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Failure-to-rescue

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https://www.readbyqxmd.com/read/29133291/watcher-initiative-associated-with-decrease-in-failure-to-rescue-events-in-pediatric-population
#1
Melanie McClain Smith, Maryanne Chumpia, Lindsey Wargo, Julie Nicol, Mark Bugnitz
BACKGROUND AND OBJECTIVES: Improved situation awareness may prevent unplanned ICU transfers. Transfers with serious safety issues may be classified as unrecognized situation awareness failure events (UNSAFE) and are associated with intubation, vasopressors, or >3 fluid boluses within 1 hour before or after ICU arrival. Our aim was to decrease the proportion of unplanned ICU transfers that met UNSAFE criteria by 50% in 1 year. METHODS: We adapted a previously described huddle-based intervention...
November 13, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/29120929/risk-factors-for-opioid-induced-respiratory-depression-and-failure-to-rescue-a-review
#2
Kapil Gupta, Arun Prasad, Mahesh Nagappa, Jean Wong, Lusine Abrahamyan, Frances Chung
PURPOSE OF REVIEW: The primary objective of this review is to identify the risk factors for opioid-induced respiratory depression (OIRD) in the postoperative period. RECENT FINDINGS: In the postoperative period, OIRD has often been reported resulting in morbidity and mortality. The risk factors which predispose surgical patients to increased risk of OIRD are not clearly defined. A literature search was performed for adult surgical patients who were prescribed opioids during their hospital stay and any available reports on postoperative respiratory depression/respiratory events...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29116490/impact-of-sarcopenic-obesity-on-failure-to-rescue-from-major-complications-following-pancreaticoduodenectomy-for-cancer-results-from-a-multicenter-study
#3
Nicolò Pecorelli, Giovanni Capretti, Marta Sandini, Anna Damascelli, Giulia Cristel, Francesco De Cobelli, Luca Gianotti, Alessandro Zerbi, Marco Braga
BACKGROUND: Failure to rescue (FTR) is a quality-of-care indicator in pancreatic surgery, but may also identify patients who may not tolerate major postoperative complications despite being treated with best available care. Previous studies found that high visceral adipose tissue-to-skeletal muscle ratio is associated with poor outcomes following pancreaticoduodenectomy (PD). The aim of the study is to assess the impact of sarcopenic obesity on occurrence of FTR from major complications in cancer patients undergoing PD...
November 7, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/29074117/intensive-care-unit-admission-after-endovascular-aortic-aneurysm-repair-is-primarily-determined-by-hospital-factors-adds-significant-cost-and-is-often-unnecessary
#4
Caitlin W Hicks, Husain N Alshaikh, Devin Zarkowsky, Ian C Bostock, Besma Nejim, Mahmoud B Malas
BACKGROUND: A large proportion of endovascular aortic aneurysm repair (EVAR) patients are routinely admitted to the intensive care unit (ICU) for postoperative observation. In this study, we aimed to describe the factors associated with ICU admission after EVAR and to compare the outcomes and costs associated with ICU vs non-ICU observation. METHODS: All patients undergoing elective infrarenal EVAR in the Premier database (2009-2015) were included. Patients were stratified as ICU vs non-ICU admission according to location on postoperative day 0...
October 23, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29044631/frailty-hospital-volume-and-failure-to-rescue-after-head-and-neck-cancer-surgery
#5
Carrie L Nieman, C Matthew Stewart, David W Eisele, Peter J Pronovost, Christine G Gourin
OBJECTIVES/HYPOTHESIS: We previously reported that high-volume hospital head and neck cancer (HNCA) surgical care is associated with decreased mortality, largely explained by reduced rates of failure to rescue. Frailty is an independent predictor of mortality, but is significantly less likely in patients receiving high-volume care. We investigate whether differences in frailty rates explain the relationship between volume and outcomes in HNCA patients and whether frailty confounds the relationship between failure to rescue and mortality...
October 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28973498/failure-to-rescue-and-mortality-following-resection-of-intracranial-neoplasms
#6
Hani Malone, Michael Cloney, Jingyan Yang, Dawn L Hershman, Jason D Wright, Alfred I Neugut, Jeffrey N Bruce
BACKGROUND: There is growing recognition that perioperative complication rates are similar between hospitals, but mortality rates are lower at high-volume centers. This may be due to differences in the ability to rescue patients from major complications. OBJECTIVE: To examine the relationship between hospital caseload and failure to rescue from complications following resection of intracranial neoplasms. METHODS: We identified adults in the Nationwide Inpatient Sample diagnosed with glioma, meningioma, brain metastasis, or acoustic neuroma, who underwent surgical resection between 1998 and 2010...
August 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28938300/enhancing-the-quality-and-safety-of-the-perioperative-patient
#7
Sven Staender, Andrew Smith
PURPOSE OF REVIEW: Many possible hazards bedevil the perioperative patient. This review focuses on a number of aspects of perioperative management where the patient's quality and safety can be enhanced. RECENT FINDINGS: Our understanding of the relationship between preoperative preparation and postoperative outcomes has improved. There have also been recent developments in our understanding of how to construct useful cognitive aids and make the best use of checklists by understanding the cultural environment supporting their use...
September 21, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28877805/increased-age-predicts-failure-to-rescue
#8
Galinos Barmparas, Matthew J Martin, Douglas A Wiegmann, Ken R Catchpole, Bruce L Gewertz, Eric J Ley
Failure to rescue (FTR), defined as any death after the development of in-hospital complications, is an important quality measure, but the relationship with age after a traumatic injury, has not been well defined. We sought to examine whether older trauma patients are at higher risk for FTR. The National Trauma Databank (NTDB) research datasets 2007 to 2011 were queried for patients ≥16 years who had any reported complication. Those who survived (non-FTR) were compared with those who did not (FTR) using a forward logistic regression model...
November 1, 2016: American Surgeon
https://www.readbyqxmd.com/read/28859006/nurses-to-their-nurse-leaders-we-need-your-help-after-a-failure-to-rescue-patient-death
#9
Cynthia Thornton Bacon
The purpose of this study was to describe nurses' needs and how they are being met and not met after caring for surgical patients who died after a failure to rescue (FTR). A qualitative, phenomenologic approach was used for the interview and analysis framework. Methods to ensure rigor and trustworthiness were incorporated into the design. The investigator conducted semistructured 1:1 interviews with 14 nurses. Data were analyzed using Colaizzi's methods. Four themes were identified: (1) coping mechanisms are important; (2) immediate peer and supervisor feedback and support are needed for successful coping; (3) subsequent supervisor support is crucial to moving on; and (4) nurses desire both immediate support and subsequent follow-up from their nurse leaders after every FTR death...
October 2017: Nursing Administration Quarterly
https://www.readbyqxmd.com/read/28854558/how-powerful-is-failure-to-rescue-as-a-global-metric-not-as-powerful-as-a-commitment-to-measurement
#10
T G Weiser
No abstract text is available yet for this article.
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28854536/use-of-failure-to-rescue-to-identify-international-variation-in-postoperative-care-in-low-middle-and-high-income-countries-a-7-day-cohort-study-of-elective-surgery
#11
T Ahmad, R A Bouwman, I Grigoras, C Aldecoa, C Hofer, A Hoeft, P Holt, L A Fleisher, W Buhre, R M Pearse
Background: The incidence and impact of postoperative complications are poorly described. Failure-to-rescue, the rate of death following complications, is an important quality measure for perioperative care but has not been investigated across multiple health care systems. Methods: We analysed data collected during the International Surgical Outcomes Study, an international 7-day cohort study of adults undergoing elective inpatient surgery. Hospitals were ranked by quintiles according to surgical procedural volume (Q1 lowest to Q5 highest)...
August 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28851486/geriatric-rescue-after-surgery-gras-score-to-predict-failure-to-rescue-in-geriatric-emergency-general-surgery-patients
#12
Muhammad Khan, Asad Azim, Terence O'Keeffe, Faisal Jehan, Narong Kulvatunyou, Chelsey Santino, Andrew Tang, Gary Vercruysse, Lynn Gries, Bellal Joseph
BACKGROUND: Geriatric-patients(GP) undergoing emergency-general-surgery(EGS) are vulnerable to develop adverse-outcomes. Impact of patient-level-factors on Failure-to-Rescue(FTR) in EGS-GP remains unclear. Aim of our study was to determine factors associated with FTR(death from major-complication) and devise simple-bedside-score that predicts FTR in EGS-GP. METHODS: 3-year(2013-15) analysis of patients, age≥65y on acute-care-surgery-service and underwent EGS. Regression analysis used to analyze factors associated with FTR and natural-logarithm of significant odds-ratio used to calculate estimated-weights for each factor...
August 15, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28815796/new-graduate-nurses-preparation-for-recognition-and-prevention-of-failure-to-rescue-a-qualitative-study
#13
Elizabeth K Herron
AIM AND OBJECTIVE: To explore new graduate nurses' experiences with recognition and prevention of failure to rescue. BACKGROUND: Failure to rescue is recognized as a quality of care indicator, a core measure of nursing care in hospitals, and a determinant for staffing in acute care facilities. Clinical reasoning is an essential component in preventing failure to rescue and should be emphasized in nursing education and new graduate orientation. Many nurses graduate without the ability to use clinical reasoning in providing patient care which can lead to adverse patient outcomes...
August 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28797755/failure-to-rescue-in-patients-undergoing-surgery-for-esophageal-or-gastric-cancer
#14
MULTICENTER STUDY
L A Busweiler, D Henneman, J L Dikken, M Fiocco, M I van Berge Henegouwen, B P Wijnhoven, R van Hillegersberg, C Rosman, M W Wouters, J W van Sandick
BACKGROUND: Complex surgical procedures such as esophagectomy and gastrectomy for cancer are associated with substantial morbidity and mortality. The purpose of this study was to evaluate trends in postoperative morbidity, mortality, and associated failure-to-rescue (FTR), in patients who underwent a potentially curative resection for esophageal or gastric cancer in the Netherlands, and to investigate differences between the two groups. METHODS: All patients with esophageal or gastric cancer who underwent a potentially curative resection, registered in the Dutch Upper GI Cancer Audit (DUCA) between 2011 and 2014, were included...
October 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28777159/icu-admission-after-surgery-who-benefits
#15
Sadia Ghaffar, Rupert M Pearse, Michael A Gillies
PURPOSE OF REVIEW: Death following surgery remains a major cause of death worldwide, and ICU admission following major surgery is considered a standard of care in many healthcare systems. However, ICU resources are finite and expensive, thus identifying those most likely to benefit is of great importance. RECENT FINDINGS: Advances in surgical and perioperative management have moved the focus of postoperative care to preventing complications and reducing duration of hospitalisation...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28746704/role-of-preventability-in-redefining-failure-to-rescue-among-major-trauma-patients
#16
Matthew Coates, Eric Pillado, Jin Kim, Richard Vasak, Arthur Yule, Dennis Y Kim
No abstract text is available yet for this article.
November 1, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28743150/-anesthesiology-and-outcome-impact-of-the-perioperative-process
#17
Jörg Zieger, Helene A Häberle
In recent years, the role of the anesthesiologist has turned tremendously from the "anaesthesia doctor" into a perioperative physician and risk specialist. Patients are older, multimorbid, and are called up for more and more extensive surgery and interventions. Socioeconomic aspects have grown in importance. The anesthesiologist, paving the way for a good outcome, is involved in nearly all perioperative processes: preoperative evaluation, definition and optimization of preoperative and intraoperative conditions, management of modern intraoperative anesthesia as well as postoperative medically indicated, effective and efficient treatment of partially highly complex patients...
July 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/28742548/association-between-survival-and-time-of-day-for-rapid-response-team-calls-in-a-national-registry
#18
Matthew Michael Churpek, Dana P Edelson, Ji Yeon Lee, Kyle Carey, Ashley Snyder
OBJECTIVES: Decreased staffing at nighttime is associated with worse outcomes in hospitalized patients. Rapid response teams were developed to decrease preventable harm by providing additional critical care resources to patients with clinical deterioration. We sought to determine whether rapid response team call frequency suffers from decreased utilization at night and how this is associated with patient outcomes. DESIGN: Retrospective analysis of a prospectively collected registry database...
October 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28722141/failure-to-rescue-as-a-nurse-sensitive-indicator
#19
Jane Mushta, Kathy L Rush, Elizabeth Andersen
PROBLEM: The aim of this concept analysis was to clarify failure to rescure as a nurse-sensitive indicator. Although the concept of failure to rescue as a nurse-sensitive outcome has appeared in the nursing literature for over a decade, conceptual clarity is needed to address its variable and ambiguous use in health care. METHODS: Walker and Avant's eight-stage method of concept analysis was used to explore the concept of failure to rescue in nursing practice. Twenty-one papers were retrieved from Cumulative Index of Nursing and Allied Health Literature (CINAHL) and MEDLINE databases and selected for review and synthesis...
July 19, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28711369/predicting-failure-to-rescue-after-abdominal-aortic-aneurysm-repair-in-elderly-patients
#20
Caitlin W Hicks, Anna O'Kelly, Tammam Obeid, Satinderjit Locham, Mahmoud B Malas
BACKGROUND: We aim to describe trends in failure to rescue (FTR) among elderly patients undergoing elective open aortic aneurysm repair (OAR) and endovascular aortic aneurysm repair (EVAR). MATERIALS AND METHODS: All patients aged ≥80 y recorded in the Vascular Quality Initiative database (2002-2014) undergoing nonruptured infrarenal AAA repair were included. Primary outcome was FTR, defined as percentage of deaths in patients who had a complication within 30 d of surgery...
September 2017: Journal of Surgical Research
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