Perioperative Care and Operating Room Management最新文献

{"title":"Prevalence of pre-operative anemia in elective surgical patients: A retrospective, observational study at a university hospital","authors":"Abdulla Albariqi ,&nbsp;Tarek Elgemmezi ,&nbsp;Afnan Jabr Al-Sulami ,&nbsp;Hasan Albarqi ,&nbsp;Salwa Hindawi","doi":"10.1016/j.pcorm.2024.100403","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100403","url":null,"abstract":"<div><h3>Background</h3><p>Anemia is the most hematological condition found in surgical patients. Pieces of empirical evidence shows that pre-operative anemia accounts for one- third of surgical patients. Yet, pre-operative anemia &amp; blood transfusion for surgical patients has been associated with many complications such as lengthy hospital stay, post operation surgical wound infections, mortality and morbidity.</p></div><div><h3>Purpose</h3><p>This Pilot preliminary study sought to determine the prevalence of pre-operative anemia in elective surgical patients and to assess health workers’ awareness and knowledge regarding patient blood management in Saudi Arabia.</p></div><div><h3>Material and methods</h3><p>A questionnaire was used to collect data from the 129 healthcare workers in a selected hospital in Saudi Arabia. Additional data was obtained from the hospital electronic data records regarding the incidences of pre-operative anemia. Therefore, the study applied both retrospective and cross-sectional designs. The collected data was then analyzed using the Statistical Package for Social Services [SPSS].</p></div><div><h3>Results</h3><p>This study established the prevalence of pre-operative anemia in elective surgical patients to be 30 % (291 out of 970). In addition, 129 participants completed the questionnaires, from different hospital departments. From the questionnaire, it was noted that 74.2 % of the of physicians had the knowledge about patient blood management while 65 % (<em>n</em> = 50) were aware of the written protocol for the management of pre-operative anemia. This study also found out that 48.1 % of physicians rarely get to meet their patients assessed for possible anemia 4–8 weeks prior surgical operation. In addition, a relatively high number of physicians (42.6, <em>n</em> = 55 rarely investigate the cause of anemia after it has been established while 45.7 % confirm to rarely transfer their patient to pre-operative clinic for anemia management. Low intervention in correction of anemia of low iron origin by the physicians was established to be 44.2 %, and the most preferred hematology analyzer for point of care management was CBC Analyzer Sysmex (79.8 %).</p></div><div><h3>Conclusion</h3><p>This study finds a significant lack of knowledge about pre-operative anemia management in line with the patient blood management protocol. Also, majority of physicians fail to follow the guidelines for anemia management despite the high incidence.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100403"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605453","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":"Surgical care bundles for surgical site infection prevention in high-income and low-to-middle-income countries: A comparative review","authors":"Sara C. Chaker ,&nbsp;Andrew J. James ,&nbsp;Galen Perdikis ,&nbsp;Peter Nthumba","doi":"10.1016/j.pcorm.2024.100406","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100406","url":null,"abstract":"<div><p>Surgical site infections (SSIs) are infections of the incision site or organ space following a surgical procedure. The ramifications of an SSI extend beyond individual patient morbidity; SSIs lead to a substantial strain on healthcare systems, irrespective of the economic standing of the country. The utilization of a “care bundle” is a recommended approach for reducing the incidence of SSIs. These bundles typically involve the integration of evidence-based interventions, spanning preoperative, intraoperative, and postoperative phases of care, which aim to standardize healthcare delivery and infection prevention practices. While there is evidence supporting the efficacy of various care bundles, comparisons between specific bundles implemented in high-income countries (HICs) and low- to middle-income countries (LMICs) remain largely unreported. Understanding variations in implemented care bundles in these settings is central to optimize approaches for SSI risk reduction on a global scale.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100406"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605455","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":"Design overview and usability of the codesigned My Surgical Pathway E-health tool for supporting patient self-managed surgical preparation and recovery","authors":"Cory James Williams ,&nbsp;Marlien Varnfield ,&nbsp;Adam Stott ,&nbsp;Jed Duff","doi":"10.1016/j.pcorm.2024.100415","DOIUrl":"10.1016/j.pcorm.2024.100415","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgery plays a critical role in global health, often facing significant quality challenges such as high rates of postoperative complications, variability in patient outcomes, and inconsistencies in care pathways, due to the complex nature of the perioperative journey. The My Surgical Pathway (MSP) app is an e-health intervention designed to address these challenges by supporting self-management and integrated care throughout the entire perioperative journey. This study aims to describe the features and functions of MSP and report on the results of usability testing from both patients and healthcare workers.</p></div><div><h3>Methods</h3><p>This mixed-methods study evaluated the usability of the My Surgical Pathway (MSP) app using quantitative surveys, qualitative feedback, and observation data from patients and healthcare workers. Structured 2-hour user testing sessions included interaction with the MSP app, completion of the User Version of the Mobile Application Rating Scale (uMARS), and think-aloud activities. Data analysis combined quantitative and qualitative insights to identify usability issues and inform potential improvements.</p></div><div><h3>Results</h3><p>The mixed-method user-testing evaluation of the co-designed e-health intervention revealed high overall app quality scores, with an average of 4.50 out of 5. All user-type interfaces received mean scores above the minimum acceptability threshold of 3.0, demonstrating the intervention's efficacy in supporting patient surgery journeys, enhancing healthcare worker coordination, and meeting diverse user needs. Notably, the highest individual item scores were for credibility of source (4.92) and interactivity (4.85), highlighting the application's reliability and engaging nature.</p></div><div><h3>Conclusions</h3><p>The study evaluated the 'My Surgical Pathway' (MSP) e-health intervention, co-designed with consumers and healthcare workers to support self-management of surgical care. Results indicate high user satisfaction, with an overall app quality score of 4.50 out of 5 on the uMARS tool. Users praised MSP's engagement, education, and responsiveness, highlighting its potential to improve patient experiences and clinician workflows. Recommendations for future research include expanding participant diversity and hospital settings, and employing longitudinal designs for a comprehensive evaluation.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100415"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405603024000499/pdfft?md5=766004a19819368c63f17bb7077f92aa&pid=1-s2.0-S2405603024000499-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141991365","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":"Surgical site infections in teaching hospitals: A call for enhanced prevention strategies","authors":"Saeid Amini Rarani","doi":"10.1016/j.pcorm.2024.100405","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100405","url":null,"abstract":"","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100405"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141605454","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":"Erector spinae plane versus paravertebral versus multiple intercostal nerve blocks in patients undergoing vats; A randomized controlled trial","authors":"Mona Mohamed Mogahed ,&nbsp;Mohamed Samir Abd El-ghaffar ,&nbsp;Taha Saad Al Noamani ,&nbsp;Mohamed Shafik Elkahwagy","doi":"10.1016/j.pcorm.2024.100409","DOIUrl":"10.1016/j.pcorm.2024.100409","url":null,"abstract":"<div><h3>Background</h3><p>Video-assisted thoracoscopic surgery (VATS) is a minimally invasive technique with shorter recovery times and lesser postoperative pain than open thoracotomies. Regional blocks decrease the anesthetic and postoperative analgesic requirements.</p></div><div><h3>Methods</h3><p>105 patients scheduled for VATS under general anesthesia were included. Patients were randomly allocated to receive 20 ml of bupivacaine 0.5 % mixed with adrenaline 2 mcg/ml by ultrasound-guided erector spinae plane block (ESPB) at T5 level (Group ESPB, <em>n</em> = 35), 20 ml of bupivacaine 0.5 % mixed with adrenaline 2 mcg/ml by paravertebral block (PVB) at T5 level (Group PVB, <em>n</em> = 35), or multiple intercostal nerve blocks (Group MICNB, <em>n</em> = 35) where 2–3 ml of bupivacaine 0.5 % mixed with adrenaline 2 mcg/ml for each intercostal space from the third to the eighth intercostal nerve were injected by the surgeon through the thoracoscope. The objectives of this study were primarily to assess the effectiveness of the erector spinae plane versus paravertebral versus multiple intercostal nerve blocks on the intraoperative patient anesthetic requirements and secondarily to assess the postoperative analgesic requirements.</p></div><div><h3>Results</h3><p>No significant differences were observed regarding End tidal Sevoflurane (Et Sevo) all over the operative time between the ESPB and the PVB group; however there were highly significant differences between either group and the MICNB group immediately after induction of anesthesia till 60 min later, No significant difference between ESPB and the PVB groups as regards to the total amount of intraoperative fentanyl consumption, on the other hand there were highly significant difference between the ESPB or the PVB group and the MICNB group; while all the three groups provide comparable postoperative analgesia with non-significant difference regarding the postoperative VAS either during rest or cough.</p></div><div><h3>Conclusion</h3><p>ESPB and PVB provided better intraoperative anesthetic sparing effect than MICNB; however all the three blocks provide comparable postoperative analgesia either during rest or during cough in patients undergoing VATS.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100409"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141951189","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":"Bridging the gaps in understanding POD and POCD: A thorough examination of genetic and clinical biomarkers","authors":"Sandra Figueiredo ,&nbsp;Miguel Devezas","doi":"10.1016/j.pcorm.2024.100401","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100401","url":null,"abstract":"<div><p>This systematic review delves into the complex and multifaceted nature of Postoperative Delirium (POD) and Postoperative Cognitive Dysfunction (POCD), conditions sharing common phenotypes and risk factors. The pathophysiology of POD/POCD, particularly prevalent in vulnerable groups like the elderly, is explored, highlighting the roles of inflammation, cellular stress, and neural injuries. The review scrutinizes 24,354 research publications, selecting 176 and a subset of 24 for in-depth analysis, to unravel the intricate web of potential biomarkers and their associations with cognitive decline post-surgery. This systematic review was performed according to norms of Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The findings underscore the lack of universally accepted biomarkers, reflecting the diversity in clinical presentations and the myriad of underlying pathophysiological mechanisms. The review also emphasizes the evolving nature of POCD's definition and the need for further research to elucidate the genetic underpinnings of these postoperative complications. Future directions in neuropsychology and biomedicine are proposed to bridge existing knowledge gaps and enhance our understanding of POD and POCD.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100401"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405603024000359/pdfft?md5=e540900d2637682923b803ddafff9e51&pid=1-s2.0-S2405603024000359-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141286310","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":"Multidisciplinary approach to optimizing immediate use steam sterilization (IUSS) workflows between the operating room and sterile processing departments: A case report","authors":"Gina L. Eberhardt ,&nbsp;Jesse Rivera-Rosario ,&nbsp;Bethany Atwood ,&nbsp;Joshua D. Smith ,&nbsp;Kenneth Romito","doi":"10.1016/j.pcorm.2024.100408","DOIUrl":"10.1016/j.pcorm.2024.100408","url":null,"abstract":"<div><h3>Background</h3><p>Immediate Use Steam Sterilization (IUSS), formerly known as Flash Sterilization, is a rapid process that allows the timely sterilization of surgical instruments in the event of accidental contamination. The infrequency of use and dependence on expedited reprocessing raised concern over omitting essential steps such as pre-cleaning, decontamination, weighing, and biologically verified sterilization cycles.</p></div><div><h3>Methods</h3><p>A multidisciplinary systematic workflow analysis was conducted utilizing Lean A3 methodology to reduce IUSS inefficiencies and enhance evidence-based guideline compliance.</p></div><div><h3>Results</h3><p>Revised IUSS workflows and protocols were implemented, focusing on effective communication, adherence to evidence-based principles for all IUSS processes, and delegating infrequent tasks to subject matter experts in the Sterile Processing Department.</p></div><div><h3>Conclusions</h3><p>Attempts to reduce the utilization of IUSS have proven effective. Due to these efforts, perioperative managers may face the challenge of dealing with outdated workflows that are no longer being utilized frequently enough to allow perioperative staff to become familiar with them and develop the necessary skills. The IUSS workflows should be subjected to process improvement methodologies to adapt them to optimize performance while minimizing risks to the organization.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100408"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141704785","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":"Occurrence of post intubation tracheal stenosis within a week of intubation: A case report","authors":"Aynalem Befkadu,&nbsp;Sara Timerga","doi":"10.1016/j.pcorm.2024.100419","DOIUrl":"10.1016/j.pcorm.2024.100419","url":null,"abstract":"<div><p>Post intubation tracheal stenosis is narrowing of tracheal lumen mainly due to endotracheal intubation associated problems. This iatrogenic complication commonly occurs after prolonged intubation. However, this case report revealed that severe tracheal stenosis could occur even after intubation last less than a week and can be misdiagnosed as bronchial asthma as first encountered with the patient. The case was 32 year old female patient who was admitted to ICU intubated for the management of status epilepticus. She was intubated for 3 days and discharged to medical ward. One month later, she experienced dyspnea and difficulty for breathing and admitted to the hospital. The three-dimensional CT scan showed trachea stenosis of 29 mm length with 8 cm wall thickness at the lower tracheal level. The stenosis was treated surgically with resection and anastomosis. This evidenced showed the occurrence of early intubation-related tracheal stenosis that mimic pulmonary problem presentation. As a conclusion if patient intubated for acceptable duration of time, patient consultation for the probability of the complications, sign and symptom and early admission will help in early treatment</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100419"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141998652","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":"Correlation between peripheral perfusion index and total vasopressor dose, nausea/ vomiting, and uterine contraction after spinal anesthesia in cesarean section: A correlative cross-sectional observational study","authors":"Mutivanya Inez Maharani,&nbsp;Dewi Yulianti Bisri,&nbsp;Radian Ahmad Halimi","doi":"10.1016/j.pcorm.2024.100414","DOIUrl":"10.1016/j.pcorm.2024.100414","url":null,"abstract":"<div><h3>Background and Aims</h3><p>Hypotension and other complications following spinal anaesthesia, such as nausea, vomiting, and poor uterine contractions during caesarean section, are common. There is no tool to predict the possibility of hypotension, nausea and vomiting, and poor uterine contractions to make proper anticipations. Peripheral Perfusion Index (PPI) is a noninvasive monitoring tool using an oximeter and can be used to indicate a patient's Systemic Vascular Resistance (SVR). This study aimed to find the correlation between pre-anaesthesia PPI and total vasopressor administration, nausea and vomiting, and uterine contraction using Linear Analogue Scale (LAS) after spinal anaesthesia for caesarean section.</p></div><div><h3>Methods</h3><p>The research subjects were 65 pregnant patients with the American Society of anaesthesiology II (ASA II) who underwent caesarean section at Hasan Sadikin General Hospital, Bandung, from November 2022 to April 2023. PPI was measured before spinal anaesthesia, and monitoring of nausea and vomiting, vasopressor administration, and LAS was performed intraoperatively.</p></div><div><h3>Results</h3><p>The results of this study showed that PPI had a strong positive correlation (<em>r</em> = 0.795) with total vasopressor administration, a moderate positive correlation (<em>r</em> = 0.506) with nausea and vomiting, and a moderate negative correlation (<em>r</em> = 0.574) with LAS. The AUC analysis revealed an excellent hypotension prediction with a cut-off value of 3.5 (AUC 0.868; CI 95%).</p></div><div><h3>Conclusion</h3><p>We conclude that PPI can be used as a predictor of vasopressor administration, nausea and vomiting, and uterine contractions.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100414"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142041006","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 effect of TeamSTEPPS® mobile-based training on perceptions of teamwork and team performance of operating room staff","authors":"Fardin Amiri,&nbsp;Mohammad Reza Sohrabi,&nbsp;Sedigheh Hannani,&nbsp;Namamali Azadi","doi":"10.1016/j.pcorm.2024.100396","DOIUrl":"10.1016/j.pcorm.2024.100396","url":null,"abstract":"<div><h3>Introduction</h3><p>TeamSTEPPS® aims to create an environment where all members feel comfortable to speak about patient safety concerns. The aim of this research was to determine the effect of TeamSTEPPS® mobile-based training on the perceptions of teamwork and team performance of operating room staff.</p></div><div><h3>Methods</h3><p>This study was a quasi-experimental method with measurements at baseline and after 2 months of intervention. The research samples included 105 OR staff (operating room technologists, anesthesia technologists, and nurses) working in 6 teaching hospitals of Iran University of Medical Sciences in 2022, which were selected by stratified random method and proportional allocation. The research tools included the demographic form, the Persian version of the ‘TeamSTEPPS® Teamwork Perception Questionnaire’ (T-TPQ) and the Persian version of the ‘Team Performance Observation Tool’ (TPOT). The intervention was carried out with sending the link of the TeamSTEPPS® 2.0 course files to participants by mobile messengers so that they could study them during five sessions, with an interval of one week between each session. Data analysis was done by calculating descriptive statistics and paired <em>t</em>-test.</p></div><div><h3>Results</h3><p>The results showed that TeamSTEPPS® mobile-based training significantly improved the perception of teamwork (<em>P</em> &lt; 0.011) and team performance of operating room staff (<em>P</em> &lt; 0.001).</p></div><div><h3>Conclusion</h3><p>With the determination of the effect of TeamSTEPPS® mobile-based training on the perception of teamwork and team performance of operating room staff, it is suggested to present this training program to this group.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100396"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141950897","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}