Patient safety education in anesthesia: current state and future directions

Harbell, Monica W.; Methangkool, Emily

doi:10.1097/aco.0000000000001060

Cited by 8 publications

(8 citation statements)

References 29 publications

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“…Dodatni značaj razmišljanju o bezbednosti daje i pandemija Covid-19, kada je funkcionisanje zdravstvenog sistema stavljeno pred brojne izazove. Posebno teškoće vezane za broj zaposlenih i obučenih ljudi, problem sagorevanja (burn out), rad u specijalizovanim bolnicama ili reorganizovanim odeljenjima pod zaštitnom opremom, koje su često novo i izmešteno okruženje za lekare i tehničare, predstavljaju značajne činioce koji mogu da utiču na učestalost neželjenih događaja 4 .…”

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“…Svaki kritični incident koji se analizira u otvorenoj atmosferi doprinosi učenju i unapređenju kliničke prakse i bezbednosti svakog bolesnika. Danas govorimo o reaktivnom odgovoru na kritični incident, što znači da bi uočavanje propusta i slabosti procedura trebalo da doprinese organizacionim promenama, koje povećavaju bezbednost (koncept Safety I) 4 . Međutim, analiza uspeha odbrambenih reakcija i postupaka koji su sprečili nastanak lošeg ishoda ili povrede bolesnika (koncept Safety II) predstavlja posebno važan deo prijavljivanja kritičnog incidenta 4 .…”

Section: Slika 5: Padajući Meni Na Stranici Cirss Prijave Kritičnog I...unclassified

“…Danas govorimo o reaktivnom odgovoru na kritični incident, što znači da bi uočavanje propusta i slabosti procedura trebalo da doprinese organizacionim promenama, koje povećavaju bezbednost (koncept Safety I) 4 . Međutim, analiza uspeha odbrambenih reakcija i postupaka koji su sprečili nastanak lošeg ishoda ili povrede bolesnika (koncept Safety II) predstavlja posebno važan deo prijavljivanja kritičnog incidenta 4 . Sagledavanje da u svakom neočekivanom događaju ima pozitivnih postupaka i da naš svakodnevni posao ima uključene odbrambene sisteme i procedure, može da bude dodatni, snažan element učenja.…”

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“…Učestvovanje i aktivnosti na unapređenju bezbednosti za bolesnike u anesteziji i intenzivnoj terapiji obuhvataju čitav radni vek. Paralelno sa poboljšanjem kvaliteta rada, otvaraju se i novi izazovi: usvajanje novih tehnologija, novih veština koje potiskuju starije, više manuelne, nepoznavanje postupaka u slučaju kvara na mašinama koje se koriste i slično 4 . Iako je jasno da je obra-zovanje iz oblasti bezbednosti neophodno, strategije o njegovom sprovođenju su slabo definisane 4 .…”

Section: Poruka: Odgovor Je U Obrazovanjuunclassified

“…Poslednjih godina, postupci i sredstva koja se primenjuju u visoko organizovanim i kompleksnima sistemima, kao što su avijacija, vojna industrija ili nuklearne elektrane, koja su razvijana sa ciljem prevencije incidenata, usvojena su i u oblasti medicine 3 . Prijavljivanje i analize kritičnih incidenata i nesreća, primena protokola i kontrolnih listi (checklist), razvijanje simulacionih centara i uvođenje obrazovanja iz oblasti bezbednosti bolesnika tokom fakulteta i specijalističkog obrazovanja, samo su neki od njih 4 .…”

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Patient safety in anesthesia: Learning from mistakes?

Nešković¹

2022

Serb J Anest Inten Therapy

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Anesthesiology is the first specialization with clearly defined activities towards patient safety. The Helsinki Declaration on patient safety in anesthesiology, launched in 2010 and signed by the Serbian Association of Anesthesiologists and Intensivists (SAAI), represents a framework for building safety culture and raising awareness on improving the quality of anesthesia and intensive care. It is important to understand why and how patients complete their surgical treatment without unexpected adverse events and which safety features are a natural part of the anesthesiologist's daily work. At the same time, it is necessary to identify weaknesses that can be corrected and prevent mistakes or complications that adversely affect the outcome. Reporting critical incidents is one element of improving patient safety through organizational changes and improved procedures in patient management. In 2018, connected to the UAIS website, a platform for critical incident reporting in anesthesia and intensive care: "Critical incident reporting system Serbia (CIRSS)", was created, which, unfortunately, has not given the expected results yet. Regardless of the complexity of implementing change, every individual who advocates safety culture and represents a role model in their working environment can make a huge contribution to improving everyday practice. Critical incident reporting and analysis should be a mandatory part of the anesthesia curriculum, as well as part of continuing medical education program.

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Section: Poruka: Odgovor Je U Obrazovanjuunclassified

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Patient safety in anesthesia: Learning from mistakes?

Nešković¹

2022

Serb J Anest Inten Therapy

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Does the type of anesthesia (regional vs. general) represent an independent predictor for in-hospital complications in operatively treated malleolar fractures? A retrospective analysis of 5262 patients

Canal

Kaserer

Morax

et al. 2023

Eur J Trauma Emerg Surg

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Purpose The impact of the type of anesthesia (regional vs. general anesthesia) on in-hospital complications in ankle fractures has not been thoroughly studied yet. Identifying factors that place patients at risk for complications following ankle fractures may help reduce their occurrence. The primary goal of this study was (1) to describe the cohort of patients and (2) to evaluate independent risk factors for complications during hospitalization. Methods We analyzed patients from 2005 to 2019 with an operatively treated isolated fracture of the medial or lateral malleolus using a prospective national quality measurement database. Patients were selected based on international classifications (ICD) and national procedural codes (CHOP). Uni- and multivariate analysis were applied. Results In total, we analyzed 5262 patients who suffered a fracture of the malleolus; 3003 patients (57%) had regional and 2259 (43%) general anesthesia. Patients with regional anesthesia were significantly older (51 vs. 46 years), but healthier (23 vs. 28% comorbidities) than patients who received general anesthesia. The in-hospital complication rate was not significantly lower in regional anesthesia (2.2% vs 3.0%). The type of anesthesia was not an independent predictor for complications while controlling for confounders. Conclusion Type of anesthesia was not an independent predictor of complications; however, higher ASA class, age over 70 years, fracture of the medial versus lateral malleolus, longer preoperative stay, and duration of surgery were significant predictors of complications. Patient and procedure characteristics, as well as changes in medical care and epidemiological changes along with patient requests, influenced the choice of the type of anesthesia.

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