Patient Safety in Surgery最新文献

{"title":"Online Supplement to “A Perioperative Intervention to Prevent and Treat Emergence Delirium at a Veteran Affairs Medical Center”","authors":"Matthew Taylor, William Pileggi, Michael Boland, M. Boudreaux-Kelly, David Julian, Amanda Beckstead","doi":"10.33940/supplement/2022.12.6","DOIUrl":"https://doi.org/10.33940/supplement/2022.12.6","url":null,"abstract":"This supplementary material was provided by the authors to give readers additional information and resources to replicate their work.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"28 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88002792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2021 PennsylvaniaPatient Safety Reporting: Updated Rates for Acute Care Event Report","authors":"Shawn Kepner","doi":"10.33940/data/2022.12.4","DOIUrl":"https://doi.org/10.33940/data/2022.12.4","url":null,"abstract":"In the article we published in June 2022 on patient safety trends in 2021,1 reporting rates and fall rates for 2021 were calculated based on Q1 and Q2 only, as denominator data for Q3 and Q4 were not yet available. Given that the COVID-19 pandemic has disrupted reliable forecasting in healthcare,2 we did not forecast rates for Q3 and Q4 in our June 2022 article. This data snapshot provides the complete rates for 2021 now that we have obtained all relevant data.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"67 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86088050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Challenges of Transition to Practice Expressed Through the Lived Experience of New-to-Practice Nurses","authors":"Rebecca D. Toothaker, Marijo Rommelfaenger, R. Flexner, Lora K. Hromadik","doi":"10.33940/culture/2022.12.1","DOIUrl":"https://doi.org/10.33940/culture/2022.12.1","url":null,"abstract":"Background: The nurse’s transition into practice is challenging. The need to facilitate a safe transition into practice and retain nurses is crucial in today’s healthcare.\u0000\u0000Objective and Design: The qualitative study aim was to describe the lived experiences of new nurses’ safe transition into practice and their perceptions of functioning as safe practitioners.\u0000\u0000Method: This descriptive, phenomenological arm of a larger, mixed methods study (Safety Transition Education to Practice study) interviewed 11 nurses with varied clinical backgrounds regarding their first six months as licensed nurses. Semistructured, one-to-one interviews with nurses representing geographical locations across the nation were conducted. Colaizzi’s method of analysis was used to extract themes.\u0000\u0000Results: The data revealed five themes with subthemes. The most universal theme was lack of practical knowledge (skills dexterity, real-world knowledge), followed by impostor syndrome, safety culture (unsafe environment, lack of supplies, lack of mentoring/management), internalized fear, and seeking the sage.\u0000\u0000Conclusion: The experiences support the understanding that transition to practice is overwhelming and uncertain. Academic faculty and practice nurses’ cooperative efforts can aid novice nurses in safe transition to practice through academic curriculum enhancement, preceptors, and nurse residency programs working toward narrowing the academic practice gap.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"40 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90108020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onward and Upward: The Future of Nursing Education","authors":"Eileen Fruchtl, Caitlyn Allen","doi":"10.33940/interview/2022.12.5","DOIUrl":"https://doi.org/10.33940/interview/2022.12.5","url":null,"abstract":"As nurses around the globe battled COVID, one inconvenient truth became glaring: There were not enough nurses to provide care. And those shortages will only get worse. Now that we have emerged from the pandemic, nurse educators have become more important than ever. What does future curricula look like? How can technology augment training and staffing? How can we ensure the next generation of nurses is dynamic enough for whatever might come their way? Patient Safety managing editor, Caitlyn Allen, sat down with Cedar Crest College senior instructor Eileen Fruchtl to learn more.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"151 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83819635","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Perioperative Intervention to Prevent and Treat Emergence Delirium at a Veterans Affairs Medical Center","authors":"Matthew Taylor, William Pileggi, M. Boland, M. Boudreaux-Kelly, David Julian, Amanda Beckstead","doi":"10.33940/med/2022.12.3","DOIUrl":"https://doi.org/10.33940/med/2022.12.3","url":null,"abstract":"Emergence delirium (ED) is a temporary condition associated with a patient awakening from an anesthetic and/or adjunct agent (e.g., sedatives and analgesics). During the condition, patients risk harming themselves or staff by engaging in dangerous behavior, which may include thrashing, kicking, punching, and attempting to exit the bed/table.\u0000\u0000A multidisciplinary team at Veterans Affairs Pittsburgh Healthcare System (VAPHS) developed and implemented a multicomponent intervention to reduce the severity and occurrence of ED. The intervention consists of a training component and 21 clinical components. The 21 clinical components are implemented on a patient-by-patient basis and include routine screening for risk factors, enhanced communication among staff, adjusting the environment, following a specific medication strategy, and application of manual restraint (hands-on). The authors provide 15 online Supplemental Materials (S1–S15) to promote replication of the intervention.\u0000\u0000To our knowledge, this is the first manuscript that describes this type of multicomponent intervention in sufficient detail to allow others to replicate it. Following implementation of the intervention at VAPHS, perioperative staff reported that they observed a substantial reduction in the occurrence and severity of ED, ED-related patient and staff injuries, and ED-related loss of intravenous access and airway patency. Despite staff’s reported success of the intervention, rigorous research is needed to evaluate the efficacy of the intervention.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"1 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83014543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Extremity Staged Revascularization (LESR) as a new innovative concept for lower extremity salvage in acute popliteal artery injuries: a hypothesis.","authors":"Joseph Edwards,&nbsp;Rebecca N Treffalls,&nbsp;Hossam Abdou,&nbsp;David P Stonko,&nbsp;Patrick F Walker,&nbsp;Jonathan J Morrison","doi":"10.1186/s13037-022-00349-2","DOIUrl":"https://doi.org/10.1186/s13037-022-00349-2","url":null,"abstract":"<p><p>Popliteal artery injury following knee dislocation is associated with significant morbidity and high amputation rates. The complex and multi-disciplinary input required to manage this injury effectively can take time to arrange, prolonging the time to revascularization. Furthermore, open surgical bypass or interposition graft can be technically challenging in the acute setting, further prolonging ischemic time.Temporary intravascular shunts can be used to temporarily restore flow but require surgical exposure which takes time. Endovascular techniques can decrease the time to revascularization; however, endovascular popliteal stent-grafting is controversial because the biomechanical forces relating to flexion and extension of the knee may increase the risk of stent thrombosis. An ideal operation would result in rapid revascularization, eventually leading to a definitive and durable surgical solution.We hypothesize that a staged approach combing extracorporeal shunting, temporary endovascular covered stent placement, external fixation of bony injury, and definitive open repair provides for a superior approach to popliteal artery injury than current standard of care. We term this approach lower extremity staged revascularization (LESR) and the aim is to minimize the known factors contributing to poor outcomes after traumatic popliteal artery injury.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"16 1","pages":"39"},"PeriodicalIF":3.7,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9756456/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10382049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid-free anesthesia: the next frontier in surgical patient safety.","authors":"Jason McLott,&nbsp;Philip F Stahel","doi":"10.1186/s13037-022-00346-5","DOIUrl":"https://doi.org/10.1186/s13037-022-00346-5","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"16 1","pages":"38"},"PeriodicalIF":3.7,"publicationDate":"2022-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9719141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9486354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The value of artificial intelligence for detection and grading of prostate cancer in human prostatectomy specimens: a validation study.","authors":"Maíra Suzuka Kudo,&nbsp;Vinicius Meneguette Gomes de Souza,&nbsp;Carmen Liane Neubarth Estivallet,&nbsp;Henrique Alves de Amorim,&nbsp;Fernando J Kim,&nbsp;Katia Ramos Moreira Leite,&nbsp;Matheus Cardoso Moraes","doi":"10.1186/s13037-022-00345-6","DOIUrl":"https://doi.org/10.1186/s13037-022-00345-6","url":null,"abstract":"<p><strong>Background: </strong>The Gleason grading system is an important clinical practice for diagnosing prostate cancer in pathology images. However, this analysis results in significant variability among pathologists, hence creating possible negative clinical impacts. Artificial intelligence methods can be an important support for the pathologist, improving Gleason grade classifications. Consequently, our purpose is to construct and evaluate the potential of a Convolutional Neural Network (CNN) to classify Gleason patterns.</p><p><strong>Methods: </strong>The methodology included 6982 image patches with cancer, extracted from radical prostatectomy specimens previously analyzed by an expert uropathologist. A CNN was constructed to accurately classify the corresponding Gleason. The evaluation was carried out by computing the corresponding 3 classes confusion matrix; thus, calculating the percentage of precision, sensitivity, and specificity, as well as the overall accuracy. Additionally, k-fold three-way cross-validation was performed to enhance evaluation, allowing better interpretation and avoiding possible bias.</p><p><strong>Results: </strong>The overall accuracy reached 98% for the training and validation stage, and 94% for the test phase. Considering the test samples, the true positive ratio between pathologist and computer method was 85%, 93%, and 96% for specific Gleason patterns. Finally, precision, sensitivity, and specificity reached values up to 97%.</p><p><strong>Conclusion: </strong>The CNN model presented and evaluated has shown high accuracy for specifically pattern neighbors and critical Gleason patterns. The outcomes are in line and complement others in the literature. The promising results surpassed current inter-pathologist congruence in classical reports, evidencing the potential of this novel technology in daily clinical aspects.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"16 1","pages":"36"},"PeriodicalIF":3.7,"publicationDate":"2022-11-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9686032/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10690480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Duplicate Medication Order Errors: Safety Gaps and Recommendations for Improvement","authors":"Lucy S. Bocknek, Tracy C. Kim, Patricia A. Spaar, Jacqueline Russell, Deanna-Nicole Busog, Jessica L. Howe, Christian Boxley, R. Ratwani, Seth Krevat, Rebecca Jones, Ella S. Franklin","doi":"10.33940/data/2022.9.6","DOIUrl":"https://doi.org/10.33940/data/2022.9.6","url":null,"abstract":"Background: Duplicate medication orders are a prominent type of medication error that in some circumstances has increased after implementation of health information technology. Duplicate medication orders are commonly defined as two or more active\u0000orders for the same medication or medications within the same therapeutic class. While there have been several studies that have identified contributing factors and described potential solutions, duplicate medication order errors continue to impact patient safety.\u0000\u0000Methods: We analyzed 377 reports from 95 healthcare facilities to more granularly define the types of duplicate medication order errors and the context under which these errors occurred, as well as potential contributing factors.\u0000\u0000Results: Of the 377 reports reviewed, 304 (80.6%) met the criteria to be defined as a duplicate medication order error. The most frequent duplicate medication order error type was same order (n=131, 43.1%), followed by same therapeutic class (n=98, 32.2%)\u0000and same medication (n=70, 23.0%). Errors were identified during different medication process tasks and most commonly during medication reconciliation during the patient’s stay in the hospital (n=72, 23.7%) and during pharmacy verification (n=36, 11.8%). Factors contributing to these errors included health information technology issues (n=63, 20.7%), gaps in care coordination (n=44, 14.5%), and a prior dose or medication order not being discontinued (n=52, 17.1%).\u0000\u0000Conclusion: Our results highlight specific areas for practice improvement, and we make recommendations for how healthcare facilities can better address duplicate medication order errors.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"15 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78350784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measuring and Improving Patient Safety in Canada","authors":"Ioana Popescu","doi":"10.33940/med/2022.9.7","DOIUrl":"https://doi.org/10.33940/med/2022.9.7","url":null,"abstract":"Patients, families, and care providers affected by patient safety incidents expect there\u0000will be learning and improvement so that others will not suffer. For that, countries need mature data systems and a culture of safety that includes improving by learning from reporting hazards, harm, and near misses, as well as learning from situations and organizations where safe care is delivered consistently over time, which is in most cases.\u0000\u0000While systems are in place to support incident reporting, sharing, and learning from a variety of sources, in Canada truly national incident reporting is limited to medications, adverse drug reactions, and device failures. However, there are other pan-Canadian and\u0000grassroots efforts to advance reporting and learning from patient safety incidents that are complementary. System and contextual factors influence the ability to improve safety, learn, and report. An important one is the COVID-19 pandemic, which resulted in limited or delayed patient safety reporting and some scaling back of improvement projects.\u0000\u0000The best systems incorporate reporting from multiple sources (patient feedback, coroner reports, etc.) and engage all people involved in care, especially patients and families, in their design, implementation, and continuous improvement. Patient groups,\u0000like Patients for Patient Safety Canada (PFPSC), provide the perspective of patients and families with lived experiences that can effectively improve safety. PFPSC contributes to the development of Canadian patient safety strategies, policies, and programs, and innovates and co-leads initiatives that matter to patients and the public.\u0000\u0000The World Health Organization’s Global Patient Safety Action Plan includes patient safety incident reporting and learning systems to “ensure a constant flow of information and knowledge to drive the mitigation of risk, a reduction in levels of avoidable harm, and improvements in the safety of care” objective.","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"13 1","pages":""},"PeriodicalIF":3.7,"publicationDate":"2022-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81880042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}