Current opinion in anaesthesiology最新文献_第8页

Obituary: John F. Butterworth IV, M.D. († 9th June 2023). 讣告：John F. Butterworth IV， M.D.（†2023年6月9日）。

Current opinion in anaesthesiology Pub Date : 2023-08-01 DOI: 10.1097/ACO.0000000000001290

Kai Zacharowski, Hugo van Aken

引用次数: 0

Scheduling staff for ambulatory anaesthesia. 安排员工进行门诊麻醉。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-12-01 Epub Date: 2022-10-20 DOI: 10.1097/ACO.0000000000001189

Franklin Dexter, Richard H Epstein

{"title":"Scheduling staff for ambulatory anaesthesia.","authors":"Franklin Dexter, Richard H Epstein","doi":"10.1097/ACO.0000000000001189","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001189","url":null,"abstract":"Purpose of review: In this study, we summarize six articles published from January 2020 through June 2022 covering anaesthesia staff scheduling and consider their relevance to ambulatory surgery. Staff scheduling refers to the planned shift length of each person working on specific dates.Recent findings: Increasing shift lengths compensates for COVID-19 pandemic staffing issues by reducing patient queues and mitigating the impact of staff absence from SAR-CoV-2 infection. Reduced labour costs can often be achieved by regularly scheduling more practitioners than expected from intuition. Probabilities of unscheduled absences, estimated using historical data, should be incorporated into staff scheduling calculations. Anesthetizing locations, wherein anaesthesiologists are scheduled, may need to be revised if the practitioner is lactating to facilitate uninterrupted breast milk pumping sessions. If room assignments are based on the educational value for residents, then schedule other practitioners based on residents' expected work hours, not their planned shift lengths. Mixed integer programming can be used effectively to reduce variability among resident physicians in workloads during their rotations.Summary: Readers can reasonably select among these studies and benefit from the one or two applicable to their facilities' characteristics and work hours.","PeriodicalId":520600,"journal":{"name":"Current opinion in anaesthesiology","volume":" ","pages":"679-683"},"PeriodicalIF":2.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40428589","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}

引用次数: 1

Checklists and cognitive aids: underutilized and under-researched tools to promote patient safety and optimize clinician performance. 检查清单和认知辅助工具:促进患者安全和优化临床医生表现的未充分利用和研究的工具。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-12-01 Epub Date: 2022-10-20 DOI: 10.1097/ACO.0000000000001193

Rodrigo J Daly Guris, Meghan B Lane-Fall

{"title":"Checklists and cognitive aids: underutilized and under-researched tools to promote patient safety and optimize clinician performance.","authors":"Rodrigo J Daly Guris, Meghan B Lane-Fall","doi":"10.1097/ACO.0000000000001193","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001193","url":null,"abstract":"Purpose of review: Checklists and other cognitive aids serve multiple purposes in the peri-operative setting and have become nearly ubiquitous in healthcare. This review lays out the evidence for their use, shortcomings and pitfalls to be aware of, and how technology and innovation may improve checklist and cognitive aid relevance and usability.Recent findings: It has been difficult to show a direct link between the use of checklists alone and patient outcomes, but simulation studies have repeatedly demonstrated an association between checklist or cognitive aid use and improved performance. When implemented as part of a bundle of interventions, checklists likely have a positive impact, but the benefit of checklists and other cognitive aids may be both context- and user dependent. Advances in technology and automation demonstrate promise, but usability, design, and implementation research in this area are necessary to maximize effectiveness.Summary: Cognitive aids like checklists are powerful tools in the perioperative and critical care setting. Further research and innovation may elevate what is possible by improving the usability and relevance of these tools, possibly translating into improved patient outcomes.","PeriodicalId":520600,"journal":{"name":"Current opinion in anaesthesiology","volume":" ","pages":"723-727"},"PeriodicalIF":2.5,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40432672","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}

引用次数: 2

Frameworks for value-based care in the nonoperating room setting. 非手术室环境下基于价值的护理框架。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-08-01 DOI: 10.1097/ACO.0000000000001164

Aakash Keswani, Brian Licht, Richard D Urman

{"title":"Frameworks for value-based care in the nonoperating room setting.","authors":"Aakash Keswani, Brian Licht, Richard D Urman","doi":"10.1097/ACO.0000000000001164","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001164","url":null,"abstract":"Purpose of review: Nonoperating room anesthesia (NORA) presents a unique opportunity for the application of value-based care (VBC) principles to procedures performed in the office-based and nonoperating room inpatient settings. The purpose of this article is to review how value is defined in NORA and enabling principles by which anesthesiologists can maximize value in NORA.Recent findings: In order to drive value, NORA providers can target improvements in clinical outcomes where NORA lags behind operating room-based anesthesia (death, over-sedation, nerve injury), implement protocols focusing on intermediate outcomes/quality (postoperative nausea and vomiting, pain control, hypothermia, delirium), incorporate patient-reported outcomes (PROs) to assess the trajectory of a patient's perioperative care, and reduce costs (direct and indirect) through operational and supply-based efficiencies. Establishing a culture of patient and provider safety first, appropriate patient selection with targeted, perioperative optimization of comorbidities, and efficient deployment of staff, space, and resources are critical enablers for success.Summary: Value in NORA can be defined as clinical outcomes, quality, patient-reported outcomes, and efficiency divided by the direct and indirect costs for achieving those outcomes. We present a novel framework adapting current VBC practices in operating room anesthesia to the NORA environment.","PeriodicalId":520600,"journal":{"name":"Current opinion in anaesthesiology","volume":" ","pages":"508-513"},"PeriodicalIF":2.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40613319","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}

引用次数: 0

Preventing patient positioning injuries in the nonoperating room setting. 在非手术室环境中预防患者体位损伤。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-08-01 DOI: 10.1097/ACO.0000000000001153

Alastair Moody, Beca Chacin, Candace Chang

{"title":"Preventing patient positioning injuries in the nonoperating room setting.","authors":"Alastair Moody, Beca Chacin, Candace Chang","doi":"10.1097/ACO.0000000000001153","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001153","url":null,"abstract":"Purpose of review: Postprocedural positioning injuries are an under-appreciated source of morbidity for patients. These injuries may not present until days after anesthesia and may be missed for multiple reasons including the distracting injury of the procedural site, illness of the patient, lack of follow-up, and insufficient awareness of this type of injury. Risks for these adverse events are exacerbated in the nonoperating room anesthesia (NORA) population for several reasons. These patients tend to be older and sicker than patients presenting to the operating room, increasing the risk of an injury. Proceduralists and anesthesia providers are usually consultants, not the primary care team, so may have limited patient follow-up. This review will discuss the risk factors for position-related injuries and how to prevent them with proper positioning and padding.Recent findings: The mainstay of preventing periprocedural positioning injuries is careful positioning of the patient and proper padding of pressure points. This may be particularly challenging because of physical constraints and positioning requirements for NORA procedures, as well as preference for radiolucent positioning materials. Recent studies have shown the potential benefit of monitoring somatosensory evoked potentials (SSEP) in high-risk patients.Summary: Careful consideration of patient positioning and thorough understanding of peripheral nerve and pressure injuries is essential for anesthesia providers to avoid positioning injuries during NORA procedures.Video abstract: http://links.lww.com/COAN/A87.","PeriodicalId":520600,"journal":{"name":"Current opinion in anaesthesiology","volume":" ","pages":"465-471"},"PeriodicalIF":2.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40613318","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}

引用次数: 0

Editorial introduction. 编辑介绍。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-08-01 DOI: 10.1097/ACO.0000000000001166

引用次数: 0

Anesthesia care in the interventional neuroradiology suite: an update. 介入神经放射学套件的麻醉护理:最新进展。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-08-01 Epub Date: 2022-07-05 DOI: 10.1097/ACO.0000000000001151

Corina Bello, Chanannait Paisansathan, Thomas Riva, Markus M Luedi, Lukas Andereggen

{"title":"Anesthesia care in the interventional neuroradiology suite: an update.","authors":"Corina Bello, Chanannait Paisansathan, Thomas Riva, Markus M Luedi, Lukas Andereggen","doi":"10.1097/ACO.0000000000001151","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001151","url":null,"abstract":"Purpose of review: The scope of procedures conducted by neurointerventionalists is expanding quickly, with lacking consensus over the best anesthesia modality. Although the procedures involve all age groups, the interventions may be complex and lengthy and may be provided in hospitals currently not yet familiar with the field. Here we review current literature addressing elective outpatient neurointerventional procedures and aim to provide an update on the management of intervention-specific crises, address special patient populations, and provide key learning points for everyday use in the neurointerventional radiology suite.Recent findings: Various studies have compared the use of different anesthesia modalities and preinterventional and postinterventional care. Monitored anesthesia care is generally recommended for elderly patients, whereas children are preferably treated with general anesthesia. Additional local anesthesia is beneficial for procedures, such as percutaneous kyphoplasty and vascular access.Summary: Combining different anesthetic modalities is a valuable approach in the neurointerventional radiology suite. More interventional and patient population-specific studies are needed to improve evidence-based perioperative management.","PeriodicalId":520600,"journal":{"name":"Current opinion in anaesthesiology","volume":" ","pages":"457-464"},"PeriodicalIF":2.5,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40610479","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}

引用次数: 1

Editorial: cardiovascular anaesthesiology. 社论:心血管麻醉学。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-02-01 DOI: 10.1097/ACO.0000000000001085

Anne D Cherry, Mark Nelson, Nirvik Pal

引用次数: 0

Editorial: Thoracic anesthesia - developments, current trends, and key recommendations. 社论:胸麻醉的发展、当前趋势和主要建议。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2022-02-01 DOI: 10.1097/ACO.0000000000001089

Torsten Loop

引用次数: 0

Same day discharge for craniotomy. 开颅手术当天出院。

IF 2.5

Current opinion in anaesthesiology Pub Date : 2021-10-01 DOI: 10.1097/ACO.0000000000001043

Jesse Goldmacher, Mark Bernstein, Lashmi Venkatraghavan

{"title":"Same day discharge for craniotomy.","authors":"Jesse Goldmacher, Mark Bernstein, Lashmi Venkatraghavan","doi":"10.1097/ACO.0000000000001043","DOIUrl":"https://doi.org/10.1097/ACO.0000000000001043","url":null,"abstract":"Purpose of review: Same-day protocols for craniotomy have been demonstrated to be feasible and safe. Its several benefits include decreased hospital costs, less nosocomial complications, fewer case cancellations, with a high degree of patient satisfaction. This paper reviews the most recent publications in the field of same-day discharge after craniotomy.Recent findings: Since 2019, several studies on same-day neurosurgical procedures were published. Ambulatory craniotomy protocols for brain tumor were successfully implemented in more centers around the world, and for the first time, in a developing country. Additional information emerged on predictors for successful early discharge, and the barriers and enablers of same-day craniotomy programs. Moreover, the cost benefits of same-day craniotomy were reaffirmed.Summary: Same- day discharge after craniotomy is feasible, safe and continues to expand to a wider variety of procedures, in new institutions and countries. There are several benefits to ambulatory surgery. Well-established protocols for perioperative management are essential to the success of early discharge programs. With continued research, these protocols can be refined and implemented in more institutions globally, ultimately to provide better, more efficient care for neurosurgical patients.","PeriodicalId":520600,"journal":{"name":"Current opinion in anaesthesiology","volume":" ","pages":"569-574"},"PeriodicalIF":2.5,"publicationDate":"2021-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39345322","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}

引用次数: 5