Abstract:
OBJECTIVE:To identify and prioritize hazards in surgical wards and recommend interventions. BACKGROUND:Retrospective and prospective studies report the frequency and severity of surgical adverse events, but not in sufficient detail to allow interventions to be recommended in surgical wards. METHODS:Seventy hours of observations were used to record all activities occurring in surgical wards, and from these activities health care processes were derived. Fifty-nine patients and staff quantified the hazard associated with each health care process through a risk assessment survey. Modified health care failure mode and effects analysis was applied to the most hazardous of these processes to quantify the hazard of their associated failures. Cause analysis was applied to the most hazardous failures within analyzed processes. Interventions addressing the prioritized failures were recommended. RESULTS:Surgical ward observations identified 81 activities. The risk assessment survey was used to quantify the hazard associated with 10 health care processes derived from these activities. The 5 most hazardous processes were prioritized for modified health care failure mode and effects analysis including hand hygiene, isolation of infection, vital signs, medication delivery, and hand off. Of 190 failures within these processes, 50 (26%) were considered hazardous and did not have effective control measures in place. The causes of these failures allowed interventions to be recommended. CONCLUSIONS:Proactive risk assessments were used to systematically identify and prioritize hazards in surgical wards and allowed interventions to be recommended. These are practical tools that can determine where patient safety efforts should be targeted in clinical health care environments.
journal_name
Ann Surgjournal_title
Annals of surgeryauthors
Anderson O,Brodie A,Vincent CA,Hanna GBdoi
10.1097/SLA.0b013e31824f5f36subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1086-92issue
6eissn
0003-4932issn
1528-1140journal_volume
255pub_type
杂志文章abstract::Barium sulfate granuloma of the rectum may develop when this contrast material is forced through a discontinuity in the rectal mucosa. The ensuing mass may be confused with carcinoma. Preoperative biopsy and attention to plain films will prevent unnecessary inappropriate surgery. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197504000-00009
更新日期:1975-04-01 00:00:00
abstract::From January 1982 to June 1986, 444 patients had localization of 500 nonpalpable mammographically suspicious lesions using the Kopans hook wire technique. Four hundred ninety-nine biopsies were performed in 443 patients. Cancer was identified in 12% of the biopsies performed for a suspicious mass or density and in 20%...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198705000-00010
更新日期:1987-05-01 00:00:00
abstract:OBJECTIVE:To determine whether insulinlike growth factor-I (IGF-I) and hepatocyte growth factor (HGF) cooperate to induce migration and invasion of human colorectal carcinoma (CRC) cells and whether the effects of IGF-I and/or HGF are mediated through activation of the urokinase plasminogen activator (uPA)/uPA receptor...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000160699.59061.92
更新日期:2005-05-01 00:00:00
abstract:OBJECTIVE:The aims of this study were to use a comprehensive whole-mount pathologic analysis to characterize microscopic patterns of residual disease, as well as circumferential and distal resection margins, in rectal cancer treated with preoperative CMT; and to identify clinicopathologic factors associated with residu...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000232540.82364.43
更新日期:2007-01-01 00:00:00
abstract::The aim of this study was to define the post-traumatic changes in body fluid compartments and to evaluate the effect of plasma colloid osmotic pressure (COP) on the partitioning of body fluid between these compartments. Forty-two measurements of plasma volume (green dye), extracellular volume (bromine), and total body...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198909000-00015
更新日期:1989-09-01 00:00:00
abstract::The development of effective, non-toxic (local and systemic) methods for the rapid chemical (enzymatic and non-enzymatic) debridement of third degree burns would dramatically reduce the morbidity and mortality of severely burned patients. Sepsis is still the major cause of death of patients with extensive deep burns. ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197410000-00032
更新日期:1974-10-01 00:00:00
abstract:OBJECTIVE:To explore the events and people that shaped Harvey Cushing, one of the nation's leading surgeons, into a political actor as he rallied support for the issue of military medical preparedness for World War One. SUMMARY BACKGROUND DATA:In a little remembered episode of American medical history, for 2 years bef...
journal_title:Annals of surgery
pub_type: 传,历史文章,杂志文章
doi:10.1097/SLA.0b013e3181e77bdc
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:Pancreatic mucinous cystic neoplasms (MCNs) provide a spectrum of neoplastic changes ranging from benign to malignant. The authors have correlated K-ras mutations and p53 overexpression with the evolution of these tumors. METHODS:Areas of mild, moderate, or severe dysplasia were microdissected from paraffin-...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199910000-00006
更新日期:1999-10-01 00:00:00
abstract::Patients recovering from acute respiratory insufficiency are usually not extubated until they can ventilate adequately while breathing spontaneously at ambient end-expiratory pressure (T-tube). It is hypothesized that this period of T-tube breathing might be detrimental to gas exchange since the endotracheal tube abol...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198005000-00004
更新日期:1980-05-01 00:00:00
abstract::The enterococcus has been relegated to a position of unimportance in the pathogenesis of surgical infections. However the increasing prevalence and virulence of these bacteria prompt reconsideration of this view, particularly because the surgical patient has become increasingly vulnerable to infectious morbidity due t...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-199008000-00007
更新日期:1990-08-01 00:00:00
abstract::Extracorporeal Membrane Oxygenation (ECMO) has been available to neonates with respiratory failure at the University of Michigan School of Medicine since June 1981. In order to evaluate the impact of this type of pulmonary support, a retrospective analysis of 50 neonates with posterolateral congenital diaphragmatic he...
journal_title:Annals of surgery
pub_type: 杂志文章,评审
doi:10.1097/00000658-198902000-00014
更新日期:1989-02-01 00:00:00
abstract:OBJECTIVE:To investigate the correlation between in-hospital surgical delay before appendectomy for suspected appendicitis and the finding of perforated appendicitis in children. METHODS:All children undergoing acute appendectomy for suspected acute appendicitis at Karolinska University Hospital, Stockholm, Sweden fro...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001694
更新日期:2017-03-01 00:00:00
abstract::Sixty patients with chronic alcohol-induced pancreatitis with endoscopic retrograde cholangiopancreatography evidence of common bile duct stenosis were studied to determine the clinical spectrum and natural history of this complication, as well as the indications for biliary bypass. In 17% of patients, common bile duc...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198911000-00007
更新日期:1989-11-01 00:00:00
abstract:OBJECTIVE:The results of proximal splenorenal shunts done in children with extrahepatic portal venous obstruction were evaluated. SUMMARY BACKGROUND DATA:Extrahepatic portal venous obstruction, a common cause of portal hypertension in children in India, is being treated increasingly by endoscopic sclerotherapy instead...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199402000-00011
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To analyze the long-term results of distal pancreatectomy with en bloc celiac axis resection (DP-CAR), a newly designed extended surgical procedure for locally advanced cancer of the pancreatic body. SUMMARY BACKGROUND DATA:Pancreatic body cancer often involves the common hepatic artery and/or the celiac axi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/01.sla.0000258608.52615.5a
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:We sought to determine whether a data-driven scheduling approach improves Operative Suite (OS) efficiency. BACKGROUND:Although efficient use of the OS is a critical determinant of access to health care services, OS scheduling methodologies are simplistic and do not account for all the available characteristi...
journal_title:Annals of surgery
pub_type: 杂志文章,随机对照试验
doi:10.1097/SLA.0000000000002763
更新日期:2019-12-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the relationship between bowel preparation and surgical site infections (SSIs), and also other postoperative complications, after elective colorectal surgery. BACKGROUND:SSI is a major source of postoperative morbidity/costs after colorectal surgery. The value of ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002159
更新日期:2018-04-01 00:00:00
abstract:OBJECTIVE:Comparison of short- and long-term effects after laparoscopic Heller myotomy (LHM) and endoscopic balloon dilation (EBD) considering the need for retreatment. BACKGROUND:Previously published studies have indicated that LHM is the most effective treatment for Achalasia. In contrast to that a recent randomized...
journal_title:Annals of surgery
pub_type: 杂志文章,meta分析
doi:10.1097/SLA.0000000000000212
更新日期:2013-12-01 00:00:00
abstract:OBJECTIVE:The authors determined if more radical surgery with extended lymphadenectomy improves the results of gastrectomy in patients with adenocarcinoma of the gastric antrum. SUMMARY BACKGROUND DATA:The overall survival in patients with gastric cancer is disappointing. Improved survival has been reported by Japanes...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199408000-00009
更新日期:1994-08-01 00:00:00
abstract:OBJECTIVE:To determine the effects of recombinant human insulin-like growth factor-1 (IGF-1) complexed with its principal binding protein, IGFBP-3, on skeletal muscle metabolism in severely burned children. SUMMARY BACKGROUND DATA:Severe burns are associated with a persistent hypermetabolic response characterized by h...
journal_title:Annals of surgery
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000658-199905000-00014
更新日期:1999-05-01 00:00:00
abstract::This is the first reported case of mumps hemorrhagic pancreatitis in a child, documented at operation, and by rising mumps titers and complicated by a pseudocyst. In severe cases when surgery is indicated, drainage of the lesser sac usually prevents pseudocyst formation. If a pseudocyst occurs, drainage is required to...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-197407000-00012
更新日期:1974-07-01 00:00:00
abstract:OBJECTIVE:To describe hospital-level variation in roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) in Michigan. BACKGROUND:Bariatric surgery is an increasingly prevalent elective surgical procedure that will likely be considered for future bundled payment programs, both public and private. Past research in ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000002462
更新日期:2018-12-01 00:00:00
abstract:OBJECTIVE:To assess ischemia and reperfusion (I/R) injury in a hemihepatectomy model in pigs after prolonged continuous or intermittent vascular inflow occlusion in the liver. SUMMARY BACKGROUND DATA:Massive intraoperative blood loss during liver resections can be prevented by temporary vascular inflow occlusion, cons...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-199903000-00011
更新日期:1999-03-01 00:00:00
abstract:OBJECTIVE:To evaluate the effects of artesunate on organ injury and dysfunction associated with hemorrhagic shock (HS) in the rat. BACKGROUND:HS is still a common cause of death in severely injured patients and is characterized by impairment of organ perfusion, systemic inflammatory response, and multiple organ failur...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001664
更新日期:2017-02-01 00:00:00
abstract:OBJECTIVE:To evaluate the clinical outcomes of multivisceral transplantation (MVT) in the setting of diffuse thrombosis of the portomesenteric venous system. BACKGROUND:Liver transplantation (LT) in the face of cirrhosis and diffuse portomesenteric thrombosis (PMT) is controversial and contraindicated in many transpla...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0b013e31825429c0
更新日期:2012-06-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to determine the fate of patients who attempted to donate organs after circulatory death (DCD) using a standardized DCD protocol. BACKGROUND:Successful donation is not always possible after attempted DCD. METHODS:Data were collected for all DCD donors between 1/2011 and 9/201...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001298
更新日期:2016-02-01 00:00:00
abstract::Release of pancreatic polypeptide (PP) after a meal is biphasic, with an early transient peak believed to be under cholinergic control, and a secondary, prolonged intestinal phase thought to be mediated by hormones. Endogenous release of PP was stimulated by intraduodenal oleate (6.8 mmol/hr) or by intravenous adminis...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198411000-00008
更新日期:1984-11-01 00:00:00
abstract::The abilities of polymorphonuclear leukocytes (PMN) and pulmonary alveolar macrophages (PAM), to demonstrate chemotaxis, phagocytosis, and superoxide release after bile duct ligation in the rat were investigated to determine the effect of cholestasis on nonspecific cellular immune mechanisms. Chemotactic response to C...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198711000-00004
更新日期:1987-11-01 00:00:00
abstract::Conversion of jejunoileal bypass to gastric bypass was performed in 11 patients because of metabolic problems and physical discomforts, and in three patients because of insufficient weight loss. There was no mortality and little morbidity after operation. An additional mean weight loss of 6% occurred, and weight stabi...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/00000658-198211000-00007
更新日期:1982-11-01 00:00:00
abstract:OBJECTIVE:To investigate differences in the quality, confidence, and consistency of intraoperative surgical decision making (DM) and using functional neuroimaging expose decision systems that operators use. SUMMARY BACKGROUND DATA:Novices are hypothesized to use conscious analysis (effortful DM) leading to activation ...
journal_title:Annals of surgery
pub_type: 杂志文章
doi:10.1097/SLA.0000000000001651
更新日期:2017-02-01 00:00:00