Safe surgery

Implementation is viewed as a continuous process in Safe Surgery Week 2012, the Trust carried out a series of workshops about the usability of the checklist with a view to understanding how its design and content could be improved. 

Haynes et al. (2011) Checklists Within three months Eight hospitals in the Safe Surgery Saves Lives programme Safety Attitudes Questionnaire On a 5-point scale, safety culture increased ITom 3.91 to 4.01... 

Teamwork within units Designation of unit team leaders triage on emergency care optimalisation of hospital unit briefings implementation of a safe surgery checklist... 

Other specialist units and institutes had put off any discussion of the results for organisational reasons or else showed no willingness to make any changes. In 23 out of 37 specialist units the patient safety climate survey led to a decision to set up an incident reporting system. In addition, targeted projects led to the establishment of safety standards for electronic prescriptions and standards for safe surgery. 

The results obtained in the follow-up survey on safety culture showed that the safe surgery standard greatly improved quality and safety. Working procedures were simplified and made safer. Many employees stated that they were glad that the standard had been introduced. They also reported that communication between nursing staff and doctors had improved. The following statements illustrate the main conclusions of the survey ... 

Lafferty K, Wyatt AP (1987) After safe sex, safe surgery BMJ 295 392... 

The anesthesiologist selects the anesthetic drug that will produce safe anesthesia, analgesia (absence of pain), and in some surgeries, effective skeletal muscle relaxation. General anesthesia is most commonly achieved when the anesthetic vapors are inhaled or administered intravenously (IV). Volatile liquid anesthetics produce anesthesia when their vapors are inhaled. Volatile liquids are liquids that evaporate on exposure to air. Examples of volatile liquids include halothane, desflurane, and enflurane. Gas anesthetics are combined with oxygen and administered by inhalation. Examples of gas anesthetics are nitrous oxide and cyclopropane. 

In general these derivatives are safe, their chemical functions being the glycine moiety the same holds for AT,0-carboxymethyl chitosan, as demonstrated for instance by studies intended to assess the efficacy of W,0-carboxymethyl chitosan to limit adhesion formation in a rabbit abdominal surgery model. The inability of fibroblasts to adhere to N,0-carboxymethyl chitosan-coated surfaces suggests that it may act as a biophysical barrier [135]. 

In 1992, the FDA issued a moratorium on silicone-gel-filled implants, and restricted their use to reconstmction and clinical smdies. In 2000, they approved saline-filled implants. In 2003, the General and Plastic Surgery Devices (GPSD) Advisory Panel recommended reapproval of gel-filled implants, but the FDA decided to wait for more clinical evidence of safety. In late 2005, the Panel recommended conditional approval of Mentor s and Inamed s gel implants. In October 2006, Health Canada approved the use of sUicone-gel-filled implants, with a warning that no medical device is 100% safe. ... 

While early CEA is considered to be relatively safe, it may not always be necessary. For instance, early surgery can be deferred in patients who are medically unstable or for those whose cardiac or respiratory status requires optimization. In the NASCET study, the rate of ipsUateral stroke at 1 month for medically treated patients with high-grade stenoses was only 3.3% and was even lower (1.7%) in patients with near-occlusions. Even in patients with free-floating intraluminal thrombus, anticoagulant therapy is a well tolerated and reasonable first step, given... 

The Food and Drug Administration (FDA) approved dose of daclizumab is 1 mg/kg within 24 hours of transplant surgery and then 1 mg/kg administered every 2 weeks after surgery for a total of five doses.7,9,11 No dose adjustment is necessary in renal impairment, but no data are available for dose adjustments in hepatic dysfunction. Several trials have shown that a shorter dosing regimen of daclizumab, two doses given in a similar manner as basiliximab, may be as safe and effective as the full five-dose course.12,13... 

Preoperative nutrition support in patients with moderate to severe malnutrition who cannot tolerate enteral nutrition and in whom surgery can be delayed safely for at least 7 days... 

The establishment of performance criteria for a given tumor marker test is not a simple process because accuracy and precision are unique for each type of analyte and its application. Establishing methodological limits for accuracy, precision, sensitivity, and specificity often requires standard reference materials, quality control materials, comparative studies, and actual clinical specimens. Accuracy and precision must be measured over the analyte reportable range for which the device is intended to be used. Sensitivity and specificity must be considered with respect to the intended clinical use of the device. Also, the indications for use should be carefully considered in the design of the study protocol. The indications for class II should be to monitor residual tumor after surgery (or radiation), the recurrence of tumor, or response to therapy. A 510(k) must provide clear evidence that the device is accurate, safe, effective, and substantially equivalent to a device legally marketed in the United States. 

An unwanted pregnancy can be terminated by suction curettage during the first trimester. The procedure is simple, relatively inexpensive, safe and completes the termination at the time of the procedure. It is estimated that approximately 50 million pregnancies worldwide are legally terminated each year by this surgery. 

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