Urological surgery and equipment

2013 ◽  
pp. 697-792
Author(s):  
John Reynard ◽  
Simon Brewster ◽  
Suzanne Biers
Keyword(s):  
Patient Safety ◽  
Antibiotic Prophylaxis ◽  
Fluid Balance ◽  
Transurethral Resection ◽  
Surgical Patient ◽  
Urological Surgery ◽  
Complications Of Surgery

Preparation of the patient for urological surgery 698 Antibiotic prophylaxis in urological surgery 702 Complications of surgery in general: DVT and PE 706 Fluid balance and the management of shock in the surgical patient 710 Patient safety in the urology theatre 712 Transurethral resection (TUR) syndrome ...

General principles of urological surgery

2020 ◽  
pp. 1-18
Author(s):  
Suzanne Biers ◽  
Noel Armenakas ◽  
Alastair Lamb ◽  
Stephen Mark ◽  
John Reynard ◽  
...  
Keyword(s):  
Antibiotic Prophylaxis ◽  
Fluid Balance ◽  
Surgical Complications ◽  
Antiplatelet Drugs ◽  
Health Issues ◽  
Urological Surgery

This chapter covers the general principles of urological surgery, from preparation of the patient, antibiotic prophylaxis, general surgical complications, fluid balance, and management of shock to antiplatelet drugs and anticoagulation. It highlights potential issues in patients where there are other underlying health issues.

scholarly journals The SURgical PAtient Safety System (SURPASS) checklist optimizes timing of antibiotic prophylaxis

2010 ◽  
Vol 4 (1) ◽  
pp. 6 ◽  
Author(s):  
Eefje N de Vries ◽  
Lucia Dijkstra ◽  
Susanne M Smorenburg ◽  
R PETER Meijer ◽  
Marja A Boermeester
Keyword(s):  
Patient Safety ◽  
Antibiotic Prophylaxis ◽  
Safety System ◽  
Surgical Patient

scholarly journals 99. Effectiveness of Antibiotic Prophylaxis Among Patients Undergoing Elective Transurethral Resection of the Prostate in the Era of Antibiotic Resistance

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S179-S180
Author(s):  
Thana Khawcharoenporn ◽  
Pimjira Kanoktipakorn
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Prophylaxis ◽  
Transurethral Resection ◽  
Tertiary Care ◽  
Multidrug Resistant ◽  
Prophylactic Antibiotics ◽  
Care Hospital ◽  
Extended Spectrum Beta Lactamase ◽  
Observational Cohort

Abstract Background Data existing on effectiveness of antibiotic prophylaxis (AP) for transurethral resection of the prostate (TURP) are limited in the era of antibiotic resistance. Methods A 4-year prospective observational cohort study was conducted among patients undergoing TURP in an academic tertiary-care hospital during 2016–2019. Patients were excluded if pre-operative (pre-op) urine cultures were not sent or grew mixed (>2) organisms, or they had pre-op urinary tract infection (UTI) or lost follow-up after TURP. Appropriateness of AP was defined as 1) correct dosing and duration and narrowest spectrum according to the hospital AP guidelines and local epidemiology and 2) being active against uropathogens isolated from the pre-op culture. Primary outcome was the rate of UTI within 30 days post TURP compared between appropriate antibiotic prophylaxis (AAP) and inappropriate antibiotic prophylaxis (IAP) groups. Results 342 patients were screened and 61 were excluded. Of the 281 patients included, 139 (49%) received AAP and 142 (51%) received IAP. The reasons for IAP were prescribing too broad-spectrum antibiotics (57%), inactive antibiotics (41%) and incorrect dosing (2%). Pre-op urine cultures were no growth in 148 patients (53%). Among the 133 positive urine cultures with 144 isolates, Escherichia coli (52%) was the most commonly isolated. Thirty-one percent of these 144 isolates produced extended-spectrum beta-lactamase (ESBL) and 23 (16%) isolates were multidrug-resistant. The resistant rates of Enterobacteriaceae were 73% for ciprofloxacin, 65% for TMP-SMX and 46% for ceftriaxone. The two most commonly prescribed prophylactic antibiotics were ceftriaxone (51%) and ciprofloxacin (34%). The rate of UTI within 30 days post-TURP was significantly higher in IAP group compared to AAP group (47% vs 27%; P< 0.001). Prescribing inactive prophylactic antibiotics was the independent factor associated with 30-day post-TURP UTI (adjusted odds ratio 2.88; P=0.001). Conclusion Appropriate antibiotic prophylaxis significantly reduced UTI within 30 days of elective TURP. Obtaining pre-op urine culture and prescribing an active prophylactic agent are critical for preventing post-TURP UTI in the era of antibiotic resistance. Disclosures All Authors: No reported disclosures

scholarly journals Attitudes and compliance with the WHO surgical safety checklist: a survey among surgeons and operating room staff in 138 hospitals in China

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Jie Tan ◽  
James Reeves Mbori Ngwayi ◽  
Zhaohan Ding ◽  
Yufa Zhou ◽  
Ming Li ◽  
...  
Keyword(s):  
Patient Safety ◽  
Adverse Events ◽  
Operating Room ◽  
World Health ◽  
Surgical Patient ◽  
Local Data ◽  
Cross Sectional ◽  
Surgical Safety Checklist ◽  
Surgical Safety ◽  
Operating Room Staff

Abstract Background Ten years after the introduction of the Chinese Ministry of Health (MoH) version of Surgical Safety Checklist (SSC) we wished to assess the ongoing influence of the World Health Organisation (WHO) SSC by observing all three checklist components during elective surgical procedures in China, as well as survey operating room staff and surgeons more widely about the WHO SSC. Methods A questionnaire was designed to gain authentic views on the WHO SSC. We also conducted a prospective cross-sectional study at five level 3 hospitals. Local data collectors were trained to document specific item performance. Adverse events which delayed the operation were recorded as well as the individuals leading or participating in the three SSC components. Results A total of 846 operating room staff and surgeons from 138 hospitals representing every mainland province responded to the survey. There was widespread acceptance of the checklist and its value in improving patient safety. 860 operations were observed for SSC compliance. Overall compliance was 79.8%. Compliance in surgeon-dependent items of the ‘time-out’ component reduced when it was nurse-led (p < 0.0001). WHO SSC interventions which are omitted from the MoH SSC continued to be discussed over half the time. Overall adverse events rate was 2.7%. One site had near 100% compliance in association with a circulating inspection team which had power of sanction. Conclusion The WHO SSC remains a powerful tool for surgical patient safety in China. Cultural changes in nursing assertiveness and surgeon-led teamwork and checklist ownership are the key elements for improving compliance. Standardised audits are required to monitor and ensure checklist compliance.

Support for Healthcare Professionals After Surgical Patient Safety Incidents

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Naresh Serou ◽  
Andy K. Husband ◽  
Simon P. Forrest ◽  
Robert D. Slight ◽  
Sarah P. Slight
Keyword(s):  
Patient Safety ◽  
Healthcare Professionals ◽  
Surgical Patient ◽  
Patient Safety Incidents

scholarly journals A randomized and prospective study on the value of antibiotic prophylaxis administration in transurethral resection of the prostate

2004 ◽  
Vol 122 (1) ◽  
pp. 4-7 ◽  
Author(s):  
Paulo Rodrigues ◽  
Flávio Hering ◽  
Alex Meller ◽  
João Carlos Campagnari ◽  
Márcio D'Império
Keyword(s):  
Antibiotic Prophylaxis ◽  
Transurethral Resection ◽  
Bacterial Resistance ◽  
Statistical Significance ◽  
Tertiary Care ◽  
Prostatic Tissue ◽  
Significant Difference ◽  
Antibiotic Group ◽  
Tissue Chip ◽  
Bacterial Sensitivity

CONTEXT: Antibiotic prophylaxis in transurethral resection of the prostate is a regular practice in urology. However, its prophylactic effect can be questioned when the antiseptic surgical technique is used. Nonetheless, urine culture-oriented antibiotic therapy is the gold standard for avoiding improper medication usage and bacterial resistance. OBJECTIVE: To study the efficacy of antibiotic usage in patients with negative urine cultures, who were submitted to transurethral resection of the prostate. TYPE OF STUDY: Prospective open labeled study. SETTING: Tertiary care referral hospital PARTICIPANTS: 124 consecutive patients, who were randomly divided into two groups to receive antibiotic prophylaxis or not. MAIN MEASUREMENTS: Cultures from meatus, urine, irrigation and antiseptic fluid, and prostate tissue chips, were compared and analyzed for bacterial sensitivity to the antibiotic used, according to the surgeon's personal criteria. McLennan's test was used for statistical analysis. RESULTS: No statistically significant difference regarding clinical evolution was found between the groups that received or antibiotics or not. Statistical significance was found regarding the occurrence of positive urine cultures during the postoperative period for those not receiving antibiotics, but not in relation to fever, prostate chip culture or bacteremic episodes. Sixty-eight subjects (57.1%) presented positive prostatic tissue culture. There was no specific correlation between the recovered bacteria from the meatus, prostatic tissue chip and urine and the spectrum of the administered antibiotic. Six cases showed the same bacteria in the urine and prostatic tissue chip. Only fifteen cases (25%) in the antibiotic group showed the desired sensitivity directed to the collected bacteria. CONCLUSIONS: Antibiotic prophylaxis for patients whose urine is sterile is debatable in patients who are candidates for transurethral resection of the prostate. Most of the time, the antibiotic agent used is not specific for any of the bacteria recovered from the various sources analyzed.

scholarly journals Hubungan Kepatuhan Tim Bedah dalam Penerapan Surgery Safety Checklist dengan Infeksi Luka Operasi dan Lama Rawat Inap pada Pasien Seksio Sesarea di Rumah Sakit Umum Daerah Kabupaten Barru

2018 ◽  
Vol 5 (3) ◽  
pp. 145
Author(s):  
Amiruddin Amiruddin ◽  
Ova Emilia ◽  
Shinta Prawitasari ◽  
Leo Prawirodihardjo
Keyword(s):  
Patient Safety ◽  
Cesarean Section ◽  
Surgical Site Infection ◽  
Medical Care ◽  
Hospital Stay ◽  
General Hospital ◽  
Surgical Patient ◽  
Site Infection ◽  
Surgical Team ◽  
Duration Of Hospital Stay

Background: Surgical Patient Safety is essential to be carried out in operating theatre to prevent mortality and surgical complication. Patient safety is the basic principal in medical care and a major component of medical care management in hospital (WHO, 2009).Objective: To investigate association between SSC implementation among surgical team, surgical site infection and duration of hospital stay.Method: This is an analytical cross sectional study. Population of this study was women who underwent cesarean section with live birth in Barru general hospital during 1 December 2016-30 April 2017. This study was carried out in Barru general hospital, 137 samples met inclusion and exclusion criteria. Data was obtained from medical records. Maternal outcome were duration of hospital stay, surgical site infection, and maternal mortality. Besides, this study also assesed knowledge and compliance of surgical team in implementation of SSC. The result of this study was analysed with computer statisctics analysis program.Result adn Discussion: One-hundred thirty seven patients met study criteria. Compliance of surgery team in SSC was 64%,. SSC was not implemented precisely in 36% patients (49 patients). There is no significant association between surgical team compliance with surgical site infection in cesarean section patients (p=0.078). A significant association was found between surgical team compliance with duration of hospital stay (p=0.006).Conclusion: The surgical team compliance in implementation of SSC was not yet optimal. An intensive socialization is needed to improve compliance of team in order that SSC implementation run promptly. This was part of efforts to reduce post operative complication and shorten hospital stay.Keywords: SSC, cesarean section, compliance, infection, duration of hospital stay

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