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Operation theatre Quality improvement

Senthurun Mylvaganam, Elizabeth J Conroy, Paula R Williamson, Nicola L P Barnes, Ramsey I Cutress, Matthew D Gardiner, Abhilash Jain, Joanna M Skillman, Steven Thrush, Lisa J Whisker, Jane M Blazeby, Shelley Potter, Christopher Holcombe
INTRODUCTION: The 2008 National Mastectomy and Breast Reconstruction Audit demonstrated marked variation in the practice and outcomes of breast reconstruction in the UK. To standardise practice and improve outcomes for patients, the British professional associations developed best-practice guidelines with specific guidance for newer mesh-assisted implant-based techniques. We explored the degree of uptake of best-practice guidelines within units performing implant-based reconstruction (IBBR) as the first phase of the implant Breast Reconstruction Evaluation (iBRA) study...
February 7, 2018: European Journal of Surgical Oncology
Gareth S Turnbull, Mounir Hakimi, George J McLauchlan
INTRODUCTION: With rising NHS clinical and financial demands, improving theatre efficiency is essential to maintain quality of patient care. Consistent teams and consultant presence have been shown to improve outcomes and productivity in elective orthopaedic surgery. The aim of this study was to investigate the impact on trauma theatre productivity of different surgeons and anaesthetists working together in a Major Trauma Centre. The influence of consultant presence and weekend operating on productivity was also considered...
February 12, 2018: Injury
Ishwarya Balasubramanian, Ben Creavin, Des Winter
BACKGROUND: The provision of emergency general surgical services is undergoing a paradigm shift towards a consultant led, patient centered model in order to improve patient outcomes. The aim of this current study is to use meta-analytical techniques to assess the efficacy of acute surgical unit (ASU) in appendectomy. METHODS: A meta-analysis was conducted according to the PRISMA guidelines. A comprehensive literature search of PubMed, Embase and Scopus for published studies comparing ASU and traditional (TRAD) model on appendectomy outcomes was performed...
February 2018: International Journal of Surgery
Lena Friedrich, Irina Boeckelmann
BACKGROUND: Hygienic and microbiologically sterile air quality is essential for successful guideline-based work in operating theatres. To ensure clean air and to reduce contamination during surgery, ventilation systems are indispensable. Ventilation systems should be especially designed to keep the number of particles and germs under statutory limits. Therefore, they must be operated to recognised standards of good practice and be periodically inspected and maintained. The objective of this study was to prove, through the analysis of observation outside surgery time (rest condition), the effects of ventilation systems on air quality in a medical facility...
January 11, 2018: Zentralblatt Für Chirurgie
Laura Dallolio, Alessandra Raggi, Tiziana Sanna, Magda Mazzetti, Alessandra Orsi, Angela Zanni, Patrizia Farruggia, Erica Leoni
The microbiological contamination of operating theatres and the lack of adherence to best practices by surgical staff represent some of the factors affecting Surgical Site Infections (SSIs). The aim of the present study was to assess the microbiological quality of operating settings and the staff compliance to the SSI evidence-based control measures. Ten operating rooms were examined for microbiological contamination of air and surfaces, after cleaning procedures, in "at rest" conditions. Furthermore, 10 surgical operations were monitored to assess staff compliance to the recommended practices...
December 28, 2017: International Journal of Environmental Research and Public Health
Roberto Bentivegna, Annita Caminati, Vanni Agnoletti, Stefano Bonilauri, Stefania Buonaccorso, Giovanna Campaniello, Antonella Dovani, Giuseppina Lanciotti, Vania Maselli, Stefano Mastrangelo, Maria Teresa Montella, Teresa Palladino, Cristiano Pelati, Lorenzo Sciolino, Evita Zoni, Elisa Porcu, Anselmo Campagna, Ottavio Nicastro
INTRODUCTION: Safety Surgery CheckList (SSCL) is a support tool for operating teams, used to carry out safety checks while also encouraging compliance with the implementation of recommended quality and safety standards. In Emilia-Romagna it was deemed appropriate to check actual surgical team compliance with correct checklist application in the operating theatre, through a project called "OssERvare". METHODS: Direct observation was identified as the preferred inspection method...
November 2017: Recenti Progressi in Medicina
M Yiasemidou, E Gkaragkani, D Glassman, C S Biyani
BACKGROUND: Traditional surgical training, largely based on the Halstedian model "see one, do one, teach one" is not as effective in the era of working time restrictions and elaborate shift-patterns. As a result, contemporary surgeons turned to educational methods outside the operating theatre such as simulation. Cadavers are high fidelity models but their use has ethical and cost implications and their availability may be limited. In this review, we explore the role of cadaveric simulation in modern surgical education...
November 14, 2017: Irish Journal of Medical Science
Matthew J Lee, Adele E Sayers, Thomas M Drake, Marianne Hollyman, Mike Bradburn, Daniel Hind, Timothy R Wilson, Nicola S Fearnhead
INTRODUCTION: Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. METHODS AND ANALYSIS: UK hospitals providing emergency general surgery are eligible to participate...
October 5, 2017: BMJ Open
Tajinere Fregene, Sarah Wintle, Vishal Venkat Raman, Holly Edmond, Shoaib Rizvi
Objective Patient experience is one of the three pillars of quality in healthcare; improving it must be a key aim if we are to make the overall quality of the healthcare we provide better. Methods We devised a quality improvement project to improve the patient experience of elective surgery. We conducted surveys of patients and assessed their experience by using semistructured interviews and patient questionnaires. We gathered data about their overall satisfaction, fasting times and their communication with staff...
2017: BMJ Open Quality
Mahmoud Abu Abeeleh, Tareq M Tareef, Amjad Bani Hani, Nader Albsoul, Omar Q Samarah, M S ElMohtaseb, Musa Alshehabat, Zuhair Bani Ismail, Omar Alnoubani, Salameh S Obeidat, Sami Abu Halawa
PURPOSE: To report rates of and reasons for operation cancellation, and to prioritize areas of improvement. METHODS: Retrospective data were extracted from the monthly reports of cancelled listed operations. Data on 14 theatres were collected by the office of quality assurance at Jordan University Hospital from August 2012 to April 2016. Rates and reasons for operation cancellation were investigated. A Pareto chart was constructed to identify the reasons of highest priority...
August 2017: Annals of Surgical Treatment and Research
Kevin Phan, Nelson Wang, Jun S Kim, Parth Kothari, Nathan J Lee, Joshua Xu, Samuel K Cho
STUDY DESIGN: Retrospective cohort study. OBJECTIVE: Preoperative anemia has been associated with an increased need for blood transfusions and postoperative complications. The effects of anemia on the outcomes of anterior cervical discectomy and fusion (ACDF) have not been explored. The present study aimed to evaluate the association between preoperative anemia and 30-day complications following ACDF surgery. METHODS: Data from the American College of Surgeons National Surgical Quality Improvement Program (2005-2012) was used...
August 2017: Global Spine Journal
A Benditz, G Maderbacher, Florian Zeman, Joachim Grifka, Markus Weber, Frederik von Kunow, Felix Greimel, Armin Keshmiri
PURPOSE: The number of total hip and knee arthroplasties (THA and TKA) is steadily increasing. Many factors that influence pain have been reported, but little is known about the correlation between the time of day and the duration of surgery and postoperative pain. On one hand, surgical interventions are performed faster due to economic pressure; on the other hand, obtaining sound surgical skills and a thorough education are most important for young surgeons, particularly at university hospitals...
August 3, 2017: Archives of Orthopaedic and Trauma Surgery
F W van de Graaf, A G Menon, M M Lange
Today, video imaging is a major part of laparoscopic surgery. Despite continuous efforts to improve or innovate laparoscopic techniques, the registration of laparoscopic imaging for quality of care purposes remains an afterthought. By recording the essential steps of a surgical procedure, it is possible to inquire in more detail about what actually occurred in the operating theatre. However, it is necessary to take the legal framework into account. Questions concerning patient consent, permission from healthcare providers, whether video documentation should enter the patient record, and the length of the period it is retained must be answered...
2017: Nederlands Tijdschrift Voor Geneeskunde
Peter A Brennan, Marieke T Brands, Lucy Caldwell, Felipe Paiva Fonseca, Nic Turley, Susie Foley, Siavash Rahimi
Essential communication between healthcare staff is considered one of the key requirements for both safety and quality care when patients are handed over from one clinical area to other. This is particularly important in environments such as the operating theatre and intensive care where mistakes can be devastating. Health care has learned from other high-risk organisations (HRO) such as aviation where the use of checklists and human factors awareness has virtually eliminated human error and mistakes. To our knowledge, little has been published around ways to improve pathology specimen handover following surgery, with pathology request forms often conveying the bare minimum of information to assist the laboratory staff...
July 10, 2017: Journal of Oral Pathology & Medicine
(no author information available yet)
Risky Business In the early 2000s, a quality improvement project brought together a group of healthcare professionals with experts from the world of motor racing. They compared handovers of critically ill infants and children from operating theatre to intensive care team after complex heart surgery with the processes of a Formula 1 pitstop.
July 10, 2017: Nursing Children and Young People
Shraddha Vidyadhar Naik, Bilal Mohammad, Vitthal K Dhulkhed
INTRODUCTION: Preoperative evaluation of a patient is the fundamental component of anaesthetic practice. Inadequate documentation and record keeping on the preoperative evaluation form (PEF) can be a major obstacle to attaining good practice and improving patient outcomes following operative procedures. AIM: The aim of the study was to conduct an audit to assess the quality of the preoperative anaesthetic information gathered and to observe the quality profile after the introduction of a standardized pre-operative evaluation form...
April 2017: Anesthesia, Essays and Researches
Mario Victor Newton, Rakesh S Ramesh, Suraj Manjunath, K ShivaKumar, Hemanth G Nanjappa, Ramu Damuluri, Elvis Peter Joseph, C Prasad
Lymphadenopathy can be due to multitude of causes. Owing to the high prevalence of infectious diseases in India, and malignancy being a life threatening cause for lymphadenopathy; accurate diagnosis is important in preventing delay or misdiagnosis and in improving patient care, thereby increasing longevity with quality. Fine needle aspiration cytology (FNAC) is the first line investigation commonly done. Should the doctor be contented with the benign FNAC or is a lymph node biopsy needed in this age? The aims of this study are the following: (1) to study the spectral pattern of lymph node biopsies done in a surgical oncology unit of tertiary care centre, (2) to assess the yield of malignant cases from lymph node biopsy and (3) to compare the reliability of benign FNAC with lymph node biopsy...
June 2017: Indian Journal of Surgical Oncology
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
December 2017: Journal of Clinical Nursing
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
June 2017: Der Anaesthesist
Ioannis Christakis, John A Livesey, Gregory P Sadler, Radu Mihai
PURPOSE: Adrenalectomy has the potential to cure or improve the control of hypertension in patients with primary hyperaldosteronism due to unilateral adrenal adenoma (Conn's syndrome). This study assesses the patients' perception of, and costs associated with, laparoscopic adrenalectomy for Conn's syndrome. MATERIALS AND METHODS: Clinical, radiological, operative, and pathological data were collected on patients undergoing adrenalectomy for Conn's syndrome over 8-years period in a UK tertiary referral center...
May 12, 2017: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
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