scholarly journals COVID-19: Pandemic surgery guidance

4open ◽  
2020 ◽  
Vol 3 ◽  
pp. 1 ◽  
Author(s):  
Björn L.D.M. Brücher ◽  
Giuseppe Nigri ◽  
Andrea Tinelli ◽  
Jose Florencio F. Lapeña ◽  
Eloy Espin-Basany ◽  
...  
Keyword(s):  
General Surgery ◽  
Trauma Surgery ◽  
Scientific Data ◽  
Endocrine Surgery ◽  
Healthcare Team ◽  
Healthcare Staff ◽  
Transplantation Surgery ◽  
Surgical Critical Care ◽  
The Usa ◽  
Responsibility Of Scientists

Based on high quality surgery and scientific data, scientists and surgeons are committed to protecting patients as well as healthcare staff and hereby provide this Guidance to address the special issues circumstances related to the exponential spread of the Coronavirus disease 2019 (COVID-19) during this pandemic. As a basis, the authors used the British Intercollegiate General Surgery Guidance as well as recommendations from the USA, Asia, and Italy. The aim is to take responsibility and to provide guidance for surgery during the COVID-19 crisis in a simplified way addressing the practice of surgery, healthcare staff and patient safety and care. It is the responsibility of scientists and the surgical team to specify what is needed for the protection of patients and the affiliated healthcare team. During crises, such as the COVID-19 pandemic, the responsibility and duty to provide the necessary resources such as filters, Personal Protective Equipment (PPE) consisting of gloves, fluid resistant (Type IIR) surgical face masks (FRSM), filtering face pieces, class 3 (FFP3 masks), face shields and gowns (plastic ponchos), is typically left up to the hospital administration and government. Various scientists and clinicians from disparate specialties provided a Pandemic Surgery Guidance for surgical procedures by distinct surgical disciplines such as numerous cancer surgery disciplines, cardiothoracic surgery, ENT, eye, dermatology, emergency, endocrine surgery, general surgery, gynecology, neurosurgery, orthopedics, pediatric surgery, reconstructive and plastic surgery, surgical critical care, transplantation surgery, trauma surgery and urology, performing different surgeries, as well as laparoscopy, thoracoscopy and endoscopy. Any suggestions and corrections from colleagues will be very welcome as we are all involved and locked in a rapidly evolving process on increasing COVID-19 knowledge.

The Impact of Hospital/University Affiliation on Research Productivity Among US-Based Authors in the Fields of Trauma, Surgical Critical Care, Acute Care, and Emergency General Surgery

2020 ◽  
pp. 000313482094950
Author(s):  
Amanda Baroutjian ◽  
Mason Sutherland ◽  
John J. Hoff ◽  
Tyler Bean ◽  
Carol Sanchez ◽  
...  
Keyword(s):  
Critical Care ◽  
Acute Care ◽  
General Surgery ◽  
Research Productivity ◽  
Trauma Surgery ◽  
Acute Care Surgery ◽  
Emergency General Surgery ◽  
Surgical Critical Care ◽  
Care Surgery ◽  
The Impact

Background Research productivity is critical to academic surgery and essential for advancing surgical knowledge and evidence-based practice. We aim to determine if surgeon affiliation with top US universities/hospitals (TOPS) is associated with increased research productivity measured by numbers of peer-reviewed publications in PubMed (PMIDs). Methods A bibliometric analysis was performed for PMIDs. Affiliated authors who published in trauma surgery (TS), surgical critical care (SCC), acute care surgery (ACS), and emergency general surgery (EGS) were evaluated for publications between 2015 and 2019, and lifetime productivity. Our analysis included 3443 authors from 443 different institutions. Our main outcome was PMIDs of first author (FA) and senior author (SA) in each field (2015-2019) and total lifetime publications. Results Significant differences exist between PMIDs from TOPS vs non-TOPS in FA-TS (1.34 vs 1.23, P = .001), SA-TS (1.71 vs 1.46, P < .001), total SA-PMIDs (44.10 vs 26.61, P < .001), and SA-lifetime PMIDs (90.55 vs 59.03, P < .001). There were no significant differences in PMIDs for FA or SA-SCC, FA or SA-ACS, FA or SA-EGS, FA-total PMIDs 2015-2019, or FA-lifetime PMIDs ( P > .05 for all). Conclusion There were significantly higher TS PMIDs among FAs and SAs affiliated with top US institutions in 2015-2019, along with higher total PMIDs (2015-2019) and lifetime PMIDs. These findings are of significance to future graduate medical applicants and academic surgeons who need to make decisions about training and future career opportunities.

Practical reflections on a collaboration with healthcare consumers on the development of a simulation

2020 ◽  
pp. bmjstel-2020-000753
Author(s):  
Benjamin Symon ◽  
Rachel Edwards ◽  
Sonia Jean Twigg ◽  
Martha Carolina Ardila Sarmiento ◽  
Stephanie Barwick
Keyword(s):  
Positive Impact ◽  
Learning Objectives ◽  
Cultural Learning ◽  
Healthcare Team ◽  
Healthcare Staff ◽  
Simulation Design ◽  
Consumer Review ◽  
Scenario Design ◽  
Port Access ◽  
Healthcare Consumer

BackgroundHealthcare simulations generate moments of ‘cultural compression’ through which we transmit core values about our professional identities and the families we care for. The engagement of healthcare consumers in this process is useful to evaluate the values we transmit and ensure authenticity in the narratives we share.MethodsA simulation package on febrile neutropenia and port access was written by healthcare staff in consultation with the parent of a child with leukaemia. Healthcare consumer review was focused on the representation of the simulated parent within the simulation scripts. The child and his mother assisted in the development of supportive video resources on family perspectives on port access and demonstration of the procedure.ResultsThe involvement of healthcare consumers in the development of the scenario had positive impact on the design and the supportive resources, both of which created opportunities for patient advocacy and reinforced the centrality of healthcare consumers within the healthcare team.ConclusionsHealthcare consumer collaboration in scenario design was achievable and impactful without significant increased cost. We hope to promote the benefits of healthcare consumer consultation in simulation design to improve the pursuit of educational and cultural learning objectives.

scholarly journals Emergency surgery during the COVID-19 pandemic: what you need to know for practice

2020 ◽  
Vol 102 (5) ◽  
pp. 323-332 ◽  
Author(s):  
B De Simone ◽  
E Chouillard ◽  
S Di Saverio ◽  
L Pagani ◽  
M Sartelli ◽  
...  
Keyword(s):  
Open Surgery ◽  
English Language ◽  
Perioperative Complications ◽  
Trauma Surgery ◽  
Current Data ◽  
Operating Theatre ◽  
Security Measures ◽  
Healthcare Staff ◽  
Risk Of Exposure ◽  
The Impact

Introduction Several articles have been published about the reorganisation of surgical activity during the COVID-19 pandemic but few, if any, have focused on the impact that this has had on emergency and trauma surgery. Our aim was to review the most current data on COVID-19 to provide essential suggestions on how to manage the acute abdomen during the pandemic. Methods A systematic review was conducted of the most relevant English language articles on COVID-19 and surgery published between 15 December 2019 and 30 March 2020. Findings Access to the operating theatre is almost exclusively restricted to emergencies and oncological procedures. The use of laparoscopy in COVID-19 positive patients should be cautiously considered. The main risk lies in the presence of the virus in the pneumoperitoneum: the aerosol released in the operating theatre could contaminate both staff and the environment. Conclusions During the COVID-19 pandemic, all efforts should be deployed in order to evaluate the feasibility of postponing surgery until the patient is no longer considered potentially infectious or at risk of perioperative complications. If surgery is deemed necessary, the emergency surgeon must minimise the risk of exposure to the virus by involving a minimal number of healthcare staff and shortening the occupation of the operating theatre. In case of a lack of security measures to enable safe laparoscopy, open surgery should be considered.

scholarly journals Morning report decreases length of stay in emergency general surgery patients

2019 ◽  
Vol 8 (6) ◽  
pp. 1
Author(s):  
James R. Gardner ◽  
John D. Wolfe ◽  
William C. Beck ◽  
Kevin W. Sexton ◽  
Avi Bhavaraju ◽  
...  
Keyword(s):  
Length Of Stay ◽  
General Surgery ◽  
Average Length ◽  
Hospital Setting ◽  
Acute Care Surgery ◽  
Morning Report ◽  
Emergency General Surgery ◽  
Medical Specialties ◽  
Surgical Critical Care ◽  
Care Surgery

Objective: Communication in the hospital setting is an easy target for quality improvement. Capturing this change via communication between providers during hand-offs is necessary to reduce delays and errors. While this process has been more widely characterized in medical specialties, we designed this study to address the knowledge gap in surgical specialties.Methods: Our institution’s division of Acute Care Surgery (ACS) implemented Morning Report (MR) in October of 2015. At MR, all admissions and service transfers were discussed from Trauma, Emergency General Surgery (EGS), and Surgical Critical Care services from the previous 24 hours. This study compared patients who underwent a surgical procedure during their hospital stay before and after protocol implementation.Results: 974 patients were included in this study. The average patient was 50.3 years of age, 65.4% were white, and 51.7% were male. The average length of stay (LOS) was 8.3 days with 1.75 days to procedure. The post-MR cohort LOS was 2.7 shorter and had 0.85 fewer days to procedure. In an adjusted regression analysis, days to procedure and LOS decreased by 33% (p < .01) and 17% (p < .01) respectively.Conclusions: Implementation of MR led to a decrease in the overall LOS and days to procedure for operative patients. Our results advocate for the standard use of structured hand-offs in surgical units.

Condoms for sexually transmissible infection prevention: politics versus science

Sexual Health ◽  
2008 ◽  
Vol 5 (1) ◽  
pp. 1 ◽  
Author(s):  
Adrian Mindel ◽  
Shailendra Sawleshwarkar
Keyword(s):  
Scientific Data ◽  
Case Control Studies ◽  
Cross Sectional ◽  
Sti Prevention ◽  
Degree Of Protection ◽  
Sexually Transmissible Infections ◽  
The Usa ◽  
Simplex Virus ◽  
The Impact ◽  
Abstinence Only

The present review assesses the protection that condoms offer against sexually transmissible infections (STI) and the impact that social, political and religious opinion in the USA has had in the past 8 years on promoting condoms for safer sex. Condoms offer protection against most STI. However, the degree of protection depends on correct and consistent use, the type of sexual activity and the biological characteristics of different infections. Cross-sectional and case-control studies and other observational data provide the majority of evidence for STI prevention. Condoms provide a high level of protection against those infections that are transmitted mainly via infected secretions, including HIV, gonorrhoea, chlamydia and trichomoniasis. Protection against those infections transmitted via skin and mucous membrane contact, including Herpes simplex virus infection and human papilloma virus, appears to be less. The Bush administration, driven by conservative political, social and religious elements in the USA, has mounted a concerted campaign to undermine the role of the condom in health-promotion activities in the USA and overseas by undervaluing and misrepresenting scientific data, and through a sustained and well-funded promotion of abstinence-only education. However, this has lead to considerable controversy and disillusionment with abstinence-only education, both at home and abroad, and there is now incontrovertible evidence that abstinence-only programs are ineffectual.

scholarly journals Are trauma research programs in academic and non-academic centers measured by equal standards? A survey of 137 level I trauma centers in the United States

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Robert M. Madayag ◽  
Erica Sercy ◽  
Gina M. Berg ◽  
Kaysie L. Banton ◽  
Matthew Carrick ◽  
...  
Keyword(s):  
General Surgery ◽  
Trauma Surgery ◽  
The United States ◽  
Full Time ◽  
Trauma Centers ◽  
Patient Volume ◽  
Non Profit ◽  
Trauma Research ◽  
Research Programs ◽  
Level I

Abstract Background American College of Surgeons level I trauma center verification requires an active research program. This study investigated differences in the research programs of academic and non-academic trauma centers. Methods A 28-question survey was administered to ACS-verified level I trauma centers in 11/12/2020–1/7/2021. The survey included questions on center characteristics (patient volume, staff size), peer-reviewed publications, staff and resources dedicated to research, and funding sources. Results The survey had a 31% response rate: 137 invitations were successfully delivered via email, and 42 centers completed at least part of the survey. Responding level I trauma centers included 36 (86%) self-identified academic and 6 (14%) self-identified non-academic centers. Academic and non-academic centers reported similar annual trauma patient volume (2190 vs. 2450), number of beds (545 vs. 440), and years of ACS verification (20 vs. 14), respectively. Academic centers had more full-time trauma surgeons (median 8 vs 6 for non-academic centers) and general surgery residents (median 30 vs 7) than non-academic centers. Non-academic centers more frequently ranked trauma surgery (100% vs. 36% academic), basic science (50% vs. 6% academic), neurosurgery (50% vs. 14% academic), and nursing (33% vs. 0% academic) in the top three types of studies conducted. Academic centers were more likely to report non-profit status (86% academic, 50% non-academic) and utilized research funding from external governmental or non-profit grants more often (76% vs 17%). Conclusions Survey results suggest that academic centers may have more physician, resident, and financial resources available to dedicate to trauma research, which may make fulfillment of ACS level I research requirements easier. Structural and institutional changes at non-academic centers, such as expansion of general surgery resident programs and increased pursuit of external grant funding, may help ensure that academic and non-academic sites are equally equipped to fulfill ACS research criteria.

Emergency surgery (DRAFT)

2018 ◽  
Author(s):  
Jonathan Wild ◽  
Emma Nofal ◽  
Imeshi Wijetunga ◽  
Antonia Durham Hall
Keyword(s):  
General Surgery ◽  
Hospital Admissions ◽  
Surgical Intervention ◽  
Elective Surgery ◽  
Trauma Surgery ◽  
Emergency Operation ◽  
Emergency General Surgery ◽  
Symptom Palliation ◽  
The Impact ◽  
Theatre List

Emergency general surgery comprises patients with surgical problems requiring surgical intervention or post-operative surgical patients who require further surgical intervention or symptom palliation at any time of the day or night. Beyond the cases discussed below, this will include also emergency presentations from all of the sub-specialty chapters covered so far. Over 600,000 emergency hospital admissions are made to general surgery. Of these patients, they comprise the sickest patient cohort relative to the majority of elective patients, which results from sepsis, shock, or organ dysfunction from the underlying causative pathology, as well as the impact of any pre-existant comorbid states. This often has a significant impact on patient outcome, with high rates of morbidity and mortality relative to elective surgery. With this in mind, a lot of work has been channelled into improving outcomes for these patients. Furthermore, emergency and trauma surgery is beginning to establish itself as a subspecialty in itself. This chapter starts by making applied discussion of the assessment and initial investigation of acute abdominal pain, a complaint that comprises half of the annual 600,000 emergency general surgical admissions. It covers the pertinent features of diagnosis, investigation, and management of a range of common or serious emergency surgical and trauma cases that will be encountered on the acute surgical take. Kidney transplantation is not in itself an emergency operation when you consider the degree of pre-operative preparation of recipient donors, but is included in this chapter as it is commonly encountered by junior trainees on the emergency theatre list when donors are found at short notice.

scholarly journals New Directions in Mental Health Care Evaluation

1988 ◽  
Vol 12 (2) ◽  
pp. 78-78
Author(s):  
Isaac Marks ◽  
Joseph Connolly ◽  
Matthijs Muijen
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Mental Health Care ◽  
Large Scale ◽  
Scientific Data ◽  
The Usa ◽  
Health Care Evaluation ◽  
Evaluative Research ◽  
The Uk ◽  
Care Evaluation

Mental health care evaluation is a priority area as mental health care services are changing rapidly, more than are most other medical services. Budgets are finite, and there is concern for value for money in meeting the needs of patients and families. A one-day workshop brought together leading figures in the USA and Europe to discuss how a unit and consortium might be established to give cohesion and catalyse evaluative research in this fragmented field in the UK. Sound scientific data are available which have not yet been widely disseminated or used in policy making. There are rich opportunities for cross-national projects. The USA has intriguing innovations in evaluative research in mental health, some on a large scale, and these are relevant to the UK.

Patient safety culture in Hungarian hospitals

2019 ◽  
Vol 32 (2) ◽  
pp. 412-424 ◽  
Author(s):  
Nina Granel ◽  
Josep Maria Manresa-Domínguez ◽  
Anita Barth ◽  
Katalin Papp ◽  
Maria Dolors Bernabeu-Tamayo
Keyword(s):  
Patient Safety ◽  
Safety Culture ◽  
Improve Patient Safety ◽  
Patient Safety Culture ◽  
Healthcare Staff ◽  
Content Type ◽  
Work Area ◽  
Exploratory Factor Analyses ◽  
The Usa ◽  
Blame Culture

Purpose The Hospital Survey on Patient Safety Culture (HSOPSC) is a rigorously designed tool for measuring inpatient safety culture. The purpose of this paper is to develop a cross-cultural HSOPSC for Hungary and determine its strengths and weaknesses. Design/methodology/approach The original US version was translated and adapted using existing guidelines. Healthcare workers (n=371) including nurses, physicians and other healthcare staff from six Hungarian hospitals participated. Answers were analyzed using exploratory factor analyses and reliability tests. Findings Positive responses in all dimensions were lower in Hungary than in the USA. Half the participants considered their work area “acceptable” regarding patient safety. Healthcare staff worked in “crisis mode,” trying to accomplish too much and too quickly. The authors note that a “blame culture” does not facilitate patient safety improvements in Hungary. Practical implications The results provide valuable information for promoting a more positive patient safety culture in Hungary and for evaluating future strategies to improve patient safety. Originality/value Introducing a validated scale to measure patient safety culture in Hungary improves healthcare quality.

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