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https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#1
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29115945/mechanical-strain-to-maxillary-incisors-during-direct-laryngoscopy
#2
Milo Engoren, Lauryn R Rochlen, Matthew V Diehl, Sarah S Sherman, Elizabeth Jewell, Mary Golinski, Paul Begeman, John M Cavanaugh
BACKGROUND: While most Direct laryngoscopy leads to dental injury in 25-39% of cases. Dental injury occurs when the forces and impacts applied to the teeth exceed the ability of the structures to dissipate energy and stress. The purpose of this study was to measure strain, (which is the change produced in the length of the tooth by a force applied to the tooth) strain rate, and strain-time integral to the maxillary incisors and determine if they varied by experience, type of blade, or use of an alcohol protective pad (APP)...
November 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29099473/a-study-of-interpersonal-conflict-among-operating-room-nurses
#3
Tsui-Fen Chang, Chung-Kuang Chen, Ming-Jia Chen
BACKGROUND: Team collaboration is an important factor that affects the performance of the operating room (OR). Therefore, the ability of OR nurses to adapt to and manage interpersonal conflict incidents properly is very important. PURPOSE: The aims of this study were to investigate the interpersonal conflict management capabilities of OR nursing staffs and to find the relationships among the demographics of OR nurses and the following: work-related variables, interpersonal conflict management style, and target of interpersonal conflict...
December 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29089740/awareness-and-use-of-surgical-checklist-among-theatre-users-at-ekiti-state-university-teaching-hospital-ado-ekiti-nigeria
#4
Johnson Dare Ogunlusi, Moruf Babatunde Yusuf, Popoola Sunday Ogunsuyi, Obafemi K Wuraola, Waheed O Babalola, Kehinde Sunday Oluwadiya, Oduwole Olayemi Ajogbasile
BACKGROUND: Surgical checklist was introduced by the World Health Organization to reduce the number of surgical deaths and complications. During a surgical conference on "safety in surgical practice," it was noticed that the awareness and the use of surgical checklist are poor in Nigerian hospitals. This study was aimed at determining the awareness and use of surgical checklist among the theater users in our hospital, factors militating against its implementation, and make recommendations...
July 2017: Nigerian Journal of Surgery: Official Publication of the Nigerian Surgical Research Society
https://www.readbyqxmd.com/read/29035894/prevalence-of-potentially-distracting-noncare-activities-and-their-effects-on-vigilance-workload-and-nonroutine-events-during-anesthesia-care
#5
Jason M Slagle, Eric S Porterfield, Amanda N Lorinc, David Afshartous, Matthew S Shotwell, Matthew B Weinger
BACKGROUND: When workload is low, anesthesia providers may perform non-patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on anesthesia workload, vigilance, and the occurrence of nonroutine events. METHODS: In 319 qualifying cases in an academic medical center using a Web-based electronic medical chart, a trained observer recorded video and performed behavioral task analysis...
October 16, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28971216/-does-annual-simulation-training-influence-the-safety-climate-of-a-university-hospital-prospective-5%C3%A2-year-investigation-using-dimensions-of-the-safety-attitude-questionnaire
#6
M St Pierre, C Gall, G Breuer, J Schüttler
BACKGROUND: Simulation-based training with a focus on non-technical skills can have a positive influence on safety relevant attitudes of participants. If an organization succeeds in training sufficient staff, it may experience a positive change in the safety climate. As the effects of a single training are of a transient nature, annual training sessions may lead to an incremental improvement of safety relevant attitudes of employees over time. In spring 2012 the Department of Anesthesia at the University Hospital of Erlangen established an annual simulation-based training for staff members (e...
October 2, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28964282/adherence-to-swedish-guidelines-for-pain-treatment-in-relation-to-pediatric-tonsil-surgery-a-survey-of-the-multidisciplinary-team
#7
F Alm, M Jaensson, S Lundeberg, E Ericsson
BACKGROUND: Pain management in children after tonsil surgery is essential, and optimal pain treatment has been discussed for many years. Data from the National Tonsil Register in Sweden (NTRS) and a national mapping have demonstrated the need for national pain treatment guidelines for pediatric tonsil surgery. As a result, Swedish national guidelines, together with updated patient information on the website tonsilloperation.se, were developed and implemented in 2013. OBJECTIVES: The objective of this study was to evaluate the professionals' opinions of and adherence to pain treatment guidelines for pediatric tonsil surgery patients in a two-year follow-up...
October 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28954456/evolving-safety-practices-in-the-setting-of-modern-complex-operating-room-role-of-nurses
#8
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/28954183/development-implementation-and-evaluation-of-a-certified-registered-nurse-anesthetist-preceptorship-mentorship-program
#9
Mary Scott-Herring, Sarabdeep Singh
Little evidence exists to support the effects of a preceptor-mentor program for orienting newly hired certified registered nurse anesthetists (CRNAs). The literature suggests that participation in a preceptorship-mentorship program will increase the satisfaction, confidence, and comfort of both preceptors and newly hired orientees. The purpose of this project was to determine the effects of these outcomes. This program was developed based on best evidence and implemented as a quality improvement project. Three sessions were held to educate preceptors (N = 12) in the following areas: communication skills, providing constructive feedback, and assessing learner's styles and needs...
October 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28938981/interaction-between-nurse-anesthetists-and-patients-in-a-highly-technological-environment
#10
Karin Aagaard, Birgitte Schantz Laursen, Bodil Steen Rasmussen, Erik Elgaard Sørensen
PURPOSE: To explore the specific interactions between patients and nurse anesthetists in the highly technological environment of anesthesia nursing, focusing on the time interval between patient entrance into the operating room and induction of general anesthesia. DESIGN: Focused ethnography was used for data collection. METHODS: Participant observation and interview of 13 hospitalized patients being admitted for major or minor surgical procedures and 13 nurse anesthetists in charge of their patients and anesthetic procedures...
October 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28938976/the-nurse-anesthetists-adherence-to-swedish-national-recommendations-to-maintain-normothermia-in-patients-during-surgery
#11
Ingrid L Gustafsson, Carina Elmqvist, Mona From-Attebring, Ingrid Johansson, Mikael Rask
PURPOSE: The aim of this study was to determine if nurse anesthetists (NAs) have access, knowledge, and adhere to recommended guidelines to maintain normal body temperature during the perioperative period. DESIGN: A descriptive survey design. METHODS: Questionnaires were sent to heads of the department (n = 56) and NAs in the operating departments in Sweden. FINDING: The level of access to the recommendations is high, but only one third of the operating departments have included the recommendations in their own local guidelines...
October 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28930765/encouraging-reflexivity-in-a-residency-leadership-development-program-expanding-outside-the-competency-approach
#12
Justin T Clapp, Emily K B Gordon, Dimitry J Baranov, Beulah Trey, Felice Y Tilin, Lee A Fleisher
PROBLEM: While leadership development is increasingly a goal of academic medicine, it is typically framed as competency acquisition, which can limit its focus to a circumscribed set of social behaviors. This orientation may also reinforce the cultural characteristics of academic medicine that can make effective leadership difficult, rather than training leaders capable of examining and changing this culture. Expanding leadership development so it promotes social reflexivity presents a way to bolster some of the weaknesses of the competency paradigm...
September 14, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#13
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28893700/comparison-of-radiation-exposure-during-endovascular-treatment-of-peripheral-arterial-disease-with-flat-panel-detectors-on-mobile-c-arm-vs-fixed-systems
#14
Marie Guillou, Blandine Maurel, Hatem Necib, Pierre-Alexandre Vent, Alain Costargent, Philippe Chaillou, Yann Gouëffic, Adrien Kaladji
PURPOSE: Flat-panel detectors on mobile C-arm (MC-arm) systems are currently challenging fixed C-arm (FC-arm) systems used in hybrid operating rooms. MC-arm systems offer an alternative to FC-arm systems in the endovascular treatment of peripheral arterial disease (PAD) but their efficiency has not been evaluated comparatively. METHODS: Two series of patients undergoing arteriography with intention to treat were included. Each series consisted of two non-randomized groups: an MC-arm group and an FC-arm group...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28789748/measuring-certified-registered-nurse-anesthetist-organizational-climate-instrument-adaptation
#15
Donald Boyd, Lusine Poghosyan
BACKGROUND AND PURPOSE: No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. METHODS: Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. RESULTS: Experts rated the tool as content valid...
August 1, 2017: Journal of Nursing Measurement
https://www.readbyqxmd.com/read/28746222/the-use-of-tenoxicam-to-prevent-symptoms-of-discomfort-induced-by-vagotonia-during-uterus-manipulation-in-cesarean-sections
#16
RANDOMIZED CONTROLLED TRIAL
Shih-Hong Chen, Shiou-Sheng Chen, Ching-Tao Chang, Chi-Hsiang Huang, Shou-Zen Fan, Li-Kuei Chen
PURPOSE: Symptoms such as nausea, vomiting, tightness of the chest, bradycardia, and shoulder or abdominal discomfort, caused by vagotonia occurring during uterus manipulation, have concerned healthcare professionals for some time. Patients sometimes report these symptoms when undergoing spinal anesthesia for cesarean sections (CSs). We designed a prospective, double-blind study to investigate the effectiveness of tenoxicam in preventing these symptoms of discomfort. METHODS: A total of 105 American Society of Anesthesiologists (ASA) class I-II nulliparous pregnant women, who were scheduled for a CS, were enrolled into this prospective, double-blind study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28725643/crisis-team-management-in-a-scarce-resource-setting-angkor-hospital-for-children-in-siem-reap-cambodia
#17
Richard Alynn Henker, Hiroko Henker, Hor Eng, John O'Donnell, Tachawan Jirativanont
INTRODUCTION: A crisis team management (CTM) simulation course was developed by volunteers from Health Volunteers Overseas for physicians and nurses at Angkor Hospital for Children (AHC) in Siem Reap, Cambodia. The framework for the course was adapted from crisis resource management (1, 2), crisis team training (3), and TeamSTEPPs© models (4). The CTM course focused on teaching physicians and nurses on the development of team performance knowledge, skills, and attitudes. Challenges to providing this course at AHC included availability of simulation equipment, cultural differences in learning, and language barriers...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28711647/surgical-training-improves-performance-in-minimally-invasive-left-ventricular-assist-device-implantation-without-cardiopulmonary-bypass
#18
Lu-Feng Zhang, Hai-Bo Feng, Zhi-Guo Yu, Shi Jing, Feng Wan
OBJECTIVE: We introduced a live animal model for training of minimally invasive implantation of a continuous-flow left ventricular assist device (CF-LVAD) without cardiopulmonary bypass for operator's performance improvement. DESIGN: After watching a videotape of LVAD implantation on the beating heart through the cardiac apex, the surgical team performed implantation of LVADs into 5 pigs during 3 training sessions in a time series. The procedure success rate, operating time, and technical and global performances by self-evaluation and senior evaluation were compared among the sessions...
July 12, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28701596/propofol-versus-ketofol-for-sedation-of-pediatric-patients-undergoing-transcatheter-pulmonary-valve-implantation-a-double-blind-randomized-study
#19
Rabie Soliman, Mohammed Mofeed, Tarek Momenah
OBJECTIVE: The study was done to compare propofol and ketofol for sedation of pediatric patients scheduled for elective pulmonary valve implantation in a catheterization laboratory. DESIGN: This was a double-blind randomized study. SETTING: This study was conducted in Prince Sultan Cardiac Centre, Saudi Arabia. PATIENTS AND METHODS: The study included 60 pediatric patients with pulmonary regurge undergoing pulmonary valve implantation...
July 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28688211/reducing-sedation-time-for-thyroplasty-with-arytenoid-adduction-with-sequential-anesthetic-technique
#20
Charles K Saadeh, Eric B Rosero, Girish P Joshi, Esra Ozayar, Ted Mau
OBJECTIVE: To determine the extent to which a sequential anesthetic technique 1) shortens time under sedation for thyroplasty with arytenoid adduction (TP-AA), 2) affects the total operative time, and 3) changes the voice outcome compared to TP-AA performed entirely under sedation/analgesia. STUDY DESIGN: Case-control study. METHODS: A new sequential anesthetic technique of performing most of the TP-AA surgery under general anesthesia (GA), followed by transition to sedation/analgesia (SA) for voice assessment, was developed to achieve smooth emergence from GA...
July 8, 2017: Laryngoscope
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