Management of anaesthesia

Author(s):  
Iain Moppett

Successful management of anaesthesia requires expertise in the triad of knowledge, technical skills, and non-technical skills. The decision-making and techniques chosen should all be focused on patient safety, followed by patient comfort and efficiency. There is increasing evidence that anaesthesia management has an influence on patient outcome beyond the first couple of postoperative days. This chapter provides an overview of some of the key aspects of management of anaesthesia: the importance of proper preparation at all stages; the evidence—or lack thereof—for choices between techniques and drugs; and the key role of effective communication by the anaesthetist.

2021 ◽  
Vol 10 (2) ◽  
pp. 90-102
Author(s):  
Vivi Silvia ◽  
Rokiah Kusumapradja ◽  
Idrus Jus'at

Patient safety has become a global issue in the field of health service including hospital. Implementation of patient safety in the hospital requires the involvement of leadership, effective communication and patient’s trust. At X Hospital Jakarta, the root case that frequently occurs on patient safety incident is communication matter. This has an impact on the reoccurrence of patient safety incident. This research aims to analyze the influence of transformational leadership and effective communication towards the implementation of patient safety by trust as mediation. The method of this research is causal associative with quantitative approach. There are 37 nurses as  samples counted with G-Power Statistics application. The technique of collecting data uses primary data questionnaires and is processed by path analysis. The result shows that there is a great influence on transformational leadership towards trust.  Therefore, in implementing patient safety in hospital, it needs program development on transformational leadership; controlling, and evaluating the implementation of effective communication; and improving nursing care as a form of professional nursing practice to create and to maintain patient’s trust towards nurse.


Author(s):  
C Grimes ◽  
L Horgan

Patients may be subject to risk during surgery as a result of nontechnical as well as technical error. Effective surgical teams have been shown to have fewer problems per operation, higher intra-operative performance and shorter operating times. There is increasing evidence that interventions that improve teamwork, leadership, decision making, communication and situational awareness within operating teams also improve technical performance and patient outcome. In addition, briefings and debriefings before and at the end of operating lists have been shown to improve teamwork and communication, thereby improving patient safety.


2020 ◽  
pp. 0000-0000
Author(s):  
Hans ten Rouwelaar ◽  
Frans Schaepkens ◽  
Sally K. Widener

The role of the management accountant (MA) has broadened to include acting as a strategic business partner. Our study examines whether MAs believe they need interpersonal skills (i.e., ability to constructively challenge and question assumptions, numbers, and their meanings), conceptual skills (i.e., making and leading decisions consistent with the organization's business environment and strategy), and/or technical skills (i.e., computer, accounting, and data modeling) to be influential and effective in this expanded role. To examine our hypotheses, we use survey data from 215 controllers in Dutch healthcare organizations and develop a partial least squares path model. We conclude that interpersonal and conceptual skills are associated with MAs' perceptions that they influence management's decision making, while all three skills are associated with their effectiveness. We also find that technical and conceptual skills are jointly associated with the influence of MAs while conceptual and interpersonal skills are jointly associated with their effectiveness.


Author(s):  
Aatefa Lunat ◽  
Denise Major

The purpose of this chapter is to address decision making in the field of children’s and young people’s nursing practice in relation to the field-specific competencies outlined by the Nursing and Midwifery Council (NMC) in the Standards for Pre-Registration Nursing Education (NMC 2010). In order to explore these competencies further, we will consider examples from practice, and links will be made between the various examples from practice and the competencies in order to demonstrate their importance. To allow an in-depth exploration of the examples from practice, we will use Johns’ (1994) model of reflection. ‘Reflection’ is described as a means by which nurses can closely examine their theoretical knowledge along with their nursing practice (Johns 2000). The process of reflection has been found to have great benefits for nurses, because it allows them the opportunity to change and develop practice in order to carry out improved care practices (O’Regan and Fawcett 2006). In this chapter, the evidence of decision making has been interlinked with critical evidence-based reflective practice, and demonstrates its integration and development in the role of the newly qualified nurse. The chapter will begin by discussing examples derived from practice, and key aspects from these examples will be taken and related to the NMC Standards (NMC 2010). The chapter will then go on to discuss key elements required to make decisions in clinical practice. The evidence base for many of the decisions taken in the case study is interwoven throughout the narrative, thus enabling you see how they link together in nursing practice. Centred on a newly qualified staff nurse on the neonatal unit, the single case study around which this chapter is structured considers the care of a sick neonate whose parents were adolescents. This example was chosen because it illustrates many aspects of caring decisions that have to be made for patients from birth through adolescence, because the parents themselves were still in the later stages of childhood. The case study itself appears as dialogue, and the Standards and competencies referred to are those generic and field-specific competencies that a student pursuing a children’s nursing field-of-practice pathway is required to achieve, found under the heading ‘Competencies for entry to the register: Children’s nursing’ in the NMC Standards (NMC 2010).


2016 ◽  
Vol 29 (1) ◽  
pp. 82-89 ◽  
Author(s):  
Ilze Buligina ◽  
Biruta Sloka ◽  
Ināra Kantāne ◽  
Anita Līce

Abstract Introduction of work-based learning (WBL) in Latvia has required new approaches in decision making of different stakeholders. Experience from countries with long-standing WBL tradition has shown the numerous advantages but also the challenges this approach presents. One of these challenges is the need for new forms and mechanisms of cooperation among the key stakeholders – policy makers, public administrators, employers, educators and social partners. The current paper analyses the results of scientific research in this field, as well as uses the empirical results of two surveys performed by the authors: a survey of public sector experts and a survey of employers in Latvia. In order to obtain detailed results, the evaluations of respondents on multiple aspects analysed in the surveys were evaluation in the scale 1–10. The data of both surveys have been analysed by descriptive analysis, cross-tabulations and multivariate analysis – factor analysis. The results have indicated that the views of employers and social partners on the most of the key aspects of introduction and implementation of WBL are similar. However, a more profound analysis has to be performed in order to develop proposals or the most efficient approach to WBL.


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