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Effect of experience on safety in operation theatre

Thomas C Sauter, Wolf E Hautz, Simone Hostettler, Monika Brodmann-Maeder, Luca Martinolli, Beat Lehmann, Aristomenis K Exadaktylos, Dominik G Haider
BACKGROUND: Sedation is a procedure required for many interventions in the Emergency department (ED) such as reductions, surgical procedures or cardioversions. However, especially under emergency conditions with high risk patients and rapidly changing interdisciplinary and interprofessional teams, the procedure caries important risks. It is thus vital but difficult to implement a standard operating procedure for sedation procedures in any ED. Reports on both, implementation strategies as well as their success are currently lacking...
2016: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
Sofia Erestam, Eva Angenete, Kristoffer Derwinger
BACKGROUND: A pause routine may reduce stress and errors during surgery. The aim of this study was to explore how the team, divided into the different professional groups, perceived the implementation of a pause routine and its possible impact on safety. METHODS: A pause routine was introduced at a University hospital operating theatre in Sweden in 2013. Questionnaires were distributed about 1 year later to all members of the operating theatre team. The questions included different perspectives of possible effects of the pause routine...
July 14, 2016: World Journal of Surgery
A Saksena, M N Pemberton, A Shaw, S Dickson, M P Ashley
Extraction of the wrong tooth or teeth is a serious and avoidable clinical error causing harm to the patient. All NHS Trusts in England are required to use a surgical safety checklist in operating theatres to prevent incorrect site surgery and ensure safe management of patients. However, the majority of patients have dental extractions and other oral surgical procedures undertaken on an outpatient basis and these patients are also at risk of having an incorrect site surgical procedure such as a wrong tooth extraction...
October 2014: British Dental Journal
Ranieri Y I Koh, Taezoon Park, Christopher D Wickens
BACKGROUND: Literature has identified failures in task management as direct determinants leading to accidents in the operating theatre. However, very few studies have investigated the factors underlying task management that directly influence the performance of the scrub nurses. The traditional belief that expertise is a general indicator of performance has been empirically investigated with varying results, but none has attempted to identify the task management determinants affecting performance, as influenced by the level of expertise...
September 2014: International Journal of Nursing Studies
Raheej Khan, Abdullatif Aydin, Muhammad Shamim Khan, Prokar Dasgupta, Kamran Ahmed
OBJECTIVES: To identify and review the currently available simulators for prostate surgery and to explore the evidence supporting their validity for training purposes. MATERIALS AND METHODS: A review of the literature between 1999 and 2014 was performed. The search terms included a combination of urology, prostate surgery, robotic prostatectomy, laparoscopic prostatectomy, transurethral resection of the prostate (TURP), simulation, virtual reality, animal model, human cadavers, training, assessment, technical skills, validation and learning curves...
October 2015: BJU International
G W Irwin, A Black, S E Refsum, S A McIntosh
INTRODUCTION: Immediate reconstruction following mastectomy for breast cancer has been shown to be oncologically safe and associated with improved psychosocial outcomes for patients. Bostwick described a technique for one-stage implant based reconstruction, combining skin-sparing mastectomy with concurrent reduction of the skin envelope. This report reviews the experience of a single centre using skin-reducing mastectomy and one-stage implant reconstruction in both early stage breast cancer and risk-reducing mastectomy, with specific reference to frequency of complications, implant loss and oncological outcomes...
September 2013: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Amna Suliman, Robert E Klaber, Oliver J Warren
It is increasingly recognised that leadership skills are a key requirement in being successful in surgery, regardless of speciality and at all levels of experience and seniority. Where the emphasis was previously on technical ability, knowledge and diagnostic acumen, we now know that non-technical skills such as communication and leadership contribute significantly to patient safety, experience and outcomes, and should be valued. The operating theatre is a unique micro-environment which is often busier, noisier, more stressful and more physically demanding than the clinic or ward setting...
2013: International Journal of Surgery
G Kirby, K Kapoor, P Das-Purkayastha, M Harries
INTRODUCTION: The General Medical Council states 'a surgeon must not work when their health state is adversely influenced by fatigue, disease, drugs or alcohol'. However, there are no defined criteria for acceptable blood alcohol levels when operating. The aim of this study was to measure the effect of varying amounts of alcohol on surgical dexterity, cognitive abilities and the social interactions required to ensure patient safety during a routine ear, nose and throat (ENT) operation...
March 2012: Annals of the Royal College of Surgeons of England
Christine M Jorm, Greg O'Sullivan
There has been no research performed concerning the effects of the use of laptops and smartphones in the operating theatre on anaesthetist performance, yet these devices are now in frequent use. This article explores the implications of this phenomenon. The cognitive and environmental factors that support or detract from vigilance and multi-tasking are explored and core anaesthetic literature on the nature of anaesthetic work and operating theatre distractions is reviewed. Experienced anaesthetists are skilled at multi-tasking while maintaining situational awareness, but there are limits...
January 2012: Anaesthesia and Intensive Care
Salman Waqar, Olayinka Williams, Jonathan Park, Neil Modi, Thomas Kersey, Tamsin Sleep
AIM: To establish the effect of acute loss of stereopsis on simulated intraocular surgical performance. METHODS: This study was performed using the EYESi ophthalmic surgical simulator. Thirty junior doctors with no previous ophthalmic surgical experience were enrolled and distance visual acuity (Snellen), near visual acuity and stereoacuity (Frisby) were recorded. All participants completed a standard introductory programme on the forceps module to eliminate the learning curve...
May 2012: British Journal of Ophthalmology
J Crossley, J Marriott, H Purdie, J D Beard
BACKGROUND: Most surgical assessment has been aimed at technical proficiency. However, non-technical skills also affect patient safety and clinical effectiveness. The NOTSS (Non-Technical Skills for Surgeons) assessment instrument was developed specifically to assess the non-technical skills of individual surgeons in the operating theatre. This study evaluated NOTSS as a real-world assessment, with a mix of minimally trained assessors. The evaluation criteria were feasibility, validity and psychometric reliability...
July 2011: British Journal of Surgery
R L Kneebone, D Nestel, C Vincent, A Darzi
BACKGROUND: A complex chain of events underpins every clinical intervention, especially those involving invasive procedures. Safety requires high levels of awareness and vigilance. In this paper we propose a structured approach to procedural training, mapping each learner's evolving experience within a matrix of clinical risk and procedural complexity. We use a traffic light analogy to conceptualize a dynamic awareness of prevailing risk and the implications of moving between zones. THE IMPORTANCE OF CONTEXT: We argue that clinical exposure can be consolidated by simulation where appropriate, ensuring that each learner gains the skills for safe care within the increasingly limited time available for training...
August 2007: Medical Education
Ioannis Mavrikakis, Tassos Georgiou, Bobby Paul, Christopher S C Liu
BACKGROUND: "Cataract Surgery by Appointment" is a new method of delivery of cataract surgery that reduces the time a patient spends in hospital by their direct arrival at the operating theatre, having self-prepared for surgery, thus avoiding admission to the ward or time spent in the Day Case Unit. The patient can stay as little as 20 minutes from their arrival to going home. We describe the process in detail, and seek to evaluate the visual outcome, safety and patient satisfaction of same...
2006: BMC Ophthalmology
Debra Nestel, Jane Kidd
UNLABELLED: Nurses' perceptions and experiences of communication in the operating theatre: a focus group interview BACKGROUND: Communication programmes are well established in nurse education. The focus of programmes is most often on communicating with patients with less attention paid to inter-professional communication or skills essential for working in specialised settings. Although there are many anecdotal reports of communication within the operating theatre, there are few empirical studies...
2006: BMC Nursing
P Mĕricka, F Hosek
This study provides supportive evidence of a possible role played by planning supplies of biological covers needed in fire disaster, based on the experience of the authors. The major steps to be taken are these: 1. Providing a technically and technologically adequate base for collection and long-term storage of cells and tissues ready for use in case of catastrophe. 2. Developing a method for estimating the amount of reserved tissue grafts. 3. Solution of logistical problems associated with providing supplies for operating theatres treating disaster casualties...
2002: Acta Chirurgiae Plasticae
C Overton, J Hargreaves, M Maresh
OBJECTIVES: To study the frequency of complications of endometrial resection and ablation for menstrual disturbances and the influence of the experience of the operators. DESIGN: Prospective survey with additional retrospective reporting by theatre staff. SETTING: 300 National Health Service and independent hospitals in the United Kingdom (excluding Scotland). POPULATION: 10,686 women registered by 690 doctors (1-222 cases/doctor) from April 1993 to October 1994...
December 1997: British Journal of Obstetrics and Gynaecology
M Klein, S P Ramoroko, A G Jacobs, M D Bomela, K P Mokhobo, M L Mohlala
OBJECTIVE: To test the practicality, safety and benefits of major cardiothoracic surgery in two rural hospitals. DESIGN: Analysis of morbidity and mortality outcomes of a random collection of 35 patients, who underwent diverse surgical procedures. At each visit, the cardiothoracic team of Ga-Rankuwa Hospital-one surgeon, three registrars, two medical officers, six nurses, and four perfusionists-moved all equipment for major surgery, including bypass machines, to two small rural hospitals...
December 1996: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
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