARATIVE STUDY
Raffaele Nuzzi, Federico Tridico
BACKGROUND: The aim of this study was to evaluate visual outcomes for different working distances (far, 60 cm and 33 cm) and impact on vision quality of multifocal IOLs AcrySof ResTOR SN6AD1 and SN6AD3 (Alcon, Inc., Fort Worth, Texas, USA) as well as REVIEW FIL611PV multifocal and OPTOFLEX FIL618 accommodative IOLs (Soleko, Ltd., Rome, Italy) in patients undergoing bilateral phacoemulsification. METHODS: In this observational prospective study 63 patients undergoing binocular cataract surgery were divided into four groups for implantation of one of the IOLs under evaluation...
February 14, 2017: BMC Ophthalmology
https://www.readbyqxmd.com/read/28148423/-the-eb-2%C3%A2-dummy-a-therapeutic-patient-education-tool-in-ent-surgery
#20
REVIEW
Pauline Mezerette, Élise Lefèvre
The day-to-day management and support of patients undergoing a total laryngectomy has led multi-disciplinary nursing teams to create a therapeutic patient education programme aiming to improve the quality of care and the autonomy of these people. In this context, the eb(2®) dummy is an essential tool.
October 2016: Revue de L'infirmière
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