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Handoff anesthesia

Julia Geynisman-Tan, Oluwateniola Brown, Margaret Mueller, Katarzyna Bochenska, Sarah Collins, Christina Lewicky-Gaupp, Kimberly Kenton
OBJECTIVES: This study aimed to determine if personnel handoffs or number of learners in the operating room (OR) are associated with longer OR times in women having pelvic organ prolapse surgery. METHODS: A retrospective review of women undergoing prolapse surgery in 2016 was conducted. Demographics; procedure; OR, anesthetic, and surgical time; number of handoffs between anesthesia members, circulators, and surgical technologies; and number of learners were abstracted...
March 2018: Female Pelvic Medicine & Reconstructive Surgery
Richard H Epstein, Franklin Dexter, David M Gratch, David A Lubarsky
BACKGROUND: When electronic anesthesia records are compared to pharmacy transactions, discrepancies in total doses of controlled drugs are commonly found (≈16% of cases), potentially affecting patient safety and placing hospitals at risk for regulatory action. Errors (≈5%) persisted even with near real-time drug reconciliation feedback to providers. A study was conducted to test the hypothesis of greater risks of discrepancy for longer-duration cases and for intraoperative handoff involving a permanent handoff of care...
August 2017: Joint Commission Journal on Quality and Patient Safety
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
Thomas J Caruso, Juan Luis Sandin Marquez, Melanie S Gipp, Stephen P Kelleher, Paul J Sharek
Purpose No studies have examined preoperative handoffs from the intensive care unit (ICU) to OR. Given the risk of patient harm, the authors developed a standardized ICU to OR handoff using a previously published handoff model. The purpose of this paper is to determine whether a standardized ICU to OR handoff process would increase the number of team handoffs and improve patient transport readiness. Design/methodology/approach The intervention consisted of designing a multidisciplinary, face-to-face handoff between sending ICU providers and receiving anesthesiologist and OR nurse, verbally presented in the I-PASS format...
May 8, 2017: International Journal of Health Care Quality Assurance
Madeline C Heck, Peter Huges, Mojca Konia
BACKGROUND: Poor-quality handoffs are a significant cause of preventable medical errors and adverse events. Handoff checklists improve handoffs but adherence to these tools is often inconsistent. In our study we aimed to investigate the effects of simulated handoff workshop and clinical instruction on resident handoff quality. METHODS: A three-week pre-education intervention observation period of handoffs was conducted to assess the deficits, variability, and common practice in handoffs at the University of Minnesota Fairview Hospital...
January 2017: Journal of Education in Perioperative Medicine: JEPM
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
Danton Char
No abstract text is available yet for this article.
September 2016: American Journal of Bioethics: AJOB
Marian Feil, Nicole A Irick
As neurosurgical interventions and procedures are advancing, so is the specialty of neuro-anesthesia. The neurosurgeon and the neuro-anesthetist are focused on providing each patient with the best possible outcome. Throughout the surgery, the main priorities of the neuro-anesthetist are patient safety, patient well-being, surgical field exposure, and patient positioning. Potential postoperative complications include nausea and vomiting. Postoperative visual loss is a complication of neurosurgery, most specifically spine surgery, whose origins are unknown...
March 2016: Critical Care Nursing Clinics of North America
Franklin Dexter, Johannes Ledolter, Bradley J Hindman
In this Statistical Grand Rounds, we review methods for the analysis of the diversity of procedures among hospitals, the activities among anesthesia providers, etc. We apply multiple methods and consider their relative reliability and usefulness for perioperative applications, including calculations of SEs. We also review methods for comparing the similarity of procedures among hospitals, activities among anesthesia providers, etc. We again apply multiple methods and consider their relative reliability and usefulness for perioperative applications...
January 2016: Anesthesia and Analgesia
Meghan B Lane-Fall
No abstract text is available yet for this article.
January 2016: Anesthesia and Analgesia
Zirka H Anastasian, Minjae Kim, Eric J Heyer, Shuang Wang, Mitchell F Berman
BACKGROUND: Factors including ASA physical status, blood loss, and case length have been described as correlating with the decision to delay tracheal extubation after specific surgical procedures. In this retrospective study, we investigated whether handoffs by anesthesia attendings were associated with delayed extubation after general anesthesia for a broad range of surgical procedures. METHODS: We reviewed the records of 37,824 patients who underwent general anesthesia with an endotracheal tube for surgery (excluding tracheostomy surgery, cardiac surgeries, and liver and lung transplant surgeries) from 2008 to 2013 at Columbia University Medical Center...
March 2016: Anesthesia and Analgesia
Holly-May Robins, Feng Dai
Information loss can occur during all phases of care. The transfer of care (handoff) from the operating room to the postoperative anesthesia care unit (PACU) is an especially susceptible time. Information loss can lead to an increase in medication errors, sentinel events, and poor patient outcomes. High-reliability organizations, such as the aviation industry, use checklists to decrease errors and improve safety. As the healthcare industry becomes more complex, it is in the interest of patient safety to develop, validate, and use similar objective procedures as those used in high-reliability organizations...
August 2015: AANA Journal
Randolph H Steadman, Amanda R Burden, Yue Ming Huang, David M Gaba, Jeffrey B Cooper
BACKGROUND: This study describes anesthesiologists' practice improvements undertaken during the first 3 yr of simulation activities for the Maintenance of Certification in Anesthesiology Program. METHODS: A stratified sampling of 3 yr (2010-2012) of participants' practice improvement plans was coded, categorized, and analyzed. RESULTS: Using the sampling scheme, 634 of 1,275 participants in Maintenance of Certification in Anesthesiology Program simulation courses were evaluated from the following practice settings: 41% (262) academic, 54% (339) community, and 5% (33) military/other...
May 2015: Anesthesiology
Michelle A Petrovic, Hanan Aboumatar, Adam T Scholl, Randeep S Gill, Dina A Krenzischek, Melissa S Camp, Carolyn M Senger, Yi Deng, Tracy Y Chang, Yanjun Xie, Zahi R Jurdi, Elizabeth A Martinez
STUDY OBJECTIVE: To evaluate a new perioperative handoff protocol in the adult perianesthesia care units (PACUs). DESIGN: Prospective, unblinded cross-sectional study. SETTING: Perianesthesia care unit in a tertiary care facility serving 55,000 patients annually. PATIENTS: One hundred three surgery patients. INTERVENTIONS: During a 4-week preintervention phase, 53 perioperative handoffs were observed, and data were collected daily by a trained observer...
March 2015: Journal of Clinical Anesthesia
Gildasio S De Oliveira, Franklin Dexter, Jane M Bialek, Robert J McCarthy
BACKGROUND: Supervision of anesthesiology residents is a major responsibility of faculty (academic) anesthesiologists. Supervision can be evaluated daily for individual anesthesiologists using a 9-question instrument. Faculty anesthesiologists with lesser individual scores contribute to lesser departmental (global) scores. Low (<3, "frequent") department-wide evaluations of supervision are associated with more mistakes with negative consequences to patients. With the long-term aim for residency programs to be evaluated partly based on the quality of their resident supervision, we assessed the 9-item instrument's reliability and validity when used to compare anesthesia programs' rotations nationwide...
January 2015: Anesthesia and Analgesia
Charlotte T Jones, Vidya T Raman, Seth DeVries, Justin W Cole, Kelly J Kelleher, Joseph D Tobias
OBJECTIVE: Children with epilepsy are at increased risk of missing scheduled anticonvulsants during the home-to-hospital transition, including when being admitted for procedures requiring anesthesia. This may contribute to breakthrough seizures because of lowered anticonvulsant levels. We conducted an interdisciplinary quality improvement project with a specific aim to increase the percentage of children receiving their anticonvulsants as scheduled before procedures requiring anesthesia...
November 2014: Pediatric Neurology
Richard P Dutton
No abstract text is available yet for this article.
October 2014: Anesthesiology
Nancy S Hagerman, Anna M Varughese, C Dean Kurth
PURPOSE OF REVIEW: Cognitive aids are tangible or intangible instruments that guide users in decision-making and in the completion of a complex series of tasks. Common examples include mnemonics, checklists, and algorithms. Cognitive aids constitute very effective approaches to achieve well tolerated, high quality healthcare because they promote highly reliable processes that reduce the likelihood of failure. This review describes recent advances in quality improvement for pediatric anesthesiology with emphasis on application of cognitive aids to impact patient safety and outcomes...
June 2014: Current Opinion in Anaesthesiology
A Dharmadasa, I Bailes, K Gough, N Ebrahimi, P N Robinson, D N Lucas
INTRODUCTION: The SAFE handover tool was developed to reduce critical omissions during handovers in obstetric anaesthesia. It comprises a simple proforma onto which the outgoing team documents patients who fall into one of four anaesthetically relevant categories: Sick patients; At-risk patients (of emergency caesarean section, major haemorrhage or anaesthetic problems); Follow-ups; and Epidurals. We hypothesised that its use would reduce the number of critical omissions at handover. METHODS: The efficacy of the SAFE handover tool was assessed through several audit cycles in a single maternity unit...
May 2014: International Journal of Obstetric Anesthesia
Paula Kobelt, Karen Burke, Paula Renker
The impact of opioid-related sedation progressing to respiratory depression in the Post Anesthesia Care Unit (PACU) can be extensive; however, there is a paucity of research on the subject of standardized assessment tools to prevent adverse events. The purposes of this study were: (1) to measure the efficacy of a standardized method of assessing sedation and administering opioids for pain management via the Pasero Opioid-Induced Sedation Scale (POSS) with interventions in the PACU; (2) to increase PACU nurses' confidence in assessing sedation associated with opioid administration for pain management and in the quality of care provided in their clinical area; and (3) to facilitate PACU and postoperative clinical unit nurses' communications during patient handoffs regarding safe opioid administration...
September 2014: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
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