The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to stu...The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone havebeen unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stake-holders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team members together and influence the emergence of a safer OR.展开更多
宁夏拍卖业基本概况宁夏作为经济欠发达地区,拍卖业经历了从无到有、从小到大的发展过程。自1992年首家拍卖企业成立以来,我区拍卖企业已发展到31家。全区 AA 级拍卖企业3家,A 级拍卖企业1家。共拥有国家注册拍卖师43名,获得拍卖从业资...宁夏拍卖业基本概况宁夏作为经济欠发达地区,拍卖业经历了从无到有、从小到大的发展过程。自1992年首家拍卖企业成立以来,我区拍卖企业已发展到31家。全区 AA 级拍卖企业3家,A 级拍卖企业1家。共拥有国家注册拍卖师43名,获得拍卖从业资格的从业人员200人以上,从业者以大专学历为主,且年龄结构普遍年轻化。2006年全区有经营业绩的25家拍卖企业。展开更多
文摘The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone havebeen unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stake-holders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to bring these team members together and influence the emergence of a safer OR.
文摘宁夏拍卖业基本概况宁夏作为经济欠发达地区,拍卖业经历了从无到有、从小到大的发展过程。自1992年首家拍卖企业成立以来,我区拍卖企业已发展到31家。全区 AA 级拍卖企业3家,A 级拍卖企业1家。共拥有国家注册拍卖师43名,获得拍卖从业资格的从业人员200人以上,从业者以大专学历为主,且年龄结构普遍年轻化。2006年全区有经营业绩的25家拍卖企业。
