Articles: checklist.
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Orthop. Clin. North Am. · Oct 2018
ReviewPerioperative Safety: Keeping Our Children Safe in the Operating Room.
The entire operating room team is responsible for the safety of children in the operating room. As a leader in the operating room, the surgeon is impactful in ensuring that all team members are committed to providing this safe environment. This is achieved by the use of perioperative huddles or briefings, the use of appropriate surgical checklists, operating room standardization, surgeons proficient in the care they provide, and team members that embrace Just Culture.
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Patient safety may be at risk when details are omitted during anesthesia handoff. The Written Handoff Anesthesia Tool (WHAT), designed by the author, was implemented to improve the quality of anesthesia handoffs in the operating room and postanesthesia care unit (PACU). The author used the Anesthesia Handoff Communication survey to evaluate Certified Registered Nurse Anesthetist (CRNA) and PACU registered nurse (RN) satisfaction with anesthesia handoff and the Targeted Solutions Tool to identify the adequacy, contributing factors, and specific patient data omitted by senders of anesthesia handoff before and after implementation of the WHAT. ⋯ After implementation of the WHAT, satisfaction with anesthesia handoff significantly improved for CRNAs (P < .001) and PACU RNs (P = .001). Factors contributing to inadequate handoffs and omitted patient details were identified and significantly improved for CRNA-to-PACU RN and CRNA-to-CRNA handoffs, respectfully: ineffective method (P < .001; P < .001), baseline vital signs (P = .009; P = .014), and preoperative neurologic status (P = .012; P = .004). Implementation of the WHAT led to evidence-based changes in practice, standardization, and improved anesthesia handoff communication.
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Since children and adolescents are frequently experiencing emotional and behavioral consequences due to pain, their parents should be aware of this emotional and behavioral status. Therefore, the aim of this study was to analyze and describe the parents' reports of the emotional and behavioral status of children and adolescents with different types of temporomandibular disorders using the Child Behavior Checklist. ⋯ The parents rated that their children with TMD-pain suffer from emotional, somatic and aggressive behavior to a higher degree than healthy control subjects. Also, the parents believed that TMD-pain influenced their children's physical activities but not social activities.
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Epilepsy & behavior : E&B · Sep 2018
SUDEP and seizure safety communication: Assessing if people hear and act.
Sudden unexpected death in epilepsy (SUDEP) is a leading cause of death among people with chronic epilepsy. People with intellectual disability (ID) are overrepresented in this population. The SUDEP and Seizure Safety Checklist ("Checklist") is a tool to discuss risk factors influencing seizures and the risk of SUDEP. It includes questions about the availability of nocturnal monitoring. In Cornwall UK, people with epilepsy and ID and their relatives and carers are routinely advised to consider nocturnal surveillance to reduce harm from potential nocturnal seizures. We assessed the retention of advice provided on nocturnal monitoring and if there were differences between those in residential care and those living with their families. ⋯ Carers in residential settings are less likely to recall specific person-centered discussion of risks to the individual they support as compared with those living with families although general awareness of SUDEP and implementing advice such as nocturnal monitoring is present equally in both groups. In improving detection of nocturnal seizures, audio monitoring may be a useful strategy to reduce risk of harm for people with ID.