Patient safety in surgery
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Patient safety in surgery · Jan 2021
Increased perioperative mortality for femoral neck fractures in patients with coronavirus disease 2019 (COVID-19): experience from the United Kingdom during the first wave of the pandemic.
The coronavirus disease 19 (COVID-19) pandemic has presented modern healthcare with an unprecedented challenge. At the peak of the pandemic, trauma and orthopaedic services at our institutions undertook internal restructuring, diverting resources to frontline medical care. Consequently, we sought to assess the impact on the elderly and comorbid patients presenting with femoral neck fractures, with a particular focus on 30-day mortality, length of stay, multidisciplinary team involvement and departmental structuring. ⋯ The increase in 30-day mortality for SARS-CoV-2 positive patients presenting with femoral neck fractures is multifactorial, resulting from a combination of the direct effects of COVID-19 pneumonia as well as changes to the delivery of orthopaedic services. The provision of multidisciplinary care was directly affected by staff redeployment, particularly reorganisation of orthogeriatric services and lack of continuity of ward based clinical care. Our experiences have re-directed efforts towards the management of theatre teams, patient services and staffing, should we be faced with either a resurgence of COVID-19 or a future pandemic.
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Patient safety in surgery · Dec 2020
ReviewThe role of saline irrigation prior to wound closure in the reduction of surgical site infection: a systematic review and meta-analysis.
Surgical site infection (SSI) describes an infectious complication of surgical wounds. Although SSI is thought to be preventable, it still represents a major cause of morbidity and substantial economic burden on the health system. Wound irrigation (WI) might reduce the level of bacterial contamination, but current data on its role in reducing or preventing SSI is conflicting. Our aim was to investigate the effectiveness of WI with normal saline prior to wound closure for the reduction of SSI in patients undergoing abdominal surgery. ⋯ PROSPERO registry number CRD42018082287 .
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Patient safety in surgery · Jan 2017
Changes in safety climate and teamwork in the operating room after implementation of a revised WHO checklist: a prospective interventional study.
Inter-professional teamwork in the operating room is important for patient safety. The World Health Organization (WHO) checklist was introduced to improve intraoperative teamwork. The aim of this study was to evaluate the safety climate in a Swedish operating room setting before and after an intervention, using a revised version of the WHO checklist to improve teamwork. ⋯ There was no significant change in teamwork climate by use of the revised WHO checklist, which may be due to insufficient implementation, as a lack of adherence to the WHO checklist was detected. We found deficiencies in teamwork and communication. Further studies exploring how to improve safety climate are needed.
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Patient safety in surgery · Jan 2015
Effect of bupivacaine soaked gauze in postoperative pain relief in laparoscopic cholecystectomy: a prospective observational controlled trial in 120 patients.
Symptomatic gallstone disease is one of the most common problem attended by a general surgeon. The application of minimally invasive surgical techniques for the removal of gallbladder is now an accepted and preferred method for treating this condition. The avoidance of a subcostal incision and minimal bowel handling leads to decreased postoperative pain, early returning to function and overall shorter duration of hospital stay. Nevertheless, patients do have significant postoperative pain, and newer techniques to further reduce this pain are the subject of many ongoing studies. Many intraoperative techniques for reducing postoperative pain have been described. The current practice at many institutions, including ours, is to discharge the patient on the first postoperative day on oral analgesics. Better control of postoperative pain may help establishing laparoscopic cholecystectomy as a day care procedure in selected patients. The aim of this study is to determine the effect of 0.5 % bupivacaine soaked oxidized regenerated cellulose surgical versus normal saline soaked surgical applied at the gallbladder bed on postoperative mean pain score after laparoscopic cholecystectomy for symptomatic gallstones. ⋯ Placing bupivacaine soaked surgicel has been shown to decrease the mean postoperative pain score in patients. No significant complication was noticed with the use of surgicel. Because adequate pain control requires intravenous medications, additional methods for pain control need to be studied before laparoscopic cholecystectomy can be routinely performed as a day care case.
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Patient safety in surgery · Jan 2015
Implementation of the WHO "Safe Surgery Saves Lives" checklist in a podiatric surgery unit in Spain: a single-center retrospective observational study.
The Surgical Safety Checklist (SSC) is a tool developed by the World Health Alliance for Patient Safety, to assist health professionals in improving patient safety during surgery. Numerous specialties have incorporated this into their clinical practice. The purpose of this study is to adapt and implement this tool within the field of podiatric surgery and to evaluate its impact upon safety standards and post-surgical complications. ⋯ The Surgical Safety Checklist allows us to improve compliance with the safety protocols recommended by the scientific community, and consequently to reduce the incidence of complications related to surgery and to improve patient safety during elective podiatric surgery.