Patient Safety in Surgery最新文献

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Evolution of management strategies for unstable pelvic ring injuries over the past 40 years: a systematic review. 在过去的40年里,不稳定骨盆环损伤管理策略的演变:一个系统的回顾。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-12-27 DOI: 10.1186/s13037-024-00421-z
Kenichi Sawauchi, Luca Esposito, Yannik Kalbas, Zygimantas Alasauskas, Valentin Neuhaus, Hans-Christoph Pape, Felix Karl-Ludwig Klingebiel, Roman Pfeifer
{"title":"Evolution of management strategies for unstable pelvic ring injuries over the past 40 years: a systematic review.","authors":"Kenichi Sawauchi, Luca Esposito, Yannik Kalbas, Zygimantas Alasauskas, Valentin Neuhaus, Hans-Christoph Pape, Felix Karl-Ludwig Klingebiel, Roman Pfeifer","doi":"10.1186/s13037-024-00421-z","DOIUrl":"10.1186/s13037-024-00421-z","url":null,"abstract":"<p><strong>Background: </strong>Hemodynamically unstable pelvic ring fractures from high-energy trauma are critical injuries in trauma care, requiring urgent intervention and precise diagnostics. With ongoing advancements in trauma management, treatment strategies have evolved, with some techniques becoming obsolete as new ones emerge. This study aimed to evaluate changes and trends in treatment algorithms for these injuries over approximately 40 years.</p><p><strong>Methods: </strong>A systematic review of PubMed and EMBASE was conducted to include articles published over roughly four decades that presented visual treatment algorithms or workflows for managing unstable pelvic ring fractures. Identified algorithms were categorized by publication period and analyzed by initial assessment, diagnostic methods, pelvic stabilization, and hemorrhage control interventions.</p><p><strong>Results: </strong>The search identified 5,434 publications, of which 32 met the inclusion criteria. 75% of these studies were published between 2011 and 2022, reflecting a growing focus on standardization, particularly in Europe, North America, and Asia. Physiological assessment remains essential in the initial management of hemodynamically unstable pelvic ring fractures, guiding resuscitation and influencing the selection of intervention and imaging. The use of pelvic binders or sheets has risen steadily, highlighting their role in hemorrhage control and temporary stabilization. CT scans and angiography have largely replaced pelvic X-rays in diagnostic protocols, becoming preferred radiological methods alongside focused assessment with sonography for trauma (FAST). Pelvic stabilization remains critical, with external fixation being the most commonly used technique, showing an upward trend in recent years. Laparotomy, pelvic packing, and angioembolization continue to play vital roles in hemorrhage management. Emerging techniques, such as resuscitative endovascular balloon occlusion of the aorta (REBOA), anterior subcutaneous internal fixation (INFIX), and rescue screws, are increasingly included in treatment algorithms, while diagnostic peritoneal lavage (DPL) has become obsolete and is no longer listed in these algorithms.</p><p><strong>Conclusions: </strong>This review provides foundational insights toward the standardization of initial treatment for hemodynamically unstable pelvic ring fractures and holds significant importance in enhancing the consistency and efficiency of treatment. Future research should focus on accumulating higher-quality evidence to evaluate the effectiveness of standardized protocols and explore the applicability of new treatment methods.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"38"},"PeriodicalIF":2.6,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11673330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899149","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}
引用次数: 0
Machine learning approaches for improvement of patient safety in surgery. 提高手术患者安全的机器学习方法。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-12-20 DOI: 10.1186/s13037-024-00422-y
Philip F Stahel, Kathryn Holland, Roy Nanz
{"title":"Machine learning approaches for improvement of patient safety in surgery.","authors":"Philip F Stahel, Kathryn Holland, Roy Nanz","doi":"10.1186/s13037-024-00422-y","DOIUrl":"10.1186/s13037-024-00422-y","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"37"},"PeriodicalIF":2.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873252","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}
引用次数: 0
A novel minimally invasive neurosurgical cranial fixation device for improved accuracy of intraventricular catheter placement: an experimental animal study. 一种新的微创神经外科颅固定装置,用于提高脑室内导管放置的准确性:实验动物研究。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-12-18 DOI: 10.1186/s13037-024-00420-0
Atai Daniel, Matan Coronel, Segev Peer, Ben Grinshpan, Soner Duru, Jose L Peiro, James L Leach, Elena Abellán, Carolyn M Doerning, David Zarrouk, Francesco T Mangano
{"title":"A novel minimally invasive neurosurgical cranial fixation device for improved accuracy of intraventricular catheter placement: an experimental animal study.","authors":"Atai Daniel, Matan Coronel, Segev Peer, Ben Grinshpan, Soner Duru, Jose L Peiro, James L Leach, Elena Abellán, Carolyn M Doerning, David Zarrouk, Francesco T Mangano","doi":"10.1186/s13037-024-00420-0","DOIUrl":"10.1186/s13037-024-00420-0","url":null,"abstract":"<p><strong>Background: </strong>External ventricular drain (EVD) insertion is one of the most commonly performed neurosurgical procedures. Herein, we introduce a new concept of a cranial fixation device for insertion of EVDs, that reduces reliance on freehand placement and drilling techniques and provides a simple, minimally invasive approach that provides strong fixation to minimal thickness skulls.</p><p><strong>Methods: </strong>An experimental device for catheter insertion and fixation was designed and tested in both ex-vivo and in-vivo conditions to assess accurate cannulation of the ventricle and to test the strength of fixation to the skull. The ex-vivo experiments were conducted at Ben-Gurion University of the Negev (BGU) in Be'er Sheva, Israel. These experiments included functionality bench testing and pullout force measurements for the ball mechanism and catheter fixation. For the in-vivo experiments the fixation device was initially tested at the Cincinnati Children's Hospital Medical Center (CCHMC) in Cincinnati, Ohio on one day of life 1 (DOL 1) male control lamb. Additional experiments were conducted on 3 hydrocephalic DOL 0 lambs (1 male 2 female) at the Jesús Usón Minimally Invasive Surgery Centre (JUMISC) in Caceres, Spain. The hydrocephalic animal model used for this study was created with in utero intracisternal injection of BioGlue in fetal lambs. The catheter insertion trajectory was determined using MR imaging to assess the device's impact on the placement accuracy. The fixation device was evaluated on reaching the ventricle and enabling extraction of CSF for all 7 fixations placed. For 5 of the fixation devices, post-mortem pullout force was measured. The general functionality of the device was also evaluated.</p><p><strong>Results: </strong>In the experiments, 7/7 (100%) catheter trajectories successfully reached the ventricle without any apparent complications related to the device or the procedure. The cranial fixation device base demonstrated significant strength in withstanding an average pull-out force of 4.18kgf (STD[Formula: see text]0.72, N = 5) without detachment from the subject's skull for all 5 devices included in this test. Additionally, the EVD catheter pull test was conducted with the addition of a safety loop which did not allow movement of the EVD to a force of 3.6kgf. At this force the catheter tore but did not release from its fixation point.</p><p><strong>Conclusion: </strong>The newly designed experimental device demonstrates initial proof of concept from ex vivo and in vivo testing. It appears suitable for accurate ventricular catheter placement and cranial fixation.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"36"},"PeriodicalIF":2.6,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11657085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142855885","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}
引用次数: 0
Patient Safety in Surgery: scaling the journal's global visibility and scientific renown. 手术中的患者安全:扩大期刊的全球知名度和科学声誉。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-12-09 DOI: 10.1186/s13037-024-00416-w
Philip F Stahel
{"title":"Patient Safety in Surgery: scaling the journal's global visibility and scientific renown.","authors":"Philip F Stahel","doi":"10.1186/s13037-024-00416-w","DOIUrl":"10.1186/s13037-024-00416-w","url":null,"abstract":"","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"34"},"PeriodicalIF":2.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11626744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802695","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}
引用次数: 0
The Power of The (First) Name: Do name tags for operating room staff improve effective communication and patient safety? A proof-of-concept study from an academic medical center in Germany. (第一个)名字的力量:手术室工作人员的姓名标签能提高有效的沟通和病人的安全吗?一项来自德国学术医疗中心的概念验证研究。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-12-09 DOI: 10.1186/s13037-024-00418-8
Alexander D Bungert, Jan Philipp Ramspott, Carsten Szardenings, Alina Knipping, Benjamin Struecker, Andreas Pascher, Jens Peter Hoelzen
{"title":"The Power of The (First) Name: Do name tags for operating room staff improve effective communication and patient safety? A proof-of-concept study from an academic medical center in Germany.","authors":"Alexander D Bungert, Jan Philipp Ramspott, Carsten Szardenings, Alina Knipping, Benjamin Struecker, Andreas Pascher, Jens Peter Hoelzen","doi":"10.1186/s13037-024-00418-8","DOIUrl":"10.1186/s13037-024-00418-8","url":null,"abstract":"<p><strong>Background: </strong>Effective and reliable communication is the cornerstone of safe communication in the operating room (OR). The OR is one of the most dynamic places in the hospital where multiple disciplines must work together in perfect harmony to ultimately improve patient outcomes. To create familiarity by name regarding constantly changing team members, individual name tagging was implemented in the OR.</p><p><strong>Methods: </strong>We analysed the impact of name tagging in the OR in a proof-of-concept study. Name tags (either first or last name), coloured according to the specific department, have been placed on the cap since March 13, 2023. On May 26, 2023, a total of 440 anaesthesiologists, general, visceral, and trauma surgeons, nurses, and service staff were invited to answer an evaluation questionnaire of nine questions. The survey period ended on August 7, 2023. 101 people answered the query which, among other things, asked for overall ratings, compliance, evaluation of specific items as well as positive and negative aspects. Statistical analyses were performed using R.</p><p><strong>Results: </strong>Most of the interviewed staff rated the implementation of name tagging positively (median=3.4; scale from 1-5, 1=bad, 5=good). The greatest benefit was seen in communication in general, direct contact with colleagues, and delegation of tasks. Most of the staff (>90 %) adhered to the new project and used it regularly. Negative aspects mentioned included potential loss of sterility, loss of respectability, and environmental impact. Potential for improvement was seen in the bonding method of attachment or in the implementation.</p><p><strong>Conclusion: </strong>Individual name tagging in the OR can improve interprofessional communication and is one tool to enhance patient safety by decreasing reservations or intimidations towards previously unknown colleagues. More studies are required to determine long-term effects on patient safety, outcome, or employee satisfaction.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"35"},"PeriodicalIF":2.6,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802759","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}
引用次数: 0
Modern anatomical locking plates are associated with increased postoperative wound complications and unplanned surgical revisions compared to standard tubular plates in the management of unstable ankle fractures: a comparative cohort study in 595 patients. 在不稳定踝关节骨折的治疗中,与标准管状钢板相比,现代解剖锁定钢板与术后伤口并发症和计划外手术翻修相关:一项595例患者的比较队列研究。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-12-03 DOI: 10.1186/s13037-024-00419-7
Patrick Gahr, Manuel Matthis, Lennart Schleese, Dagmar-C Fischer, Thomas Mittlmeier
{"title":"Modern anatomical locking plates are associated with increased postoperative wound complications and unplanned surgical revisions compared to standard tubular plates in the management of unstable ankle fractures: a comparative cohort study in 595 patients.","authors":"Patrick Gahr, Manuel Matthis, Lennart Schleese, Dagmar-C Fischer, Thomas Mittlmeier","doi":"10.1186/s13037-024-00419-7","DOIUrl":"10.1186/s13037-024-00419-7","url":null,"abstract":"<p><strong>Background: </strong>The clinical benefit of locking plates in distal fibula fractures has not yet been proven. In addition, the risk of wound complications appears to be higher than with conventional tubular plates. We hypothesize that the benefits of locking plates in terms of biomechanical properties are outweighed by a higher risk of wound complications.</p><p><strong>Methods: </strong>We conducted a retrospective review of fibula fractures treated by osteosynthesis with either a conventional one-third tubular plate or an anatomically shaped locking plate from January 1, 2015 to December 31, 2021. We recorded baseline data and relevant comorbidities and defined the need for revision surgery due to wound-related or mechanical complications as primary endpoints.</p><p><strong>Results: </strong>A total of 595 out of 727 patients were eligible for our study. Of these 595 fractures, 526 were fixed with a one-third tubular plate, 69 with a locking plate. Revision surgery was required in 54 patients, in 51 cases due to wound complications. Three patients required revision surgery for mechanical reasons and all of them were younger than 40 years of age, have not been diagnosed with osteoporosis, but experienced complex fracture types. As the third tubular plate and locking plate groups differed in terms of age and comorbidities, we performed a 2:1 matching based on age and gender, leaving data from 138 patients receiving a third tubular plate. While the two groups were comparable in many aspects, the rate of wound complications was significantly higher in the locking plate group. Although the locking plate group had a higher percentage of diabetes mellitus, there was no correlation between this comorbidity and the higher revision rate in this group.</p><p><strong>Conclusions: </strong>Our data do not support the general use of locking plates in the treatment of distal fibular fractures. The risk of mechanical complications in osteoporotic ankle fractures seems to be overrated, as there were no mechanical revisions in the osteoporotic subgroup. The rate of wound-related revision surgery was significantly higher after the use of locking plates. This might be attributed to the greater thickness of locking plates.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"33"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11613479/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773493","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}
引用次数: 0
Bilateral lower extremity compartment syndrome after prolonged gynecological surgery in lithotomy position: a case report. 长时间平卧位妇科手术后的双侧下肢室间隔综合征:病例报告。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-11-25 DOI: 10.1186/s13037-024-00415-x
Xiaowen Wang, Ziwei Zhao, Jie Chen, Hong Zhang
{"title":"Bilateral lower extremity compartment syndrome after prolonged gynecological surgery in lithotomy position: a case report.","authors":"Xiaowen Wang, Ziwei Zhao, Jie Chen, Hong Zhang","doi":"10.1186/s13037-024-00415-x","DOIUrl":"10.1186/s13037-024-00415-x","url":null,"abstract":"<p><strong>Background: </strong>Acute compartment syndrome is a rare but serious complication following gynecological surgery in the lithotomy position, potentially resulting in permanent neuromuscular dysfunction or limb loss, making early recognition and prompt management essential.</p><p><strong>Case presentation: </strong>A 41-year-old woman underwent a laparoscopic myomectomy for uterine fibroids, during which she was positioned in the high lithotomy and head-down position for 118 min. Six hours post-surgery, she experienced spasmodic pain and swelling in both lower extremities. Thirteen hours after surgery, her symptoms worsened, leading to the diagnosis of acute compartment syndrome in both legs. An emergency bilateral fasciotomy was performed, and the patient fully recovered within two months without any neuromuscular dysfunction.</p><p><strong>Conclusions: </strong>ACS should be an important differential diagnosis for lower extremity pain after gynecologic surgery, especially with prolonged lithotomy positioning. Gynecologists should be vigilant for ACS signs and symptoms to prevent delayed diagnosis.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"32"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11587634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717587","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}
引用次数: 0
The role of spinal injections towards optimizing patient selection for spinal surgery: A proof-of-concept study in 176 lower back pain patients. 脊柱注射对优化脊柱手术患者选择的作用:在 176 名下背痛患者中进行的概念验证研究。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-10-31 DOI: 10.1186/s13037-024-00414-y
Anna Voelker, Katharina Kroboth, Christoph-Eckhard Heyde
{"title":"The role of spinal injections towards optimizing patient selection for spinal surgery: A proof-of-concept study in 176 lower back pain patients.","authors":"Anna Voelker, Katharina Kroboth, Christoph-Eckhard Heyde","doi":"10.1186/s13037-024-00414-y","DOIUrl":"10.1186/s13037-024-00414-y","url":null,"abstract":"<p><strong>Background: </strong>Managing degenerative lumbar diseases is challenging due to the complexity of identifying symptom causes, especially when multiple pathologies coexist. This study evaluated the impact of patient-specific lumbar spine infiltrations on therapeutic strategies in patients with multiple spinal pathologies (MSP) or specific spinal pathologies (SSP).</p><p><strong>Methods: </strong>A retrospective cohort of 176 patients treated for subacute or chronic lumbar pain with targeted spinal infiltrations was analyzed. Patients were categorized based on the presence of MSP or SSP. The primary endpoint was the relief of lumbar spine-specific symptoms following each infiltration. Secondary endpoints included epidemiological factors and comorbidities, while tertiary endpoints focused on post-treatment recommendations and performed treatments.</p><p><strong>Results: </strong>High rates of spinal pain (97.1% in both groups) and radiating symptoms (88.2% in SSP and 92.3% in MSP) were reported. Psychological conditions were significantly more prevalent in female patients (19.4% vs. 7.7%, p = 0.0307), whereas hip osteoarthritis was more common in male patients (20.5% vs. 9.2%, p = 0.0490). Among all infiltration types, lumbar transforaminal injections were the most effective, leading to pain reduction in 80.1% of SSP patients and 72.2% of MSP patients. Facet joint and sacroiliac joint infiltrations also frequently resulted in pain reduction in both groups. Overall, conservative treatment was recommended for most patients (73.3%), while only 22.7% of all evaluated patients were recommended for surgical intervention. Additionally, seven patients received a hip prosthesis.</p><p><strong>Conclusions: </strong>Patient-specific lumbar spine infiltrations effectively relieve pain, support therapeutic decision-making, and tend to favor conservative treatment approaches. These findings highlight the role of infiltration therapies in managing both mixed and specific lumbar spine pathologies, suggesting their potential to reduce the need for surgical interventions.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"31"},"PeriodicalIF":2.6,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142559119","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}
引用次数: 0
Implementation of the WHO surgical safety checklist in resource-limited Somalia: a new standard in surgical safety. 在资源有限的索马里实施世界卫生组织手术安全核对表:手术安全的新标准。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-10-14 DOI: 10.1186/s13037-024-00410-2
Najib Isse Dirie, Abdullahi Hassan Elmi, Abdishakor Mohamud Ahmed, Mohamed Mustaf Ahmed, Mohamed Abdinor Omar, Mulki Mukhtar Hassan, Ahmed Omar Abdi
{"title":"Implementation of the WHO surgical safety checklist in resource-limited Somalia: a new standard in surgical safety.","authors":"Najib Isse Dirie, Abdullahi Hassan Elmi, Abdishakor Mohamud Ahmed, Mohamed Mustaf Ahmed, Mohamed Abdinor Omar, Mulki Mukhtar Hassan, Ahmed Omar Abdi","doi":"10.1186/s13037-024-00410-2","DOIUrl":"https://doi.org/10.1186/s13037-024-00410-2","url":null,"abstract":"<p><strong>Background: </strong>Surgical safety remains a critical global health concern, with complications from surgical procedures resulting in significant morbidity and mortality, particularly in low- and middle-income countries. The World Health Organization (WHO) Surgical Safety Checklist (SSC) has been shown to reduce surgical complications and mortality rates. However, its implementation and impact in resource-limited settings like Somalia remain understudied. This study aimed to evaluate the implementation of the WHO SSC in selected hospitals in Mogadishu, Somalia, and assess its impact on surgical safety practices.</p><p><strong>Methods: </strong>A pre- and post-intervention study was conducted in 15 randomly selected hospitals in Mogadishu, Somalia. The intervention involved a comprehensive training program on the WHO SSC for surgical teams. Data on hospital characteristics, surgical details, and adherence to the SSC were collected over two periods: pre-intervention (April 12th to May 4th, 2024) and post-intervention (May 12th to June 3rd, 2024). The primary outcome was the adherence to the SSC, categorized as good (> 60%) or poor (≤ 60%). Descriptive statistics, McNemar's test, and binary logistic regression were used for data analysis.</p><p><strong>Results: </strong>Adherence to the WHO SSC significantly improved post-intervention, with 98.8% of surgical cases demonstrating good adherence compared to 37% pre-intervention (p < 0.001). The mean adherence score increased from 51.6% (SD = 29.6) to 94.1% (SD = 8.2). Significant improvements were observed for most individual checklist items, including patient identity confirmation, surgical site marking, anesthesia machine checks, and pulse oximeter use (p < 0.001). Team dynamics and communication also improved significantly post-intervention. Hospital type, size, years of service, funding source, surgical department, surgery type, urgency, and staff numbers were associated with checklist adherence pre-intervention.</p><p><strong>Conclusion: </strong>The implementation of a comprehensive training intervention significantly improved adherence to the WHO Surgical Safety Checklist in resource-limited hospitals in Mogadishu, Somalia. The findings highlight the feasibility and effectiveness of the SSC in enhancing surgical safety practices, team communication, and patient outcomes in challenging healthcare environments. Tailored implementation strategies, ongoing training, and cultural adaptation are crucial for the successful adoption of the SSC in resource-constrained settings.</p>","PeriodicalId":46782,"journal":{"name":"Patient Safety in Surgery","volume":"18 1","pages":"30"},"PeriodicalIF":2.6,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11472478/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477475","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}
引用次数: 0
Association between postoperative complications and hospital length of stay: a large-scale observational study of 4,495,582 patients in the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) registry. 术后并发症与住院时间之间的关系:美国外科学院国家外科质量改进计划(ACS-NSQIP)登记处对 4495582 名患者进行的大规模观察研究。
IF 2.6
Patient Safety in Surgery Pub Date : 2024-10-01 DOI: 10.1186/s13037-024-00409-9
Garrett L Healy, Christina M Stuart, Adam R Dyas, Michael R Bronsert, Robert A Meguid, Tochi Anioke, Ahmad M Hider, Richard D Schulick, William G Henderson
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