Conception and design of novel lumbar drain insertion simulator

2021 ◽  
pp. bmjstel-2021-000873
Author(s):  
Nikhil Krishna Murthy ◽  
Ellie O’Brien ◽  
Nader S Dahdaleh
Keyword(s):  
Patient Safety ◽  
Supervised Learning ◽  
Drainage System ◽  
Needle Insertion ◽  
Structural Components ◽  
Common Procedure ◽  
Lumbar Drain ◽  
Patients At Risk ◽  
Drain Placement ◽  
Critical Aspects

Lumbar drain insertion is a common procedure that is performed by anaesthesiologists, radiologists and neurosurgeons that is generally taught through supervised learning that can place patients at risk. We describe in detail the creation and considerations of a novel lumbar drain simulator designed to allow learners to rehearse the complete lumbar drain insertion procedure from start to finish. A lumbar drain simulator was designed with the goal of simulating drain placement on a patient including identifying physical landmarks, sterile field preparation, technical steps of the procedure, troubleshooting and securing and connecting the drainage system. Emphasis was placed on simulating the structural components of the anatomic compartments encountered during needle insertion and accurate reproduction of the tactile aspects of the procedure. The simulator is able to reproduce the critical aspects of drain placement, allowing for learners to practice a complete lumbar drain placement from start to finish. A complete simulation of lumbar drain placement can be created that allows learners to practise all aspects of the lumbar drain procedure. Learners can rehearse all steps of the procedure allowing them to be more confident and facile with the procedure, which can lead to improved patient safety and satisfaction.

New Concept for a Thoracic Drainage System Using Magnetic Actuation

2019 ◽  
Vol 26 (6) ◽  
pp. 705-711
Author(s):  
Daisuke Taniguchi ◽  
Keitaro Matsumoto ◽  
Yoshihiro Kondo ◽  
Tomoshi Tsuchiya ◽  
Ikuo Yamamoto ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Drainage System ◽  
Magnetic Actuation ◽  
Thoracic Cavity ◽  
Common Procedure ◽  
Thoracic Drainage ◽  
Drain Fluid ◽  
Laboratory Trial ◽  
General Surgeons ◽  
Effective Drainage

Objectives. Thoracic drainage is a common procedure to drain fluid, blood, or air from the pleural cavity. Some attempts to develop approaches to new thoracic drainage systems have been made; however, a simple tube is often currently used. The existing drain presupposes that it is placed correctly and that the tip does not require moving after insertion into the thoracic cavity. However, in some cases, the drain is not correctly placed and reinsertion of an additional drain is required, resulting in significant invasiveness to the patient. Therefore, a more effective drainage system is needed. This study aimed to develop and assess a new thoracic drain via a collaboration between medical and engineering personnel. Methods. We developed the concept of a controllable drain system using magnetic actuation. A dry laboratory trial and accompanying questionnaire assessment were performed by a group of thoracic and general surgeons. Objective mechanical measurements were obtained. Porcine experiments were also carried out. Results. In a dry laboratory trial, use of the controllable drain required significantly less time than that required by replacing the drain. The average satisfaction score of the new drainage system was 4.07 out of 5, indicating that most of the research participants were satisfied with the quality of the drain with a magnetic actuation. During the porcine experiment, the transfer of the tip of the drain was possible inside the thoracic cavity and abdominal cavity. Conclusion. This controllable thoracic drain could reduce the invasiveness for patients requiring thoracic or abdominal cavity drainage.

Complications Associated with Lumbar Drain Placement for Endovascular Aortic Repair

2020 ◽  
Author(s):  
Anastasia Plotkin ◽  
Sukgu M. Han ◽  
Fred A. Weaver ◽  
Vincent L. Rowe ◽  
Kenneth R. Ziegler ◽  
...  
Keyword(s):  
Endovascular Aortic Repair ◽  
Lumbar Drain ◽  
Aortic Repair ◽  
Drain Placement

Promoting Patient Safety within Implantable Medical Devices: Patient Alert™

2005 ◽  
Vol 49 (11) ◽  
pp. 1084-1088
Author(s):  
Holly Vitense
Keyword(s):  
Patient Safety ◽  
Ventricular Tachyarrhythmia ◽  
Medical Attention ◽  
Implantable Medical Devices ◽  
System Integrity ◽  
Threatening Condition ◽  
Patients At Risk ◽  
Life Threatening ◽  
Communication Modalities ◽  
Therapy Delivery

Implantable Cardioverter Defibrillator (ICD) systems have been shown to provide lifesaving therapy for patients at risk of sudden cardiac death due to ventricular tachyarrhythmia. In order to assure an ICD system is operating properly, some models of ICDs perform periodic system checks. The Patient Alert™ feature, in Medtronic® ICDs, monitors and alerts patients, via audible tones, to system integrity issues that have the potential to comprise patient safety. The objective of this research was to evaluate: how often patients are being alerted to ICD system issues, and how effective the alerts are at bringing patients into medical clinics for treatment and thus promoting patient safety. An analysis of 14,092 ICDs revealed that the probability of first alert occurrence increased with time since implant, but overall occurrence rates remained low (< 7% per patient year). The average median time from the alert sounding until the patient received medical attention was 4.3 days. Overall, for a life-threatening condition such as ICD therapy delivery being turned off, the majority (76%) of patients with this alert were brought into a clinic within one week to have therapy delivery turned back on. To reach the remaining patients, as well as bring all patients in quicker to seek medial treatment, additional communication modalities are being planned for the next generation of ICD systems.

scholarly journals Using the electronic health record to build a culture of practice safety: evaluating the implementation of trigger tools in one general practice

2018 ◽  
Vol 68 (669) ◽  
pp. e279-e285 ◽  
Author(s):  
Tom Margham ◽  
Natalie Symes ◽  
Sally A Hull
Keyword(s):  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Patient Safety ◽  
Ease Of Use ◽  
High Yield ◽  
Case Review ◽  
Patients At Risk ◽  
Barriers To Implementation ◽  
Narrative Evaluation

BackgroundIdentifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations.AimThis study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety.Design and settingMixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice.MethodThe project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians.ResultsTrigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs’ work is generally reactive and GPs welcomed an approach that identified patients who were ‘under the radar’ of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time.ConclusionElectronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks.

Patient Safety in Microvascular Plastic Surgery

2019 ◽  
Vol 35 (09) ◽  
pp. 631-639
Author(s):  
Salih Colakoglu ◽  
Seth Tebockhorst ◽  
Tae W. Chong ◽  
David W. Mathes
Keyword(s):  
Risk Factors ◽  
Patient Safety ◽  
Adverse Events ◽  
Surgical Procedures ◽  
Evidence Based ◽  
Surgical Team ◽  
Related Risk ◽  
Prophylactic Measures ◽  
Patients At Risk ◽  
Preventable Harm

Patient safety is defined as freedom from accidental or preventable harm produced by medical care. The identification of patient- and procedure-related risk factors enables the surgical team to carry out prophylactic measures to reduce the rate of complications and adverse events.The purpose of this review is to identify the characteristics of patients, practitioners, and microvascular surgical procedures that place patients at risk for preventable harm, and to discuss evidence-based prevention practices that can potentially help to generate a culture of patient safety.

scholarly journals Complications Associated With Lumbar Drain Placement for Endovascular Aortic Repair

2020 ◽  
Vol 71 (3) ◽  
pp. e38
Author(s):  
Anastasia Plotkin ◽  
Sukgu M. Han ◽  
Fred A. Weaver ◽  
Vincent L. Rowe ◽  
Fernando Fleischman ◽  
...  
Keyword(s):  
Endovascular Aortic Repair ◽  
Lumbar Drain ◽  
Aortic Repair ◽  
Drain Placement
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