Ensuring patient safety within the operating room is a paramount concern in contemporary healthcare, and this guide aims to provide an in-depth exploration of this crucial aspect from the perspective of nurses. Nurses...Ensuring patient safety within the operating room is a paramount concern in contemporary healthcare, and this guide aims to provide an in-depth exploration of this crucial aspect from the perspective of nurses. Nurses play a pivotal role in supporting surgeons and maintaining a safe environment for patients undergoing various medical procedures.展开更多
Objective:This study aimed to describe the implementation of the surgical safety check policy and the surgical safety checklist for invasive procedures outside the operating room(OR)and evaluate its effectiveness.Meth...Objective:This study aimed to describe the implementation of the surgical safety check policy and the surgical safety checklist for invasive procedures outside the operating room(OR)and evaluate its effectiveness.Methods:In 2017,to improve the safety of patients who underwent invasive procedures outside of the OR,the hospital quality and safety committee established the surgery safety check committee responsible for developing a new working plan,revise the surgery safety check policy,surgery safety check Keywords:Invasive procedures outside the operating room Safety management Surgical safety checklist Patient safety form,and provide training to the related staff,evaluated their competency,and implemented the updated surgical safety check policy and checklist.The study compared the data of pre-implementation(Apr to Sep 2017)and two post-implementation phases(Apr to Sep 2018,Apr to Sep 2019).It also evaluated the number of completed surgery safety checklist,correct signature,and correct timing of signature.Results:The results showed an increase in the completion rate of the safety checklist after the program implementation from 41.7%(521/1,249)to 90.4%(3,572/3,950),the correct rates of signature from 41.9%(218/521)to 99.0%(4,423/4,465),and the correct timing rates of signature from 34.4%(179/521)to 98.5%(4,401/4,465),with statistical significance(P<0.01).Conclusion:Implementing the updated surgery safety check significantly is a necessary and effective measure to ensure patient safety for those who underwent invasive procedures outside the OR.Implementing surgical safety checks roused up the clinical staff's compliance in performing safety checks,and enhanced team collaboration and communication.展开更多
As non-operating room anesthesia (NORA) vastly increases, so does the complexity of both the patients and the procedures. Unfamiliar environment, remote locations, and limited access to resources are some of the many ...As non-operating room anesthesia (NORA) vastly increases, so does the complexity of both the patients and the procedures. Unfamiliar environment, remote locations, and limited access to resources are some of the many challenges faced by the anesthesiologist in this environment. Understanding the environmental factors such as the room layout, machine placement and patient positioning needs advanced planning in the COVID-19 patient to determine airway management, intravenous access and overall patient safety. Communication with the proceduralist and healthcare workers (HCW) is of essence as both the procedure and anesthetic requirements may need to be altered as the case progresses. Standard monitoring guidelines should apply to all patients regardless of depth of anesthesia. The COVID-19 patient adds to these challenges. Aerosol generating medical procedures (AGMP’s) need to be identified ahead of time in order to ensure the safety of both the staff and patients. This allows for planning and preparation required for transportation of the patient to the room. HCWs may need to be identified and be available to assist with the procedure. Time should be allocated for transportation, briefing, room preparation, personal protective equipment needs of the staff and donning and doffing procedures as per institutional protocol. Communication means with staff outside of the room should be discussed in advance should an emergent situation arise during the procedure. Debriefing should be performed at the end of every procedure to improve patient safety and outcomes.展开更多
Dear editor,Patients frequently visit the emergency room with acute chest pain.While some potentially life-threatening disorders may cause the pain,in approximately 80%of cases,the chest pain source is benign,and musc...Dear editor,Patients frequently visit the emergency room with acute chest pain.While some potentially life-threatening disorders may cause the pain,in approximately 80%of cases,the chest pain source is benign,and musculoskeletal chest pain accounts for nearly 20%– 50%of those cases.^[1–6]Thus,pain caused by benign and pathological conditions of the chest wall encountered in the emergency department is sometimes incorrectly attributed to angina pectoris or pleuritic and other serious cardiopulmonary diseases.展开更多
BACKGROUND It has been shown that children with Pierre Robin sequence(PRS)have a higher risk of difficult intubation before surgery.When mask ventilation or tracheobronchial intubation is expected to be challenging,fl...BACKGROUND It has been shown that children with Pierre Robin sequence(PRS)have a higher risk of difficult intubation before surgery.When mask ventilation or tracheobronchial intubation is expected to be challenging,flexible bronchoscopy(FB)is advantageous in airway safety when it is used to guide tracheobronchial intubation(TI).AIM To evaluate the complications of TI using FB in children with PRS and explore the effect of nursing services on postoperative complications.METHODS One hundred and five children with PRS underwent TI using FB before early mandibular distraction osteogenesis.One hundred and eight children with common pneumonia who did not have a difficult airway were set as the control group.Demographic data,success rates of TI,time required for TI,number of TI attempts,and the incidence of postoperative complications were assessed.Besides,the strategies used to attenuate complications were investigated.RESULTS The success rate of TI was 100%in children with PRS,while the success rate at the first attempt in the PRS group was significantly lower than that in the control group(88.6%vs 98.2%,P=0.005).The time required for TI in the PRS group was markedly longer than that in the control group(P<0.001).Children in the PRS group required repetitive operations to enter the glottis successfully(P=0.017).The incidence of complications was noticeably higher in the PRS group(50/105,47.6%)than in the control group(36/108,33.3%)(P=0.034).Seven of 105 PRS children experienced laryngeal edema (LE) (6.7%), compared with one (0.9%) in the control group(P = 0.034). Out of the seven patients who had LE, all were reintubated and managed withsteroids: six recovered with inhaled steroids alone before extubated, and one was given systemiccorticosteroids before recovery.CONCLUSIONFB contributes to a high success rate of TI in children with PRS. To prevent LE, operators shouldpay more attention to catheter material, catheter lubrication and intubation time.展开更多
Introduction: Interfacility transfers (IFT) of acute ischemic stroke (AIS) may not always lead to a better prognosis. Methods: Retrospective cohort study included AIS patients at an emergency department (ED) with tele...Introduction: Interfacility transfers (IFT) of acute ischemic stroke (AIS) may not always lead to a better prognosis. Methods: Retrospective cohort study included AIS patients at an emergency department (ED) with telestroke. Multiple linear regression for departure time from ED (DT), quantile regression for length of in-hospital stay (LOS), and Kaplan-Meier estimator with Cox proportional hazards model for one-year survival (SV) were performed. Results: 192 patients included were categorised according to IFT. Mechanical thrombectomy was performed in 50% who had been transferred. Differences were found in DT, discharge disposition and LOS. An inverse relationship existed between DT and NIHSS. The strongest predictor of LOS was TACS (β = 3.14 [0.03 - 8.49];p = 0.005). SV was related to IFT (HR 4.68 [1.37 - 16.07];p = 0.014), age (HR 1.1 [1.04 - 1.17]), BI Conclusions: Shared decision-making with a stroke unit through telemedicine enabled a standardised clinical management in a non-metropolitan setting. Several improvement opportunities were identified: multimodal computed tomography availability before transfer, as well as optimization of response time and training in neurosonology of emergency physicians.展开更多
Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterect...Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterectomy.Results:The uterus was successfully removed and the bleeding was successfully stopped.It was transferred to the ICU under general anesthesia.Conclusion:For pregnant women with postpartum massive bleeding and hemorrhagic shock and diffuse intravascular coagulation(DIC),targeted surgical treatment and complete operating room emergency care are of great significance to save maternal lives.展开更多
文摘Ensuring patient safety within the operating room is a paramount concern in contemporary healthcare, and this guide aims to provide an in-depth exploration of this crucial aspect from the perspective of nurses. Nurses play a pivotal role in supporting surgeons and maintaining a safe environment for patients undergoing various medical procedures.
文摘Objective:This study aimed to describe the implementation of the surgical safety check policy and the surgical safety checklist for invasive procedures outside the operating room(OR)and evaluate its effectiveness.Methods:In 2017,to improve the safety of patients who underwent invasive procedures outside of the OR,the hospital quality and safety committee established the surgery safety check committee responsible for developing a new working plan,revise the surgery safety check policy,surgery safety check Keywords:Invasive procedures outside the operating room Safety management Surgical safety checklist Patient safety form,and provide training to the related staff,evaluated their competency,and implemented the updated surgical safety check policy and checklist.The study compared the data of pre-implementation(Apr to Sep 2017)and two post-implementation phases(Apr to Sep 2018,Apr to Sep 2019).It also evaluated the number of completed surgery safety checklist,correct signature,and correct timing of signature.Results:The results showed an increase in the completion rate of the safety checklist after the program implementation from 41.7%(521/1,249)to 90.4%(3,572/3,950),the correct rates of signature from 41.9%(218/521)to 99.0%(4,423/4,465),and the correct timing rates of signature from 34.4%(179/521)to 98.5%(4,401/4,465),with statistical significance(P<0.01).Conclusion:Implementing the updated surgery safety check significantly is a necessary and effective measure to ensure patient safety for those who underwent invasive procedures outside the OR.Implementing surgical safety checks roused up the clinical staff's compliance in performing safety checks,and enhanced team collaboration and communication.
文摘As non-operating room anesthesia (NORA) vastly increases, so does the complexity of both the patients and the procedures. Unfamiliar environment, remote locations, and limited access to resources are some of the many challenges faced by the anesthesiologist in this environment. Understanding the environmental factors such as the room layout, machine placement and patient positioning needs advanced planning in the COVID-19 patient to determine airway management, intravenous access and overall patient safety. Communication with the proceduralist and healthcare workers (HCW) is of essence as both the procedure and anesthetic requirements may need to be altered as the case progresses. Standard monitoring guidelines should apply to all patients regardless of depth of anesthesia. The COVID-19 patient adds to these challenges. Aerosol generating medical procedures (AGMP’s) need to be identified ahead of time in order to ensure the safety of both the staff and patients. This allows for planning and preparation required for transportation of the patient to the room. HCWs may need to be identified and be available to assist with the procedure. Time should be allocated for transportation, briefing, room preparation, personal protective equipment needs of the staff and donning and doffing procedures as per institutional protocol. Communication means with staff outside of the room should be discussed in advance should an emergent situation arise during the procedure. Debriefing should be performed at the end of every procedure to improve patient safety and outcomes.
文摘Dear editor,Patients frequently visit the emergency room with acute chest pain.While some potentially life-threatening disorders may cause the pain,in approximately 80%of cases,the chest pain source is benign,and musculoskeletal chest pain accounts for nearly 20%– 50%of those cases.^[1–6]Thus,pain caused by benign and pathological conditions of the chest wall encountered in the emergency department is sometimes incorrectly attributed to angina pectoris or pleuritic and other serious cardiopulmonary diseases.
文摘BACKGROUND It has been shown that children with Pierre Robin sequence(PRS)have a higher risk of difficult intubation before surgery.When mask ventilation or tracheobronchial intubation is expected to be challenging,flexible bronchoscopy(FB)is advantageous in airway safety when it is used to guide tracheobronchial intubation(TI).AIM To evaluate the complications of TI using FB in children with PRS and explore the effect of nursing services on postoperative complications.METHODS One hundred and five children with PRS underwent TI using FB before early mandibular distraction osteogenesis.One hundred and eight children with common pneumonia who did not have a difficult airway were set as the control group.Demographic data,success rates of TI,time required for TI,number of TI attempts,and the incidence of postoperative complications were assessed.Besides,the strategies used to attenuate complications were investigated.RESULTS The success rate of TI was 100%in children with PRS,while the success rate at the first attempt in the PRS group was significantly lower than that in the control group(88.6%vs 98.2%,P=0.005).The time required for TI in the PRS group was markedly longer than that in the control group(P<0.001).Children in the PRS group required repetitive operations to enter the glottis successfully(P=0.017).The incidence of complications was noticeably higher in the PRS group(50/105,47.6%)than in the control group(36/108,33.3%)(P=0.034).Seven of 105 PRS children experienced laryngeal edema (LE) (6.7%), compared with one (0.9%) in the control group(P = 0.034). Out of the seven patients who had LE, all were reintubated and managed withsteroids: six recovered with inhaled steroids alone before extubated, and one was given systemiccorticosteroids before recovery.CONCLUSIONFB contributes to a high success rate of TI in children with PRS. To prevent LE, operators shouldpay more attention to catheter material, catheter lubrication and intubation time.
文摘Introduction: Interfacility transfers (IFT) of acute ischemic stroke (AIS) may not always lead to a better prognosis. Methods: Retrospective cohort study included AIS patients at an emergency department (ED) with telestroke. Multiple linear regression for departure time from ED (DT), quantile regression for length of in-hospital stay (LOS), and Kaplan-Meier estimator with Cox proportional hazards model for one-year survival (SV) were performed. Results: 192 patients included were categorised according to IFT. Mechanical thrombectomy was performed in 50% who had been transferred. Differences were found in DT, discharge disposition and LOS. An inverse relationship existed between DT and NIHSS. The strongest predictor of LOS was TACS (β = 3.14 [0.03 - 8.49];p = 0.005). SV was related to IFT (HR 4.68 [1.37 - 16.07];p = 0.014), age (HR 1.1 [1.04 - 1.17]), BI Conclusions: Shared decision-making with a stroke unit through telemedicine enabled a standardised clinical management in a non-metropolitan setting. Several improvement opportunities were identified: multimodal computed tomography availability before transfer, as well as optimization of response time and training in neurosonology of emergency physicians.
文摘Objective:To summarize the first aid and nursing of the operating room due to serious complications caused by postpartum massive bleeding.Methods:One case of emergency hemorrhage was ineffective in emergency hysterectomy.Results:The uterus was successfully removed and the bleeding was successfully stopped.It was transferred to the ICU under general anesthesia.Conclusion:For pregnant women with postpartum massive bleeding and hemorrhagic shock and diffuse intravascular coagulation(DIC),targeted surgical treatment and complete operating room emergency care are of great significance to save maternal lives.
