scholarly journals Perioperative safety indicators: surgery cancellation and immediate postoperative complications

2020 ◽  
Vol 42 ◽  
pp. e46808
Author(s):  
Sibéle da Silva ◽  
Bruna Kruczewski ◽  
Sirlei Fávero Cetolin ◽  
Andreia Dalla Vecchia ◽  
Vilma Beltrame
Keyword(s):  
Postoperative Complications ◽  
Surgical Procedures ◽  
Medical Records ◽  
Perioperative Period ◽  
University Hospital ◽  
Hospital Environment ◽  
Postanesthesia Care Unit ◽  
Perioperative Safety ◽  
Clinical Conditions

The perioperative period comprises the moments before, during and after surgery. Based on the concern about the care for and safety of patients in this process, this study sought to assess the quality of surgical procedures in a hospital environment. It is an epidemiological, descriptive and retrospective research conducted at Santa Terezinha University Hospital [Hospital Universitário Santa Terezinha], in the municipality of Joaçaba, Santa Catarina (SC). The investigation aimed to identify the reasons for surgical cancellation, as well as immediate postoperative complications that occur in the postanesthesia care unit. A total of 456 records from surgery cancellation daily maps and 361 medical records of patients in postoperative care were analyzed. Results show that the main cause for cancellation of surgeries was transfer or unscheduled procedure (23.1%), but 27% of the unscheduled surgeries did not have the reason for cancellation reported. Adult (over 80%) and female individuals were the majority for both cancelled surgeries and postoperative complications. The most frequent postoperative complication was hypotension. Among performed surgeries, thoracic ones (41.8%) were most prevalent, while abdominal/pelvic (49%) surgeries were the most cancelled.  It is concluded that a big portion of the cancelled surgical procedures could have been prevented, since only 6.8% of them were related to clinical conditions.

scholarly journals Clinical outcome after liver resection for colorectal versus non-colorectal metastasis: a comparative study

2018 ◽  
Vol 5 (2) ◽  
pp. 390
Author(s):  
Ashraf M. El-Badry ◽  
Omar Abdelraheem
Keyword(s):  
Liver Resection ◽  
Postoperative Complications ◽  
Clinical Outcome ◽  
Medical Records ◽  
Multivisceral Resection ◽  
University Hospital ◽  
Significant Difference ◽  
Complication Score ◽  
Primary Neoplasm

Background: Liver resection is the only curative treatment option for specific types of metastatic neoplasms. Comparative studies on the clinical outcome of liver resection for colorectal liver metastasis (CRLM) and non CRLM (N-CRLM) in Egypt remain inadequate.Methods: Medical records of patients who underwent liver metastasectomy (April 2013-May 2017) at Sohag University Hospital were reviewed. Patients were categorized according to the origin of the primary tumor into CRLM versus N-CRLM. Demographic, clinical, operative and histopathologic data, postoperative surgical complications and survival were analyzed.Results: Twenty-six patients (15 CRLM and 11 N-CRLM) were retrospectively enrolled. N-CRLM group comprised metastatic gall bladder (6), pancreas (2), breast (1) lung (1) and recurrent ovarian (1) cancers. There was no significant difference regarding age or gender predilection. The complication score in CRLM group was not significantly different compared with N-CRLM patients. However, subgroups of multivisceral resections showed significantly higher grades of postoperative complications compared with sole liver resection in both groups. Elderly patients (>70-year-old) exhibited high risk of morbidity compared with younger patients. Early post-operative mortality within the first month was 7.7% (2 patients died, one per each group). After a mean follow up of 32 months, the overall survival rate among patients with CRLM and N-CRLM was 75% and 64% respectively.Conclusions: Liver resection for CRLM and N-CRLM can be safely accomplished. Multivisceral resection and advanced age were associated with increased severity of postoperative complications irrespective of the location of primary neoplasm.

scholarly journals Prevalence of Provocative Seizures in Persons with Epilepsy: A Longitudinal Study at Khon Kaen University Hospital, Thailand

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Nutthaya Vongkasamchai ◽  
Sunee Lertsinudom ◽  
Acharawan Topark-Ngarm ◽  
Udomlack Peansukwech ◽  
Kittisak Sawanyawisuth ◽  
...  
Keyword(s):  
Medical Records ◽  
Causative Factor ◽  
University Hospital ◽  
Limited Data ◽  
Asian Populations ◽  
Khon Kaen ◽  
The Mean ◽  
One Year ◽  
Seizure Attacks

Background and Objective. Provocative factors are one causative factor of seizure attacks in persons with epilepsy (PWE). There are limited data of prevalence and major provocative factors in Asian populations.Methods. This study was performed at the Epilepsy Clinic, Khon Kaen University Hospital. The patients who aged 15 years or over, who had been treated at least 3 months with at least one antiepileptic drug, and who were followed up for at least one year were included. Data of seizure control and triggers were collected retrospectively from medical records. Data analysis was performed to identify independent provocative factors.Results. A total of 382 PWE met the study criteria. The mean age was40.4±0.8years. Approximately 44% of the patients had at least one provocative factor. By multivariate analysis, the independent provocative factors with the first three highest adjusted odds ratios were sleep deprivation (adjustedOR=8.64, 95% CI 3.73–19.99), alcohol consumption (adjustedOR=6.76, 95% CI 1.44–31.78), and feeling stressful (adjustedOR=2.97, 95% CI 1.29–6.86).Conclusion. Almost half of seizure attacks may be caused by provocative factors in Thai PWEs and some factors may be preventable. Avoidance of these factors should be emphasized to epilepsy patients for improving clinical outcomes and quality of life.

scholarly journals Perioperative communication from the perspective of patients undergoing bariatric surgery

2014 ◽  
Vol 23 (2) ◽  
pp. 347-355 ◽  
Author(s):  
Caroline Lemes Pozza Morales ◽  
Jenefer Garcez Alexandre ◽  
Suzana Prim ◽  
Lúcia Nazareth Amante
Keyword(s):  
Bariatric Surgery ◽  
Multidisciplinary Team ◽  
Surgical Care ◽  
Perioperative Period ◽  
Communication Process ◽  
University Hospital ◽  
Southern Brazil ◽  
Individual Interviews ◽  
Surgical Unit

This was a qualitative and descriptive study that aimed to determine how patients understand instructions provided by a multidisciplinary team during perioperative periods of bariatric surgery. Data were collected through three individual interviews. Six patients admitted to a surgical unit of a university hospital in southern Brazil, in April and May 2012, participated in the study. Thematic analysis revealed three categories: communication in the perioperative period of bariatric surgery; quality of life and post- surgical care following bariatric surgery; and communication in the work process of the multidisciplinary team. The results showed satisfaction with the information received, but problems in the communication process and apprehension about life after surgery were highlighted. Furthermore, the absence of outpatient nursing care was demonstrated.

scholarly journals Children and adolescents on hemodialysis: attributes associated with quality of life

2014 ◽  
Vol 48 (4) ◽  
pp. 602-609 ◽  
Author(s):  
Isabella Schroeder Abreu ◽  
Maria Fernanda Cabral Kourrouski ◽  
Danielle Maria de Souza Serio dos Santos ◽  
Monika Bullinger ◽  
Lucila Castanheira Nascimento ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Records ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Factors Associated ◽  
Surgical Clinic ◽  
Length Of Hospitalization


The aim of this study was to estimate the prevalence and factors associated with the occurrence of incidents related to medication, registered in the medical records of patients admitted to a Surgical Clinic, in 2010. This is a cross-sectional study, conducted at a university hospital, with a sample of 735 hospitalizations. Was performed the categorization of types of incidents, multivariate analysis of regression logistic and calculated the prevalence. The prevalence of drug-related incidents was estimated at 48.0% and were identified, as factors related to the occurrence of these incidents: length of hospitalization more than four days, prescribed three or more medications per day and realization of surgery intervention. It is expected to have contributed for the professionals and area managers can identify risky situations and rethink their actions.


scholarly journals Change Management and Digital Innovations in Hospitals of Five European Countries

Healthcare ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1508
Author(s):  
Petra Hospodková ◽  
Jana Berežná ◽  
Miroslav Barták ◽  
Vladimír Rogalewicz ◽  
Lucie Severová ◽  
...  
Keyword(s):  
Change Management ◽  
Medical Records ◽  
Historical Context ◽  
Readiness For Change ◽  
European Countries ◽  
Hospital Environment ◽  
Local Context ◽  
Similar Degree ◽  
Prisma Statement

The objective of the paper is to evaluate the quality of systemic change management (CHM) and readiness for change in five Central European countries. The secondary goal is to identify trends and upcoming changes in the field of digital innovations in healthcare. The results show that all compared countries (regardless of their historical context) deal with similar CHM challenges with a rather similar degree of success. A questionnaire distributed to hospitals clearly showed that there is still considerable room for improvement in terms of the use of specific CHM tools. A review focused on digital innovations based on the PRISMA statement showed that there are five main directions, namely, data collection and integration, telemedicine, artificial intelligence, electronic medical records, and M-Health. In the hospital environment, there are considerable reservations in applying change management principles, as well as the absence of a systemic approach. The main factors that must be monitored for a successful and sustainable CHM include a clearly defined and widely communicated vision, early engagement of all stakeholders, precisely set rules, adaptation to the local context and culture, provision of a technical base, and a step-by-step implementation with strong feedback.

scholarly journals Indoor mass concentrations of particulate matter in hospital environment

2014 ◽  
Vol 16 (5) ◽  
pp. 832-839 ◽  
Keyword(s):  
Particulate Matter ◽  
Air Quality ◽  
Indoor Environment ◽  
University Hospital ◽  
Hospital Environment ◽  
World Health ◽  
Safe Level ◽  
Health Organization ◽  
Concentration Levels

<p>The assessment of the air quality of indoor environment where people usually spend extended time periods, especially for sensitive population groups such as patients during their hospitalization, is of major importance. Ensuring a safe level of air quality in these indoor environment serves as an amelioration factor for human health not only for the often habitués of those indoors places, but also for the working personnel that spend more than 90% of their time indoors. In that aspect the concentration of coarse (PM<sub>10</sub>) and fine (PM<sub>2.5</sub>, PM<sub>1.0</sub>) particulate matter was measured in two Intensive Care Units (ICU), with different spatial and trespassing characteristics, of the Democritus University Hospital situated at Alexandroupolis, Greece. The measurements were conducted with the application of two portable aerosol monitoring equipment (TSI DustTrak 8520 and Grimm 107).</p> <div> <p>The results indicated that the 24-h average concentrations were below the indicative limits proposed by the World Health Organization (WHO) (50 and 25 μg m<sup>-3</sup> for PM<sub>10</sub> and PM<sub>2.5</sub> respectively). Relatively elevated instant concentration levels (&gt;100 μg m<sup>-3</sup>) were also recorded during specific activities and in conjunction with the temporal variation of the observed concentration levels raised questions regarding the side effects of cleaning activities.</p> </div> <p>&nbsp;</p>

scholarly journals Results of the implementation of integrated care after cardiorespiratory arrest in a university hospital

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Evelyn Carla Borsari Mauricio ◽  
Maria Carolina Barbosa Teixeira Lopes ◽  
Ruth Ester Assayag Batista ◽  
Meiry Fernanda Pinto Okuno ◽  
Cássia Regina Vancini Campanharo
Keyword(s):  
Medical Records ◽  
Neurological Status ◽  
Spontaneous Circulation ◽  
University Hospital ◽  
Cardiorespiratory Arrest ◽  
Advanced Airway ◽  
One Year ◽  
Airway Access ◽  
Discharge Method

ABSTRACT Objectives: to identify the care measures performed after cardiorespiratory arrest (CRA) and to relate them to the neurological status and survival at four moments: within the first 24 hours, at the discharge, six months after discharge, and one year after discharge. Method: retrospective, analytical and quantitative study performed at the Emergency Department of a university hospital in São Paulo. Eighty-eight medical records of CRA patients who had a return of spontaneous circulation sustained for more than 20 minutes were included and the post-CRA care measures performed in the first 24 hours were identified, as well as its relationship with survival and neurological status. Results: the most frequent post-CRA care measures were use of advanced airway access techniques and indwelling bladder catheterization. Patients who had maintained good breathing and circulation, temperature control and who were transferred to intensive care unit had a better survival in the first 24 hours, after six months and one year after discharge. Good neurological status at six months and one year after discharge was associated with non-use of vasoactive drugs and investigation of the causes of the CRA. Conclusion: the identification of good practices in post-CRA care may help to reduce the mortality of these individuals and to improve their quality of life.

scholarly journals O20 ASSESSING THE VALIDITY AND COVER RATE OF NATIONAL HERNIA REGISTERS

2021 ◽  
Vol 108 (Supplement_8) ◽  
Author(s):  
Erik Axman
Keyword(s):  
Postoperative Complications ◽  
Data Collection ◽  
Data Quality ◽  
Medical Records ◽  
Specific Region ◽  
Waiting List ◽  
Quality Of Data ◽  
Systematic Data ◽  
Systematic Data Collection

Abstract Aim To assess the validity and cover rate of the Swedish hernia register. Material and Methods Annual validation of the Swedish Hernia Register has been carried out since the start in 1992 and since 2013 in a more standardized way to allow a systematic data collection and evaluation. 10% of all participating units are randomly selected each year in a specific region of Sweden, ensuring a systematic validation of all regions from North to South. Data from 2013 to 2018 was analyzed regarding data quality and from 2014 to 2018 regarding cover rate. All operations registered at the validated clinics was checked against the Swedish Hernia Register to assess cover rate. 50 operations were randomly selected at each clinic and data in the Swedish Hernia register was compared to the medical records to evaluate data quality. Results In total 55 participating units were evaluated and 73764 variables compared to medical records. Cover rate between 2014 to 2018 was 97% and proportion of correct variables was 98%. Most frequent errors where ASA-grade, date at which the patient was put on the waiting list and postoperative complications. Conclusions This unique validation of a national hernia register show a high cover rate and good quality of data. Efforts to maintain and improve national registers are of great importance. Research with data from the Swedish hernia register should be evaluated on the basis of the results presented in this study.

Transoesophageal echocardiography in monitoring, guiding, and evaluating surgical repair of congenital cardiac malformations in children

2007 ◽  
Vol 17 (3) ◽  
pp. 301-306 ◽  
Author(s):  
Xiao-Jing Ma ◽  
Guo-Ying Huang ◽  
Xue-Cun Liang ◽  
Zhang-Gen Chen ◽  
Bing Jia ◽  
...  
Keyword(s):  
Surgical Procedures ◽  
Transthoracic Echocardiography ◽  
Surgical Repair ◽  
Perioperative Period ◽  
Transoesophageal Echocardiography ◽  
Cardiac Diseases ◽  
Cardiac Malformations ◽  
Before And After

Objective: To evaluate the role of transoesophageal echocardiography and problems related to safety during the surgical repair of congenital cardiac malformations in children. Methods: We examined the transoesophageal recordings made in 350 children with congenital cardiac diseases, aged from 2 months to 17 years and 9 months, with a median age of 2.7 years, tracings having been taken both before and after cardiopulmonary bypass. All patients had been scanned by transthoracic echocardiography before the operative procedures. Results: Preoperative transoesophageal echocardiography added additional findings, or changed the diagnoses made using transthoracic echocardiography, in 33 cases (9.4%), among which the findings had therapeutic significance in 23 cases (6.6%) that altered the planned surgical procedures. Residual problems or sequels were detected by postoperative transoesophageal echocardiography in 57 cases (16.3%), with 13 patients (3.7%) requiring instant intervention or return to bypass for modifications of the surgical procedures. We encountered no severe complications due to the performance of transoesophageal echocardiography. Mild complications occurred in only 2 patients (0.6%). Conclusions: Transoesophageal echocardiography is a useful tool with which to determine the strategies for treatment in the perioperative period, and to improve the quality of surgical procedures in children with congenital cardiac diseases. Complications were few, but still deserved careful attention to detail.

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