scholarly journals Feasibility and Safety of Outpatient Thyroidectomy: A Narrative Scoping Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Justine Philteos ◽  
Elif Baran ◽  
Christopher W. Noel ◽  
Jesse D. Pasternak ◽  
Kevin M. Higgins ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Scoping Review ◽  
Interprofessional Collaboration ◽  
Length Of Hospital Stay ◽  
American Thyroid Association ◽  
Patient Anxiety ◽  
Home Support ◽  
Preoperative Selection ◽  
Same Day Discharge ◽  
Discharge Criteria

BackgroundOutpatient thyroid surgery is gaining popularity as it can reduce length of hospital stay, decrease costs of care, and increase patient satisfaction. There remains a significant variation in the use of this practice including a perceived knowledge gap with regards to the safety of outpatient thyroidectomies and how to go about implementing standardized institutional protocols to ensure safe same-day discharge. This review summarizes the information available on the subject based on existing published studies and guidelines.MethodsThis is a scoping review of the literature focused on the safety, efficacy and patient satisfaction associated with outpatient thyroidectomies. The review also summarizes and editorializes the most recent American Thyroid Association guidelines.ResultsIn total, 11 studies were included in the analysis: 6 studies were retrospective analyses, 3 were retrospective reviews of prospective data, and 2 were prospective studies. The relative contraindications to outpatient thyroidectomy have been highlighted, including: complex medical conditions, anticipated difficult surgical dissection, patients on anticoagulation, lack of home support, and patient anxiety toward an outpatient procedure. Utilizing these identified features, an outpatient protocol has been proposed.ConclusionThe salient features regarding patient safety and selection criteria and how to develop a protocol implementing ambulatory thyroidectomies have been identified and reviewed. In conclusion, outpatient thyroidectomy is safe, associated with high patient satisfaction and decreased health costs when rigorous institutional protocols are established and implemented. Successful outpatient thyroidectomies require standardized preoperative selection, clear discharge criteria and instructions, and interprofessional collaboration between the surgeon, anesthetist and same-day nursing staff.

scholarly journals Antimicrobial Use in COVID-19 Patients in the First Phase of the SARS-CoV-2 Pandemic: A Scoping Review

Antibiotics ◽  
2021 ◽  
Vol 10 (6) ◽  
pp. 745
Author(s):  
Wenjuan Cong ◽  
Ak Narayan Poudel ◽  
Nour Alhusein ◽  
Hexing Wang ◽  
Guiqing Yao ◽  
...  
Keyword(s):  
Critical Illness ◽  
Scoping Review ◽  
Clinical Evidence ◽  
Length Of Hospital Stay ◽  
Severity Of Illness ◽  
Antibiotic Prescribing ◽  
Antimicrobial Use ◽  
Clinical Scenarios ◽  
Scoping Reviews ◽  
The Impact

This scoping review provides new evidence on the prevalence and patterns of global antimicrobial use in the treatment of COVID-19 patients; identifies the most commonly used antibiotics and clinical scenarios associated with antibiotic prescribing in the first phase of the pandemic; and explores the impact of documented antibiotic prescribing on treatment outcomes in COVID-19 patients. The review complies with PRISMA guidelines for Scoping Reviews and the protocol is registered with the Open Science Framework. In the first six months of the pandemic, there was a similar mean antibiotic prescribing rate between patients with severe or critical illness (75.4%) and patients with mild or moderate illness (75.1%). The proportion of patients prescribed antibiotics without clinical justification was 51.5% vs. 41.9% for patients with mild or moderate illness and those with severe or critical illness. Comparison of patients who were provided antibiotics with a clinical justification with those who were given antibiotics without clinical justification showed lower mortality rates (9.5% vs. 13.1%), higher discharge rates (80.9% vs. 69.3%), and shorter length of hospital stay (9.3 days vs. 12.2 days). In the first 6 months of the pandemic, antibiotics were prescribed for COVID-19 patients regardless of severity of illness. A large proportion of antibiotic prescribing for mild and moderate COVID-19 patients did not have clinical evidence of a bacterial co-infection. Antibiotics may not be beneficial to COVID-19 patients without clinical evidence of a bacterial co-infection.

Exploring implicit influences on interprofessional collaboration: a scoping review

2021 ◽  
pp. 1-9
Author(s):  
Javeed Sukhera ◽  
Kaitlyn Bertram ◽  
Shawn Hendrikx ◽  
Margaret S. Chisolm ◽  
Juliette Perzhinsky ◽  
...  
Keyword(s):  
Scoping Review ◽  
Interprofessional Collaboration

scholarly journals Risk Factors for Impaired Patient-Reported Satisfaction and Increased Length of Hospital Stay Following Hysterectomy on Benign Indications in Premenopausal Women: a Study From the Swedish National Register for Gynecological Surgery

2019 ◽  
Vol 80 (03) ◽  
pp. 288-299
Author(s):  
Ninnie Borendal Wodlin
Keyword(s):  
Risk Factors ◽  
Patient Satisfaction ◽  
Hospital Stay ◽  
Length Of Hospital Stay ◽  
Premenopausal Women ◽  
Gynecological Surgery ◽  
National Register ◽  
Logistic Regression Models ◽  
Patient Reported ◽  
The Impact

Abstract Introduction The aims of the study were to evaluate the impact of intra- and postoperative complications on satisfaction one year after hysterectomy for benign conditions, to determine risk factors for low patient satisfaction and to analyze whether complications were associated with the length of hospital stay. Material and Methods A retrospective study of 27 938 women from the Swedish National Register for Gynecological Surgery undergoing hysterectomy for benign conditions between January 2004 and June 2016. Data were obtained from prospectively collected pre-, peri- and postoperative forms. Statistical analyses were performed using multivariable logistic regression models. Crude and adjusted odds ratios and 95% confidence intervals are presented. Results More than 90% were satisfied with the hysterectomy. Dissatisfaction was associated with complications. Pelvic pain as indication, preoperatively having less expectations to get rid of symptoms or being alleviated from surgery, and current smoking were also risk factors for low patient satisfaction. Vaginal and abdominal subtotal hysterectomies were associated with high satisfaction. Occurrence of complications intra- and postoperatively before discharge was associated with increased length of hospital stay, as well as occurrence and severity of complications reported after discharge from hospital. Conclusions Complications were strongly associated with lower patient satisfaction. Preoperative expectations of surgery, indication, mode of surgery and life-style factors had impact on the satisfaction. Patient-centered information to ensure realistic expectations and prevention of complications seem to be essential to gain optimal patient satisfaction with surgery.

Organizational Considerations for Supporting the Safety of Home Support Workers: Results From a Scoping Review

2017 ◽  
Vol 29 (4) ◽  
pp. 242-248 ◽  
Author(s):  
Marilyn Macdonald ◽  
Elaine Moody ◽  
Heather MacLean
Keyword(s):  
Home Care ◽  
Injury Prevention ◽  
Human Resource ◽  
Scoping Review ◽  
Chronic Conditions ◽  
Resource Planning ◽  
Safety Factors ◽  
Human Resource Planning ◽  
Factors Associated ◽  
Home Support

As the population ages, and more people are living at home with chronic conditions, there is an increasing need for home support workers (HSWs). Safety is a central concern for HSWs, and contributes to the recruitment and retention of HSWs and ultimately to a sustainable home care sector. This article reports on a scoping review that was conducted to assess the state of the literature related to the safety of HSWs. Studies were selected that address the central phenomenon and that were conducted from 2000 to 2015. One hundred twenty-six studies were included in the synthesis of findings. This article outlines two of the four major findings, those related to safety factors associated with home care organizations: (1) injury prevention initiatives and (2) human resource planning. The findings have important implications for developing strategies to address safety concerns for HSWs.

Patient Anxiety and Patient Satisfaction in Hospital-based and Freestanding Ambulatory Surgery Centers

2005 ◽  
Vol 20 (3) ◽  
pp. 238-243 ◽  
Author(s):  
Timothy F. Gardner ◽  
CPT Michael U. Nnadozie ◽  
Barbara A. Davis ◽  
Sharon Kirk
Keyword(s):  
Patient Satisfaction ◽  
Ambulatory Surgery ◽  
Patient Anxiety ◽  
Ambulatory Surgery Centers

scholarly journals The use of interprofessional simulation interventions in medical student education: A scoping review

2021 ◽  
Vol 22 (1) ◽  
pp. 33-67
Author(s):  
Victoria Langton ◽  
Dimitra Dounas ◽  
Abby Moore ◽  
Stephen Bacchi ◽  
Josephine Thomas
Keyword(s):  
Medical Student ◽  
Medical Students ◽  
Scoping Review ◽  
Student Attitudes ◽  
Interprofessional Collaboration ◽  
Data Extraction ◽  
Medical Student Education ◽  
Interprofessional Learning ◽  
Medical Emergencies ◽  
Teaching Modality

Introduction: Simulation is commonly used by health and education institutions to facilitate interprofessional learning (IPL). The use of simulation in IPL is resource intensive. Evidence of what works, and with whom, is important to inform practice, policymaking and further research. The aim of this scoping review was to summarise the existing literature on IPL involving medical students, where simulation was the teaching modality. This review examined a variety of simulation-based interventions used to teach IPL to medical students and identified key features and outcomes. Methods: The databases Pubmed, Medline, EMBASE and PsychINFO were searched using the terms related to medical student and simulation combined with interprofessional. Included articles involved medical students alongside a student or practitioner from at least one other health profession taking part in at least one simulation session. Data extraction was performed by two authors using a standardised form. Results: It emerged that simulations of medical emergencies were the most common format to deliver IPL interventions. Most studies evaluated the success of their IPL intervention using the Readiness for Interprofessional Learning Scale (RIPLS). Conclusion: All studies were successful in improving student attitudes towards IPL and interprofessional collaboration when these were measured outcomes. Formal team training prior to simulation is effective in improving teamwork skills. IPL interventions with participants from a greater mix of professions have more positive results.

scholarly journals Day-case open reduction for developmental dysplasia of the hip

2021 ◽  
Vol 2 (4) ◽  
pp. 271-277
Author(s):  
Michael Flatman ◽  
Ben H. Barkham ◽  
Eyal Ben David ◽  
Andrea Yeo ◽  
Joanne Norman ◽  
...  
Keyword(s):  
Blood Loss ◽  
Open Reduction ◽  
Corrective Osteotomy ◽  
Length Of Hospital Stay ◽  
Pain Scale ◽  
Developmental Dysplasia ◽  
Day Case ◽  
Satisfaction Questionnaire ◽  
Same Day Discharge ◽  
Dysplasia Of The Hip

Aims Open reduction in developmental dysplasia of the hip (DDH) is regularly performed despite screening programmes, due to failure of treatment or late presentation. A protocol for open reduction of DDH has been refined through collaboration between surgical, anaesthetic, and nursing teams to allow same day discharge. The objective of this study was to determine the safety and feasibility of performing open reduction of DDH as a day case. Methods A prospectively collected departmental database was visited. All consecutive surgical cases of DDH between June 2015 and March 2020 were collected. Closed reductions, bilateral cases, cases requiring corrective osteotomy, and children with comorbidities were excluded. Data collected included demographics, safety outcome measures (blood loss, complications, readmission, reduction confirmation), and feasibility for discharge according to the Face Legs Activity Cry Consolidability (FLACC) pain scale. A satisfaction questionnaire was filled by the carers. Descriptive statistics were used for analysis. Results Out of 168 consecutive DDH cases, 16 patients fit the inclusion criteria (age range 10 to 26 months, 13 female). Intraoperative blood loss ranged from "minimal" to 120 ml, and there were no complications or readmissions. The FLACC score was 0 for all patients. The carers satisfaction questionnaire expressed high satisfaction from the experience with adequate information and support provided. Conclusion Open reduction in DDH, without corrective osteotomy, is safe and feasible to be managed as a day case procedure. It requires a clear treatment pathway, analgesia, sufficient counselling, and communication with carers. It is even more important during the COVID-19 pandemic when reduced length of hospital stay is likely to be safer for both patient and their parents. Cite this article: Bone Joint Open 2021;2(4):271–277.

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