Top PDF Improving operating room safety

Improving operating room safety

Improving operating room safety

training sessions lasted 4 hours. Physicians and operating room staff members were trained together to emphasize the team concept. The training was mandatory for the operating room staff, but voluntary for the surgeons. 200 perioperative staff and 60 physicians participated in the training. At the core of the human factors training was a preoperative briefing by the attending surgeon. This brief- ing is very similar to the checklists currently being pro- posed by the World Health Organization (WHO) [1]. The preoperative briefing sets expectations as to how the con- duct of the case will proceed. It informs the operating room staff as to what equipment will be needed and if any difficulties are expected. More importantly the preopera- tive briefing also opens the lines of communication and helps to break down the hierarchy of the operating room. Under conditions of great stress it is easy to lose situa- tional awareness and become focused on only one aspect of the case. Often there are other people in the room who recognize that an error is being made, but are too afraid to speak up. The preoperative briefing should encourage anyone in the room to speak up if an error is being made. A postoperative debriefing was also encouraged to help critique the conduct of the case. We measured two out- comes.
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Operating Room Scheduling Analysis and Evaluation.

Operating Room Scheduling Analysis and Evaluation.

outpatient clinics. Since 1953, VAMC Durham has been improving the health of the men and women who have so proudly served their nation. The VA considers it their privilege to serve the health care needs of veterans in any way they can. Services are available to more than 200,000 veterans living in the 26-county area of central and eastern North Carolina.

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Effectiveness of time out procedure protocol on knowledge and skill regarding patient safety among operating room nurses at selected hospitals, Chennai

Effectiveness of time out procedure protocol on knowledge and skill regarding patient safety among operating room nurses at selected hospitals, Chennai

The investigator administered Timeout procedure protocol through a lecture cum discussion (30 minutes) and through role play demonstration and return demonstration (15 minutes) on patient safety in operating room. The investigator explained in detail about the definition, purpose, importance, surgical safety checklist, do’s and don’ts while performing a Timeout procedure using power point presentation. Role play on how to perform a better time out procedure was enacted by the investigator with other few OR nurses. approximately it took around 45 minutes to complete the power point presentation and the role play on demonstration and return demonstration of Timeout procedure. The same sequence was repeated for the control group, but Timeout procedure protocol was not executed instead they carried out their routine hospital procedure.
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A Study of Rochester Area Hospital Information Systems

A Study of Rochester Area Hospital Information Systems

Lab, Admitting, Emergency, Operating Room, X-rays, Dietary, Accounting, Business office, Telephone office, Data safety, Information Radiation Shantanu Bhagoji processing, therapy, desk, [r]

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Effects of the reduction of surgical residents’ work hours and implications for surgical residency programs: a narrative review

Effects of the reduction of surgical residents’ work hours and implications for surgical residency programs: a narrative review

At present, the effect on resident operating room experience appears neutral, although it may be too early to determine the exact impact, particularly in the con- text of non-compliance, as reported by two studies included in this review. Moreover, the current literature scarcely evaluates other educational aspects of surgical training, such as time spent in clinic or attendance at other academic activities such as morbidity and mortal- ity meetings, grand rounds, and tumour board confer- ences. Although improving patient safety, rather than resident education, was the original impetus behind work hour restrictions, we might expect that the time freed up by such restrictions could be allocated to other educational activities such as reading. This potential benefit, however, has not been properly studied. The nuances of the impact of the ACGME restrictions on the service-to-education ratio for surgical residents therefore remain unclear.
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Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study

Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study

Methods: This study is a single center prospective interventional study. Participants were personnel working in operating room teams including surgeons, anesthesiologists, scrub nurses, nurse anaesthetists and nurse assistants. The study started with pre-interventional observations of the WHO checklist use followed by education on safety climate, the WHO checklist, and non-technical skills in the operating room. Thereafter a revised version of the WHO checklist was introduced. Post-interventional observations regarding the performance of the WHO checklist were carried out. The Safety Attitude Questionnaire was used to assess safety climate at baseline and post-intervention. Results: At baseline we discovered a need for improved teamwork and communication. The participants considered teamwork to be important for patient safety, but had different perceptions of good teamwork between professions. The intervention, a revised version of the WHO checklist, did not affect teamwork climate. Adherence to the revision of the checklist was insufficient, dominated by a lack of structure.
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An ioMRI-assisted case of cervical intramedullary diffuse glioma resection

An ioMRI-assisted case of cervical intramedullary diffuse glioma resection

Conclusion: ioMRI-assisted surgical removal of cervical spinal cord diffuse glioma should be systematically developed and applied to enhance therapeutic efficacy. The reported logistic flow of operating room tasks and imaging technical management are innovative for performing the tumor removal procedures in hospitals where designated ioMRI surgical suites do not exist. Critically, we emphasize implementation of stringent quality control measures for patient trans- portation safety and contamination prevention in establishing and maintaining such a system. Keywords: intraoperative imaging, spine, spinal cord, glioma, residual tumor, decompression
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Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones

Using operating room turnover time by anesthesia trainee level to assess improving systems-based practice milestones

Although qualitative factors like professional satisfaction among surgeons and OR staff are a relevant priority, educa- tional requisites are another aspect to consider [8]. One of the six core competencies dictated by The Accreditation Council for Graduate Medical Education (ACGME) is systems-based practice and “using system resources to facilitate cost-effective and safe non-subspecialty anesthesia care” [9]. Studies correl- ating training level and quality of care are scarce. Some show heterogeneous results with some inefficiencies found in specific procedure times or new exposure to subspecialty cases [10, 11]. Efforts to improve cost efficiency in the aca- demic setting may threaten thorough training in a foster- ing environment [12]. Ensuring efficiency for trainees is a challenging blend of hospital cost, ACGME core compe- tency, and effective education. Previously, Eappen et al. concluded that OR metrics across three two-week periods in a single resident training year concluded “no clinically or economically meaningful adverse effect on the anesthesia-controlled time component of operating room efficiency” [6]. In this study, we hypothesized that turn- over times are correlated with the level of training for anesthesiology residents. We aim to look at a broader amount of trainee levels over a larger span of time to ob- serve for competency.
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Improving cardiac operating room to intensive care unit handover using a standardised handover process

Improving cardiac operating room to intensive care unit handover using a standardised handover process

Implementation of a standardised handover protocol for postcardiac surgery patients was associated with fewer interruptions during handover, more reliable transfer of critical content[r]

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<p>A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel</p>

<p>A Multidisciplinary Focus Review of Musculoskeletal Disorders Among Operating Room Personnel</p>

According to the evidence, musculoskeletal disorders are responsible for a signi fi cant portion of the costs in the healthcare system. 69 The Canadian Occupational Safety and Health Center recommends the use of fl ooring, Suitable shoes, and ergonomic chairs to prevent prolonged standing risks as an appropriate way to prevent musculos- keletal disorders. 32 Other preventive strategies include regular exercise and physical activity, the use of stretching and gentle exercise to reduce physical pressure, 70 regard to the principles of ergonomics in the workplace, regular physical examinations, 71 yoga, 72 using laterally-tilting operating room tables and friction-reducing devices for patient lateral transfers, 73 and awareness of the risk factors for these disorders. 71 In addition to the above, Karahan and Bayraktar introduced teaching patient transfer techni- ques as one of the most effective and cost-effective ways to prevent musculoskeletal disorders. 74 In another study, Tamminen-Peter et al revealed that the education scheme can both teaches how to work ergonomically and safely, and applies the basic know-how of the physical load and risk assessment and the ergonomic principles in the pre- vention of musculoskeletal strain and disorders. 75
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Technology assessment of innovative operating room technology

Technology assessment of innovative operating room technology

HTA for surgical innovations is characterized by a broad spectrum of variables. Surgical innovations can have great consequences on diverse aspects, because performing a surgery is a complex process with clinical and logistic protocols. Also the definition of surgical innovation requires a broad spectrum of variables, because the definition is very general to make it applicable for different kinds of surgical innovations. Therefore a holistic vision is needed. Depending on the technology at hand, the assessment has to focus on a mix of relevant aspects. Based on the results of the interviews and the available research methods for early assessment, the following aspects of surgical innovations should be assessed in an early stage of diffusion: 'environmental preconditions', 'accuracy, reliability & validity', 'reinvention', 'applicability', 'effectiveness', 'social outcomes', 'safety', 'risk of malpractice litigation', 'acceptability of the user' and the 'ethical considerations'. These aspects seem to be possible to assess and relevant in that stage. In/after the early adopterphase, the organisational element gets more important, because the driving forces of adoption and the used implementation strategies can enhance a smooth diffusion. When starting HTA, all aspects should be taken into consideration for the assessment, but in the actual design, only those are included that are estimated relevant for the particular technology, environmental interaction and phase of diffusion. The prioritization of aspects can be determined by using VOI analysis.
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Assessing the similarity of mental models of operating room team members and implications for patient safety: a prospective, replicated study

Assessing the similarity of mental models of operating room team members and implications for patient safety: a prospective, replicated study

Our new Momento tool could be used to identify the potential differences between members of OR teams in their understanding of the key tasks and related respon- sibilities regarding the upcoming surgical procedure. Making team members aware of the extent of the dis- crepancies in individual mental models prior to embark- ing on a case gives them an opportunity to regroup and address the gaps in shared understanding, to make sure all team members are “on the same page” as to who should be responsible for which crucial tasks and when. Providing time for team members to agree, perhaps through a briefing session or in relation to the WHO Surgical Safety Checklist ahead of a procedure, on the order of crucial tasks and on who should be responsible for each task, may help clarify potential ambiguities and better align mental models [39, 40]. The level of disagreement seen in this study for some tasks rein- forces an increasing body of evidence supporting a pre-procedure briefing to align understandings and circumvent intra- and postoperative complications and reduce wasted time [41 – 44].
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Adjusting team involvement: a grounded theory study of challenges in utilizing a surgical safety checklist as experienced by nurses in the operating room

Adjusting team involvement: a grounded theory study of challenges in utilizing a surgical safety checklist as experienced by nurses in the operating room

Checklist are described in this study. According to the WHO the checklist provides a tool for two purposes: enabling consistency in safety for patients, and introdu- cing and maintaining a culture which values achieving it. However, our findings show that within a surgical team, obtaining social and professional acceptance within the team seems to be of crucial importance for nurses to in- volve themselves in the team and fully participate in the performance- and use of the checklist. Even though nurses seem to have a loyal attitude towards the WHO’s checklist regarding their task work, they adjusted their surgical team involvement according to practical, social and professional conditions in their work environment. This resulted in an incomplete use of the checklist and therefore a low compliance rate. Findings also empha- sized the importance of management support when implementing WHO’s Safe Surgical Checklist, and a team–based approach to local adaptation of the check- lists use. Building expectations of performance standards into work processes, when introducing the WHO’s “Safe Surgical Checklist”, might contribute to improve the cul- ture. Further research should explore strategies to strengthen social and professional acceptance within the surgical team in order to improve team involvement.
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Freestanding Emergency Room Operating Model Defined

Freestanding Emergency Room Operating Model Defined

Evaluating the residential demographics around freestanding ERs in Greater Houston demonstrates the centers are not located to serve the Medicaid and indigent populations who depend on the “safety net” of urban hospital emergency rooms. Rather, as detailed by Table 2.0, the typical freestanding ER site is a high-traffic, high-visibility retail strip serving well-established, high-income, high density residential areas.

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Hand washing in operating room: a procedural comparison

Hand washing in operating room: a procedural comparison

Background: Hand washing has been considered a measure of personal hygiene for centuries and it is known that improper hand hygiene among healthcare workers is responsible for about 40% of healthcare-associated infections. Therefore, surgical hand preparation is a critical element for healthcare safety in order to reduce the microbial contamination of surgical wounds in case of a non-detected perforation of a glove. The aim of our study was to evaluate the efficacy of three antiseptics: Povi-iodine scrub, EPG (Ethanol, Hydrogen Peroxide, Glycerol) recommended by WHO and common Marseille soap in a liquid formulation.
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Sedation Strategies for Procedures Outside the Operating Room

Sedation Strategies for Procedures Outside the Operating Room

With the rapid development of diagnostic and therapeutic procedures performed outside the operating room (OR), the need for appropriate sedation care has emerged in importance to ensure the safety and comfort of patients and clinicians. The preparation and administration of sedatives and sedation care outside the OR require careful attention, proper monitoring systems, and clini- cally useful sedation guidelines. This literature review addresses proper monitoring and selection of sedatives for diagnostic and interventional procedures outside the OR. As the depth of sedation increases, respiratory depression and cardiovascular suppres- sion become serious, necessitating careful surveillance using appropriate monitoring equipment.
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Virtual reality as an adjunct to anesthesia in the operating room

Virtual reality as an adjunct to anesthesia in the operating room

Background: Advancements in virtual reality (VR) technology have resulted in its expansion into health care. Preliminary studies have found VR to be effective as an adjunct to anesthesia to reduce pain and anxiety for patients during upper gastrointestinal endoscopies, dental procedures and joint arthroplasties. Current standard care practice for upper extremity surgery includes a combination of regional anesthesia and intraoperative propofol sedation. Commonly, patients receive deep propofol sedation during these cases, leading to potentially avoidable risks of over-sedation, hypotension, upper airway obstruction, and apnea. The objective of this study is to evaluate the effectiveness of VR technology to promote relaxation for patients undergoing upper extremity surgery, thereby reducing intraoperative anesthetic requirements and improving the perioperative patient experience.
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Effectiveness of Safety Training on Knowledge and Practice of Operating Room Personnel Regarding Fire Prevention

Effectiveness of Safety Training on Knowledge and Practice of Operating Room Personnel Regarding Fire Prevention

This quasi-experimental intervention study was conducted on 64 staffs working in operating rooms in 5 teaching hospitals in the Khuzestan province. The subjects were selected by simple random sampling and divided into 2 groups: case and control. After the samples were matched for gender, age, work experience and previous training level, the staffs in the case group were trained indirectly in the fire field. Then, in order to evaluate the effectiveness of training, they were compared with the control group.

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Objectives. APNA 27th Annual Conference Session 1041: October 9, Sheehan, Matthew 1

Objectives. APNA 27th Annual Conference Session 1041: October 9, Sheehan, Matthew 1

Glick, Sharfstein and Schwartz go on to call for “(new models of care)call for specialized nurses, analogous to operating room nurses, who are experienced in acute care, safety and the procedures for achieving (patient care) objectives: psychopharmacology processes, managing and treating co‐morbid factors, addressing intra psychic life, adhering to recovery principles and providing psycho‐education”

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Assessment of the impact of new medical technology on teamwork and patient safety in the operating room

Assessment of the impact of new medical technology on teamwork and patient safety in the operating room

During the observations three minor incidents were observed that could potentially disrupt the surgical flow. An incident with the sterile coverings of the instrument sets was observed with the first operation. Because of the high costs of the instruments, the NKI-AVL only has a small number of instrument sets available. The time required to sterilize one set can take up to over one hour. During the first operation the assistants noticed that the sterile coverings of the two back-up sets were punctured. The punctures were probably causes by defects of the protective casings in which the instrument sets are transported. Had another set been used already or punctured then the operating team would have had an insufficient amount of set to complete all operations. This is an errors associated with re-use errors in sterilization as describe in the framework presented in table 4b.
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