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https://www.readbyqxmd.com/read/28718098/massive-hemorrhage-and-transfusion-in-the-operating-room
#1
Brian Muirhead, Andrew D H Weiss
PURPOSE: In this Continuing Professional Development module, we review the pathophysiology and clinical manifestations associated with massive hemorrhage as well as laboratory investigations and appropriate therapeutic measures. In addition to reviewing the available blood/plasma products and adjunct therapy, we also explore the role of the anesthesiologist in a massive transfusion protocol scenario. PRINCIPAL FINDINGS: Massive hemorrhage can be either anticipated or unexpected...
July 17, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28683726/factors-contributing-to-airborne-particle-dispersal-in-the-operating-room
#2
Chieko Noguchi, Hironobu Koseki, Hidehiko Horiuchi, Akihiko Yonekura, Masato Tomita, Takashi Higuchi, Shinya Sunagawa, Makoto Osaki
BACKGROUND: Surgical-site infections due to intraoperative contamination are chiefly ascribable to airborne particles carrying microorganisms. The purpose of this study is to identify the actions that increase the number of airborne particles in the operating room. METHODS: Two surgeons and two surgical nurses performed three patterns of physical movements to mimic intraoperative actions, such as preparing the instrument table, gowning and donning/doffing gloves, and preparing for total knee arthroplasty...
July 6, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28662248/surgical-efficiency-of-anterior-cruciate-ligament-reconstruction-in-outpatient-surgical-center-versus-hospital-operating-room
#3
Nathan C Patrick, Christopher A Kowalski, William L Hennrikus
Anterior cruciate ligament (ACL) reconstructions are complex orthopedic procedures in which a proficient team is of vital importance. Outpatient surgical centers (OSCs) often provide orthopedic-specific teams; however, hospital operating rooms (ORs) commonly rotate staff. The purpose of this study was to compare the efficiency of pediatric ACL reconstructions between a surgical center and a hospital OR owned and directed by a single institution. Cases examined involved pediatric patients, aged 12 to 18 years (mean age, 15...
June 29, 2017: Orthopedics
https://www.readbyqxmd.com/read/28657942/perception-of-safety-of-surgical-practice-among-operating-room-personnel-from-survey-data-is-associated-with-all-cause-30-day-postoperative-death-rate-in-south-carolina
#4
George Molina, William R Berry, Stuart R Lipsitz, Lizabeth Edmondson, Zhonghe Li, Bridget A Neville, Aunyika T Moonan, Lorri R Gibbons, Atul A Gawande, Sara J Singer, Alex B Haynes
OBJECTIVE: To evaluate whether the perception of safety of surgical practice among operating room (OR) personnel is associated with hospital-level 30-day postoperative death. BACKGROUND: The relationship between improvements in the safety of surgical practice and benefits to postoperative outcomes has not been demonstrated empirically. METHODS: As part of the Safe Surgery 2015: South Carolina initiative, a baseline survey measuring the perception of safety of surgical practice among OR personnel was completed...
June 27, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28633152/state-of-pelvic-and-acetabular-surgery-in-the-developing-world-a-global-survey-of-orthopaedic-surgeons-at-surgical-implant-generation-network-sign-hospitals
#5
Paul S Whiting, Duane R Anderson, Daniel D Galat, Lewis G Zirkle, Douglas W Lundy, Hassan R Mir
OBJECTIVES: To document the current state of pelvic and acetabular surgery in the developing world and to identify critical areas for improvement in the treatment of these complex injuries. DESIGN: A 50-question online survey. SETTING: International, multicenter. PATIENTS/PARTICIPANTS: One hundred eighty-one orthopaedic surgeons at Surgical Implant Generation Network (SIGN) hospitals, which represent a cross-section of institutions in low- and middle-income countries that treat high-energy musculoskeletal trauma...
July 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28625430/sensorimotor-and-executive-function-slowing-in-anesthesiology-residents-after-overnight-shifts
#6
George W Williams, Bairavi Shankar, Eliana M Klier, Alice Z Chuang, Salma El Marjiya-Villarreal, Omonele O Nwokolo, Aanchal Sharma, Anne B Sereno
STUDY OBJECTIVE: Medical residents working overnight call shifts experience sleep deprivation and circadian clock disruption. This leads to deficits in sensorimotor function and increases in workplace accidents. Using quick tablet-based tasks, we investigate whether measureable executive function differences exist following a single overnight call versus routine shift, and whether factors like stress, rest and caffeine affect these measures. DESIGN: A prospective, observational, longitudinal, comparison study was conducted...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28601724/ifna-approved-chinese-anaesthesia-nurse-education-program-a-delphi-method
#7
Jiale Hu, Michael D Fallacaro, Lili Jiang, Junyan Wu, Hong Jiang, Zhen Shi, Hong Ruan
BACKGROUND: Numerous nurses work in operating rooms and recovery rooms or participate in the performance of anaesthesia in China. However, the scope of practice and the education for Chinese Anaesthesia Nurses is not standardized, varying from one geographic location to another. Furthermore, most nurses are not trained sufficiently to provide anaesthesia care. OBJECTIVES: This study aimed to develop the first Anaesthesia Nurse Education Program in Mainland China based on the Educational Standards of the International Federation of Nurse Anaesthetists...
June 4, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28601312/improving-staff-perception-of-a-safety-climate-with-crew-resource-management-training
#8
SreyRam Kuy, Ramon A L Romero
BACKGROUND: Communication failure is one of the top root causes in patient safety adverse events. Crew resource management (CRM) is a team building communication process intended to improve patient safety by improving team dynamics. First, to describe implementation of CRM in a Veterans Affair (VA) surgical service. Second, to assess whether staff CRM training is related to improvement in staff perception of a safety climate. MATERIAL AND METHODS: Mandatory CRM training was implemented for all surgical service staff at a VA Hospital at 0 and 12 mo...
June 1, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28599728/at-the-post-anaesthesia-care-unit
#9
Isabelle Clavagnier
Pierre is assigned to the Post-operational Recovery room. The care team comprises two anaesthetic nurses, a trainee anaesthetic nurse, a qualified registered nurse, and a healthcare assistant. In addition, an anaesthetist is available to intervene at any time.
June 2017: Revue de L'infirmière
https://www.readbyqxmd.com/read/28580562/-applying-team-resource-management-to-accelerate-rewarming-among-patients-undergoing-general-anesthesia
#10
Ya-Ching Fang, Yen-Hsueh Chen, Yu-Ting Liu, Tzu-Chia Lin
BACKGROUND & PROBLEMS: Hypothermia is the cause of multiple problems such as delayed awaking from anesthesia, feelings of discomfort, increased oxygen consumption, and increased risks of surgical wound infection and complications. A review of the record of post-operative patients receiving general anesthesia (GA) revealed that only 74% of the patients in our post-anesthesia room (PAR) had restored their body temperature to 36℃ after 60 minutes. Through situation analysis, several causes were identified, including insufficient warming facilities, lack of standard procedures and an audit system, lack of knowledge regarding hyperthermia among nurses, and the incompleteness of perioperative warming interventions performed by the healthcare team...
June 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28579070/improving-teamwork-evaluating-workload-of-surgical-team-during-robot-assisted-surgery
#11
Lora A Cavuoto, Ahmed A Hussein, Vivek Vasan, Youssef Ahmed, Ayesha Durrani, Saira Khan, Adam Cole, Derek Wang, Justen Kozlowski, Basim Ahmad, Khurshid A Guru
OBJECTIVE: To investigate the cognitive and physical workload experienced by each operating room team member for different types of urological procedures. METHODS: Surgeons, anesthesiologists, surgical fellows, bedside assistants, circulating nurses and scrub nurses completed the NASA Task Load Index (NASA-TLX) questionnaire for various urological RAS procedures. A total of 338 questionnaires from 55 unique individuals were collected. Workload differences by role, type of procedure, and surgery duration were analyzed using analysis of variance (ANOVA) for each of the six domains of NASA-TLX...
June 1, 2017: Urology
https://www.readbyqxmd.com/read/28574957/-attention-everyone-time-out-safety-attitudes-and-checklist-practices-in-anesthesiology-in-germany-a-cross-sectional-study
#12
Christopher Neuhaus, Aline Spies, Henryk Wilk, Markus A Weigand, Christoph Lichtenstern
BACKGROUND: The use of perioperative checklists has generated a growing body of evidence pointing toward reduction of mortality and morbidity, improved compliance with guidelines, reduction of adverse events, and improvements in human factor-related areas. Usual quality management metrics generally fall short in assessing compliance with their perioperative application. Our study assessed application attitudes and compliance with safety measures centered around the World Health Organization (WHO) "Safe Surgery Saves Lives" campaign as perceived by anesthesia professionals in Germany...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28574955/safety-culture-in-the-operating-room-variability-among-perioperative-healthcare-workers
#13
Marc Philip T Pimentel, Stephanie Choi, Karen Fiumara, Allen Kachalia, Richard D Urman
INTRODUCTION: Safety culture is defined as the product of individual and group values, attitudes, perceptions, competencies, and patterns of behavior that determine an organization's health and safety management. There is a lack of studies assessing patient safety culture in the perioperative setting. OBJECTIVES: We examined safety culture at a single tertiary care hospital, across all types of surgery, using previously collected data from a validated survey tool...
June 1, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28570718/free-flap-reconstruction-monitoring-techniques-and-frequency-in-the-era-of-restricted-resident-work-hours
#14
Urjeet A Patel, David Hernandez, Yelizaveta Shnayder, Mark K Wax, Matthew M Hanasono, Joshua Hornig, Tamer A Ghanem, Matthew Old, Ryan S Jackson, Levi G Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B Greene, James Bekeny, Yin Yiu, Salem Noureldine, David X Li, Joel Fontanarosa, Evan Greenbaum, Jeremy M Richmon
Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps...
June 1, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28570286/design-and-implementation-of-the-intensive-care-unit-quality-management-registry-monitoring-quality-and-cost-of-an-adult-intensive-care-unit-in-a-greek-state-hospital
#15
Dimitrios Kosmidis, Sotiria Koutsouki, Klairi Lampiri, Eva Ottilia Nagy, Vasilios Papaioannou, Ioannis Pneumatikos, George Anastassopoulos
Intensive care electronic registries have been instrumental in quality measurement, improvement, and assurance of intensive care. In this article, the development and pilot implementation of the Intensive Care Unit Quality Management Registry are described, with a particular focus on monitoring the quality and operational cost in an adult ICU at a northern Greek state hospital. A relational database was developed for a hospital ICU so that qualitative and financial data are recorded for further analysis needed for planning quality care improvement and enhanced efficiency...
May 31, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28567575/analysis-of-the-cost-effectiveness-of-laparoscopic-pancreatoduodenectomy
#16
Michael H Gerber, Daniel Delitto, Cristina J Crippen, Thomas J George, Kevin E Behrns, Jose G Trevino, Jessica L Cioffi, Steven J Hughes
OBJECTIVE: We sought to determine if laparoscopic pancreatoduodenectomy (LPD) is a cost-effective alternative to open pancreatoduodenectomy (OPD). METHODS: Hospital cost data, discharge disposition, readmission rates, and readmission costs from periampullary cancer patient cohorts of LPD and OPD were compared. The surgical cohorts over a 40-month period were clinically similar, consisting of 52 and 50 patients in the LPD and OPD groups, respectively. RESULTS: The total operating room costs were higher in the LPD group as compared to the OPD group (median US$12,290 vs US$11,299; P = 0...
May 31, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28560549/cost-analysis-of-prostate-artery-embolization-pae-and-transurethral-resection-of-the-prostate-turp-in-the-treatment-of-benign-prostatic-hyperplasia
#17
Sandeep Bagla, John Smirniotopoulos, Julie Orlando, Rachel Piechowiak
PURPOSE: Prostatic arterial embolization (PAE) has emerged as a minimally invasive alternative to TURP; however, there are limited cost comparisons reported. The purpose of this study was to compare in-hospital direct costs of elective PAE and TURP in a hospital setting. MATERIALS AND METHODS: Institutional Review Board-approved retrospective review was performed on patients undergoing PAE and TURP from January to December 2014. Inclusion criteria included male patients greater than 40 years of age who presented for ambulatory TURP or PAE with no history of prior surgical intervention for BPH...
May 30, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28551445/decreasing-postoperative-narcotics-in-reconstructive-pelvic-surgery-a%C3%A2-randomized-controlled-trial
#18
Krista M L Reagan, David M O'Sullivan, Richard Gannon, Adam C Steinberg
BACKGROUND: Postoperative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused. OBJECTIVE: The objective of our study was to evaluate the efficacy of a multimodal pain regimen after pelvic reconstructive surgery. STUDY DESIGN: The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea, and constipation. Patients were randomized to either usual care postoperative treatment or multimodal pain regimen...
May 25, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28538983/assocation-of-a-surgical-task-during-training-with-team-skill-acquisition-among-surgical-residents-the-missing-piece-in-multidisciplinary-team-training
#19
Jessica L Sparks, Dustin L Crouch, Kathryn Sobba, Douglas Evans, Jing Zhang, James E Johnson, Ian Saunders, John Thomas, Sarah Bodin, Ashley Tonidandel, Jeff Carter, Carl Westcott, R Shayn Martin, Amy Hildreth
Importance: The human patient simulators that are currently used in multidisciplinary operating room team training scenarios cannot simulate surgical tasks because they lack a realistic surgical anatomy. Thus, they eliminate the surgeon's primary task in the operating room. The surgical trainee is presented with a significant barrier when he or she attempts to suspend disbelief and engage in the scenario. Objective: To develop and test a simulation-based operating room team training strategy that challenges the communication abilities and teamwork competencies of surgeons while they are engaged in realistic operative maneuvers...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28523040/the-patient-safety-culture-perception-of-turkish-nurses-who-work-in-operating-room-and-intensive-care-unit
#20
Selda Rizalar, Sacide Yildizeli Topcu
OBJECTIVE: To determine the patient safety culture perception of operating room and intensive care nurses and the factors affecting this perception. METHODS: This descriptive study was conducted on 232 nurses working in a Turkish city hospitals. The data obtained from the nurses were collected using personal information form and Patient Safety Culture Scale (PSCS) from June to July 2015. RESULTS: The total score average of the nurses on the PSCS was 2...
March 2017: Pakistan Journal of Medical Sciences Quarterly
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