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https://www.readbyqxmd.com/read/30327396/proficiency-based-progression-training-an-end-to-end-model-for-decreasing-error-applied-to-achievement-of-effective-epidural-analgesia-during-labour-a-randomised-control-study
#1
Karthikeyan Kallidaikurichi Srinivasan, Anthony Gallagher, Niall O'Brien, Vinod Sudir, Nick Barrett, Raymund O'Connor, Francesca Holt, Peter Lee, Brian O'Donnell, George Shorten
BACKGROUND: Training procedural skills using proficiency-based progression (PBP) methodology has consistently resulted in error reduction. We hypothesised that implementation of metric-based PBP training and a valid assessment tool would decrease the failure rate of epidural analgesia during labour when compared to standard simulation-based training. METHODS: Detailed, procedure-specific metrics for labour epidural catheter placement were developed based on carefully elicited expert input...
October 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/30062007/intraoperative-oxygenation-in-adult-patients-undergoing-surgery-iops-a-retrospective-observational-study-across-29-uk-hospitals
#2
Clare M Morkane, Helen McKenna, Andrew F Cumpstey, Alex H Oldman, Michael P W Grocott, Daniel S Martin
Background: Considerable controversy remains about how much oxygen patients should receive during surgery. The 2016 World Health Organization (WHO) guidelines recommend that intubated patients receive a fractional inspired oxygen concentration (FIO2 ) of 0.8 throughout abdominal surgery to reduce the risk of surgical site infection. However, this recommendation has been widely criticised by anaesthetists and evidence from other clinical contexts has suggested that giving a high concentration of oxygen might worsen patient outcomes...
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29954293/professor-ross-holland-the-special-committee-investigating-deaths-under-anaesthesia-scidua-and-his-other-contributions-to-anaesthesia
#3
A B Baker
As a young anaesthetic trainee in 1959 Ross Holland persuaded the Minister of Health in NSW, Australia, to establish SCIDUA, which by law required compulsory reporting for all deaths occurring during anaesthesia or up to 24 hours after cessation of the anaesthetic. The committee was multidisciplinary and, most importantly, had statutory privilege so that no discussions or findings were able to be subpoenaed for other legal investigations or case law. Holland was the foundation secretary of SCIDUA and later Chair...
March 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29716497/addressing-burnout-in-anaesthetic-trainees
#4
LETTER
H P Grocott
No abstract text is available yet for this article.
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29246975/exams-are-eroding-anaesthetic-trainees-work-life-balance-college-warns
#5
Abi Rimmer
No abstract text is available yet for this article.
December 15, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29137586/burnout-and-the-learning-environment-of-anaesthetic-trainees
#6
D J Castanelli, S A Wickramaarachchi, S Wallis
Burnout has a high prevalence among healthcare workers and is increasingly recognised as an environmental problem rather than reflecting a personal inability to cope with work stress. We distributed an electronic survey, which included the Maslach Burnout Inventory Health Services Survey and a previously validated learning environment instrument, to 281 Victorian anaesthetic trainees. The response rate was 50%. We found significantly raised rates of burnout in two of three subscales. Ninety-one respondents (67%) displayed evidence of burnout in at least one domain, with 67 (49%) reporting high emotional exhaustion and 57 (42%) reporting high depersonalisation...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29111790/early-adopters-of-perioperative-medicine-who-are-they-and-what-motivates-them
#7
C Groves, A Whiteman, G Kumar, R Stephens, D Walker
Perioperative medicine is an emerging specialty aimed at improving outcomes in the high-risk surgical population. The authors set out to characterize the demographics and determine the motivation of 'early adopters' of this specialty by retrospectively reviewing the application forms of students enrolled on the UCL Perioperative Medicine Masters Programme. A total of 139 applications were reviewed. The median age of applicants was 35 years; 81% were UK based, with the remainder from a worldwide distribution...
November 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/28741649/the-effect-of-metrics-based-feedback-on-acquisition-of-sonographic-skills-relevant-to-performance-of-ultrasound-guided-axillary-brachial-plexus-block
#8
O M A Ahmed, T Niessen, B D O'Donnell, A G Gallagher, D S Breslin, A DunnGalvin, G D Shorten
The objective of this study was to examine the effect of metrics-based vs. non-metrics-based feedback on novices learning predefined competencies for acquisition and interpretation of sonographic images relevant to performance of ultrasound-guided axillary brachial plexus block. Twelve anaesthetic trainees were randomly assigned to either metrics-based-feedback or non-metrics-based feedback groups. After a common learning phase, all participants attempted to perform a predefined task that involved scanning the left axilla of a single volunteer...
September 2017: Anaesthesia
https://www.readbyqxmd.com/read/28687534/over-half-of-anaesthetic-trainees-have-had-car-crash-or-near-miss-after-night-shift-survey-finds
#9
Abi Rimmer
No abstract text is available yet for this article.
July 7, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28665092/establishing-a-mentoring-system-for-anaesthetic-trainees
#10
A Quinn, D Moore
Mentoring for doctors has been identified as an area requiring development. Currently, there is a void of trained mentors available. This article considers the evidence basis to support mentoring, and outlines the mentoring programme recently introduced by trainees in the College of Anaethetists.
April 10, 2017: Irish Medical Journal
https://www.readbyqxmd.com/read/28249602/relating-professionalism-and-conscientiousness-to-develop-an-objective-scalar-proxy-measure-of-professionalism-in-anaesthetic-trainees
#11
M A Sawdon, K Whitehouse, G M Finn, J C McLachlan, D Murray
BACKGROUND: The concept of professionalism is complex and subjective and relies on expert judgements. Currently, there are no existing objective measures of professionalism in anaesthesia. However, it is possible that at least some elements of professionalism may be indicated by objective measures. A number of studies have suggested that conscientiousness as a trait is a significant contributor to professionalism. METHODS: A 'Conscientiousness Index' (CI) was developed by collation of routinely collected data from tasks expected to be carried out by anaesthetic trainees such as punctual submission of holiday and 'not-on-call' requests, attendance at audit meetings, timely submission of completed appraisal documentation and sickness/absence notifications...
March 1, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/27734483/speak-up-barriers-to-challenging-erroneous-decisions-of-seniors-in-anaesthesia
#12
T Beament, S J Mercer
'Speaking up' or the ability to effectively challenge erroneous decisions is essential to preventing harm. This mixed-methods study in two parts explores the concept of 'barriers to challenging seniors' for anaesthetic trainees, and proposes a conceptual framework. Using a fully immersive simulation scenario with unanticipated airway difficulty, we investigated how junior anaesthetists (one to two years of training) challenged a scripted error. We also conducted focus groups with senior trainees (three to seven years of training) and undertook a 'thematic network analysis' of responses...
November 2016: Anaesthesia
https://www.readbyqxmd.com/read/27307473/identifying-and-exploring-factors-influencing-career-choice-recruitment-and-retention-of-anaesthesia-trainees-in-the-uk
#13
J N Moore, A J McDiarmid, P W Johnston, J A Cleland
BACKGROUND: Many acute hospital specialties are experiencing low recruitment and high attrition of trainees. Understanding what is important to current trainees is critical in terms of identifying and addressing factors which adversely affect recruitment and retention. OBJECTIVES: To identify and explore factors involved in anaesthetic trainees' career decision making. METHODS: This was a mixed methods study using a questionnaire survey (assessing how influential 18 different factors were when choosing anaesthetics, using a five-point Likert scale), supplemented by semi-structured interviews, carried out in August-December 2014, in Scotland, UK...
February 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/27108826/analysis-of-cricoid-pressure-application-anaesthetic-trainee-doctors-vs-nursing-anaesthetic-assistants
#14
RANDOMIZED CONTROLLED TRIAL
Nurul Haizam Yahaya, Rufinah Teo, Azarinah Izaham, Shereen Tang, Aliza Mohamad Yusof, Norsidah Abdul Manap
BACKGROUND AND OBJECTIVE: To evaluate the ability of anaesthetic trainee doctors compared to nursing anaesthetic assistants in identifying the cricoid cartilage, applying the appropriate cricoid pressure and producing an adequate laryngeal inlet view. METHODS: Eighty-five participants, 42 anaesthetic trainee doctors and 43 nursing anaesthetic assistants, were asked to complete a set of questionnaires which included the correct amount of force to be applied to the cricoid cartilage...
May 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/26993407/-analysis-of-cricoid-pressure-application-anaesthetic-trainee-doctors-vs-nursing-anaesthetic-assistants
#15
Nurul Haizam Yahaya, Rufinah Teo, Azarinah Izaham, Shereen Tang, Aliza Mohamad Yusof, Norsidah Abdul Manap
BACKGROUND AND OBJECTIVE: To evaluate the ability of anaesthetic trainee doctors compared to nursing anaesthetic assistants in identifying the cricoid cartilage, applying the appropriate cricoid pressure and producing an adequate laryngeal inlet view. METHODS: Eighty-five participants, 42 anaesthetic trainee doctors and 43 nursing anaesthetic assistants, were asked to complete a set of questionnaires which included the correct amount of force to be applied to the cricoid cartilage...
May 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/26792648/the-effect-of-two-cognitive-aid-designs-on-team-functioning-during-intra-operative-anaphylaxis-emergencies-a-multi-centre-simulation-study
#16
MULTICENTER STUDY
S D Marshall, P Sanderson, C A McIntosh, H Kolawole
This multi-centre repeated measures study was undertaken to determine how contrasting designs of cognitive aids affect team performance during simulated intra-operative anaphylaxis crises. A total of 24 teams consisting of a consultant anaesthetist, an anaesthetic trainee and anaesthetic assistant managed three simulated intra-operative anaphylaxis emergencies. Each team was assigned at random to a counterbalanced order of: no cognitive aid; a linear cognitive aid; and a branched cognitive aid, and scored for team functioning...
April 2016: Anaesthesia
https://www.readbyqxmd.com/read/26733403/improving-the-peri-operative-care-of-patients-by-instituting-a-block-room-for-regional-anaesthesia
#17
Maria Chazapis, Navkiran Kaur, Damon Kamming
Regional anaesthesia has multiple known benefits over general anaesthesia alone, but requires time and expertise for its application. This study aimed to decrease anaesthetic time and increase total surgical operative time by instituting a 'block room' where regional anaesthesia nerve blocks could be provided by expert anaesthetists in regular scheduled sessions. A baseline audit showed that 2 hours per day was spent on performing nerve blocks. Development of the block room allowed nerve blocks to be performed in parallel to surgical operations, reducing the mean anaesthetic control time from 44 mins to 27 mins...
2014: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/26016261/the-rapid-sequence-spinal-for-category-1-caesarean-section-anaesthetic-trainee-knowledge-and-practice
#18
Suyogi V Jigajinni, Baskar Rajala, Nadir El Sharawi
Rapid sequence induction of general anaesthesia (GA) is the fastest anaesthetic technique in a category-1 caesarean section (C1CS) for foetal distress. Recently rapid sequence spinal anaesthesia (RSS) has been explored as a technique to avoid the potential risks of GA in such cases. Out of hours, trainee anaesthetists are often required to provide anaesthesia for these emergencies. We surveyed their practices when performing a RSS. The aim of a RSS is to rapidly and safely achieve anaesthesia for C1CS, while optimising foetal oxygenation and preparing for possible GA...
January 2015: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/25857597/a-randomised-controlled-trial-of-radial-artery-cannulation-guided-by-doppler-vs-palpation-vs-ultrasound
#19
RANDOMIZED CONTROLLED TRIAL
K Ueda, E O Bayman, C Johnson, N J Odum, J Jy Lee
We randomly allocated 749 participants to radial artery cannulation by anaesthetic trainees, guided by Doppler (244), palpation (256) or ultrasound (249). Ultrasound increased the rate of cannulation at the first attempt by 14% (95% CI 5-22%), from 39% with Doppler or palpation, p = 0.002 for both. There were no differences in the rates of cannulation 5 min after the procedure started: 147/244 (60%) with Doppler; 160/256 (63%) with palpation; and 171/249 (69%) with ultrasound, p = 0.13.
September 2015: Anaesthesia
https://www.readbyqxmd.com/read/25482585/the-advance-nurse-practitioner-in-critical-care-a-workload-evaluation
#20
Audrey Jackson, Martin Carberry
BACKGROUND: The Advanced Nurse Practitioner in Critical Care role was developed to support the critical care team by undertaking specific roles traditionally associated with medical staff in the intensive care unit and high dependency unit. The rationale for the evaluation was to establish the specific tasks undertaken and scope of workload of these newly created posts. AIMS: To report on an evaluation of the specific activities, workload and patterns of prescribing of advanced nursing practice posts within a critical care settings METHODS: A data collection form was designed to capture clinically and patient-related activities of these post-holders...
March 2015: Nursing in Critical Care
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