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https://www.readbyqxmd.com/read/29871729/sbar-tool-implementation-to-advance-communication-teamwork-and-the-perception-of-patient-safety-culture
#1
Raymond L Bonds
Current evidence reveals that surgical patients are more prone to adverse events when compared to any other population in the acute care setting. In a military training hospital, handoff communication between surgical intensive care unit (SICU) nurses, physicians, and anesthesia providers (certified registered nurse anesthetists and anesthesiologists) about patients being prepared for surgery was identified as a problem by an initial inquiry of the staff. This article discusses an evidence-based project (EBP) that utilized a standardized multidisciplinary Situation, Background, Assessment, Recommendation (SBAR) tool to improve communication, teamwork, and the perception of a patient safety culture between the SICU nurses and physicians and the anesthesia providers in preparation for surgery...
May 1, 2018: Creative Nursing
https://www.readbyqxmd.com/read/29847429/anesthesia-care-team-composition-and-surgical-outcomes
#2
Eric C Sun, Thomas R Miller, Jasmin Moshfegh, Laurence C Baker
BACKGROUND: In the United States, anesthesia care can be provided by an anesthesia care team consisting of nonphysician providers (nurse anesthetists and anesthesiologist assistants) working under the supervision of a physician anesthesiologist. Nurse anesthetists may practice nationwide, whereas anesthesiologist assistants are restricted to 16 states. To inform policies concerning the expanded use of anesthesiologist assistants, the authors examined whether the specific anesthesia care team composition (physician anesthesiologist plus nurse anesthetist or anesthesiologist assistant) was associated with differences in perioperative outcomes...
May 24, 2018: Anesthesiology
https://www.readbyqxmd.com/read/29776768/-topical-anesthesia-without-the-use-of-an-anesthesiologist-in-adult-outpatient-cataract-surgery-assessment-of-selection-criteria-on-consultation-report-of-248-cases
#3
M Pepin, E Rineau, A Caignard, S Leruez, P Gohier
INTRODUCTION: This work aims to evaluate selection criteria used during the cataract surgery scheduling visit, to choose whether or not there will be an anesthesiologist available during the surgery, depending upon the patient's comorbidities. MATERIALS AND METHODS: Retrospective study performed in 2016 in Angers university medical center. Two groups were established on the cataract surgery scheduling visit, based on patients' comorbidities and vital signs (blood pressure, heart rate)...
May 15, 2018: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/29772984/pain-upon-inserting-a-peripheral-intravenous-catheter-size-does-not-matter
#4
Fredericus Hj van Loon, Lisette Apm Puijn, Wesly H van Aarle, Angelique Tm Dierick-van Daele, Arthur Ra Bouwman
BACKGROUND: Approximately 1.2 billion peripheral intravenous catheters are inserted across the world annually. It is known that intravenous cannulation may be a painful procedure, which affects cognitive abilities by increasing anxiety and discomfort. AIM: We hypothesized that inserting a smaller sized peripheral intravenous catheter has a lower level of pain sensation compared to a larger sized catheter. METHODS: This observational, cross-sectional study was conducted between May and October 2016, in which surgical patients, aged 18 years or older, were eligible to participate...
May 2018: Journal of Vascular Access
https://www.readbyqxmd.com/read/29750692/trainability-of-cricoid-pressure-force-application-a-simulation-based-study
#5
Eric Noll, Shivam Shodhan, Arnavi Varshney, Christopher Gallagher, Pierre Diemunsch, F Barry Florence, Jamie Romeiser, Elliott Bennett-Guerrero
BACKGROUND: Aspiration of gastric contents is a leading cause of airway management-related mortality during anesthesia practice. Cricoid pressure (CP) is widely used during rapid sequence induction to prevent aspiration. National guidelines for CP suggest a target force of 10 N before and 30 N after loss of consciousness. However, few studies have rigorously assessed whether clinicians can be trained to consistently achieve these levels of force. We hypothesized that clinicians can be trained effectively to deliver 10-30 N during application of CP...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29690961/shortened-preoperative-fasting-time-to-allow-oral-rehydration-solution-clear-liquid-up-to-two-hours-before-elective-major-surgery-in-adults
#6
Jay N Shah, Shantabir Maharjan, Rajan Gurung
OBJECTIVE: To generate evidence of feasibility to allow clear liquid 2 hours before elective surgery. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: The Department of Surgery, Patan Hospital, Patan Academy of Health Sciences, Nepal, from October to December 2016. METHODOLOGY: One hundred consecutive adult elective major surgery patients of American Society of Anesthesiologist criteria 1 or 2 were enrolled...
May 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29613935/the-use-of-emergency-physicians-to-deliver-anesthesia-for-orthopaedic-surgery-in-austere-environments-the-expansion-of-the-emergency-physician-s-general-anesthesia-syllabus-to-orthopaedic-surgery
#7
Ogedad Pierre, John F Lovejoy, Robert Stanton, Richard Skupski, Harold Previl, Jerry Bernard, Lia Losonczy, Mark Walsh
BACKGROUND: Five billion people, primarily in low-income and middle-income countries, cannot access safe, affordable surgical and anesthesia care, particularly for orthopaedic trauma. The rate-limiting step for many orthopaedic surgical procedures performed in the developing world is the absence of safe anesthesia. Even surgical mission teams providing surgical care are limited by the availability of anesthesiologists. Emergency physicians, who are already knowledgeable in airway management and procedural sedation, may be able to help to fulfill the need for anesthetists in disaster relief and surgical missions...
April 4, 2018: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29580599/anesthetists-and-surgeons-predict-postoperative-pain
#8
Selena A Hunter, Rachel Martin, Mark Weatherall, Duncan Galletly
PURPOSE: Nurses, surgeons and anesthetists are responsible for the management of postoperative pain. This study aimed to investigate surgeons', surgical residents', anesthesiologists', and anesthetic residents' predictions of patients' postoperative pain and satisfaction with pain management, compared to patients' postoperative ratings. DESIGN: The bias and limits of agreement between physician and patient ratings of postoperative pain were compared. METHODS: Doctors and patients completed a pain questionnaire (Numeric Rating Scale 11-point) regarding patients' overall pain, worst pain, and dissatisfaction with pain management during the first three days postoperatively...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29548712/dynamic-configuration-scheduling-problem-for-stochastic-medical-resources
#9
Wen-Tso Huang, Ping-Shun Chen, John J Liu, Yi-Ru Chen, Yen-Hsin Chen
Scheduling approaches for conventional surgery operating rooms in a hospital treat surgeons as bottleneck resources directly, but do not deal with stochastic medical resources, leading to an uneven human resource distribution in optimizing medical resource scheduling. Thus, this research focuses on the dynamic configuration scheduling problem for stochastic medical resources. In this paper, the surgical operating room is limited, and the arriving calls (i.e., number of patients) are dynamic. When a patient arrives, the nurse anesthetist and anesthesiologist are limited, but the medical service duration per patient is random...
April 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29491752/preliminary-indications-for-the-use-of-sugammadex-after-its-addition-to-a-formulary-at-a-tertiary-care-children-s-hospital
#10
N'Diris Barry, Joshua C Uffman, Dmitry Tumin, Joseph D Tobias
OBJECTIVES: Neuromuscular blocking agents (NMBAs) are administered to facilitate endotracheal intubation and provide skeletal muscle relaxation in surgical procedures. Sugammadex (Bridion) recently received approval by the United States Food and Drug Administration for reversal of rocuronium and vecuronium-induced neuromuscular blockade thereby providing an alternative to acetylcholinesterase inhibitors such as neostigmine. This quality improvement analysis sought to investigate the clinical reasons and common clinical perceptions for choosing sugammadex over neostigmine to reverse NMBAs...
January 2018: Journal of Pediatric Pharmacology and Therapeutics: JPPT: the Official Journal of PPAG
https://www.readbyqxmd.com/read/29274837/dedicated-operating-room-teams-and-clinical-outcomes-in-an-enhanced-recovery-after-surgery-pathway-for-colorectal-surgery
#11
Michael C Grant, Andrew Hanna, Andrew Benson, Deborah Hobson, Christopher L Wu, Christina T Yuan, Michael Rosen, Elizabeth C Wick
BACKGROUND: Our aim was to determine whether the establishment of a dedicated operating room team leads to improved process measure compliance and clinical outcomes in an Enhanced Recovery after Surgery (ERAS) program. Enhanced Recovery after Surgery programs involve the application of bundled best practices to improve the value of perioperative care. Successful implementation and sustainment of ERAS programs has been linked to compliance with protocol elements. STUDY DESIGN: Development of dedicated teams of anesthesia providers was a component of ERAS implementation...
March 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29157768/identifying-nurse-anesthetists-professional-identity
#12
Karin Aagaard, Erik Elgaard Sørensen, Bodil Steen Rasmussen, Birgitte Schantz Laursen
PURPOSE: To explore professional identity of registered nurse anesthetists (RNAs) and RNAs' expectations of their professional self and the expectations RNAs meet from interdisciplinary team members when preparing patients for general anesthesia. DESIGN: Focused ethnography was used for data collection. METHODS: Participant observations and interviews were conducted with patients scheduled for surgery and with RNAs in charge of the patients during the anesthetic procedures...
December 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29148326/understanding-professional-jurisdiction-changes-in-the-field-of-anesthesiology
#13
Scott Feyereisen, Joseph P Broschak, Beth Goodrick
We further our understanding of jurisdictional disputes between established professional groups through a 10-year longitudinal analysis of the differential adoption by U.S. states of policies expanding Certified Registered Nurse Anesthetists' (CRNAs) autonomy. In the United States, CRNAs are trained to deliver anesthetics to patients in the same way as physician anesthesiologists but have more restrictions in practice. Following a 2001 federal decision regarding Medicare reimbursement, states were permitted but not required to allow CRNAs to practice without physician supervision, potentially reducing health care costs...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29035894/prevalence-of-potentially-distracting-noncare-activities-and-their-effects-on-vigilance-workload-and-nonroutine-events-during-anesthesia-care
#14
Jason M Slagle, Eric S Porterfield, Amanda N Lorinc, David Afshartous, Matthew S Shotwell, Matthew B Weinger
BACKGROUND: When workload is low, anesthesia providers may perform non-patient care activities of a clinical, educational, or personal nature. Data are limited on the incidence or impact of distractions on actual care. We examined the prevalence of self-initiated nonclinical distractions and their effects on anesthesia workload, vigilance, and the occurrence of nonroutine events. METHODS: In 319 qualifying cases in an academic medical center using a Web-based electronic medical chart, a trained observer recorded video and performed behavioral task analysis...
January 2018: Anesthesiology
https://www.readbyqxmd.com/read/28789748/measuring-certified-registered-nurse-anesthetist-organizational-climate-instrument-adaptation
#15
Donald Boyd, Lusine Poghosyan
BACKGROUND AND PURPOSE: No tool exists measuring certified registered nurse anesthetist (CRNA) organizational climate. The study's purpose is to adapt a validated tool to measure CRNA organizational climate. METHODS: Content validity of the Certified Registered Nurse Anesthetist Organizational Climate Questionnaire (CRNA-OCQ) was established. Pilot testing was conducted to determine internal reliability consistency of the subscales. RESULTS: Experts rated the tool as content valid...
August 1, 2017: Journal of Nursing Measurement
https://www.readbyqxmd.com/read/28746222/the-use-of-tenoxicam-to-prevent-symptoms-of-discomfort-induced-by-vagotonia-during-uterus-manipulation-in-cesarean-sections
#16
RANDOMIZED CONTROLLED TRIAL
Shih-Hong Chen, Shiou-Sheng Chen, Ching-Tao Chang, Chi-Hsiang Huang, Shou-Zen Fan, Li-Kuei Chen
PURPOSE: Symptoms such as nausea, vomiting, tightness of the chest, bradycardia, and shoulder or abdominal discomfort, caused by vagotonia occurring during uterus manipulation, have concerned healthcare professionals for some time. Patients sometimes report these symptoms when undergoing spinal anesthesia for cesarean sections (CSs). We designed a prospective, double-blind study to investigate the effectiveness of tenoxicam in preventing these symptoms of discomfort. METHODS: A total of 105 American Society of Anesthesiologists (ASA) class I-II nulliparous pregnant women, who were scheduled for a CS, were enrolled into this prospective, double-blind study...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28688211/reducing-sedation-time-for-thyroplasty-with-arytenoid-adduction-with-sequential-anesthetic-technique
#17
Charles K Saadeh, Eric B Rosero, Girish P Joshi, Esra Ozayar, Ted Mau
OBJECTIVE: To determine the extent to which a sequential anesthetic technique 1) shortens time under sedation for thyroplasty with arytenoid adduction (TP-AA), 2) affects the total operative time, and 3) changes the voice outcome compared to TP-AA performed entirely under sedation/analgesia. STUDY DESIGN: Case-control study. METHODS: A new sequential anesthetic technique of performing most of the TP-AA surgery under general anesthesia (GA), followed by transition to sedation/analgesia (SA) for voice assessment, was developed to achieve smooth emergence from GA...
December 2017: Laryngoscope
https://www.readbyqxmd.com/read/28625457/erratum-to-anesthesiologists-perceptions-of-minimum-acceptable-work-habits-of-nurse-anesthetists-j-clin-anesth-38-2017-107-110
#18
Ilana I Logvinov, Franklin Dexter, Bradley J Hindman, Sorin J Brull
No abstract text is available yet for this article.
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28625430/sensorimotor-and-executive-function-slowing-in-anesthesiology-residents-after-overnight-shifts
#19
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/28414657/death-by-propofol
#20
James H Diaz, Alan David Kaye
Since its introduction in 1986, propofol ( two, 6-diisopropylphenol) , an intravenous sedative-hypnotic agent, has been utilized for the induction and maintenance of general anesthesia and conscious sedation in over 80 percent of cases; largely replacing thiopental ( sodium pentothal) over a decade ago. Unrestricted as a controlled substance, propofol's abuse potential emerged quickly and was highlighted by the death of pop singer, Michael Jackson, in 2009. In order to assess the epidemiological features of fatal propofol abuse, a descriptive analysis of the scientific literature was conducted using Internet search engines...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
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