scholarly journals Impact of Multidisciplinary Team on Duodenoscope Reprocessing to Minimize Infections with High-Risk Organisms

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S193-S193
Author(s):  
Evan Mosier ◽  
Preciosa Marasigan ◽  
Stephanie Hall ◽  
Neha Nanda
Keyword(s):  
High Risk ◽  
Multidisciplinary Team

scholarly journals Comparison of Orthognathic Surgery Outcomes Between Patients With and Without Underlying High-Risk Conditions: A Multidisciplinary Team-Based Approach and Practical Guidelines

2019 ◽  
Vol 8 (11) ◽  
pp. 1760 ◽  
Author(s):  
Chou ◽  
Denadai ◽  
Chen ◽  
Pai ◽  
Hsu ◽  
...  
Keyword(s):  
High Risk ◽  
Blood Loss ◽  
Multidisciplinary Team ◽  
Orthognathic Surgery ◽  
Wide Spectrum ◽  
Well Being ◽  
Intraoperative Blood Loss ◽  
Healthy Individuals ◽  
Patient Reported ◽  
Comorbidity Scores

Orthognathic surgery (OGS) has been successfully adopted for managing a wide spectrum of skeletofacial deformities, but patients with underlying conditions have not been treated using OGS because of the relatively high risk of surgical anesthetic procedure-related complications. This study compared the OGS outcomes of patients with and without underlying high-risk conditions, which were managed using a comprehensive, multidisciplinary team-based OGS approach with condition-specific practical perioperative care guidelines. Data of surgical anesthetic outcomes (intraoperative blood loss, operative duration, need for prolonged intubation, reintubation, admission to an intensive care unit, length of hospital stay, and complications), facial esthetic outcomes (professional panel assessment), and patient-reported outcomes (FACE-Q social function, psychological well-being, and satisfaction with decision scales) of consecutive patients with underlying high-risk conditions (n = 30) treated between 2004 and 2017 were retrospectively collected. Patients without these underlying conditions (n = 30) treated during the same period were randomly selected for comparison. FACE-Q reports of 50 ethnicity-, sex-, and age-matched healthy individuals were obtained. The OGS-treated patients with and without underlying high-risk conditions differed significantly in their American Society of Anesthesiologists Physical Status (ASA-PS) classification (p < 0.05), Charlson comorbidity scores, and Elixhauser comorbidity scores. The two groups presented similar outcomes (all p > 0.05) for all assessed outcome parameters, except for intraoperative blood loss (p < 0.001; 974.3 ± 592.7 mL vs. 657.6 ± 355.0 mL). Comparisons with healthy individuals revealed no significant differences (p > 0.05). The patients with underlying high-risk conditions treated using a multidisciplinary team-based OGS approach and the patients without the conditions had similar OGS-related outcomes.

Optimizing care for high-risk neuroblastoma patients treated with dinutuximab: Challenges for the multidisciplinary team

2020 ◽  
Vol 26 (7) ◽  
pp. 1721-1724
Author(s):  
Tiene Bauters ◽  
Veronique Van de Velde ◽  
Stefanie Bekaert ◽  
Geneviève Laureys
Keyword(s):  
High Risk ◽  
Multidisciplinary Team ◽  
Neuroblastoma Cells ◽  
High Dose Chemotherapy ◽  
Current Treatment ◽  
High Dose ◽  
Treatment Protocols ◽  
Pediatric Hematology ◽  
Key Points ◽  
Promising Treatment

Current treatment protocols for high-risk neuroblastoma include high-dose chemotherapy, surgery, stem cell transplantation and radiation. Recently, dinutuximab, a chimeric monoclonal antibody, specifically targeting the disialoganglioside highly expressed on neuroblastoma cells, has been licensed. Its incorporation in maintenance therapy represents a promising treatment approach. The introduction of its use was a challenge for the entire multidisciplinary team in our pediatric hematology and oncology ward just as for the pharmacy team. An overview of the key points that were observed is presented.

scholarly journals The multidisciplinary team approach for high-risk and major cancer surgery

BJA Education ◽  
2017 ◽  
Vol 17 (8) ◽  
pp. 255-261 ◽  
Author(s):  
Y Ziabari ◽  
T Wigmore ◽  
R Kasivisvanathan
Keyword(s):  
High Risk ◽  
Multidisciplinary Team ◽  
Cancer Surgery ◽  
Team Approach ◽  
Multidisciplinary Team Approach

scholarly journals Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study

2021 ◽  
Vol 10 (4) ◽  
pp. e001583
Author(s):  
Leopoldo Muniz da Silva ◽  
Helidea de Oliveira Lima ◽  
Ricardo Ferrer ◽  
Anthony M-H Ho ◽  
Saullo Queiroz Silveira ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
High Risk ◽  
Postoperative Period ◽  
Multidisciplinary Team ◽  
Intervention Study ◽  
Surgical Patients ◽  
Medical Documentation ◽  
Vte Prophylaxis ◽  
Before And After ◽  
Multiple Stages

BackgroundVenous thromboembolism (VTE) is a major cause of perioperative morbimortality. Despite significant efforts to advance evidence-based practice, prevention rates remain inadequate in many centres.ObjectiveTo evaluate the effectiveness of different strategies aimed at improving adherence to adequate VTE prophylaxis in surgical patients at high risk of VTE.MethodBefore and after intervention study conducted at a tertiary hospital. Adherence to adequate VTE prophylaxis was compared according to three strategies consecutively implemented from January 2019 to December 2020. A dedicated hospitalist physician alone (strategy A) or in conjunction with a nurse (strategy B) overlooked the postoperative period to ensure adherence and correct inadequacies. Finally, a multidisciplinary team approach (strategy C) focused on promoting adequate VTE prophylaxis across multiple stages of care—from the operating room (ie, preoperative team-based checklist) to collaboration with clinical pharmacists in the postoperative period—was implemented.ResultsWe analysed 2074 surgical patients: 783 from January to June 2019 (strategy A), 669 from July 2019 to May 2020 (strategy B), and 622 from June to December 2020 (strategy C). VTE prophylaxis adherence rates for strategies (A), (B) and (C) were (median (25th–75th percentile)) 43.29% (31.82–51.69), 50% (42.57–55.80) and 92.31% (91.38–93.51), respectively (p<0.001; C>A=B). There was a significant reduction in non-compliance on all analysed criteria (risk stratification (A (25.5%), B (22%), C (6%)), medical documentation (A (68%), B (55.2%) C (9%)) and medical prescription (A (51.85%), B (48%), C (6.10%)) after implementation of strategy C (p<0.05). Additionally, a significant increase in compliance with adequate dosage, dosing interval and scheduling of the prophylactic regimen was observed.ConclusionPerioperative VTE prophylaxis strategies that relied exclusively on physicians and/or nurses were associated with suboptimal execution and prevention. A multidisciplinary team-based approach that covers multiple stages of patient care significantly increased adherence to adequate VTE prophylaxis in surgical patients at high risk of developing perioperative VTE.

scholarly journals Perioperative Management of Pheochromocytomas and Sympathetic Paragangliomas

2022 ◽  
Author(s):  
Gustavo F C Fagundes ◽  
Madson Q Almeida
Keyword(s):  
High Risk ◽  
Surgical Approach ◽  
Multidisciplinary Team ◽  
Chromaffin Cells ◽  
Perioperative Management ◽  
Distant Metastases ◽  
Endocrine Tumors ◽  
Genetic Syndromes ◽  
First Choice ◽  
Complete Surgical Resection

Abstract Pheochromocytomas and paragangliomas (PPGLs) are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla or extra-adrenal paraganglia, respectively. PPGLs have the highest degree of heritability among endocrine tumors. Currently, ~40% of PPGL individuals have a genetic germline and there exist at least 12 different genetic syndromes related to these tumors. Metastatic PPGLs are defined by the presence of distant metastases at sites where chromaffin cells are physiologically absent. Approximately 10% of pheochromocytomas and ~40% of sympathetic paragangliomas are linked to metastases explaining why complete surgical resection is the first-choice treatment for all PPGL patients. The surgical approach is a high-risk procedure requiring perioperative management by a specialized multidisciplinary team in centers with broad expertise. In this review, we summarize and discuss the most relevant aspects of perioperative management in patients with pheochromocytomas and sympathetic paragangliomas.

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