Perioperative communication practices of anesthesiologists: A need to introspect and change

Kumar, Vinay; Jahagirdar, Sameer Mahamud; Ravishankar, M; Athiraman, Umesh Kumar; Maclean, Jennyl; Parthasarathy, Srinivasan

doi:10.4103/0259-1162.167848

Cited by 4 publications

(2 citation statements)

References 13 publications

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“…Specific team training on the steps of this strategy took place in May and June 2020, and included anaesthesiologists, hospitalists, nurses, nursing technicians and pharmacists. For logistical purposes, training for surgeons was made available electronically through a Problem Based Learning methodology, 10 followed by a post-test for evidence of training effectiveness. This multidisciplinary strategy was in effect from June to December 2020.…”

Section: Methodsmentioning

confidence: 99%

Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study

Silva¹,

Lima²,

Ferrer³

et al. 2021

BMJ Open Qual

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BackgroundVenous thromboembolism (VTE) is a major cause of perioperative morbimortality. Despite significant efforts to advance evidence-based practice, prevention rates remain inadequate in many centres.ObjectiveTo evaluate the effectiveness of different strategies aimed at improving adherence to adequate VTE prophylaxis in surgical patients at high risk of VTE.MethodBefore and after intervention study conducted at a tertiary hospital. Adherence to adequate VTE prophylaxis was compared according to three strategies consecutively implemented from January 2019 to December 2020. A dedicated hospitalist physician alone (strategy A) or in conjunction with a nurse (strategy B) overlooked the postoperative period to ensure adherence and correct inadequacies. Finally, a multidisciplinary team approach (strategy C) focused on promoting adequate VTE prophylaxis across multiple stages of care—from the operating room (ie, preoperative team-based checklist) to collaboration with clinical pharmacists in the postoperative period—was implemented.ResultsWe analysed 2074 surgical patients: 783 from January to June 2019 (strategy A), 669 from July 2019 to May 2020 (strategy B), and 622 from June to December 2020 (strategy C). VTE prophylaxis adherence rates for strategies (A), (B) and (C) were (median (25th–75th percentile)) 43.29% (31.82–51.69), 50% (42.57–55.80) and 92.31% (91.38–93.51), respectively (p<0.001; C>A=B). There was a significant reduction in non-compliance on all analysed criteria (risk stratification (A (25.5%), B (22%), C (6%)), medical documentation (A (68%), B (55.2%) C (9%)) and medical prescription (A (51.85%), B (48%), C (6.10%)) after implementation of strategy C (p<0.05). Additionally, a significant increase in compliance with adequate dosage, dosing interval and scheduling of the prophylactic regimen was observed.ConclusionPerioperative VTE prophylaxis strategies that relied exclusively on physicians and/or nurses were associated with suboptimal execution and prevention. A multidisciplinary team-based approach that covers multiple stages of patient care significantly increased adherence to adequate VTE prophylaxis in surgical patients at high risk of developing perioperative VTE.

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Section: Methodsmentioning

confidence: 99%

Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study

Silva¹,

Lima²,

Ferrer³

et al. 2021

BMJ Open Qual

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“…Any aspect of care, such as expected outcomes, consent form considerations, and risks, should be extensively discussed with the patient and/or their family to achieve the greatest possible understanding, especially in situations involving sensory and intellectually challenged individuals. [ 68 ]…”

Section: Introductionmentioning

confidence: 99%

Preoperative evaluation of the elderly patient

Schipa,

Luca,

Ripa

et al. 2023

Saudi Journal of Anaesthesia

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Nowadays, the pre-operative evaluation of older patients is a critical step in the decision-making process. Clinical assessment and care planning should be considered a whole process rather than separate issues. Clinicians should use validated tools for pre-operative risk assessment of older patients to minimize surgery-related morbidity and mortality and enhance care quality. Traditional pre-operative consultation often fails to capture the pathophysiological and functional profiles of older patients. The elderly’s pre-operative evaluation should be focused on determining the patient’s functional reserve and reducing any possible peri-operative risk. Therefore, older adults may benefit from the Comprehensive Geriatric Assessment (CGA) that allows clinicians to evaluate several aspects of elderly life, such as depression and cognitive disorders, social status, multi-morbidity, frailty, geriatric syndromes, nutritional status, and polypharmacy. Despite the recognized challenges in applying the CGA, it may provide a realistic risk assessment for post-operative complications and suggest a tailored peri-operative treatment plan for older adults, including pre-operative optimization strategies. The older adults’ pre-operative examination should not be considered a mere stand-alone, that is, an independent stage of the surgical pathway, but rather a vital step toward a personalized therapeutic approach that may involve professionals from different clinical fields. The aim of this review is to revise the evidence from the literature and highlight the most important items to be implemented in the pre-operative evaluation process in order to identify better all elderly patients’ needs.

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Identifying patient safety competences among anesthesiology residents: systematic review

Pereira¹,

Garcia²,

Ribeiro³

2022

Brazilian Journal of Anesthesiology (English Edition)

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Perioperative communication practices of anesthesiologists: A need to introspect and change

Cited by 4 publications

References 13 publications

Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study

Comparison of strategies for adherence to venous thromboembolism prophylaxis in high-risk surgical patients: a before and after intervention study

Preoperative evaluation of the elderly patient

Identifying patient safety competences among anesthesiology residents: systematic review

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