Underreporting of Veress Needle Injuries: Comparing Direct Observation and Chart Review Methods

Jung, James J.; Adams-McGavin, Robert C.; Grantcharov, Teodor P.

doi:10.1016/j.jss.2018.11.039

Cited by 11 publications

(14 citation statements)

References 27 publications

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“…[5][6][7][8] This has included the use of video review to evaluate AEs and safety threats in the healthcare environment, such as the trauma bay or operating room. 2,[9][10][11][12][13] Trauma video review (TVR) has been utilized as an important educational, quality improvement and research tool since the 1980s. 9, [14][15][16] Current technology allows for simultaneous audiovisual recording of trauma resuscitations from multiple positions (i.e., overhead and foot-of-the-bed views) as well as the visualization of patient monitors and ultrasound/video laryngoscope screens.…”

Section: Backg Rou N Dmentioning

confidence: 99%

Staff perceptions of the implementation of a trauma video review program at a level I trauma center

Dainty

Seaton

McGowan³

et al. 2021

AEM Education and Training

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Objectives: Successful implementation of any new technology requires extensive engagement with front-line staff. We explored the perceptions of emergency department and trauma staff about a trauma video review program (TVR) prior to implementation of the first such program in Canada at our level I trauma center. Methods:We conducted semi-structured individual interviews and in situ small group interviews with 35 multidisciplinary ED and trauma staff members of a teaching and research hospital in Toronto, Canada. We sought maximum variation in the sample of purposively selected participants. Interviews were recorded with audiotapes or detailed field notes, transcribed verbatim, coded, and analyzed using standard thematic analysis techniques.Results: Participants expressed overall support for the concept of TVR, but there is a core sense of unease that influenced overall staff perceptions. Despite several departmental presentations, very few participants actually had a solid understanding of how the TVR worked. Many were apprehensive about their own professional privacy, deeply concerned about vulnerable patients being filmed without consent, and questioned how video data would be used. Despite significant hesitancy, ED and trauma staff identified positive opportunities that TVR could bring, including providing an evidence base for quality improvement. Conclusions:TVR is an evolving approach to evaluate quality and patient safety in the trauma bay. As such it brings with it natural concerns and apprehension from staff regarding privacy, confidentiality, and how data will be captured and used. There is opportunity for these types of concerns to be addressed with a robust knowledge translation plan and engagement of staff throughout the implementation process.

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Section: Backg Rou N Dmentioning

confidence: 99%

Staff perceptions of the implementation of a trauma video review program at a level I trauma center

Dainty

Seaton

McGowan³

et al. 2021

AEM Education and Training

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“… 10 The authors identified device failure, improper assembly of devices and absent or wrong devices as being the most frequent causes of intraoperative device-related interruptions. 11 A black box system in the OR has been used to detect previously missed or unreported intraoperative needle injuries, 12 and assess team performance in the OR. 13 The technology we are proposing to implement uses a similar data capture and analytic platform.…”

Section: Is There Evidence For This Technology?mentioning

confidence: 99%

Pushing boundaries of video review in trauma: using comprehensive data to improve the safety of trauma care

Nolan

Hicks

Petrosoniak

et al. 2020

Trauma Surg Acute Care Open

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Adverse events and lapses in safety are identified after the fact and often discussed through postevent review. These rounds rely on personal recollection, information from patient charts and incident reports that are limited by retrospective data collection. This results in recall bias and inaccurate or insufficient detail related to timeline, incidence and nature adverse events. To better understand the interplay of the complex team and task-based challenges in the trauma bay, we have developed a synchronized data capture and analysis platform called the Trauma Black Box (Surgical Safety Technologies, Toronto). This system continuously acquires audiovisual, patient physiological and environmental data from a sophisticated array of wall-mounted cameras, microphones and sensors. Expert analysts and software-based algorithms then populate a data timeline of case events from start to finish, retaining a handful of anonymized video clippings to supplement the review. These data also provide a consistent and reliable method to track specific quality metrics, such as time to trauma team assembly or time to blood product arrival. Furthermore, data can also be linked to patients’ electronic medical records to explore relationships between initial trauma resuscitation and downstream patient-oriented outcomes. A video capture and data analysis system for the trauma bay overcomes the inherent deficiencies in the current standard for evaluating patient care in the trauma bay and offers exciting potential to enhance patient safety through a comprehensive data collection system.

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“…20 This surgical data recording system also demonstrated a significantly better ability to identify and report veress needle injuries when compared with traditional chart review. 21 Using the OR Black Box, 12 veress needle injuries were identified as opposed to 3 through traditional chart review, and 47 near misses were identified as opposed to 0 by chart review analysis. 21 OR Black Box data have also been applied to better analyze nontechnical performance, including teamwork and interpersonal dynamics.…”

Section: Technology Features and Use Casesmentioning

confidence: 99%

“…21 Using the OR Black Box, 12 veress needle injuries were identified as opposed to 3 through traditional chart review, and 47 near misses were identified as opposed to 0 by chart review analysis. 21 OR Black Box data have also been applied to better analyze nontechnical performance, including teamwork and interpersonal dynamics. 22 In one study, surgeons, fellows, scrub nurses, and circulating nurses were rated for specific nontechnical behaviors, including leadership, situational awareness, decision-making, communication, and teamwork.…”

Section: Technology Features and Use Casesmentioning

confidence: 99%

“…27 The aforementioned studies suggest that information collected via surgical data recording systems can benefit physicians and improve patient safety in a multitude of ways, allowing surgeons to review and critique their surgical technique, distractions, and interpersonal dynamics, which enable discussion of performance improvement, situational awareness and judgment in light of an adverse event, along with more targeted teaching mechanisms and opportunities. [20][21][22][26][27][28]…”

Section: Technology Features and Use Casesmentioning

confidence: 99%

See 1 more Smart Citation

An Interdisciplinary Review of Surgical Data Recording Technology Features and Legal Considerations

2019

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Surgical data recording technology has great promise to generate patient safety and quality data that can be utilized to potentially reduce medical errors. Variations of these systems aim to improve surgical technique, develop better training simulation, and promote adverse event investigation similar to the aims of black box technology utilized in other industries. However, many unknowns remain for surgical data recording utilization in operating rooms and clinical settings in the United States. This includes the need to appropriately design systems so they collect meaningful and useful data that can be discussed by surgical team members in an open and safe environment to optimize clinical care processes. In order to better understand the clinical and regulatory environment for surgical data recording systems, we conducted an interdisciplinary review to identify key technology approaches, and assess legal and regulatory implications associated with this potentially disruptive technology. We found technology ranging from audio and visual data, to systems utilizing mobile applications, and kinematic data capture. The data collected present legal questions over ownership of information and privacy, along with regulatory issues at the federal and state levels. The benefits of these data should be balanced with the need to develop appropriate policies and regulations that protect the interests of both clinicians and patients in order to encourage further innovation and better realize the potential of surgical data recording technology to improve clinical decision making and patient safety outcomes.

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Underreporting of Veress Needle Injuries: Comparing Direct Observation and Chart Review Methods

Cited by 11 publications

References 27 publications

Staff perceptions of the implementation of a trauma video review program at a level I trauma center

Staff perceptions of the implementation of a trauma video review program at a level I trauma center

Pushing boundaries of video review in trauma: using comprehensive data to improve the safety of trauma care

An Interdisciplinary Review of Surgical Data Recording Technology Features and Legal Considerations

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