Science.gov

Sample records for organization surgical safety

  1. 77 FR 25179 - Patient Safety Organizations: Voluntary Relinquishment From Surgical Safety Institute

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... patient safety and the quality of health care delivery. HHS issued the Patient Safety and Quality... of health care delivery. The Patient Safety Rule, 42 CFR part 3, authorizes AHRQ, on behalf of the... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  2. Impact of the World Health Organization's Surgical Safety Checklist on safety culture in the operating theatre: a controlled intervention study

    PubMed Central

    Haugen, A. S.; Søfteland, E.; Eide, G. E.; Sevdalis, N.; Vincent, C. A.; Nortvedt, M. W.; Harthug, S.

    2013-01-01

    Background Positive changes in safety culture have been hypothesized to be one of the mechanisms behind the reduction in mortality and morbidity after the introduction of the World Health Organization's Surgical Safety Checklist (SSC). We aimed to study the checklist effects on safety culture perceptions in operating theatre personnel using a prospective controlled intervention design at a single Norwegian university hospital. Methods We conducted a study with pre- and post-intervention surveys using the intervention and control groups. The primary outcome was the effects of the Norwegian version of the SSC on safety culture perceptions. Safety culture was measured using the validated Norwegian version of the Hospital Survey on Patient Safety Culture. Descriptive characteristics of operating theatre personnel and checklist compliance data were also recorded. A mixed linear regression model was used to assess changes in safety culture. Results The response rate was 61% (349/575) at baseline and 51% (292/569) post-intervention. Checklist compliance ranged from 77% to 85%. We found significant positive changes in the checklist intervention group for the culture factors ‘frequency of events reported’ and ‘adequate staffing’ with regression coefficients at −0.25 [95% confidence interval (CI), −0.47 to −0.07] and 0.21 (95% CI, 0.07–0.35), respectively. Overall, the intervention group reported significantly more positive culture scores—including at baseline. Conclusions Implementation of the SSC had rather limited impact on the safety culture within this hospital. PMID:23404986

  3. Use of a Surgical Safety Checklist to Improve Team Communication.

    PubMed

    Cabral, Richard A; Eggenberger, Terry; Keller, Kathryn; Gallison, Barry S; Newman, David

    2016-09-01

    To improve surgical team communication, a team at Broward Health Imperial Point Hospital, Ft Lauderdale, Florida, implemented a program for process improvement using a locally adapted World Health Organization Surgical Safety Checklist. This program included a standardized, comprehensive time out and a briefing/debriefing process. Postimplementation responses to the Safety Attitudes Questionnaire revealed a significant increase in the surgical team's perception of communication compared with that reported on the pretest (6% improvement resulting in t79 = -1.72, P < .05, d = 0.39). Perceptions of communication increased significantly for nurses (12% increase, P = .002), although the increase for surgeons and surgical technologists was lower (4% for surgeons, P = .15 and 2.3% for surgical technologists, P = .06). As a result of this program, we have observed improved surgical teamwork behaviors and an enhanced culture of safety in the OR. PMID:27568533

  4. World Health Organization (WHO) surgical safety checklist implementation and its impact on perioperative morbidity and mortality in an academic medical center in Chile

    PubMed Central

    Lacassie, Hector J.; Ferdinand, Constanza; Guzmán, Sergio; Camus, Lorena; Echevarria, Ghislaine C.

    2016-01-01

    Abstract Health care organizations are unsafe. Numerous centers have incorporated the WHO Surgical Safety Checklist in their processes with good results; however, only limited information is available about its effectiveness in Latin America. We aimed to evaluate the impact of the checklist implementation on the in-hospital morbidity and mortality rate in a tertiary health care center. After Institutional review board approval, and using data from our hospital administrative records, we conducted a retrospective analysis of all surgical encounters (n = 70,639) over the period from January 2005 to December 2012. Propensity scoring (PS) methods (matching and inverse weighting) were used to compare the pre and postintervention period, after controlling for selection bias. After PS matching (n = 29,250 matched pairs), the in-hospital mortality rate was 0.82% [95% confidence interval (CI), 0.73–0.92] before and 0.65% (95% CI, 0.57–0.74) after checklist implementation [odds ratio (OR) 0.73; 95% CI, 0.61–0.89]. The median length of stay was 3 days [interquartile range (IQR), 1–5] and 2 days (IQR, 1–4) for the pre and postchecklist period, respectively (P < 0.01). This is the first Latin American study reporting a decrease in mortality after the implementation of the WHO Surgical Checklist in adult surgical patients. This is a strong and simple tool to make health care safer, especially in developing countries. PMID:27281092

  5. World Health Organization (WHO) surgical safety checklist implementation and its impact on perioperative morbidity and mortality in an academic medical center in Chile.

    PubMed

    Lacassie, Hector J; Ferdinand, Constanza; Guzmán, Sergio; Camus, Lorena; Echevarria, Ghislaine C

    2016-06-01

    Health care organizations are unsafe. Numerous centers have incorporated the WHO Surgical Safety Checklist in their processes with good results; however, only limited information is available about its effectiveness in Latin America. We aimed to evaluate the impact of the checklist implementation on the in-hospital morbidity and mortality rate in a tertiary health care center. After Institutional review board approval, and using data from our hospital administrative records, we conducted a retrospective analysis of all surgical encounters (n = 70,639) over the period from January 2005 to December 2012. Propensity scoring (PS) methods (matching and inverse weighting) were used to compare the pre and postintervention period, after controlling for selection bias. After PS matching (n = 29,250 matched pairs), the in-hospital mortality rate was 0.82% [95% confidence interval (CI), 0.73-0.92] before and 0.65% (95% CI, 0.57-0.74) after checklist implementation [odds ratio (OR) 0.73; 95% CI, 0.61-0.89]. The median length of stay was 3 days [interquartile range (IQR), 1-5] and 2 days (IQR, 1-4) for the pre and postchecklist period, respectively (P < 0.01).This is the first Latin American study reporting a decrease in mortality after the implementation of the WHO Surgical Checklist in adult surgical patients. This is a strong and simple tool to make health care safer, especially in developing countries. PMID:27281092

  6. Perspectives in quality: designing the WHO Surgical Safety Checklist.

    PubMed

    Weiser, Thomas G; Haynes, Alex B; Lashoher, Angela; Dziekan, Gerald; Boorman, Daniel J; Berry, William R; Gawande, Atul A

    2010-10-01

    The World Health Organization's Patient Safety Programme created an initiative to improve the safety of surgery around the world. In order to accomplish this goal the programme team developed a checklist with items that could and, if at all possible, should be practised in all settings where surgery takes place. There is little guidance in the literature regarding methods for creating a medical checklist. The airline industry, however, has more than 70 years of experience in developing and using checklists. The authors of the WHO Surgical Safety Checklist drew lessons from the aviation experience to create a safety tool that supports essential clinical practice. In order to inform the methodology for development of future checklists in health care, we review how we applied lessons learned from the aviation experience in checklist development to the development of the Surgical Safety Checklist and also discuss the differences that exist between aviation and medicine that impact the use of checklists in health care. PMID:20702569

  7. Safety organizations and experts

    NASA Technical Reports Server (NTRS)

    Mandel, G.; Rubinstein, R. I.; Pinto, J. J.; Meschkow, S. Z.

    1977-01-01

    Handbook lists organizations and experts in specific, well defined areas of safety technology. Special emphasis is given to relevant safety information sources on aircraft fire hazards and aircraft interior flammability.

  8. Surgical safety checklists briefings: Perceived efficacy and team member involvement.

    PubMed

    McDowell, D S; McComb, S

    2016-06-01

    Researchers have shown inconsistencies in compliance, outcomes and attitudes of surgical team members related to surgical safety checklist briefings. The purpose of this study was to examine surgical circulator and scrub practitioners' perceptions of safety checklist briefings and team member involvement, and to identify potential improvements in the process based on those perceptions. An anonymous survey was conducted with members of the Association of periOperative Registered Nurses (AORN) and the Association of Surgical Technologists (AST). Questions focused on perceptions of checklist briefing efficacy and team member involvement in safety practices. From the 346 usable responses, a third respondent group of self-identified perioperative leaders emerged. Significant results were obtained related to leaders' perceptions, post-procedure briefings and various perceptions of team member involvement. Study results indicate that variances in safety practices continue as perceived by surgical team members thus presenting opportunities for further examination and improvement of processes in reducing surgical errors. PMID:27498438

  9. [Organization of surgical measure in military hospitals].

    PubMed

    Efimenko, N A

    2007-09-01

    The reform of military health service intends a clear organization of medical attendance, and, first of all, surgical one, particularly in military hospitals with different patient capacity. Seeing it leaders of surgery units in medical service got the task to elaborate the standards of realization of surgical attendance for military hospitals with different patient capacity during peaceful time, correctly execute all orders on preparation of military surgeons, enroot new high-quality and expensive types of maintenance into practice. Optimization and standardization of processes of surgical maintenance in Defense Establishment of Russian Federation, of tasks in the sphere of staff politics and of teaching process, modernization of technical equipment of medical service and enrooting new high-quality methods in practice allows augment the effectiveness of surgical attendance in military hospitals with different patient capacity. PMID:18154046

  10. Surgical Safety in Pediatrics: practical application of the Pediatric Surgical Safety Checklist1

    PubMed Central

    Pires, Maria Paula de Oliveira; Pedreira, Mavilde L. G.; Peterlini, Maria Angélica Sorgini

    2015-01-01

    Objectives: to assess the practical application of the Pediatric Surgical Safety Checklist on the preoperative period and to verify family satisfaction regarding the use of the material. Method: exploratory study that aimed to analyze the use of the checklist by children who underwent surgical interventions. The sample was constituted by 60 children (from preschoolers to teens) and 60 family members. The variables related to demographic characterization, filling out the checklist, and family satisfaction, being evaluated through inferential and descriptive statistical analysis. Results: most children (71.7%) were male, with a median age of 7.5 years. We identified the achievement of 65.3% of the checklist items, 30.0% were not filled due to non-performance of the team and 4.7% for children and family reasons. In the association analysis, we found that the removal of accessories item (p = 0.008) was the most checked by older children. Regarding satisfaction, the family members evaluated the material as great (63.3%) and good (36.7%) and believed that there was a reduction of the child's anxiety (83.3%). Conclusion: the use of the checklist in clinical practice can change health services regarding safety culture and promote customer satisfaction. PMID:26626002

  11. Patients' Perspectives of Surgical Safety: Do They Feel Safe?

    PubMed Central

    Dixon, Jennifer L.; Tillman, Matthew M.; Wehbe-Janek, Hania; Song, Juhee; Papaconstantinou, Harry T.

    2015-01-01

    Background Increased focus on reducing patient harm has led to surgical safety initiatives, including time-out, surgical safety checklists, and debriefings. The perception of the lay public of the surgical safety process is largely unknown. Methods A 20-question survey focused on perceptions of surgical safety practice was distributed to a random sample of patients following elective operations requiring hospitalization. Responses were measured by a 7-point Likert scale. Qualitative feedback was obtained through nonphysician-moderated sessions. Participation was voluntary and anonymous. Results Surveys were distributed to 345 patients of whom 102 (29.5%) responded. Overall, patients felt safe as evidenced by scores for the questions “I felt safe the day of my surgery” (6.53 ± 0.72) and “Mistakes rarely happen during surgery” (5.39 ± 1.51). Patients undergoing their first surgery and patients with higher income levels were associated with a significant decrease in specific safety perceptions. Qualitative feedback sessions identified the physician-patient relationship as the most important factor positively influencing patient safety perceptions. Conclusion Current surgical safety practice is perceived positively by our patients; however, patients still identify physician-patient interactions, relationships, and trust as the most positive factors influencing their perception of the safety environment. PMID:26130976

  12. The WHO surgical safety checklist: survey of patients’ views

    PubMed Central

    Russ, Stephanie Jane; Rout, Shantanu; Caris, Jochem; Moorthy, Krishna; Mayer, Erik; Darzi, Ara; Sevdalis, Nick; Vincent, Charles

    2014-01-01

    Background Evidence suggests that full implementation of the WHO surgical safety checklist across NHS operating theatres is still proving a challenge for many surgical teams. The aim of the current study was to assess patients’ views of the checklist, which have yet to be considered and could inform its appropriate use, and influence clinical buy-in. Method Postoperative patients were sampled from surgical wards at two large London teaching hospitals. Patients were shown two professionally produced videos, one demonstrating use of the WHO surgical safety checklist, and one demonstrating the equivalent periods of their operation before its introduction. Patients’ views of the checklist, its use in practice, and their involvement in safety improvement more generally were captured using a bespoke 19-item questionnaire. Results 141 patients participated. Patients were positive towards the checklist, strongly agreeing that it would impact positively on their safety and on surgical team performance. Those worried about coming to harm in hospital were particularly supportive. Views were divided regarding hearing discussions around blood loss/airway before their procedure, supporting appropriate modifications to the tool. Patients did not feel they had a strong role to play in safety improvement more broadly. Conclusions It is feasible and instructive to capture patients’ views of the delivery of safety improvements like the checklist. We have demonstrated strong support for the checklist in a sample of surgical patients, presenting a challenge to those resistant to its use. PMID:25038036

  13. [Errors in surgery. Strategies to improve surgical safety].

    PubMed

    Arenas-Márquez, Humberto; Anaya-Prado, Roberto

    2008-01-01

    Surgery is an extreme experience for both patient and surgeon. The patient has to be rescued from something so serious that it may justify the surgeon to violate his/her integrity in order to resolve the problem. Nevertheless, both physician and patient recognize that the procedure has some risks. Medical errors are the 8th cause of death in the U.S., and malpractice can be documented in >50% of the legal prosecutions in Mexico. Of special interest is the specialty of general surgery where legal responsibility can be confirmed in >80% of the cases. Interest in mortality attributed to medical errors has existed since the 19th century; clearly identifying the lack of knowledge, abilities, and poor surgical and diagnostic judgment as the cause of errors. Currently, poor organization, lack of team work, and physician/ patient-related factors are recognized as the cause of medical errors. Human error is unavoidable and health care systems and surgeons should adopt the culture of error analysis openly, inquisitively and permanently. Errors should be regarded as an opportunity to learn that health care should to be patient centered and not surgeon centered. In this review, we analyze the causes of complications and errors that can develop during routine surgery. Additionally, we propose measures that will allow improvements in the safety of surgical patients. PMID:18778549

  14. [How frequently is the WHO Surgical Safety Checklist used?].

    PubMed

    Nørgaard, Aleksander; Johnsen, Roar; Marhaug, Gudmund

    2016-05-01

    BACKGROUND Through its patient safety programme «In safe hands,» the Norwegian Directorate of Health's objective is to ensure that the WHO Surgical Safety Checklist is used for all relevant surgical procedures. The purpose of this study was to investigate the recorded use of the WHO Surgical Safety Checklist, as well as to illuminate the factors that covary with its use, in order to be able to identify improvement measures.MATERIAL AND METHOD All surgical operations were reviewed at five surgical units at St Olavs Hospital Health Trust in three two-week periods in 2013. Recorded use of the checklist at each unit was compared to time of surgery, day surgery, acute or elective surgery and operating theatre time before, during and after surgery.RESULTS A total of 2297 operations were included. In 47 % of the operations, use of the entire checklist was recorded, in 31 % use of only parts was recorded and in 22 % no parts of it were recorded as having been used. The unit to which the patient belonged had the most bearing on the extent to which the checklists were used. A short time spent in the operating theatre, as well as operations that were classified in advance as acute, were associated with less recorded use.INTERPRETATION St. Olavs Hospital Health Trust has not achieved the objective of full implementation of the WHO checklist. There is considerable variation in recorded use at the units studied, and less recorded use of the checklist in the case of short and acute operations. PMID:27221181

  15. Use of the surgical safety checklist to improve communication and reduce complications.

    PubMed

    Pugel, Anne E; Simianu, Vlad V; Flum, David R; Patchen Dellinger, E

    2015-01-01

    Existing evidence suggests that communication failures are common in the operating room, and that they lead to increased complications, including infections. Use of a surgical safety checklist may prevent communication failures and reduce complications. Initial data from the World Health Organization Surgical Safety Checklist (WHO SSC) demonstrated significant reductions in both morbidity and mortality with checklist implementation. A growing body of literature points out that while the physical act of "checking the box" may not necessarily prevent all adverse events, the checklist is a scaffold on which attitudes toward teamwork and communication can be encouraged and improved. Recent evidence reinforces the fact the compliance with the checklist is critical for the effects on patient safety to be realized. PMID:25731674

  16. [Does Surgical Safety Checklist for cesarean section improve maternal and neonatal outcome?].

    PubMed

    Sumikura, Hiroyuki

    2014-03-01

    Surgical Safety Checklist published by WHO (World Health Organization) has been widely accepted and contributed to reduce postoperative mortality and morbidity. However, the implementation of the original checklist for cesarean section has been questioned as most of the patients for cesarean section being awake at the occasion of time out, and some patients requiring emergency cesarean section. From these points of view, modified versions of the checklist for cesarean section have been proposed. Recently, NPSA (National Patient Safety Agency) and RCOG (Royal College of Obstetricians and Gynaecologists) from U. K. published a checklist specifically for obstetric surgery, and its usefulness has been evaluated. The most important modification of the checklist seems to be adoption of classification of urgency of cesarean section by NICE (National Institute of Clinical Excellence) into the time out Surgical Safety Checklist from U. K. is introduced with its recent evaluation, and its possible adoption in Japanese hospitals will be discussed. PMID:24724434

  17. 14 CFR 417.103 - Safety organization.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety organization. 417.103 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Launch Safety Responsibilities § 417.103 Safety organization. (a) A launch operator must maintain and document a safety organization. A launch operator...

  18. 14 CFR 417.103 - Safety organization.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Safety organization. 417.103 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Launch Safety Responsibilities § 417.103 Safety organization. (a) A launch operator must maintain and document a safety organization. A launch operator...

  19. 14 CFR 417.103 - Safety organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Safety organization. 417.103 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Launch Safety Responsibilities § 417.103 Safety organization. (a) A launch operator must maintain and document a safety organization. A launch operator...

  20. 14 CFR 417.103 - Safety organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Safety organization. 417.103 Section 417... OF TRANSPORTATION LICENSING LAUNCH SAFETY Launch Safety Responsibilities § 417.103 Safety organization. (a) A launch operator must maintain and document a safety organization. A launch operator...

  1. [Surgical safety cheklist at the management of the hybrid operating room].

    PubMed

    Cherkashin, M A; Berezina, N A; Kuplevatsky, V I; Serov, A V; Mefodovsky, A A

    2016-01-01

    An essential aspect of the work of the operating room is the provision of safety of both the patient and staff. The organization of the activity of the surgical service requires serious elaboration of each of its stage, as well as standardization in using various validated instruments. When speaking of a hybrid operating room with the use of intraoperative magnetic resonance tomography, such an approach becomes not merely a recommendation but rather forced and justified necessity. Simultaneous use of various technologies of imaging and treatment with the engagement of physicians of various specialties requires especially thorough control. A generally accepted international standard of the work of the operating block is the use of checklists, and since 2008 the initiative of the World Health Organization "Safe Surgery Saves Lives" has globally been working to promote implementation of the WHO Surgical Safety Checklists (SSCL) to the real clinical practice. The intraoperative MR-diagnostic stage dictates rigid requirements for proper inventory of ferromagnetic and nonmagnetic surgical tools, verified logistics, and routing of the patient in the conditions of high and extremely high (1.5-3.0 T) magnetic field. A separate and not less important problem is anaesthesiological support during MRT. In order to optimise the patient's movements and adequate monitoring of his/her safety inside the operating department, the authors have modified the standard WHO Surgical Safety Checklist. Implementation of the modified checklist for the MRT-equipped hybrid operating room should improve the control over the processes, as well as increase safety of both the patient and personnel. PMID:27336334

  2. Undergraduate Organic Chemistry Laboratory Safety

    NASA Astrophysics Data System (ADS)

    Luckenbaugh, Raymond W.

    1996-11-01

    Each organic chemistry student should become familiar with the educational and governmental laboratory safety requirements. One method for teaching laboratory safety is to assign each student to locate safety resources for a specific class laboratory experiment. The student should obtain toxicity and hazardous information for all chemicals used or produced during the assigned experiment. For example, what is the LD50 or LC50 for each chemical? Are there any specific hazards for these chemicals, carcinogen, mutagen, teratogen, neurotixin, chronic toxin, corrosive, flammable, or explosive agent? The school's "Chemical Hygiene Plan", "Prudent Practices for Handling Hazardous Chemicals in the Laboratory" (National Academy Press), and "Laboratory Standards, Part 1910 - Occupational Safety and Health Standards" (Fed. Register 1/31/90, 55, 3227-3335) should be reviewed for laboratory safety requirements for the assigned experiment. For example, what are the procedures for safe handling of vacuum systems, if a vacuum distillation is used in the assigned experiment? The literature survey must be submitted to the laboratory instructor one week prior to the laboratory session for review and approval. The student should then give a short presentation to the class on the chemicals' toxicity and hazards and describe the safety precautions that must be followed. This procedure gives the student first-hand knowledge on how to find and evaluate information to meet laboartory safety requirements.

  3. Developing and Implementing a Culture of Safety in the Dentoalveolar Surgical Practice.

    PubMed

    Hupp, James R

    2015-08-01

    The health care industry and delivery systems are placing greater emphasis on making their organizations safe. They do this by cultivating a culture of safety to help anticipate and prevent injuries and documenting and investigating injuries to develop prevention protocols. Many of the strategies used in the hospital industry can be applied to the dentoalveolar surgery practice of oral-maxillofacial surgeons and other dentists. This article discusses the development of a culture of safety in the dentoalveolar practice and gives ideas of how threats of injuries to patients, guests, and the surgical care team can be reduced or eliminated. PMID:26001630

  4. 14 CFR 415.33 - Safety organization.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety organization. 415.33 Section 415.33... TRANSPORTATION LICENSING LAUNCH LICENSE Safety Review and Approval for Launch From a Federal Launch Range § 415.33 Safety organization. (a) An applicant shall maintain a safety organization and document it...

  5. 14 CFR 415.33 - Safety organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 14 Aeronautics and Space 4 2012-01-01 2012-01-01 false Safety organization. 415.33 Section 415.33... TRANSPORTATION LICENSING LAUNCH LICENSE Safety Review and Approval for Launch From a Federal Launch Range § 415.33 Safety organization. (a) An applicant shall maintain a safety organization and document it...

  6. 14 CFR 415.33 - Safety organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Safety organization. 415.33 Section 415.33... TRANSPORTATION LICENSING LAUNCH LICENSE Safety Review and Approval for Launch From a Federal Launch Range § 415.33 Safety organization. (a) An applicant shall maintain a safety organization and document it...

  7. 14 CFR 415.33 - Safety organization.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 14 Aeronautics and Space 4 2014-01-01 2014-01-01 false Safety organization. 415.33 Section 415.33... TRANSPORTATION LICENSING LAUNCH LICENSE Safety Review and Approval for Launch From a Federal Launch Range § 415.33 Safety organization. (a) An applicant shall maintain a safety organization and document it...

  8. 76 FR 9350 - Patient Safety Organizations: Voluntary Delisting From Rocky Mountain Patient Safety Organization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... Delisting From Rocky Mountain Patient Safety Organization AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Delisting. SUMMARY: Rocky Mountain Patient Safety Organization: AHRQ has accepted a notification of voluntary relinquishment from Rocky Mountain Patient Safety Organization,...

  9. 14 CFR 415.33 - Safety organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Safety organization. 415.33 Section 415.33....33 Safety organization. (a) An applicant shall maintain a safety organization and document it by... communication, both within the applicant's organization and between the applicant and any federal launch...

  10. Surgical team member assessment of the safety of surgery practice in 38 South Carolina hospitals.

    PubMed

    Singer, Sara J; Jiang, Wei; Huang, Lyen C; Gibbons, Lorri; Kiang, Mathew V; Edmondson, Lizabeth; Gawande, Atul A; Berry, William R

    2015-06-01

    We assessed surgical team member perceptions of multiple dimensions of safe surgical practice in 38 South Carolina hospitals participating in a statewide initiative to implement surgical safety checklists. Primary data were collected using a novel 35-item survey. We calculated the percentage of 1,852 respondents with strongly positive, positive, and neutral/negative responses about the safety of surgical practice, compared results by hospital and professional discipline, and examined how readiness, teamwork, and adherence related to staff perception of care quality. Overall, 78% of responses were positive about surgical safety at respondent's hospitals, but in each survey dimension, from 16% to 40% of responses were neutral/negative, suggesting significant opportunity to improve surgical safety. Respondents not reporting they would feel safe being treated in their operating rooms varied from 0% to 57% among hospitals. Surgeons responded more positively than nonsurgeons. Readiness, teamwork, and practice adherence related directly to staff perceptions of patient safety (p < .001). PMID:25828528

  11. 14 CFR 417.103 - Safety organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 14 Aeronautics and Space 4 2011-01-01 2011-01-01 false Safety organization. 417.103 Section 417... organization. (a) A launch operator must maintain and document a safety organization. A launch operator must... within the launch operator's organization and between the launch operator and any federal launch range...

  12. Obstetrical and Gynecological Devices; Reclassification of Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair; Final order.

    PubMed

    2016-01-01

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to reclassify surgical mesh for transvaginal pelvic organ prolapse (POP) repair from class II to class III. FDA is reclassifying these devices based on the determination that general controls and special controls together are not sufficient to provide reasonable assurance of safety and effectiveness for this device, and these devices present a potential unreasonable risk of illness or injury. The Agency is reclassifying surgical mesh for transvaginal POP repair on its own initiative based on new information. PMID:26742182

  13. Surgical techniques for advanced stage pelvic organ prolapse.

    PubMed

    Brown, Douglas N; Strauchon, Christopher; Gonzalez, Hector; Gruber, Daniel

    2016-02-01

    Pelvic organ prolapse is an extremely common condition, with approximately 12% of women requiring surgical correction over their lifetime. This manuscript reviews the most recent literature regarding the comparative efficacy of various surgical repair techniques in the treatment of advanced stage pelvic organ prolapse. Uterosacral ligament suspension has similar anatomic and subjective outcomes when compared to sacrospinous ligament fixation at 12 months and is considered to be equally effective. The use of transvaginal mesh has been shown to be superior to native tissue vaginal repairs with respect to anatomic outcomes but at the cost of a higher complication rate. Minimally invasive sacrocolpopexy appears to be equivalent to abdominal sacrocolpopexy (ASC). Robot-assisted sacrocolpopexy (RSC) and laparoscopic sacrocolpopexy (LSC) appear as effective as abdominal sacrocolpopexy, however, prospective studies of comparing long-term outcomes of ASC, LSC, and RSC in relation to health care costs is paramount in the near future. Surgical correction of advanced pelvic organ prolapse can be accomplished via a variety of proven techniques. Selection of the correct surgical approach is a complex decision process and involves a multitude of factors. When deciding on the most suitable surgical intervention, the chosen route must be individualized for each patient taking into account the specific risks and benefits of each procedure. PMID:26448444

  14. 14 CFR 431.33 - Safety organization.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 14 Aeronautics and Space 4 2010-01-01 2010-01-01 false Safety organization. 431.33 Section 431.33... TRANSPORTATION LICENSING LAUNCH AND REENTRY OF A REUSABLE LAUNCH VEHICLE (RLV) Safety Review and Approval for Launch and Reentry of a Reusable Launch Vehicle § 431.33 Safety organization. (a) An applicant...

  15. Guidelines for providing privileges and credentials to physicians for transvaginal placement of surgical mesh for pelvic organ prolapse.

    PubMed

    2012-01-01

    The adoption of new technology or procedures into a clinician's surgical armamentarium is driven by multiple factors. Patient safety and anticipated long-term improvement in outcomes should be the primary objective that guides a surgeon's decision to deliver care involving new procedures. Surgically complex procedures require a balance of knowledge, surgical skill, and experience, with appropriate ongoing surgical volume and monitoring of outcomes and adverse events. Transvaginal placement of surgical mesh for pelvic organ prolapse has the potential to improve quality of life and anatomic outcomes (especially in the anterior compartment), but also has potential serious adverse events as outlined by the FDA's July 2011 Safety Communication. This document provides Guidelines for privileging and credentialing of physicians planning to implement or continue using this new technology in clinical practice. PMID:22777366

  16. Surgical checklist application and its impact on patient safety in pediatric surgery

    PubMed Central

    Oak, SN; Dave, NM; Garasia, MB; Parelkar, SV

    2015-01-01

    Background: Surgical care is an essential component of health care of children worldwide. Incidences of congenital anomalies, trauma, cancers and acquired diseases continue to rise and along with that the impact of surgical intervention on public health system also increases. It then becomes essential that the surgical teams make the procedures safe and error proof. The World Health Organization (WHO) has instituted the surgical checklist as a global initiative to improve surgical safety. Aims: To assess the acceptance, application and adherence to the WHO Safe Surgery Checklist in Pediatric Surgery Practice at a university teaching hospital. Materials and Methods: In a prospective study, spanning 2 years, the checklist was implemented for all patients who underwent operative procedures under general anesthesia. The checklist identified three phases of an operation, each corresponding to a specific period in the normal flow of work: Before the induction of anesthesia (“sign in”), before the skin incision (“time out”) and before the patient leaves the operating room (“sign out”). In each phase, an anesthesiologist,-“checklist coordinator”, confirmed that the anesthesia, surgery and nursing teams have completed the listed tasks before proceeding with the operation and exit. The checklist was used for 3000 consecutive patients. Results: No major perioperative errors were noted. In 54 (1.8%) patients, children had the same names and identical surgical procedure posted on the same operation list. The patient identification tag was missing in four (0.1%) patients. Mention of the side of procedures was missing in 108 (3.6%) cases. In 0.1% (3) of patients there was mix up of the mention of side of operation in the case papers and consent forms. In 78 (2.6%) patients, the consent form was not signed by parents/guardians or the side of the procedure was not quoted. Antibiotic orders were missing in five (0.2%) patients. In 12 (0.4%) cases, immobilization of

  17. 76 FR 58812 - Patient Safety Organizations: Delisting for Cause of Patient Safety Organization One, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-22

    ... information regarding the quality and safety of health care delivery. The Patient Safety and Quality... organizations whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety......

  18. 14 CFR 431.33 - Safety organization.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... TRANSPORTATION LICENSING LAUNCH AND REENTRY OF A REUSABLE LAUNCH VEHICLE (RLV) Safety Review and Approval for Launch and Reentry of a Reusable Launch Vehicle § 431.33 Safety organization. (a) An applicant shall... organization, between the applicant and the launch site, and between the applicant and the reentry site,...

  19. 14 CFR 431.33 - Safety organization.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... TRANSPORTATION LICENSING LAUNCH AND REENTRY OF A REUSABLE LAUNCH VEHICLE (RLV) Safety Review and Approval for Launch and Reentry of a Reusable Launch Vehicle § 431.33 Safety organization. (a) An applicant shall... organization, between the applicant and the launch site, and between the applicant and the reentry site,...

  20. 14 CFR 431.33 - Safety organization.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... TRANSPORTATION LICENSING LAUNCH AND REENTRY OF A REUSABLE LAUNCH VEHICLE (RLV) Safety Review and Approval for Launch and Reentry of a Reusable Launch Vehicle § 431.33 Safety organization. (a) An applicant shall... organization, between the applicant and the launch site, and between the applicant and the reentry site,...

  1. Elastically deformable 3D organs for haptic surgical simulation.

    PubMed

    Webster, Roger; Haluck, Randy; Ravenscroft, Rob; Mohler, Betty; Crouthamel, Eric; Frack, Tyson; Terlecki, Steve; Sheaffer, Jeremy

    2002-01-01

    This paper describes a technique for incorporating real-time elastically deformable 3D organs in haptic surgical simulators. Our system is a physically based particle model utilizing a mass-springs-damper connectivity with an implicit predictor to speed up calculations during each time step. The solution involves repeated application of Newton's 2ndd Law of motion: F = ma using an implicit solver for numerically solving the differential equations. PMID:15458154

  2. Surgical innovation-enhanced quality and the processes that assure patient/provider safety: A surgical conundrum.

    PubMed

    Bruny, Jennifer; Ziegler, Moritz

    2015-12-01

    Innovation is a crucial part of surgical history that has led to enhancements in the quality of surgical care. This comprises both changes which are incremental and those which are frankly disruptive in nature. There are situations where innovation is absolutely required in order to achieve quality improvement or process improvement. Alternatively, there are innovations that do not necessarily arise from some need, but simply are a new idea that might be better. All change must assure a significant commitment to patient safety and beneficence. Innovation would ideally enhance patient care quality and disease outcomes, as well stimulate and facilitate further innovation. The tensions between innovative advancement and patient safety, risk and reward, and demonstrated effectiveness versus speculative added value have created a contemporary "surgical conundrum" that must be resolved by a delicate balance assuring optimal patient/provider outcomes. This article will explore this delicate balance and the rules that govern it. Recommendations are made to facilitate surgical innovation through clinical research. In addition, we propose options that investigators and institutions may use to address competing priorities. PMID:26653169

  3. 78 FR 59036 - Patient Safety Organizations: Voluntary Relinquishment From Cogent Patient Safety Organization, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-09-25

    ... regarding the quality and safety of health care delivery. The Patient Safety and Quality Improvement Final... organizations whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient......

  4. 76 FR 79192 - Patient Safety Organizations: Voluntary Relinquishment From HSMS Patient Safety Organization

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... conduct activities to improve patient safety and the quality of health care delivery. HHS issued the... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  5. 14 CFR 431.33 - Safety organization.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 14 Aeronautics and Space 4 2013-01-01 2013-01-01 false Safety organization. 431.33 Section 431.33 Aeronautics and Space COMMERCIAL SPACE TRANSPORTATION, FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION LICENSING LAUNCH AND REENTRY OF A REUSABLE LAUNCH VEHICLE (RLV) Safety Review and Approval for Launch and Reentry of a...

  6. Surgical safety checklists and understanding of Never Events, in UK and Irish dental hospitals.

    PubMed

    Pemberton, M N

    2016-06-10

    Aim To identify the procedures in dental hospitals where a surgical safety checklist is used and in addition, in England, to identify the understanding of hospitals regarding patient safety incidents requiring reporting as Never Events to NHS England.Method A self-completed questionnaire survey asking about the use of checklists was distributed to 16 dental hospitals associated with undergraduate dental schools in the UK and Ireland in the summer of 2015. For hospitals in England (10), additional questions regarding their understanding of incidents to be reported as Never Events were asked.Results Thirteen hospitals replied (8 in England). All use a surgical safety checklist in an operating theatre setting. Ten use a surgical safety checklist in an outpatient setting for the extraction of teeth. There is variable use of checklists for other procedures. The majority of English hospitals thought that the reporting of a 'Never Event' was required following wrong tooth extraction in whatever setting it occurred, including general dental practice.Conclusion Surgical safety checklists are increasingly used in dental hospitals, especially for oral surgery procedures. Beyond 'wrong tooth extraction', English dental hospitals have different understandings of what other oral and dental procedures require reporting as Never Events to NHS England. PMID:27283566

  7. 75 FR 75471 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act... organizations whose mission and primary activity is to conduct activities to improve patient safety and...

  8. Parental involvement in the preoperative surgical safety checklist is welcomed by both parents and staff.

    PubMed

    Corbally, Martin T; Tierney, Eamon

    2014-01-01

    We involved the parents of paediatric patients in the first part of the three-stage WHO Surgical Safety Checklist (SSC) process. Forty-two parents took part in the study. They came to the theatre suite with their child and into the induction room. Immediately before induction of anaesthesia they were present at, and took part in, the first stage of the three-stage SSC process, confirming with staff the identity of their child, the procedure to be performed, the operating site, and the consent being adequately obtained and recorded. We asked parents and theatre staff later whether they thought that parental involvement in the SSC was beneficial to patient safety. Both parents and staff welcomed parental involvement in the WHO Surgical Safety Checklist and felt that it improved patient safety. PMID:24834075

  9. Recommendations for surgical safety checklist use in Canadian children’s hospitals

    PubMed Central

    Skarsgard, Erik D.

    2016-01-01

    Background There is ample evidence that avoidable harm occurs in patients, including children, who undergo surgical procedures. Among a number of harm mitigation strategies, the use of surgical safety checklists (SSC) is now a required organizational practice for accreditation in all North American hospitals. Although much has been written about the effects of SSC on outcomes of adult surgical patients, there is a paucity of literature on the use and role of the SSC as an enabler of safe surgery for children. Methods The Pediatric Surgical Chiefs of Canada (PSCC) advocates on behalf of all Canadian children undergoing surgical procedures. We undertook a survey of the use of SSC in Canadian children’s hospitals to understand the variability of implementation of the SSC and understand its role as both a measure and driver of patient safety and to make specific recommendations (based on survey results and evidence) for standardized use of the SSC in Canadian children’s hospitals. Results Survey responses were received from all 15 children’s hospitals and demonstrated significant variability in how the checklist is executed, how compliance is measured and reported, and whether or not use of the checklist resulted in specific instances of error prevention over a 12-month observation period. There was near unanimous agreement that use of the SSC contributed positively to the safety culture of the operating room. Conclusion Based on the survey results, the PSCC have made 5 recommendations regarding the use of the SSC in Canadian children’s hospitals. PMID:27240284

  10. Thinking in three's: Changing surgical patient safety practices in the complex modern operating room

    PubMed Central

    Gibbs, Verna C

    2012-01-01

    The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won’t ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to

  11. Thinking in three's: changing surgical patient safety practices in the complex modern operating room.

    PubMed

    Gibbs, Verna C

    2012-12-14

    The three surgical patient safety events, wrong site surgery, retained surgical items (RSI) and surgical fires are rare occurrences and thus their effects on the complex modern operating room (OR) are difficult to study. The likelihood of occurrence and the magnitude of risk for each of these surgical safety events are undefined. Many providers may never have a personal experience with one of these events and training and education on these topics are sparse. These circumstances lead to faulty thinking that a provider won't ever have an event or if one does occur the provider will intuitively know what to do. Surgeons are not preoccupied with failure and tend to usually consider good outcomes, which leads them to ignore or diminish the importance of implementing and following simple safety practices. These circumstances contribute to the persistent low level occurrence of these three events and to the difficulty in generating sufficient interest to resource solutions. Individual facilities rarely have the time or talent to understand these events and develop lasting solutions. More often than not, even the most well meaning internal review results in a new line to a policy and some rigorous enforcement mandate. This approach routinely fails and is another reason why these problems are so persistent. Vigilance actions alone have been unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stakeholders to optimize the OR environment. This article discusses standardized processes of care for mitigation of injury or outright prevention of wrong site surgery, RSI and surgical fires in an action-oriented framework illustrating the strategic elements important in each event and focusing on the responsibilities for each of the three major OR agents-anesthesiologists, surgeons and nurses. A Surgical Patient Safety Checklist is discussed that incorporates the necessary elements to

  12. What Does a Hospital Survey on Patient Safety Reveal About Patient Safety Culture of Surgical Units Compared With That of Other Units?

    PubMed

    Shu, Qin; Cai, Miao; Tao, Hong-Bing; Cheng, Zhao-Hui; Chen, Jing; Hu, Yin-Huan; Li, Gang

    2015-07-01

    The objective of this study was to examine the strengths and weaknesses of surgical units as compared with other units, and to provide an opportunity to improve patient safety culture in surgical settings by suggesting targeted actions using Hospital Survey on Patient Safety Culture (HSOPSC) investigation.A Hospital Survey on Patient Safety questionnaire was conducted to physicians and nurses in a tertiary hospital in Shandong China. 12 patient safety culture dimensions and 2 outcome variables were measured.A total of 23.5% of respondents came from surgical units, and 76.5% worked in other units. The "overall perceptions of safety" (48.1% vs 40.4%, P < 0.001) and "frequency of events reported" (63.7% vs 60.7%, P = 0.001) of surgical units were higher than those of other units. However, the communication openness (38.7% vs 42.5%, P < 0.001) of surgical units was lower than in other units. Medical workers in surgical units reported more events than those in other units, and more respondents in the surgical units assess "patient safety grade" to be good/excellent. Three dimensions were considered as strengths, whereas 5 other dimensions were considered to be weaknesses in surgical units. Six dimensions have potential to aid in improving events reporting and patient safety grade. Appropriate working times will also contribute to ensuring patient safety. Medical staff with longer years of experience reported more events.Surgical units outperform the nonsurgical ones in overall perception of safety and the number of events reported but underperform in the openness of communication. Four strategies, namely deepening the understanding about patient safety of supervisors, narrowing the communication gap within and across clinical units, recruiting more workers, and employing the event reporting system and building a nonpunitive culture, are recommended to improve patient safety in surgical units in the context of 1 hospital. PMID:26166083

  13. 75 FR 57048 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-17

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Patient Safety of Chicagoland (CQPS) of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109-41, 42 U.S.C....

  14. Attitudes and beliefs about the surgical safety checklist: Just another tick box?

    PubMed Central

    Dharampal, Navjit; Cameron, Christopher; Dixon, Elijah; Ghali, William; Quan, May Lynn

    2016-01-01

    Background Following a landmark study showing decreased morbidity and mortality after implementation of the surgical safety checklist (SSC), it has been widely adopted into perioperative policy. We explored the impact of attitudes and beliefs surrounding the SSC on its uptake in Calgary. Methods We used qualitative methodology to examine factors influencing SSC use. We performed semistructured interviews based on Rogers’ theory of diffusion of innovation. Purposive and snowball sampling were used to identify surgeons, anesthesiologists and operating room nurses from hospitals in Calgary. Data collection and analysis were based on grounded theory. Two individuals jointly analyzed data and achieved consensus on emerging themes. Results Generated themes included 1) the SSC has brought organization to previous informal perioperative checks, 2) the SSC is most helpful when it is simple, and 3) the 3 current components of the checklist are redundant. The briefing was considered the most important aspect and the debriefing the least important. Initially the SSC was difficult to implement owing to a shift in time management and perioperative culture; however, it has now assimilated into perioperative routine. Finally, though most participants agreed that the SSC might avoid some delays and complications, only a few believe there have been observable improvements to morbidity and mortality. Conclusion Although the SSC has been integrated into perioperative practice in Calgary, participants believe that previous informal checkpoints were able to circumvent most perioperative issues. Although the SSC may help with flow and equipment, participants believe it fails to show a subjective, clinically important improvement. PMID:27454839

  15. 75 FR 57281 - Patient Safety Organizations: Voluntary delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-20

    ... safety of health care ] delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety... patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  16. 75 FR 63498 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-10-15

    ... safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety... patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  17. Surgical Mesh

    MedlinePlus

    ... Device Safety Safety Communications Surgical Mesh: FDA Safety Communication Share Tweet Linkedin Pin it More sharing options ... Prolapse and Stress Urinary Incontinence More in Safety Communications Information About Heparin Preventing Tubing and Luer Misconnections ...

  18. 75 FR 57477 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-21

    ... the quality and safety of health care delivery. The Patient Safety and Quality Improvement Final Rule... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  19. 75 FR 75472 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Group, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality... or component organizations whose mission and primary activity is to conduct activities to...

  20. 75 FR 75473 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Medical, Inc., of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality... or component organizations whose mission and primary activity is to conduct activities to...

  1. Effectiveness in professional organizations: the impact of surgeons and surgical staff organizations on the quality of care in hospitals.

    PubMed Central

    Flood, A B; Scott, W R; Ewy, W; Forrest, W H

    1982-01-01

    In this research, we examine the relative importance of different structural units in a professional organization, the hospital, as they affect organizational effectiveness. The difficulties of measuring effectiveness in a complex professional organization are discussed, and an adjusted measure of surgical outcome is developed. Data are drawn from a prospective study of over 8,000 surgical patients treated by more than 500 surgeons in 15 hospitals throughout the nation. Two different types of analyses are presented, both indicating that hospital features have more impact on surgical outcomes than do surgeon characteristics. The second analysis assesses the relative importance of specific attributes of the hospital, surgical staff organization, and surgeon characteristics on surgical outcomes. PMID:7152960

  2. 76 FR 60495 - Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary Relinquishment From the Patient Safety Group AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS... relinquishment from The Patient Safety Group of its status as a Patient Safety Organization (PSO). The...

  3. 78 FR 17212 - Patient Safety Organizations: Voluntary Relinquishment From Universal Safety Solution PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ... and primary activity is to conduct activities to improve patient safety and the quality of health care... safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  4. 78 FR 40146 - Patient Safety Organizations: Voluntary Relinquishment From Northern Metropolitan Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-03

    ... information regarding the quality and safety of health care delivery. The Patient Safety and Quality... patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  5. [Work strain by anaesthetic gas and surgical smoke due to tissue coagulation as well as safety measures in surgical operating rooms - what the surgeon needs to know].

    PubMed

    Boeckelmann, I; Sammito, S; Meyer, F

    2013-02-01

    Exposure of the respiratory tract during surgical interventions is an important topic of occupational medicine, which has only rarely been investigated. Based on a literature search, relevant information on the possible health risk is summarised. Within the operating room, an exposure of the respiratory tract to gas (volatile anaesthetics) and aerosols (smoking gas by coagulation) can occur. This exposure needs to be considered as a potential health risk if safety measures are not sufficient. Health risks comprise possible disturbances of gravidity and fertility, neurotoxicity and cancer generation. Such health risks can be prevented with primary preventive measures and can be early recognised/diagnosed by preventive investigations of occupational medicine (secondary prevention). Safety measures are developed according to the STOP principle (substitution, technical, organisatory and personal measures). Assessment of the potential danger begins with an appropriate description of the working procedure and detection of the toxic features of the drugs and medical products, which helps to determine individual exposure and to estimate risk potential. Required occupational safety measures can be derived from this and, subsequently, the work organisation can be optimised. In addition, employees in the operating room are to be instructed about the indicated preventive mode of behaviour. Due to better implementation of the above-mentioned basic principles, introduction of novel narcotics and technological developments, potential exposure of the respiratory tract within the operating room has been reduced over the last 10 years. Thus, risks for gravidity and possible disturbances of fertility by exposure to volatile narcotics are currently assessed to be low. However, available data on health risks of the chronic exposure to smoking gases are still deficient although toxic and cancerogenic organic pyrolysis products are generated. The protection effect of modern air

  6. Organic Tanks Safety Program: Waste aging studies

    SciTech Connect

    Camaioni, D.M.; Samuels, W.D.; Lenihan, B.D.; Clauss, S.A.; Wahl, K.L.; Campbell, J.A.

    1994-11-01

    The underground storage tanks at the Hanford Complex contain wastes generated from many years of plutonium production and recovery processes, and mixed wastes from radiological degradation processes. The chemical changes of the organic materials used in the extraction processes have a direct on several specific safety issues, including potential energy releases from these tanks. This report details the first year`s findings of a study charged with determining how thermal and radiological processes may change the composition of organic compounds disposed to the tank. Their approach relies on literature precedent, experiments with simulated waste, and studies of model reactions. During the past year, efforts have focused on the global reaction kinetics of a simulated waste exposed to {gamma} radiation, the reactions of organic radicals with nitrite ion, and the decomposition reactions of nitro compounds. In experiments with an organic tank non-radioactive simulant, the authors found that gas production is predominantly radiolytically induced. Concurrent with gas generation they observe the disappearance of EDTA, TBP, DBP and hexone. In the absence of radiolysis, the TBP readily saponifies in the basic medium, but decomposition of the other compounds required radiolysis. Key organic intermediates in the model are C-N bonded compounds such as oximes. As discussed in the report, oximes and nitro compounds decompose in strong base to yield aldehydes, ketones and carboxylic acids (from nitriles). Certain aldehydes can react in the absence of radiolysis to form H{sub 2}. Thus, if the pathways are correct, then organic compounds reacting via these pathways are oxidizing to lower energy content. 75 refs.

  7. Simulation Training Improves Surgical Proficiency and Safety During Diagnostic Shoulder Arthroscopy Performed by Residents.

    PubMed

    Waterman, Brian R; Martin, Kevin D; Cameron, Kenneth L; Owens, Brett D; Belmont, Philip J

    2016-05-01

    Although virtual reality simulators have established construct validity, no studies have proven transfer of skills from a simulator to improved in vivo surgical skill. The current authors hypothesized that simulation training would improve residents' basic arthroscopic performance and safety. Twenty-two orthopedic surgery trainees were randomized into simulation or standard practice groups. At baseline testing, all of the participants performed simulator-based testing and a supervised, in vivo diagnostic shoulder arthroscopy with video recording. The simulation group subsequently received 1 hour of total instruction during a 3-month period, and the standard practice group received no simulator training. After intervention, both groups were reevaluated with simulator testing and a second recorded diagnostic shoulder arthroscopy. Two blinded, independent experts evaluated arthroscopic performance using the anatomic checklist, Arthroscopic Surgery Skill Evaluation Tool (ASSET) score, and total elapsed time. All outcome measures were compared within and between groups. After intervention, mean time required by the simulation group to complete the simulator task (30.64 seconds) was 8±1.2 seconds faster than the time required by the control group (38.64 seconds; P=.001). Probe distance (51.65 mm) was improved by 41.2±6.08 mm compared with the control (92.83 mm; P=.001). When comparing ASSET safety scores, the simulation group was competent (3.29) and significantly better than the control group (3.00; P=.005) during final arthroscopic testing. This study establishes transfer validity for an arthroscopic shoulder simulator model. Simulator training for residents in training can decrease surgical times, improve basic surgical skills, and confer greater patient safety during shoulder arthroscopy. [Orthopedics. 2016; 39(3):e479-e485.]. PMID:27135460

  8. A Targeted E-Learning Program for Surgical Trainees to Enhance Patient Safety in Preventing Surgical Infection

    ERIC Educational Resources Information Center

    McHugh, Seamus Mark; Corrigan, Mark; Dimitrov, Borislav; Cowman, Seamus; Tierney, Sean; Humphreys, Hilary; Hill, Arnold

    2010-01-01

    Introduction: Surgical site infection accounts for 20% of all health care-associated infections (HCAIs); however, a program incorporating the education of surgeons has yet to be established across the specialty. Methods: An audit of surgical practice in infection prevention was carried out in Beaumont Hospital from July to November 2009. An…

  9. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Child Health Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... conduct activities to improve patient safety and the quality of health care delivery. HHS issued the... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  10. 76 FR 9351 - Patient Safety Organizations: Voluntary Delisting From West Virginia Center for Patient Safety

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-17

    ... information regarding the quality and safety of health care delivery. The Patient Safety and Quality... is to conduct activities to improve patient safety and the quality of health care delivery. HHS... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  11. 76 FR 71345 - Patient Safety Organizations: Voluntary Relinquishment From Emergency Medicine Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... conduct activities to improve patient safety and the quality of health care delivery. HHS issued the... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  12. 76 FR 7853 - Patient Safety Organizations: Voluntary Delisting From Oregon Patient Safety Commission

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... organizations whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety Act..., and analyze confidential information regarding the quality and safety of health care delivery....

  13. 75 FR 75472 - Patient Safety Organizations: Voluntary Delisting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-12-03

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Group (A Component of Helmet Fire, Inc. of its status as a Patient Safety Organization (PSO). The... the listing of PSOs, which are entities or component organizations whose mission and primary...

  14. Diffusion of Surgical Innovations, Patient Safety, and Minimally Invasive Radical Prostatectomy

    PubMed Central

    Parsons, J. Kellogg; Messer, Karen; Palazzi, Kerrin; Stroup, Sean; Chang, David

    2015-01-01

    IMPORTANCE Surgical innovations disseminate in the absence of coordinated systems to ensure their safe integration into clinical practice, potentially exposing patients to increased risk for medical error. OBJECTIVE To investigate associations of patient safety with the diffusion of minimally invasive radical prostatectomy (MIRP) resulting from the development of the da Vinci robot. DESIGN, SETTING, AND PARTICIPANTS A cohort study of 401 325 patients in the Nationwide Inpatient Sample who underwent radical prostatectomy during MIRP diffusion between January 1, 2003, and December 31, 2009. MAIN OUTCOMES AND MEASURES We used Agency for Healthcare Research and Quality Patient Safety Indicators (PSIs), which measure processes of care and surgical provider performance. We estimated the prevalence of MIRP among all prostatectomies and compared PSI incidence between MIRP and open radical prostatectomy in each year during the study. We also collected estimates of MIRP incidence attributed to the manufacturer of the da Vinci robot. RESULTS Patients who underwent MIRP were more likely to be white (P = .004), have fewer comorbidities (P = .02), and have undergone surgery in higher-income areas (P = .005). The incidence of MIRP was substantially lower than da Vinci manufacturer estimates. Rapid diffusion onset occurred in 2006, when MIRP accounted for 10.4% (95% CI, 10.2-10.7) of all radical prostatectomies in the United States. In 2005, MIRP was associated with an increased adjusted risk for any PSI (adjusted odds ratio, 2.0; 95% CI, 1.1-3.7; P = .02) vs open radical prostatectomy. Stratification by hospital status demonstrated similar patterns: rapid diffusion onset among teaching hospitals occurred in 2006 (11.7%; 95% CI, 11.3-12.0), with an increased risk for PSI for MIRP in 2005 (adjusted odds ratio, 2.7; 95% CI, 1.4-5.3; P = .004), and onset among nonteaching hospitals occurred in 2008 (27.1%; 95% CI, 26.6-27.7), with an increased but nonsignificant risk for PSI in 2007

  15. Women as leaders in organized surgery and surgical education. Has the time come?

    PubMed

    Jonasson, O

    1993-06-01

    Women have entered medicine in large numbers during the past three decades, and are increasing their representation in some surgical fields at a rapid pace. Few women are found in senior roles in organized surgery or at the senior ranks of academic surgical faculty. Factors influencing this imbalance include family demands, sexism, and stereotypes that hinder the advancement of women into leadership roles. Strategies for correcting this imbalance include affirmative recruitment of women into surgery, particularly into academic surgical faculties; support systems, such as child care and adjustment of promotion and tenure timetables; mentoring; and programs of career development that emphasize skills in management as well as research and teaching. PMID:8503762

  16. [Clinical governance and continuous quality improvement in surgical organizations].

    PubMed

    Finocchiaro, G; Paparo, D; Gitto, G; Caruso, R; Parisi, A

    2009-01-01

    Recently the awareness had progressively strengthened that the main interest of health care organizations is effectiveness and appropriateness of clinical performance. They have a statutory duty to seek quality improvement through clinical governance. All health care operators are involved in clinical governance implementation, in respect of their organizational positions toward continuous quality improvement. In this way health care organizations, professionals and patients will benefit of outcomes of the change. PMID:19272236

  17. A preliminary study of patients' perceptions on the implementation of the WHO surgical safety checklist in women who had Cesarean sections.

    PubMed

    Kawano, Takashi; Tani, Megumi; Taniwaki, Miki; Ogata, Kimiyo; Yokoyama, Masataka

    2015-06-01

    The surgical safety checklist (SSCL), developed by the World Health Organization, is widely implemented by surgical staff for the improvement of their communication, teamwork, and safety culture in the operating room. However, there is no research available addressing the question of how surgical patients perceive the implementation of the SSCL. In order to address this issue, a questionnaire-based preliminary study was conducted for patients who had undergone elective Cesarean section under awake regional anesthesia. Although most participants had not been informed about the implementation of the SSCL before surgery, all of the patients were aware that the SSCL had been performed in the operating room. Over 80% of patients answered that the implementation of the SSCL could help to reduce their feelings of anxiety, tension, and fear, as well as enhance their feeling of security. Furthermore, most patients answered that they were able to understand the components as well as the purpose of the SSCL, and considered that the SSCL should be implemented. These results suggest that awake patients undergoing Cesarean section perceive the implementation of the SSCL to be a highly positive aspect of their surgical care. PMID:25374137

  18. Safety in Numbers: Progressive Implementation of a Robotics Program in an Academic Surgical Oncology Practice.

    PubMed

    King, Jonathan C; Zeh, Herbert J; Zureikat, Amer H; Celebrezze, James; Holtzman, Matthew P; Stang, Michael L; Tsung, Allan; Bartlett, David L; Hogg, Melissa E

    2016-08-01

    Background Robotic-assisted surgery has potential benefits over laparoscopy yet little has been published on the integration of this platform into complex surgical oncology. We describe the outcomes associated with integration of robotics into a large surgical oncology program, focusing on metrics of safety and efficiency. Methods A retrospective review of a prospectively maintained database of robotic procedures from July 2009 to October 2014 identifying trends in volume, operative time, complications, conversion to open, and 90-day mortality. Results Fourteen surgeons performed 1236 cases during the study period: thyroid (246), pancreas/duodenum (458), liver (157), stomach (56), colorectal (129), adrenal (38), cholecystectomy (102), and other (48). There were 38 conversions to open (3.1%), 230 complications (18.6%), and 13 mortalities (1.1%). From 2009 to 2014, operative volume increased (7 cases/month vs 24 cases/month; P < .001) and procedure time decreased (471 ± 166 vs 211 ± 140 minutes; P < .001) with statistically significant decreases for all years except 2014 when volume and time plateaued. Conversion to open decreased (12.1% vs 1.7%; P = .009) and complications decreased (48.5% vs 12.3%; P < .001) despite increasing complexity of cases performed. There were 13 deaths within 90 days (5/13 30-day mortality) and 2 (15.4%) were from palliative surgeries. Conclusions Implementation of a diverse robotic surgical oncology program utilizing multiple surgeons is safe and feasible. As operative volume increased, operative time, complications, and conversions to open decreased and plateaued at approximately 3 years. No unanticipated adverse events attributable to the introduction of this platform were observed. PMID:27130645

  19. 77 FR 11120 - Patient Safety Organizations: Voluntary Relinquishment From UAB Health System Patient Safety...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-24

    ... analyze confidential information regarding the quality and safety of health care delivery. The Patient... mission and primary activity is to conduct activities to improve patient safety and the quality of health... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  20. System Safety in an IT Service Organization

    NASA Astrophysics Data System (ADS)

    Parsons, Mike; Scutt, Simon

    Within Logica UK, over 30 IT service projects are considered safetyrelated. These include operational IT services for airports, railway infrastructure asset management, nationwide radiation monitoring and hospital medical records services. A recent internal audit examined the processes and documents used to manage system safety on these services and made a series of recommendations for improvement. This paper looks at the changes and the challenges to introducing them, especially where the service is provided by multiple units supporting both safety and non-safety related services from multiple locations around the world. The recommendations include improvements to service agreements, improved process definitions, routine safety assessment of changes, enhanced call logging, improved staff competency and training, and increased safety awareness. Progress is reported as of today, together with a road map for implementation of the improvements to the service safety management system. A proposal for service assurance levels (SALs) is discussed as a way forward to cover the wide variety of services and associated safety risks.

  1. Improving patient safety in cardiothoracic surgery: an audit of surgical handover in a tertiary center

    PubMed Central

    Bauer, Natasha Johan

    2016-01-01

    Background Novel research has revealed that the relative risk of death increased by 10% and 15% for admissions on a Saturday and Sunday, respectively. With an imminent threat of 7-day services in the National Health Service, including weekend operating lists, handover plays a pivotal role in ensuring patient safety is paramount. This audit evaluated the quality, efficiency, and safety of surgical handover of pre- and postoperative cardiothoracic patients in a tertiary center against guidance on Safe Handover published by the Royal College of Surgeons of England and the British Medical Association. Methods A 16-item questionnaire prospectively audited the nature, time and duration of handover, patient details, operative history and current clinical status, interruptions during handover, and difficulties cross-covering specialties over a month. Results Just over half (52%) of the time, no handover took place. The majority of handovers (64%) occurred over the phone; two-thirds of these were uninterrupted. All handovers were less than 10 minutes in duration. About half of the time, the senior house officer had previously met the registrar involved in the handover, but the overwhelming majority felt it would facilitate the handover process if they had prior contact. Patient details handed over 100% of the time included name, ward, and current clinical diagnosis. A third of the time, the patient’s age, responsible consultant, and recent operations or procedures were not handed over, potentially compromising future management due to delays and lack of relevant information. Perhaps the most revealing result was that the overall safety of handover was perceived to be five out of ten, with ten being very safe with no aspects felt to impact negatively on optimal patient care. Conclusion These findings were presented to the department, and a handover proforma was implemented. Recommendations included the need for a new face-to-face handover. A reaudit will evaluate the

  2. GSFC Safety and Mission Assurance Organization

    NASA Technical Reports Server (NTRS)

    Kelly, Michael P.

    2010-01-01

    This viewgraph presentation reviews NASA Goddard Space Flight Center's approach to safety and mission assurance. The contents include: 1) NASA GSFC Background; 2) Safety and Mission Assurance Directorate; 3) The Role of SMA-D and the Technical Authority; 4) GSFC Mission assurance Requirements; 5) GSFC Systems Review Office (SRO); 6) GSFC Supply Chain Management Program; and 7) GSFC ISO9001/AS9100 Status Brief.

  3. Mathematical simulation of an urgent surgical pathology of abdominal cavity organs

    NASA Astrophysics Data System (ADS)

    Shorokh, G. P.; Savel'Ev, V. A.; Lobachenko, M. B.; Lobachenko, N. I.

    1996-05-01

    We developed a technology of creating computer models of acute surgical diseases of abdominal cavity organs on the basis of the pattern recognition theory and multifactor analysis of traditional symptomatology. We employed an algorithm consisting of the method of evaluating vectors and method of patterns that rests on special rules of extended production for solving medicinal problems.

  4. Using patient safety organizations to further clinical integration.

    PubMed

    Gosfield, Alice G

    2014-01-01

    This article addresses why in the current context of driving toward improved value, physician groups ought to consider developing a patient safety evaluation system and reporting to a patient safety organization. The fundamental challenge to physicians to succeed in the future is to clinically integrate within their own practices, standardizing to the evidence base, and measuring their performance. In addition, it is increasingly clear that the physician office practice is a source of patient safety issues. The Patient Safety and Quality Improvement Act provides two powerful protections for data that will support and bolster clinical integration and patient safety. The protections and how to deploy them are presented. PMID:24873122

  5. Clinical Characteristics and Surgical Safety in Patients with Acute Appendicitis Aged over 80

    PubMed Central

    Moon, Kwon Sang; Jung, Yong Hwan; Lee, Eun Hun

    2012-01-01

    Purpose The aim of this study was to evaluate the clinical characteristics and treatment outcomes, including surgical safety, in patients over 80 years of age who underwent an appendectomy. Methods This study involved 160 elderly patients who underwent an appendectomy for acute appendicitis: 28 patients over 80 years old and 132 patients between 65 and 79 years old. Results The rate of positive rebound tenderness was significantly higher in the over 80 group (P = 0.002). Comparisons of comorbidity, diagnostic tool and delay in surgical treatment between the two groups were not statistically different. American Society of Anesthesiologists score was significantly higher in the over 80 group than in the 65 to 79 group (2.4 ± 0.5 vs. 1.6 ± 0.5; P < 0.00005). Comparisons of operative times and use of drainage between the two groups were not statistically different. In the pathologic findings, periappendiceal abscess was more frequent in the over 80 group (P = 0.011). No significant differences existed between the two groups when comparing the results of gas out and the time to liquid diet, but the postoperative hospital stay was significantly longer in the over 80 group (P = 0.001). Among the postoperative complications, pulmonary complication was significantly higher in the over 80 group (P = 0.005). However, operative mortality was zero in each group. Conclusion In case of suspicious appendicitis in elderly patients, efforts should be made to use aggressive diagnostic intervention, do appropriate surgery and prevent pulmonary complications especially in patients over 80 years of age. PMID:22606649

  6. Automating Safety for a More Efficient Organization

    ERIC Educational Resources Information Center

    Folkman, John; Strasburger, Tom

    2009-01-01

    Despite the challenges of understaffing, unfunded legislative mandates, and tight budgets, district support services departments are still expected to meet school systems' myriad noncurriculum-related needs. But the very nature of these services, even when they are focused on school safety and security, is so diverse and labor-intensive that…

  7. Surgical briefings, checklists, and the creation of an environment of safety in the neurosurgical intraoperative magnetic resonance imaging suite.

    PubMed

    Rahmathulla, Gazanfar; Recinos, Pablo F; Traul, David E; Avitsian, Rafi; Yunak, Marisa; Harper, Nicole T; Barnett, Gene H; Recinos, Violette Renard

    2012-11-01

    Technological advances have made it possible to seamlessly integrate modern neuroimaging into the neurosurgical operative environment. This integration has introduced many new applications improving surgical treatments. One major addition to the neurosurgical armamentarium is intraoperative navigation and MRI, enabling real-time use during surgery. In the 1970s, the American College of Radiology issued safety guidelines for diagnostic MRI facilities. Until now, however, no such guidelines existed for the MRI-integrated operating room, which is a high-risk zone requiring standardized protocols to ensure the safety of both the patient and the operating room staff. The forces associated with the strong 1.5- and 3.0-T magnets used for MRI are potent and hazardous, creating distinct concerns regarding safety, infection control, and image interpretation. Authors of this paper provide an overview of the intraoperative MRI operating room, safety considerations, and a series of checklists and protocols for maintaining safety in this zero tolerance environment. PMID:23116092

  8. Safety culture in the nuclear versus non-nuclear organization

    SciTech Connect

    Haber, S.B.; Shurberg, D.A.

    1996-10-01

    The importance of safety culture in the safe and reliable operation of nuclear organizations is not a new concept. The greatest barriers to this area of research are twofold: (1) the definition and criteria of safety culture for a nuclear organization and (2) the measurement of those attributes in an objective and systematic fashion. This paper will discuss a proposed resolution of those barriers as demonstrated by the collection of data across nuclear and non-nuclear facilities over a two year period.

  9. Safety zone for surgical access in the middle third of the clavicle: study on cadavers☆

    PubMed Central

    Ribeiro, Fabiano Rebouças; de Marchi Bosi Porto, Fernanda; Silva, Marcio Vieira Sanches; Tenor Junior, Antonio Carlos; da Costa, Miguel Pereira; Filardi, Cantidio

    2015-01-01

    Objective The aim of this study was to establish a neurovascular safety zone for surgical access in the middle third of the clavicle, by means of dissection on cadavers. Methods Twenty shoulders were dissected in 10 cadavers, with deep dissection of the middle third of the clavicle. The following structures were identified: subclavian vein, upper trunk of the brachial plexus (anterior and posterior divisions) and suprascapular nerve. These structures were marked out in order to measure their distances from the most proximal point of the middle third of the clavicle. Results The mean distances from the middle third of the clavicle to the suprascapular nerve, subclavian vein, upper trunk, anterior division of the upper trunk and posterior division of the upper trunk were respectively, for the right side: 15.92 cm, 10.77 cm, 23.68 cm, 14.60 cm and 15.42 cm; and for the left side: 12.69 cm; 9.82 cm; 22.19 cm; 12.16 cm and 13.46 cm. Conclusion There was a statistical difference in the distances to the suprascapular nerve and anterior division of the upper trunk, in comparing between the right and left sides. The closest neurovascular structures to the middle third of the clavicle were the suprascapular nerve and subclavian vein. PMID:26229929

  10. Development of a surgical site infection (SSI) surveillance system, calculation of SSI rates and specification of important factors affecting SSI in a digestive organ surgical department.

    PubMed

    Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji

    2007-06-01

    We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures. PMID:17760267

  11. Safety assessment and detection methods of genetically modified organisms.

    PubMed

    Xu, Rong; Zheng, Zhe; Jiao, Guanglian

    2014-01-01

    Genetically modified organisms (GMOs), are gaining importance in agriculture as well as the production of food and feed. Along with the development of GMOs, health and food safety concerns have been raised. These concerns for these new GMOs make it necessary to set up strict system on food safety assessment of GMOs. The food safety assessment of GMOs, current development status of safety and precise transgenic technologies and GMOs detection have been discussed in this review. The recent patents about GMOs and their detection methods are also reviewed. This review can provide elementary introduction on how to assess and detect GMOs. PMID:25342147

  12. When Operating on Dead People Saves Lives: Benefits of Surgical Organ Donor Intensivists.

    PubMed

    Long, Kristin; Talley, Cynthia; Yarrison, Rebecca B; Bernard, Andrew

    2015-01-01

    Solid organ transplantation has emerged as a life-saving treatment for many patients suffering from end-stage organ failure. Organs have been successfully recovered after a variety of aggressive interventions. We propose that decompressive laparotomy, when clinically indicated, should be considered in the aggressive resuscitation of potential organ donors. A thorough literature review examining aggressive interventions on potential organ donors was conducted after experience with a unique case at this institution. Articles were reviewed for the types of interventions performed as well as the time frame in relation to organ donation. In our case, several ethical issues were raised when considering decompressive laparotomy in a patient pronounced dead by neurologic criteria. We propose that having a surgical intensivist involved in the management of potential donors will further increase the salvage rate, as more invasive resuscitation options are possible. PMID:26078909

  13. Infective Endocarditis: Diagnosis, Treatment, and Mortality, as Related to Surgical Timing and Infectious Organism

    PubMed Central

    Attum, Abdulla A.; Masri, Zahi; Yared, Sam F.; Johnson, G. Stephan; Girardet, Roland; Lansing, Allan M.

    1987-01-01

    To evaluate the timing of surgical treatment in infective endocarditis and to determine the relationship between the risk of mortality and the species of infectious organism, we reviewed a consecutive series of 65 cases involving patients with infective endocarditis who had been treated over a 17-year period. The patients included 41 males and 24 females, who ranged in age from 6 to 85 years (mean, 39.3 years). Forty-five had native valve endocarditis, 14 had prosthetic valve endocarditis, and six had endocarditis associated with congenital heart defects. Fifty-two patients underwent valve replacement, which was associated with an overall operative mortality of 19%. Those who underwent valve replacement during the early active stage (first 3 weeks) of infection had a higher mortality rate than those who had surgery either during the late active stage (second 3 weeks) of infection or after 6 weeks of antibiotic therapy. S. aureus and Pseudomonas organisms were responsible for the most deaths. On the basis of this study, we recommend that, when cardiovascular function permits, patients who are hemodynamically stable and free of emboli should receive 4 to 6 weeks of antibiotic therapy before undergoing surgical treatment. In contrast, patients with high-risk organisms are more likely to survive if subjected to early surgical intervention. (Texas Heart Institute Journal 1987; 14:401-410) Images PMID:15227297

  14. Implementation of a Surgical Safety Checklist: Interventions to Optimize the Process and Hints to Increase Compliance

    PubMed Central

    Sendlhofer, Gerald; Mosbacher, Nina; Karina, Leitgeb; Kober, Brigitte; Jantscher, Lydia; Berghold, Andrea; Pregartner, Gudrun; Brunner, Gernot; Kamolz, Lars Peter

    2015-01-01

    Background A surgical safety checklist (SSC) was implemented and routinely evaluated within our hospital. The purpose of this study was to analyze compliance, knowledge of and satisfaction with the SSC to determine further improvements. Methods The implementation of the SSC was observed in a pilot unit. After roll-out into each operating theater, compliance with the SSC was routinely measured. To assess subjective and objective knowledge, as well as satisfaction with the SSC implementation, an online survey (N = 891) was performed. Results During two test runs in a piloting unit, 305 operations were observed, 175 in test run 1 and 130 in test run 2. The SSC was used in 77.1% of all operations in test run 1 and in 99.2% in test run 2. Within used SSCs, completion rates were 36.3% in test run 1 and 1.6% in test run 2. After roll-out, three unannounced audits took place and showed that the SSC was used in 95.3%, 91.9% and 89.9%. Within used SSCs, completion rates decreased from 81.7% to 60.6% and 53.2%. In 2014, 164 (18.4%) operating team members responded to the online survey, 160 of which were included in the analysis. 146 (91.3%) consultants and nursing staff reported to use the SSC regularly in daily routine. Conclusion These data show that the implementation of new tools such as the adapted WHO SSC needs constant supervision and instruction until it becomes self-evident and accepted. Further efforts, consisting mainly of hands-on leadership and training are necessary. PMID:25658317

  15. [Report of a tour of the surgical centers in the United States organized by the Japanese Association for Operative Medicine].

    PubMed

    Mizutani, Koh; Nagase, Kiyoshi; Shinomiya, Satoshi; Orita, Mutsuko

    2011-11-01

    We, 4 authors, visited 4 surgical centers in the United States last year on a tour sponsored by the Japanese Association for Operative Medicine. The surgical center of each hospital we visited aimed to contribute to the hospital not only in terms of financial strength but also in the creation of a unique hospital brand value by increasing the number of surgeries compared with previous years as much as possible. The role of surgical centers in the United States was comparable with what we consider an ideal center in Japan. We also found that management of the surgical centers by directors who are specialized anesthesiologists is well organized to promote efficiency with respect to organization, utilities and human resources, and realized that these anesthesiologists must know how to manage the team members and the organization of the surgical centers to improve the quality of operative medicine. PMID:22175177

  16. Product Safety, It's No Accident. A Consumer Product Safety Monthly Planning Guide for Community Organizations.

    ERIC Educational Resources Information Center

    Consumer Product Safety Commission, Washington, DC.

    A consumer product safety monthly planning guide for community organizations is provided. The material is organized into suggested monthly topics with seasonal emphasis. Each section highlights selected information about how to identify potential hazards associated with categories of products. Each section also includes recommendaitons of ways to…

  17. Characterization strategy report for the organic safety issues

    SciTech Connect

    Goheen, S.C.; Campbell, J.A.; Fryxell, G.E.

    1997-08-01

    This report describes a logical approach to resolving potential safety issues resulting from the presence of organic components in hanford tank wastes. The approach uses a structured logic diagram (SLD) to provide a pathway for quantifying organic safety issue risk. The scope of the report is limited to selected organics (i.e., solvents and complexants) that were added to the tanks and their degradation products. The greatest concern is the potential exothermic reactions that can occur between these components and oxidants, such as sodium nitrate, that are present in the waste tanks. The organic safety issue is described in a conceptual model that depicts key modes of failure-event reaction processes in tank systems and phase domains (domains are regions of the tank that have similar contents) that are depicted with the SLD. Applying this approach to quantify risk requires knowing the composition and distribution of the organic and inorganic components to determine (1) how much energy the waste would release in the various domains, (2) the toxicity of the region associated with a disruptive event, and (3) the probability of an initiating reaction. Five different characterization options are described, each providing a different level of quality in calculating the risks involved with organic safety issues. Recommendations include processing existing data through the SLD to estimate risk, developing models needed to link more complex characterization information for the purpose of estimating risk, and examining correlations between the characterization approaches for optimizing information quality while minimizing cost in estimating risk.

  18. The use of report cards and outcome measurements to improve the safety of surgical care: the American College of Surgeons National Surgical Quality Improvement Program

    PubMed Central

    Maggard-Gibbons, Melinda

    2014-01-01

    Postoperative adverse events occur all too commonly and contribute greatly to our large and increasing healthcare costs. Surgeons, as well as hospitals, need to know their own outcomes in order to recognise areas that need improvement before they can work towards reducing complications. In the USA, the American College of Surgeons National Surgical Quality Improvement Project (ACS NSQIP) collects clinical data that provide benchmarks for providers and hospitals. This review summarises the history of ACS NSQIP and its components, and describes the evidence that feeding outcomes back to providers, along with real-time comparisons with other hospital rates, leads to quality improvement, better patient outcomes, cost savings and overall improved patient safety. The potential harms and limitations of the program are discussed. PMID:24748371

  19. Safety and Efficacy of Laparoscopic Access in a Surgical Training Program.

    PubMed

    Johnson, Timothy G; Hooks, William B; Adams, Ashley; Hope, William W

    2016-02-01

    Our study evaluated outcomes of laparoscopic access in a surgical residency program and identified variables associated with adverse outcomes. Following IRB approval, we reviewed prospectively collected data from consecutive laparoscopic surgeries from a single surgeon August 2008 to November 2011. Descriptive statistics were generated, and successful and unsuccessful access techniques were compared using the t test, Fisher exact test, and χ test of independence, with P<0.05 considered significant. Five hundred consecutive laparoscopic surgeries were evaluated; the average patient age was 47 years and 55% of patients were female. The most common procedures included laparoscopic cholecystectomy (29%), laparoscopic ventral hernia (15%), laparoscopic appendectomy (12%), laparoscopic colon/small bowel (11%), and laparoscopic inguinal hernia (10%). Successful laparoscopic access was obtained in 98% of patients. The most common access techniques were umbilical stalk technique (57%) and Veress followed by optical trocar technique (29%). The complication rate was 7% and included multiple access attempts in 3.4%, attending physician having to take over access in 1.6%, bleeding/solid organ injury in 0.8%, insufflating peritoneum in 0.6%, and bowel injury in 0.2%. There was a significant relationship between entry technique and failure rate. Open cutdown away from umbilicus had a higher failure rate than other techniques (P=0.0002). There was also a significant relationship between type of surgery and failure rate of technique, with laparoscopic ventral hernia and laparoscopic small bowel cases having the highest failure rate (P=0.005). We observed no difference in success rate based on age, sex, race, previous surgery, and resident training level (P>0.05). Laparoscopic access using appropriate techniques can be safely performed in a residency training program. Laparoscopic ventral hernia and small bowel procedures for obstruction can be difficult cases to obtain access, and

  20. Procedure-specific Surgical Site Infection Incidence Varies Widely within Certain National Healthcare Safety Network Surgery Groups

    PubMed Central

    Saeed, Mohammed J; Dubberke, Erik R; Fraser, Victoria J; Olsen, Margaret A

    2015-01-01

    Background The National Healthcare Safety Network (NHSN) classifies surgical procedures into 40 categories. The objective of this study was to determine surgical site infection (SSI) incidence for clinically defined subgroups within 5 heterogeneous NHSN surgery categories. Methods This is a retrospective cohort study using the longitudinal State Inpatient Database. We identified 5 groups of surgical procedures (amputation; biliary, liver and pancreas [BILI]; breast; colon and hernia) using ICD-9-CM procedure codes in community hospitals in California, Florida and New York from January 2009 through September 2011 in persons aged ≥18 years. Each of these 5 categories was classified to more specific surgical procedures within the group. 90-day SSI rates were calculated using ICD-9-CM diagnosis codes. Results There were 62,901 amputation, 33,358 BILI, 72,058 breast, 125,689 colon and 85,745 hernia surgeries in 349,298 people. 90-day SSI rates varied significantly within each of the 5 subgroups. Within the BILI category, bile duct, pancreas and laparoscopic liver procedures had SSI rates of 7.2%, 17.2%, and 2.2%, respectively (p<0.0001 for each) compared to open liver procedures (11.1% SSI). Conclusion 90-day SSI rates varied widely within certain NHSN categories. Risk adjustment for specific surgery type is needed in order to make valid comparisons between hospitals. PMID:25818024

  1. Safety and Tumor-specificity of Cetuximab-IRDye800 for Surgical Navigation in Head and Neck Cancer

    PubMed Central

    Rosenthal, Eben L; Warram, Jason M; de Boer, Esther; Chung, Thomas K; Korb, Melissa L; Brandwein-Gensler, Margie; Strong, Theresa V; Schmalbach, Cecelia E; Morlandt, Anthony B; Agarwal, Garima; Hartman, Yolanda E; Carroll, William R; Richman, Joshua S; Clemons, Lisa K; Nabell, Lisle M; Zinn, Kurt R

    2016-01-01

    Purpose Positive margins dominate clinical outcomes after surgical resections in most solid cancer types including head and neck squamous cell carcinoma. Unfortunately, surgeons remove cancer in the same manner they have for a century with complete dependence on subjective tissue changes to identify cancer in the operating room. To effect change, we hypothesize that epidermal growth factor receptor (EGFR) can be targeted for safe and specific real-time localization of cancer. Experimental design A dose escalation study of cetuximab conjugated to IRDye800 was performed in patients (n=12) undergoing surgical resection of squamous cell carcinoma arising in the head and neck. Safety and pharmacokinetic data were obtained out to 30 days post-infusion. Multi-instrument fluorescence imaging was performed in the operating room and in surgical pathology. Results There were no grade 2 or higher adverse events attributable to cetuximab-IRDye800. Fluorescence imaging with an intraoperative, wide-field device successfully differentiated tumor from normal tissue during resection with an average tumor-to-background ratio of 5.2 in the highest dose range. Optical imaging identified opportunity for more precise identification of tumor during the surgical procedure and during the pathological analysis of tissues ex-vivo. Fluorescence levels positively correlated with EGFR levels. Conclusion We demonstrate for the first time that commercially available antibodies can be fluorescently labeled and safely administered to humans to identify cancer with sub-millimeter resolution, which has the potential to improve outcomes in clinical oncology. PMID:25904751

  2. Resolution of Hanford tanks organic complexant safety issue

    SciTech Connect

    Kirch, N.W.

    1998-05-14

    The Hanford Site tanks have been assessed for organic complexant reaction hazards. The results have shown that most tanks contain insufficient concentrations of TOC to support a propagating reaction. It has also been shown that those tanks where the TOC concentration approaches levels of concern, degradation of the organic complexants to less energetic compounds has occurred. The results of the investigations have been documented. The residual organic complexants in the Hanford Site waste tanks do not present a safety concern for long-term storage.

  3. 76 FR 60494 - Patient Safety Organizations: Voluntary Relinquishment From HPI-PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109... Patient Safety Act authorizes the listing of PSOs, which are entities or component organizations...

  4. Project plan for resolution of the organic waste tank safety issues at the Hanford Site

    SciTech Connect

    Meacham, J.E.

    1996-10-03

    A multi-year project plan for the Organic Safety Project has been developed with the objective of resolving the organic safety issues associated with the High Level Waste (HLW) in Hanford`s single-shell tanks (SSTS) and double-shell tanks (DSTs). The objective of the Organic Safety Project is to ensure safe interim storage until retrieval for pretreatment and disposal operations begins, and to resolve the organic safety issues by September 2001. Since the initial identification of organics as a tank waste safety issue, progress has been made in understanding the specific aspects of organic waste combustibility, and in developing and implementing activities to resolve the organic safety issues.

  5. Nuclear Criticality Safety Organization training implementation. Revision 4

    SciTech Connect

    Carroll, K.J.; Taylor, R.G.; Worley, C.A.

    1997-05-19

    The Nuclear Criticality Safety Organization (NCSO) is committed to developing and maintaining a staff of qualified personnel to meet the current and anticipated needs in Nuclear Criticality Safety (NCS) at the Oak Ridge Y-12 Plant. This document provides a listing of the roles and responsibilities of NCSO personnel with respect to training and details of the Training Management System (TMS) programs, Mentoring Checklists and Checksheets, as well as other documentation utilized to implement the program. This Training Implementation document is applicable to all technical and managerial NCSO personnel, including temporary personnel, sub-contractors and/or LMES employees on loan to the NCSO, who are in a qualification program.

  6. 76 FR 7854 - Patient Safety Organizations: Voluntary Delisting From Quality Excellence, Inc./PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety... patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  7. 76 FR 7855 - Patient Safety Organizations: Voluntary Delisting From Community Medical Foundation for Patient...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety... patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  8. [Genetically modified organisms: a new threat to food safety].

    PubMed

    Spendeler, Liliane

    2005-01-01

    This article analyzes all of the food safety-related aspects related to the use of genetically modified organisms into agriculture and food. A discussion is provided as to the uncertainties related to the insertion of foreign genes into organisms, providing examples of unforeseen, undesirable effects and of instabilities of the organisms thus artificially fabricated. Data is then provided from both official agencies as well as existing literature questioning the accuracy and reliability of the risk analyses as to these organisms being harmless to health and discusses the almost total lack of scientific studies analyzing the health safety/dangerousness of transgenic foods. Given all these unknowns, other factors must be taken into account, particularly genetic contamination of the non-genetically modified crops, which is now starting to become widespread in some parts of the world. Not being able of reversing the situation in the even of problems is irresponsible. Other major aspects are the impacts on the environment (such as insects building up resistances, the loss of biodiversity, the increase in chemical products employed) with indirect repercussions on health and/or future food production. Lastly, thoughts for discussion are added concerning food safety in terms of food availability and food sovereignty, given that the transgenic seed and related agrochemicals market is currently cornered by five large-scale transnational companies. The conclusion entails an analysis of biotechnological agriculture's contribution to sustainability. PMID:15913060

  9. Qualitative study exploring surgical team members' perception of patient safety in conflict-ridden Eastern Democratic Republic of Congo

    PubMed Central

    Labat, Francoise; Sharma, Anjali

    2016-01-01

    Objective To identify potential barriers to patient safety (PS) interventions from the perspective of surgical team members working in an operating theatre in Eastern Democratic Republic of Congo (DRC). Design In-depth interviews were conducted and analysed using qualitative content analysis. Setting Governmental referral teaching hospital in Eastern DRC. Participants We purposively selected 2–4 national and expatriate surgical team members from each specialisation. Of the 31 eligible surgical health workers (HWs), 17 volunteered to be interviewed. Results Economics issues affected PS throughout the entire health system, from human resources and hospital management, to access to healthcare for patients. Surgical team members seemed embedded in a paternalistic organisational structure and blame culture accompanied by perceived inefficient support services and low salaries. The armed conflict did not only worsen these system failures, it also carried direct threats to patients and HWs, and resulted in complex indirect consequences compromising PS. The increased corruption within health organisations, and population impoverishment and substance abuse among health staff adversely altered safe care. Simultaneously, HWs’ reported resilience and resourcefulness to address barrier to PS. Participants had varying views on external aid depending on its relevance. Conclusions The complex links between war and PS emphasise the importance of a comprehensive approach including occupational health to strengthen HWs' resilience, external clinical audits to limit corruption, and educational programmes in PS to support patient-centred care and address blame culture. Finally, improvement of equity in the health financing system seems essential to ensure access to healthcare and safe perioperative outcomes for all. PMID:27113232

  10. Surgical innovation and safety: femoroacetabular impingement and the IDEAL collaborative framework.

    PubMed

    Lee, Cara Beth

    2016-07-01

    Operative treatment of femoroacetabular impingement (FAI) is a relatively new, yet rapidly expanding surgical innovation. Although the practice of surgery is inherently innovative, there is no clear distinction between minor technical variation and true modification that warrants testing. This raises important questions about how new procedures should be evaluated before being broadly disseminated. The IDEAL Collaborative is a consortium that promotes safe and responsible translation of research into clinical practice. The collaborative has delineated the typical stages of evolution of new interventional technologies, and the type of study designs appropriate for each stage. This report examines the surgical treatment of FAI as a case study of the IDEAL framework and discusses both missed and future opportunities for critical assessment. PMID:27583143

  11. Surgical innovation and safety: femoroacetabular impingement and the IDEAL collaborative framework

    PubMed Central

    Lee, Cara Beth

    2016-01-01

    Operative treatment of femoroacetabular impingement (FAI) is a relatively new, yet rapidly expanding surgical innovation. Although the practice of surgery is inherently innovative, there is no clear distinction between minor technical variation and true modification that warrants testing. This raises important questions about how new procedures should be evaluated before being broadly disseminated. The IDEAL Collaborative is a consortium that promotes safe and responsible translation of research into clinical practice. The collaborative has delineated the typical stages of evolution of new interventional technologies, and the type of study designs appropriate for each stage. This report examines the surgical treatment of FAI as a case study of the IDEAL framework and discusses both missed and future opportunities for critical assessment. PMID:27583143

  12. A Phase II Randomized Controlled Trial Comparing Safety, Procedure Time, and Cost of the PrePex™ Device to Forceps Guided Surgical Circumcision in Zimbabwe

    PubMed Central

    Tshimanga, Mufuta; Mangwiro, Tonderayi; Mugurungi, Owen; Xaba, Sinokuthemba; Murwira, Munyaradzi; Kasprzyk, Danuta; Montaño, Daniel E.; Nyamukapa, Daisy; Tambashe, Basile; Chatikobo, Pesanai; Gundidza, Patricia; Gwinji, Gerald

    2016-01-01

    Background The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a new approach was needed. The primary objective of the current trial was to assess the performance (safety, procedure time, and cost) of the PrePex device compared to forceps-guided surgical circumcision. Methods and Findings This Phase II, randomized, open-label trial in Zimbabwe involved healthy, non-circumcised adult male volunteers who were randomly assigned to the PrePex device (n = 160) or surgical arm (n = 80). Three doctors and 4 nurses, all certified on both circumcision methods, performed the procedures. The PrePex device procedure involves a plastic ring with a rubber O-ring that necrotizes the foreskin to facilitate easy and minimally invasive removal. Total procedure time was the primary endpoint. Adverse event (AE) data were also gathered for 90 days post-procedure. All 80 participants in the surgical arm and 158 participants in the PrePex arm achieved complete circumcision. The total procedure time for the PrePex device was approximately one-third of the total surgical procedure (4.8 minutes, Standard Deviation [SD]: 1.2 versus 14.6 minutes; SD: 4.2; p<0.00001). There were 2 AEs for 2 participants (rate of 1.3%, 95% Confidence Interval: 0.0025–4.53%), which were resolved with simple intervention. The AEs were device related, including 1 case of pain leading to device removal and 1 case of removal of the device. Conclusions The trial supports previous studies’ conclusions that the PrePex procedure is safe, quick, easy to apply, and effective in terms of procedure time as an alternative to traditional surgical circumcision. The PrePex device has great potential for use in overburdened health systems and in

  13. 78 FR 70560 - Patient Safety Organizations: Voluntary Relinquishment From GE-PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule), 42 CFR... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  14. 78 FR 17212 - Patient Safety Organizations: Voluntary Relinquishment From QAISys, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-03-20

    ... of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  15. 77 FR 65892 - Patient Safety Organizations: Voluntary Relinquishment From PDR Secure, LLC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-31

    ... of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  16. 78 FR 6819 - Patient Safety Organizations: Voluntary Relinquishment From the BREF PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient Safety Rule... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  17. 78 FR 70561 - Patient Safety Organizations: Delisting for Cause for Leadership Triad

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... patient safety and the quality of health care delivery. HHS issued the Patient Safety and Quality... confidential information regarding the quality and safety of health care delivery. The Patient Safety Rule, 42... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Delisting...

  18. 77 FR 42738 - Patient Safety Organizations: Voluntary Relinquishment From the Coalition for Quality and Patient...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:......

  19. Organizing safety: conditions for successful information assurance programs.

    PubMed

    Collmann, Jeff; Coleman, Johnathan; Sostrom, Kristen; Wright, Willie

    2004-01-01

    Organizations must continuously seek safety. When considering computerized health information systems, "safety" includes protecting the integrity, confidentiality, and availability of information assets such as patient information, key components of the technical information system, and critical personnel. "High Reliability Theory" (HRT) argues that organizations with strong leadership support, continuous training, redundant safety mechanisms, and "cultures of high reliability" can deploy and safely manage complex, risky technologies such as nuclear weapons systems or computerized health information systems. In preparation for the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Office of the Assistant Secretary of Defense (Health Affairs), the Offices of the Surgeons General of the United States Army, Navy and Air Force, and the Telemedicine and Advanced Technology Research Center (TATRC), US Army Medical Research and Materiel Command sponsored organizational, doctrinal, and technical projects that individually and collectively promote conditions for a "culture of information assurance." These efforts include sponsoring the "P3 Working Group" (P3WG), an interdisciplinary, tri-service taskforce that reviewed all relevant Department of Defense (DoD), Miliary Health System (MHS), Army, Navy and Air Force policies for compliance with the HIPAA medical privacy and data security regulations; supporting development, training, and deployment of OCTAVE(sm), a self-directed information security risk assessment process; and sponsoring development of the Risk Information Management Resource (RIMR), a Web-enabled enterprise portal about health information assurance. PMID:15650526

  20. 76 FR 60495 - Patient Safety Organizations: Voluntary Relinquishment From Illinois PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-29

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Voluntary... from the Illinois PSO of its status as a Patient Safety Organization (PSO). The Patient Safety and... PSOs, which are entities or component organizations whose mission and primary activity is to...

  1. Surgical debriefing: a reliable roadmap to completing the patient safety cycle.

    PubMed

    Zuckerman, Scott L; France, Daniel J; Green, Cain; Leming-Lee, Susie; Anders, Shilo; Mocco, J

    2012-11-01

    Morbidity and mortality due to preventable medical errors are a disastrous reality in medicine. Debriefing, a process that allows individuals to discuss team performance in a constructive, supportive environment, has been linked to improved performance in various medical and surgical fields, including improvements in specific procedures, teamwork and communication, and error identification. However, the neurosurgical literature on this topic is limited. The authors review the debriefing literature in the field of medicine, with a specific emphasis on the operating room, and they report their own institutional experience with a debriefing module, from invention to pilot implementation, at Vanderbilt University Medical Center. The authors share the challenges and lessons learned from their quality improvement project. The field of neurosurgery would undoubtedly benefit from embracing debriefing, as its potential has been established in other medical specialties and can serve as a valuable role in immediately learning from mistakes. The authors hope that their colleagues can learn from this experience and improve their own. PMID:23116099

  2. Forum for debate: Safety of allogeneic blood transfusion alternatives in the surgical/critically ill patient.

    PubMed

    Muñoz Gómez, M; Bisbe Vives, E; Basora Macaya, M; García Erce, J A; Gómez Luque, A; Leal-Noval, S R; Colomina, M J; Comin Colet, J; Contreras Barbeta, E; Cuenca Espiérrez, J; Garcia de Lorenzo Y Mateos, A; Gomollón García, F; Izuel Ramí, M; Moral García, M V; Montoro Ronsano, J B; Páramo Fernández, J A; Pereira Saavedra, A; Quintana Diaz, M; Remacha Sevilla, Á; Salinas Argente, R; Sánchez Pérez, C; Tirado Anglés, G; Torrabadella de Reinoso, P

    2015-12-01

    In recent years, several safety alerts have questioned or restricted the use of some pharmacological alternatives to allogeneic blood transfusion in established indications. In contrast, there seems to be a promotion of other alternatives, based on blood products and/or antifibrinolytic drugs, which lack a solid scientific basis. The Multidisciplinary Autotransfusion Study Group and the Anemia Working Group España convened a multidisciplinary panel of 23 experts belonging to different healthcare areas in a forum for debate to: 1) analyze the different safety alerts referred to certain transfusion alternatives; 2) study the background leading to such alternatives, the evidence supporting them, and their consequences for everyday clinical practice, and 3) issue a weighted statement on the safety of each questioned transfusion alternative, according to its clinical use. The members of the forum maintained telematics contact for the exchange of information and the distribution of tasks, and a joint meeting was held where the conclusions on each of the items examined were presented and discussed. A first version of the document was drafted, and subjected to 4 rounds of review and updating until consensus was reached (unanimously in most cases). We present the final version of the document, approved by all panel members, and hope it will be useful for our colleagues. PMID:26183121

  3. Effective Date of Requirement for Premarket Approval for Surgical Mesh for Transvaginal Pelvic Organ Prolapse Repair. Final order.

    PubMed

    2016-01-01

    The Food and Drug Administration (FDA or the Agency) is issuing a final order to require the filing of a premarket approval application (PMA) or notice of completion of a product development protocol (PDP) for surgical mesh for transvaginal pelvic organ prolapse (POP) repair. PMID:26742183

  4. Organic Tanks Safety Program: Advanced organic analysis FY 1996 progress report

    SciTech Connect

    1996-09-01

    Major focus during the first part of FY96 was to evaluate using organic functional group concentrations to screen for energetics. Fourier transform infrared and Raman spectroscopy would be useful screening tools for determining C-H and COO- organic content in tank wastes analyzed in a hot cell. These techniques would be used for identifying tanks of potential safety concern that may require further analysis. Samples from Tanks 241-C-106 and -C-204 were analyzed; the major organic in C-106 was B2EHPA and in C-204 was TBP. Analyses of simulated wastes were also performed for the Waste Aging Studies Task; organics formed as a result of degradation were identified, and the original starting components were monitored quantitatively. Sample analysis is not routine and required considerable methods adaptation and optimization. Several techniques have been evaluated for directly analyzing chelator and chelator fragments in tank wastes: matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and liquid chromatography with ultraviolet detection using Cu complexation. Although not directly funded by the Tanks Safety Program, the success of these techniques have implications for both the Flammable Gas and Organic Tanks Safety Programs.

  5. Safety of instrumentation and fusion at the time of surgical debridement for spinal infection.

    PubMed

    Talia, Adrian J; Wong, Michael L; Lau, Hui C; Kaye, Andrew H

    2015-07-01

    The present study aims to assess the results of single-stage instrumentation and fusion at the time of surgical debridement of spinal infections; vertebral osteomyelitis or epidural abscess. Nine patients with spinal infection were treated with instrumentation and fusion after radical debridement in a single-stage operation. Predisposing factors and comorbidities, pain, American Spinal Injury Association motor scores, primary pathologies, microbiology and perioperative markers were recorded. Seven patients with pyogenic and two with tuberculous spinal infection were encountered; the most common pathogen was Staphylococcus aureus. Five patients were predisposed to infection because of diabetes mellitus. Duration of antibiotic therapy lasted up to 12 months. Six patients had thoracic infection, two lumbar and one cervical. No post-operative complications were encountered. There was a significant reduction in pain scores compared to pre-operatively. All patients with neurological deficits improved post-operatively. Despite introduction of hardware, no patients had a recurrence of their infection in the 12 month follow up period. Single-stage debridement and instrumentation appeared to be a safe and effective method of managing spinal infections. The combination of debridement and fusion has the dual benefit of removing a focus of infection and stabilising the spine. The current series confirms that placing titanium cages into an infected space is safe in a majority of patients. Stabilisation and correction of spinal deformity reduces pain, aids neurologic recovery and improves quality of life. The small patient population and retrospective nature limit the present study. PMID:25911501

  6. Establishment and use of surgical rat models for assessment of organ specific in vivo clearance.

    PubMed

    Vestergaard, Bill

    2016-06-01

    Knowledge of clearance plays a key role in the development of new drug entities, especially in the development of improved analogues for treatment of chronic conditions. Improved pharmacokinetic properties can be used to increase dosing interval and thereby improve patient compliance. This will lead to improved treatment outcome or decreased risk of treatment failure when treating chronic conditions. Therefore, animal models for assessment of organ-specific clearance are of great value in preclinical drug development. These models can be used to obtain insights into the relative importance of a clearance organ and thereby guide drug design of new analogues in early drug discovery. The current PhD project was undertaken to explore surgical in vivo models, which could be used in the assessment of the relative importance of major clearance organs. It was the aim of the PhD project to establish and validate both a nephrectomy model and a hepatectomy model as tools to investigate relative importance of renal and hepatic clearance. Furthermore, the project aim was to investigate renal clearance of rFVIIa and rhGH using a nephrectomy model in rats. The thesis is composed of a short theoretical background, a literature review, two papers based on experimental work as well as experimental work not included in the papers. Chapter one is an introduction with the specific aims and hypotheses. The chapters from two to five contain theoretical background of the clearance concept, anatomical and physiological description of clearance organs and a brief overview of potential clearance models including in vivo models. Chapters six through nine highlight the experimental work with the results obtained during the PhD project. Lastly, the chapters from ten to twelve contain a general discussion, conclusion and perspectives of the current thesis. Paper I "Nephrectomized and hepatectomized animal models as tools in preclinical pharmacokinetics" provides a literature review of animal

  7. 76 FR 7853 - Patient Safety Organizations: Voluntary Delisting From HealthDataPSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... collect, aggregate, and analyze confidential information regarding the quality and safety of health care... quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety Act... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  8. 76 FR 79192 - Patient Safety Organizations: Voluntary Relinquishment From the Georgia Hospital Association...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-21

    ... organizations whose mission and primary activity is to ] conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety Rule to implement the Patient Safety Act..., and analyze confidential information regarding the quality and safety of health care delivery....

  9. 78 FR 70560 - Patient Safety Organizations: Voluntary Relinquishment From Morgridge Institute for Research PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-26

    ... and primary activity is to conduct activities to improve patient safety and the quality of health care... quality and safety of health care delivery. The Patient Safety and Quality Improvement Final Rule (Patient... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  10. 76 FR 7853 - Patient Safety Organizations: Voluntary Delisting From Apollo Publishing, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... is to conduct activities to improve patient safety and the quality of health care delivery. HHS... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  11. 78 FR 6819 - Patient Safety Organizations: Voluntary Relinquishment From The Connecticut Hospital Association...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-31

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... conduct activities to improve patient safety and the quality of health care delivery. HHS issued the... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  12. An investigation of safety climate in OHSAS 18001-certified and non-certified organizations.

    PubMed

    Ghahramani, Abolfazl

    2016-09-01

    Many organizations worldwide have implemented Occupational Health and Safety Assessment Series (OHSAS) 18001 in their premises because of the assumed positive effects of this standard on safety. Few studies have analyzed the effect of the safety climate in OHSAS 18001-certified organizations. This case-control study used a new safety climate questionnaire to evaluate three OHSAS 18001-certified and three non-certified manufacturing companies in Iran. Hierarchical regression indicated that the safety climate was influenced by OHSAS implementation and by safety training. Employees who received safety training had better perceptions of the safety climate and its dimensions than other respondents within the certified companies. This study found that the implementation of OHSAS 18001 does not guarantee improvement of the safety climate. This study also emphasizes the need for high-quality safety training for employees of the certified companies to improve the safety climate. PMID:27108658

  13. Bilateral deep brain stimulation of the fornix for Alzheimer's disease: surgical safety in the ADvance trial.

    PubMed

    Ponce, Francisco A; Asaad, Wael F; Foote, Kelly D; Anderson, William S; Rees Cosgrove, G; Baltuch, Gordon H; Beasley, Kara; Reymers, Donald E; Oh, Esther S; Targum, Steven D; Smith, Gwenn S; Lyketsos, Constantine G; Lozano, Andres M

    2016-07-01

    OBJECT This report describes the stereotactic technique, hospitalization, and 90-day perioperative safety of bilateral deep brain stimulation (DBS) of the fornix in patients who underwent DBS for the treatment of mild, probable Alzheimer's disease (AD). METHODS The ADvance Trial is a multicenter, 12-month, double-blind, randomized, controlled feasibility study being conducted to evaluate the safety, efficacy, and tolerability of DBS of the fornix in patients with mild, probable AD. Intraoperative and perioperative data were collected prospectively. All patients underwent postoperative MRI. Stereotactic analyses were performed in a blinded fashion by a single surgeon. Adverse events (AEs) were reported to an independent clinical events committee and adjudicated to determine the relationship between the AE and the study procedure. RESULTS Between June 6, 2012, and April 28, 2014, a total of 42 patients with mild, probable AD were treated with bilateral fornix DBS (mean age 68.2 ± 7.8 years; range 48.0-79.7 years; 23 men and 19 women). The mean planned target coordinates were x = 5.2 ± 1.0 mm (range 3.0-7.9 mm), y = 9.6 ± 0.9 mm (range 8.0-11.6 mm), z = -7.5 ± 1.2 mm (range -5.4 to -10.0 mm), and the mean postoperative stereotactic radial error on MRI was 1.5 ± 1.0 mm (range 0.2-4.0 mm). The mean length of hospitalization was 1.4 ± 0.8 days. Twenty-six (61.9%) patients experienced 64 AEs related to the study procedure, of which 7 were serious AEs experienced by 5 patients (11.9%). Four (9.5%) patients required return to surgery: 2 patients for explantation due to infection, 1 patient for lead repositioning, and 1 patient for chronic subdural hematoma. No patients experienced neurological deficits as a result of the study, and no deaths were reported. CONCLUSIONS Accurate targeting of DBS to the fornix without direct injury to it is feasible across surgeons and treatment centers. At 90 days after surgery, bilateral fornix DBS was well tolerated by patients with

  14. Attitudes towards the surgical safety checklist and factors associated with its use: A global survey of frontline medical professionals☆

    PubMed Central

    Vohra, Ravinder S.; Cowley, Jonathan B.; Bhasin, Neeraj; Barakat, Hashem M.; Gough, Michael J.

    2015-01-01

    Background The Surgical Safety Checklist (SSC) has been shown to reduce perioperative errors and complications and its implementation is recommended by the World Health Organisation (WHO). However, it is unknown how widely this intervention is used. We investigated attitudes and factors associated with use of WHO SSC in frontline medical professionals across the globe using a survey distributed through social networks. Methods A survey of usage and opinions regarding the SSC was posted on the Facebook and Twitter pages of a not-for-profit surgical news website for one month (March 2013). Respondents were grouped into four groups based on their country's Gross National Income: high, upper middle, lower middle and low income. Univariate and multivariate analyses were performed to investigate how different factors were associated with the use of the SSC. Results 6269 medical professionals from 69 countries responded to the survey: most respondents were from lower middle (47.4%) countries, followed by: high (35.0%), upper middle (14.6%), and low (3.0%) income countries. In total, 57.5% reported that they used the WHO SSC perioperatively. Fewer respondents used the WHO SSC in upper middle, lower middle and low income countries (LMICs) compared to high income countries (43.5% vs. 83.5%, p < 0.001). Female (61.3% vs. 56.4% males, p = 0.001), consultant surgeons (59.6% vs. 53.2% interns, p < 0.001) and working in university hospitals (61.4% vs. 53.7% non-university hospitals, p < 0.001) were more likely to use the SSC. Believing the SSC was useful, did not work or caused delays was independently associated with the respondents reported use of the SSC (OR 1.22 95% CI 1.07–1.39; OR 0.47 95% CI 0.36–0.60; OR 0.64 95% CI 0.53–0.77, respectively). Conclusion This study suggests the use of the WHO SSC is variable across countries, especially in LMICs where it has the most potential to improve patient safety. Critical appraisal of the documented benefits of the WHO

  15. Efficiency and safety of surgical intervention to patients with Non-Cystic Fibrosis bronchiectasis: a meta-analysis

    PubMed Central

    Fan, Li-Chao; Liang, Shuo; Lu, Hai-Wen; Fei, Ke; Xu, Jin-Fu

    2015-01-01

    No quantitative systematic review was found to report the efficiency and safety of surgical resection in the management of non-cystic fibrosis (non-CF) bronchiectasis. We therefore conducted a meta-analysis to assess the effects of operative intervention to patients with non-CF bronchiectasis. PubMed, the Cochrane library and Web of Science databases were searched up to July 8th, 2015. The pooled mortality from 34 studies recruiting 4788 patients was 1.5% (95% CI, 0.9–2.5%). The pooled morbidity from 33 studies consisting of 4583 patients was 16.7% (95% CI, 14.8–18.6%). The pooled proportion of patients from 35 studies, consisting of 4614 patients who were free of symptoms was 66.5% (95% CI, 61.3–71.7%) after surgery. The summary proportion of patients from 35 articles including 4279 participants who were improved was 27.5% (95% CI, 22.5–32.5%), and 9.1% (95% CI, 7.3–11.5%) showed no clinical improvement. In conclusion, our analysis indicated that lung resection in the management of non-CF bronchiectasis is associated with significant improvements in symptoms, low risk of mortality and acceptable morbidity. PMID:26627202

  16. Thermal effects of white light illumination during microsurgery: clinical pilot study on the application safety of surgical microscopes

    NASA Astrophysics Data System (ADS)

    Hibst, Raimund; Saal, David; Russ, Detlef; Kunzi-Rapp, Karin; Kienle, Alwin; Stock, Karl

    2010-07-01

    Modern operating microscopes offer high power illumination to ensure optimal visualization, but can also cause thermal damage. The aim of our study is to quantify the thermal effects in vivo and discuss conditions for safe use. In a pilot study on volunteers, we measured the temperature at the skin surface during microscope illumination, including the influence of anaesthesia and the effects of staining, draping, or moistening of the skin. Irradiation within the limit given by safety regulations (200 mW/cm2) results in skin surface temperature of 43 °C. Higher intensities (forearm 335 mW/cm2, back 250 mW/cm2) are tolerated, resulting in reversible hyperaemia. At a very high illumination intensity (750 mW/cm2), pain occurs within 30 s at temperatures of 46 °C+/-1 °C (hand and forearm), and 43 °C+/-2 °C (back), respectively. Anaesthesia has no distinct effect on the temperature, whereas staining and drapes result in much higher temperatures (>100 °C). Moistening at practicable flow rates can reduce temperature efficiently when combined with a light absorbing and water absorbent drape. In conclusion, surgeons must be aware that surgical microscope illumination without protective means can cause skin temperatures to rise much above pain threshold, which in our study serves as a (conservative) benchmark for potential damage.

  17. The process and results of departmental specific safety surveys for health care organizations. Successful program.

    PubMed

    Meittunen, E; Snyder, B; Meyer, M

    2001-04-01

    1. Meeting compliance and accreditation standards can be challenging for any organization, especially in the health care setting. Safety surveys can play a strategic role in proactively preparing for such events. 2. Implementing department specific safety surveys offers a tailored approach to monitoring and addressing the occupational safety issues that occur within each department. 3. Safety surveys are a method for assessing and monitoring the environment and employee training needs, and for driving safety decisions. 4. Safety in the workplace must be a shared and continuous responsibility among employees. A formal safety survey process instilling a culture of responsibility and "buy in" by all employees is necessary. PMID:11760523

  18. 78 FR 12065 - Patient Safety Organizations: Delisting for Cause for Independent Data Safety Monitoring, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-21

    ... whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety and Quality Improvement Final Rule (Patient Safety..., aggregate, and analyze confidential information regarding the quality and safety of health care...

  19. Intraocular Lens-Shell Technique: Adjustment of the Surgical Procedure Leads to Greater Safety When Treating Dense Nuclear Cataracts

    PubMed Central

    Chen, Weirong; Qu, Bo; Zhang, Xinyu; Lin, Zhuoling; Chen, Jingjing; Liu, Yizhi

    2014-01-01

    Objective To compare the efficacy and safety of the intraocular lens (IOL)-shell procedure versus conventional phacoemulsification for the surgical treatment of dense cataracts. Methods Eighty eyes with dense nuclear cataracts were enrolled in a prospective, randomized controlled study. Patients were assigned to two groups. In Group I, the IOL was traditionally implanted after all nuclear fragments were completely removed, and in Group II, the IOL was innovatively implanted in the bag before the last residual nuclear fragment was removed. This novel adjusted surgical procedure, named the “IOL-shell technique”, features use of the IOL as a protective barrier rather than simply as a refractive alternative, and it is conceptually different from the traditional step-by-step procedure. Clinical examinations, including uncorrected visual acuity, central corneal thickness (CCT), temporal clear corneal incision thickness and corneal endothelial cell density, were carried out. Results The inter-group difference in temporal corneal thickness was found to be of no statistical significance at any of the visits. Compared to eyes in Group I, those in Group II were shown to have significantly less corneal endothelial cell loss on both the 7th and 30th day following surgery. At 7 days after surgery, the mean corneal endothelial cell loss in Group II was 10.29%, compared to 14.37% in Group I (P<0.05). The mean endothelial cell loss measured on postoperative day 30 was 16.88% in Group II compared to 23.32% in Group I (P<0.05). On the 1st day after surgery, the mean CCT of eyes in Group II was significantly smaller compared to Group I (Group I vs. Group II: 19.42% vs. 13.50%, P<0.05). Conclusions Compared to conventional phacoemulsification, the IOL-shell technique was shown to be a relatively safer procedure without compromised efficiency for dense cataracts, and it caused less corneal endothelial cell loss and milder postoperative corneal edema (Clinical Trials Identifier: NCT

  20. Advanced organic analysis and analytical methods development: FY 1995 progress report. Waste Tank Organic Safety Program

    SciTech Connect

    Wahl, K.L.; Campbell, J.A.; Clauss, S.A.

    1995-09-01

    This report describes the work performed during FY 1995 by Pacific Northwest Laboratory in developing and optimizing analysis techniques for identifying organics present in Hanford waste tanks. The main focus was to provide a means for rapidly obtaining the most useful information concerning the organics present in tank waste, with minimal sample handling and with minimal waste generation. One major focus has been to optimize analytical methods for organic speciation. Select methods, such as atmospheric pressure chemical ionization mass spectrometry and matrix-assisted laser desorption/ionization mass spectrometry, were developed to increase the speciation capabilities, while minimizing sample handling. A capillary electrophoresis method was developed to improve separation capabilities while minimizing additional waste generation. In addition, considerable emphasis has been placed on developing a rapid screening tool, based on Raman and infrared spectroscopy, for determining organic functional group content when complete organic speciation is not required. This capability would allow for a cost-effective means to screen the waste tanks to identify tanks that require more specialized and complete organic speciation to determine tank safety.

  1. Feasibility and safety of on table extubation after corrective surgical repair of tetralogy of Fallot in a developing country: a case series.

    PubMed

    Akhtar, Mohammad Irfan; Hamid, Mohammad; Minai, Fauzia; Rehman, Naveed

    2015-01-01

    Fast-track extubation is an established safe practice in pediatric congenital heart disease (CHD) surgical patients. On table extubation (OTE) in acyanotic CHD surgical patients is well established with validated safety profile. This practice is not yet reported in tetralogy of Fallot (TOF) cardiac surgical repair patients in developing countries. Evidence suggests that TOF total correction patients should be extubated early, as positive pressure ventilation has a negative impact on right ventricular function and the overall increase in post-TOF repair complications such as low cardiac output state and arrhythmias. The objective of the case series was to determine the safety and feasibility of OTE in elective TOF total correction cardiac surgical patients with an integrated team approach. To the best of our knowledge, this is the first reported case series. A total of 8 elective male and female TOF patients were included. Standard anesthetic, surgical and perfusion techniques were used in these procedures. All patients were extubated in the operating room safely without any complications with the exception of one patient who continued to bleed for 3 h of postextubation at 2-3 ml/kg/h which was managed with transfusion of fresh frozen plasma at 15 mL/kg, packed red blood cells 10 mL/kg and bolus of transamine at 20 mg/kg. Apart from better surgical and bypass techniques, the most important factor leading to successful OTE was an excellent analgesia. On the basis of the case series, it is suggested to extubate selected TOF cardiac surgery repair patients on table safely with integrated multidisciplinary approach. PMID:25849700

  2. Feasibility and safety of on table extubation after corrective surgical repair of tetralogy of Fallot in a developing country: A case series

    PubMed Central

    Akhtar, Mohammad Irfan; Hamid, Mohammad; Anwar-Ul-Haq; Minai, Fauzia; Rehman, Naveed

    2015-01-01

    Fast-track extubation is an established safe practice in pediatric congenital heart disease (CHD) surgical patients. On table extubation (OTE) in acyanotic CHD surgical patients is well established with validated safety profile. This practice is not yet reported in tetralogy of Fallot (TOF) cardiac surgical repair patients in developing countries. Evidence suggests that TOF total correction patients should be extubated early, as positive pressure ventilation has a negative impact on right ventricular function and the overall increase in post-TOF repair complications such as low cardiac output state and arrhythmias. The objective of the case series was to determine the safety and feasibility of OTE in elective TOF total correction cardiac surgical patients with an integrated team approach. To the best of our knowledge, this is the first reported case series. A total of 8 elective male and female TOF patients were included. Standard anesthetic, surgical and perfusion techniques were used in these procedures. All patients were extubated in the operating room safely without any complications with the exception of one patient who continued to bleed for 3 h of postextubation at 2–3 ml/kg/h which was managed with transfusion of fresh frozen plasma at 15 mL/kg, packed red blood cells 10 mL/kg and bolus of transamine at 20 mg/kg. Apart from better surgical and bypass techniques, the most important factor leading to successful OTE was an excellent analgesia. On the basis of the case series, it is suggested to extubate selected TOF cardiac surgery repair patients on table safely with integrated multidisciplinary approach. PMID:25849700

  3. [EXPERIENCE OF RELAPAROTOMY APPLICATION IN SURGICAL TREATMENT OF THE ABDOMINAL CAVITY ORGANS DISEASES].

    PubMed

    Malyk, S V; Podlesnyi, V I; Lavrenko, D O; Ksyonz, I V

    2015-10-01

    During 2011 - 2014 yrs in Surgical Clinic of The First City Clinic (Poltava) a relaparotomy was performed in 127 patients. There was established, that relaparotomy constitutes the only one procedure for such life threatening states, as intraabdominal bleeding, ileus in a decompensation stage, eventration, progressing peritonitis, abdominal compartment syndrome stages III - IV. The rate of relaparotomy application after performance of urgent operative interventions is bigger than after planned operations (ratio 4:1). Individual estimation of a state and choice of optimal surgical tactics during primary and secondary operative interventions are needed to improve the results of treatment. PMID:26946667

  4. Community Organizations' Involvement in School Safety Planning: Does It Make a Difference in School Violence?

    ERIC Educational Resources Information Center

    Patton, Joy D.

    2011-01-01

    This study examines the relationship between school violence and involvement of community organizations in school safety planning. The study is a secondary analysis of data from the School Survey on Crime and Safety 2003-2004 (U.S. Department of Education, Institute of Education Sciences, 2006). This survey collects data on crime and safety from…

  5. 77 FR 25179 - Patient Safety Organizations: Expired Listing for Medkinetics, LLC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-04-27

    ... mission and primary activity is to conduct activities to improve patient safety and the quality of health..., aggregate, and analyze confidential information regarding the quality and safety of health care delivery... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Expired...

  6. 76 FR 7854 - Patient Safety Organizations: Voluntary Delisting From Lumetra PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-11

    ... mission and primary activity is to conduct activities to improve patient safety and the quality of health... analyze confidential information regarding the quality and safety of health care delivery. The Patient... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  7. Simultaneous “hybrid” percutaneous coronary intervention and minimally invasive surgical bypass grafting: Feasibility, safety, and clinical outcomes

    PubMed Central

    Reicher, Barry; Poston, Robert S.; Mehra, Mandeep R.; Joshi, Ashish; Odonkor, Patrick; Kon, Zachary; Reyes, Peter A.; Zimrin, David A.

    2009-01-01

    Surgical and percutaneous coronary artery intervention revascularization are traditionally considered isolated options. A simultaneous hybrid approach may allow an opportunity to match the best strategy for a particular anatomic lesion. Concerns regarding safety and feasibility of such an approach exist. We examined the safety, feasibility, and early outcomes of a simultaneous hybrid revascularization strategy (minimally invasive direct coronary bypass grafting of the left anterior descending [LAD] artery and drug-eluting stent [DES] to non-LAD lesions) in 13 patients with multivessel coronary artery disease that underwent left internal mammary artery to LAD minimally invasive direct coronary bypass performed through a lateral thoracotomy, followed by stenting of non-LAD lesions, in a fluoroscopy-equipped operating room. Assessment of coagulation parameters was also undertaken. Inhospital and postdischarge outcomes of these patients were compared to a group of 26 propensity score matched parallel controls that underwent standard off-pump coronary artery bypass. Baseline characteristics were similar in both groups. All hybrid patients were successfully treated with DES and no inhospital mortality occurred in either group. Hybrid patients had a shorter length of stay (3.6 ± 1.5 vs 6.3 ± 2.3 days, P < .0001) and intubation times (0.5 ± 1.3 vs 11.7 ± 9.6 hours, P < .02). Despite aggressive anticoagulation and confirmed platelet inhibition, hybrid patients had less blood loss (581 ± 402 vs 1242 ± 941 mL, P < .05) and decreased transfusions (0.33 ± 0.49 vs 1.47 ± 1.53 U, P < .01). Six-month angiographic vessel patency and major adverse cardiac events were similar in the hybrid and off-pump coronary artery bypass groups. A simultaneous hybrid approach consisting of minimally invasive coronary artery bypass grafting with left internal mammary artery to LAD combined with revascularization of the remaining coronary targets using percutaneous coronary artery

  8. The Gap between Individual Perception and Compliance: A Qualitative Follow-Up Study of the Surgical Safety Checklist Application

    PubMed Central

    Sendlhofer, Gerald; Lumenta, David Benjamin; Leitgeb, Karina; Kober, Brigitte; Jantscher, Lydia; Schanbacher, Monika; Berghold, Andrea; Pregartner, Gudrun; Brunner, Gernot; Tax, Christa; Kamolz, Lars Peter

    2016-01-01

    Background “The Surgical Safety Checklist (SSC) is important, but we don’t use it adequately” is a well-suited statement that reflects the SSC's application in hospitals. Our aim was to follow up on our initial study on compliance (2014) by analysing differences between individual perception and compliance with the SSC. Methods We conducted a follow-up online survey to assess healthcare professionals’ individual perception of, as well as satisfaction and compliance with the SSC three years following its thorough implementation. Results 171 (19.5%) of 875 operating team members completed the online survey. 99.4% confirmed using the SSC. Self-estimated subjective knowledge about the intention of the checklist was high, whereas objective knowledge was moderate, but improved as compared to 2014. According to an independent audit the SSC was used in 93.1% of all operations and among the SSCs used the completion rate was 57.2%. The use of the SSC was rated as rather easy [median (IQR): 7 (6–7)], familiar [7 (6–7)], generally important [7 (7–7)], and good for patients [7 (6–7)] as well as for employees [7 (7–7)]. Only comfort of use was rated lower [6 (5–7)]. Conclusion There is a gap between individual perception and actual application of the SSC. Despite healthcare professionals confirming the importance of the SSC, compliance was moderate. The introduction of SSCs in the health care sector remains a constant challenge and requires continuous re-evaluation as well as a sensible integration into existing workflows in hospitals. PMID:26925579

  9. Using the Job Demands-Resources model to investigate risk perception, safety climate and job satisfaction in safety critical organizations.

    PubMed

    Nielsen, Morten Birkeland; Mearns, Kathryn; Matthiesen, Stig Berge; Eid, Jarle

    2011-10-01

    Using the Job Demands-Resources model (JD-R) as a theoretical framework, this study investigated the relationship between risk perception as a job demand and psychological safety climate as a job resource with regard to job satisfaction in safety critical organizations. In line with the JD-R model, it was hypothesized that high levels of risk perception is related to low job satisfaction and that a positive perception of safety climate is related to high job satisfaction. In addition, it was hypothesized that safety climate moderates the relationship between risk perception and job satisfaction. Using a sample of Norwegian offshore workers (N = 986), all three hypotheses were supported. In summary, workers who perceived high levels of risk reported lower levels of job satisfaction, whereas this effect diminished when workers perceived their safety climate as positive. Follow-up analyses revealed that this interaction was dependent on the type of risks in question. The results of this study supports the JD-R model, and provides further evidence for relationships between safety-related concepts and work-related outcomes indicating that organizations should not only develop and implement sound safety procedures to reduce the effects of risks and hazards on workers, but can also enhance other areas of organizational life through a focus on safety. PMID:21534979

  10. Resistance to synthetic blood penetration of National Institute for Occupational Safety and Health-approved N95 filtering facepiece respirators and surgical N95 respirators

    PubMed Central

    Rengasamy, Samy; Sbarra, Deborah; Nwoko, Julian; Shaffer, Ronald

    2015-01-01

    Background Surgical N95 filtering facepiece respirators (FFRs), certified by the National Institute for Occupational Safety and Health (NIOSH) as a respirator and cleared by the Food and Drug Administration (FDA) as a surgical mask, are often used to protect from the inhalation of infectious aerosols and from splashes/sprays of body fluids in health care facilities. A shortage of respirators can be expected during a pandemic. The availability of surgical N95 FFRs can potentially be increased by incorporating FDA clearance requirements in the NIOSH respirator approval process. Methods Fluid resistance of NIOSH-approved N95 FFRs, and FDA-cleared surgical N95 FFRs and surgical masks was tested using the ASTM F1862 method at 450 and 635 cm/sec velocities and compared with the results from a third-party independent laboratory. Blood penetration through different layers of filter media of masks were also analyzed visually. Results Four N95 FFR models showed no test failures at both velocities. The penetration results obtained in the NIOSH laboratory were comparable to those from the third-party independent laboratory. The number of respirator samples failing the test increased with increasing test velocity. Conclusions The results indicate that several NIOSH-approved N95 FFR models would likely pass FD clearance requirements for resistance to synthetic blood penetration. PMID:26231551

  11. [Achievements and challenges in implementing the surgical checklist in a pediatric hospital].

    PubMed

    Dackiewicz, Nora; Viteritti, Laura; Marciano, Beatriz; Bailez, Marcela; Merino, Patricia; Bortolato, Diana; Jaichenko, André; Seminara, Rodolfo; Amarilla, Analía

    2012-12-01

    Patient safety in the operating room is a topic of universal concern. Several studies support the existence of a high percentage of complications and a high mortality rate in surgical procedures (0.5 to 5%). The World Health Organization (WHO) has proposed the implementation of surgical check list in order to improve patient safety in the operating room. In Hospital Garrahan, 9600 surgeries and surgical anesthesia for more than 8000 studies and other invasive procedures are performed per year. WHO checklist adaptation and implementation was considered an institutional priority. We describe difficulties and solutions in implementing the surgical checklist. Surgical team involvement in project planning and development was essential. PMID:23224308

  12. 77 FR 38294 - Patient Safety Organizations: Delisting for Cause for Medical Informatics

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-27

    ... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Delisting for Cause for Medical Informatics AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Delisting. SUMMARY: AHRQ has delisted Medical Informatics as a Patient Safety Organization...

  13. 76 FR 74788 - Patient Safety Organizations: Voluntary Relinquishment From HealthWatch, Inc.

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-12-01

    ...AHRQ has accepted a notification of voluntary relinquishment from HealthWatch, Inc. of its status as a Patient Safety Organization (PSO). The Patient Safety and Quality Improvement Act of 2005 (Patient Safety Act), Public Law 109-41, 42 U.S.C. 299b-21--b-26, provides for the formation of PSOs, which collect, aggregate, and analyze confidential information regarding the quality and safety of......

  14. [A surgical safety checklist implementation: experience of a start-up phase of a collaborative project in hospitals of Catalonia, Spain].

    PubMed

    Secanell, Mariona; Orrego, Carola; Vila, Miquel; Vallverdú, Helena; Mora, Núria; Oller, Anna; Bañeres, Joaquim

    2014-07-01

    Surgical patient safety is a priority in the national and international quality healthcare improvement strategies. The objective of the study was to implement a collaborative intervention with multiple components and to evaluate the impact of the patient surgical safety checklist (SSC) application. This is a prospective, longitudinal multicenter study with a 7-month follow-up period in 2009 based on a collaborative intervention for the implementation of a 24 item-SSC distributed in 3 different stages (sign in, time out, sign out) for its application to the surgical patient. A total number of 27 hospitals participated in the strategy. The global implementation rate was 48% (95%CI, 47.6%-48.4%) during the evaluation period. The overall compliance with all the items of the SSC included in each stage (sign in, time out, sign out) was 75,1% (95%CI, 73.5%-76.7%) for the sign in, 77.1% (95%CI, 75.5%-78.6%) for the time out and 88.3% (95%CI, 87.2%-89.5%) for the sign out respectively. The individual compliance with each item of the SSC has remained above 85%, except for the surgical site marking with an adherence of 67.4% (95%CI, 65.7%-69.1%)] and 71.2% (95%CI, 69.6%-72.9%)] in the sign in and time out respectively. The SSC was successfully implemented to 48% of the surgeries performed to the participating hospitals. The global compliance with the SSC was elevated and the intervention trend was stable during the evaluation period. Strategies were identified to allow of a higher number of surgeries with application of the SSC and more professional involvement in measures compliance such as surgical site marking. PMID:25128355

  15. Non-surgical interventions for pelvic organ prolapse in rural Nepal: a prospective monitoring and evaluation study

    PubMed Central

    Fitchett, Joseph R; Bhatta, Surya; Sherpa, Tenzing Y; Malla, Bishwo S; A Fitchett, Elizabeth J; Samen, Arlene

    2015-01-01

    Objectives Pelvic organ prolapse (POP) is a major cause of morbidity in Nepal, particularly affecting women in the rural communities. Women with POP in Nepal may suffer from symptoms for decades. At present, the Government of Nepal advocates surgical intervention but access to surgical care is inadequate. This report evaluated the feasibility of a non-surgical public health programme in rural Nepal, and describes risk factors associated with POP in this setting. Design Prospective monitoring and evaluation study of a new public health programme. Setting Baglung district, rural Nepal. Participants Women with gynaecological symptoms of POP. Main outcome measures Risk factors for disease progression were assessed using Fisher’s exact test, Pearson’s χ2-test and logistic regression analysis. Results Of the 74 women included in this analysis, 70.8% were diagnosed with stage 2 POP or greater. The majority of women did not have any further children following the onset of POP symptoms (63.5%). Duration of symptoms ranged from 2 months to 60 years, with 73.4% of women suffering for over 5 years and 28.4% suffering for over 20 years. Univariate analyses identified age at screening, age at onset of symptoms, the duration of symptoms and an associated rectocele as factors associated with increasing POP severity (p < 0.05). Kegel exercises were taught to 25 (33.8%) women with POP and ring pessaries were offered to 47 (63.5%) women with POP. Conclusions Non-surgical interventions may provide an opportunity to address the significant burden of POP in rural Nepal. PMID:26664731

  16. Spectrophotometer properties of vein blood plasma in UF-region patients with sharp surgical pathology of abdominal region organs

    NASA Astrophysics Data System (ADS)

    Guminestskij, S. G.; Polianski, I. J.; Motrich, A. V.; Grunchuk, F. W.

    2006-05-01

    It is set that there are two maximums in UF- region absorption of vein blood plasma of a man: at λ = 235 nm and at λ = 280 nm. It is shown that there are the substantial changes of values of the optical density D comparative with controls (for donors) exactly in a maximum at development of sharp surgical diseases of organs of abdominal region λ = 280 nm, in that time as maximum at λ = 235 nm in this plan is not informing. Resulted results of researches of dynamics of changes of optical properties of vein blood plasma in UF- region of patients with pathology of abdominal region organs in after operating period (sharp appendicitis, sharp pancreatitis, intestinal impassability and others like that), which can have the diagnostic value.

  17. 77 FR 32975 - Patient Safety Organizations: Expired Listing for The American Cancer Biorepository, Inc. d/b/a...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-06-04

    ... activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety... regarding the quality and safety of health care delivery. The Patient Safety Rule, 42 CFR part 3, authorizes... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations: Expired......

  18. Waste Tank Organic Safety Project: Analysis of liquid samples from Hanford waste tank 241-C-103

    SciTech Connect

    Pool, K.H.; Bean, R.M.

    1994-03-01

    A suite of physical and chemical analyses has been performed in support of activities directed toward the resolution of an Unreviewed Safety Question concerning the potential for a floating organic layer in Hanford waste tank 241-C-103 to sustain a pool fire. The analysis program was the result of a Data Quality Objectives exercise conducted jointly with staff from Westinghouse Hanford Company and Pacific Northwest Laboratory (PNL). The organic layer has been analyzed for flash point, organic composition including volatile organics, inorganic anions and cations, radionuclides, and other physical and chemical parameters needed for a safety assessment leading to the resolution of the Unreviewed Safety Question. The aqueous layer underlying the floating organic material was also analyzed for inorganic, organic, and radionuclide composition, as well as other physical and chemical properties. This work was conducted to PNL Quality Assurance impact level III standards (Good Laboratory Practices).

  19. 76 FR 37817 - Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-28

    ... levels, across the full length of the food-production chain, in order to reduce significantly the... HUMAN SERVICES Food and Drug Administration Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses in Support of Strategies That Address Food Safety Problems That...

  20. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... problem. Your pregnancy is harmful to your health (therapeutic abortion). The pregnancy resulted after a traumatic event ...

  1. Environment Health & Safety Research Program. Organization and 1979-1980 Publications

    SciTech Connect

    1981-01-01

    This document was prepared to assist readers in understanding the organization of Pacific Northwest Laboratory, and the organization and functions of the Environment, Health and Safety Research Program Office. Telephone numbers of the principal management staff are provided. Also included is a list of 1979 and 1980 publications reporting on work performed in the Environment, Health and Safety Research Program, as well as a list of papers submitted for publication.

  2. Corporate Functional Management Evaluation of the LLNL Radiation Safety Organization

    SciTech Connect

    Sygitowicz, L S

    2008-03-20

    A Corporate Assess, Improve, and Modernize review was conducted at Lawrence Livermore National Laboratory (LLNL) to evaluate the LLNL Radiation Safety Program and recommend actions to address the conditions identified in the Internal Assessment conducted July 23-25, 2007. This review confirms the findings of the Internal Assessment of the Institutional Radiation Safety Program (RSP) including the noted deficiencies and vulnerabilities to be valid. The actions recommended are a result of interviews with about 35 individuals representing senior management through the technician level. The deficiencies identified in the LLNL Internal Assessment of the Institutional Radiation Safety Program were discussed with Radiation Safety personnel team leads, customers of Radiation Safety Program, DOE Livermore site office, and senior ES&H management. There are significant issues with the RSP. LLNL RSP is not an integrated, cohesive, consistently implemented program with a single authority that has the clear roll and responsibility and authority to assure radiological operations at LLNL are conducted in a safe and compliant manner. There is no institutional commitment to address the deficiencies that are identified in the internal assessment. Some of these deficiencies have been previously identified and corrective actions have not been taken or are ineffective in addressing the issues. Serious funding and staffing issues have prevented addressing previously identified issues in the Radiation Calibration Laboratory, Internal Dosimetry, Bioassay Laboratory, and the Whole Body Counter. There is a lack of technical basis documentation for the Radiation Calibration Laboratory and an inadequate QA plan that does not specify standards of work. The Radiation Safety Program lack rigor and consistency across all supported programs. The implementation of DOE Standard 1098-99 Radiological Control can be used as a tool to establish this consistency across LLNL. The establishment of a site

  3. Promoting child passenger safety in children served by a health maintenance organization.

    PubMed

    Chang, A; Hearey, C D; Gallagher, K D; English, P; Chang, P C

    1989-06-01

    A patient education program, based on the health belief model, promoting child passenger safety was developed and implemented at a health maintenance organization. The program included individual counseling by pediatricians, use of audiovisual materials and pamphlets, and (for newborn infants) a home visit by a child safety specialist. Based on parking lot observations, child safety device use increased to greater than 60% in both intervention and comparison-group children 1-4 years of age. During the child health supervision visit, pediatricians can play a leadership role in promoting child passenger safety. PMID:10293483

  4. Abortion - surgical

    MedlinePlus

    Suction curettage; Surgical abortion; Elective abortion - surgical; Therapeutic abortion - surgical ... Surgical abortion involves dilating the opening to the uterus (cervix) and placing a small suction tube into the uterus. ...

  5. Surgical extraction of human dorsal root ganglia from organ donors and preparation of primary sensory neuron cultures.

    PubMed

    Valtcheva, Manouela V; Copits, Bryan A; Davidson, Steve; Sheahan, Tayler D; Pullen, Melanie Y; McCall, Jordan G; Dikranian, Krikor; Gereau, Robert W

    2016-10-01

    Primary cultures of rodent sensory neurons are widely used to investigate the cellular and molecular mechanisms involved in pain, itch, nerve injury and regeneration. However, translation of these preclinical findings may be greatly improved by direct validation in human tissues. We have developed an approach to extract and culture human sensory neurons in collaboration with a local organ procurement organization (OPO). Here we describe the surgical procedure for extraction of human dorsal root ganglia (hDRG) and the necessary modifications to existing culture techniques to prepare viable adult human sensory neurons for functional studies. Dissociated sensory neurons can be maintained in culture for >10 d, and they are amenable to electrophysiological recording, calcium imaging and viral gene transfer. The entire process of extraction and culturing can be completed in <7 h, and it can be performed by trained graduate students. This approach can be applied at any institution with access to organ donors consenting to tissue donation for research, and is an invaluable resource for improving translational research. PMID:27606776

  6. Organic tanks safety program FY95 waste aging studies

    SciTech Connect

    Camaioni, D.M.; Samuels, W.D.; Clauss, S.A.; Lenihan, B.D.; Wahl, K.L.; Campbell, J.A.; Shaw, W.J.

    1995-09-01

    This report gives the second year`s findings of a study of how thermal and radiological processes may change the composition of organic compounds in the underground tanks at Hanford. Efforts were focused on the global reaction kinetics in a simulated waste exposed to {gamma} rays and the reactions of organic radicals with nitrite ion. The gas production is predominantly radiolytic. Decarboxylation of carboxylates is probably an aging pathway. TBP was totaly consumed in almost every run. Radiation clearly accelerated consumption of the other compounds. EDTA is more reactive than citrate. Oximes and possibly organic nitro compounds are key intermediates in the radiolytic redox reactions of organic compounds with nitrate/nitrite. Observations are consistent with organic compounds being progressively degraded to compounds with greater numbers of C-O bonds and fewer C-H and C-C bonds, resulting in an overall lower energy content. If the radwaste tanks are adequately ventilated and continually dosed by radioactivity, their total energy content should have declined. Level of risk depends on how rapidly carboxylate salts of moderate energy content (including EDTA fragments) degrade to low energy oxalate and formate.

  7. Work organization research at the National Institute for Occupational Safety and Health.

    PubMed

    Rosenstock, L

    1997-01-01

    For 25 years, the National Institute for Occupational Safety and Health (NIOSH) has conducted and sponsored laboratory, field, and epidemiological studies that have helped define the role of work organization factors in occupational safety and health. Research has focused on the health effects of specific job conditions, occupational stressors in specific occupations, occupational difference in the incidence of stressors and stress-related disorders, and intervention strategies. NIOSH and the American Psychological Association have formalized the concept of occupational health psychology and developed a postdoctoral training program. The National Occupational Research Agenda recognizes organization of work as one of 21 national occupational safety and health research priority areas. Future research should focus on industries, occupations, and populations at special risk; the impact of work organization on overall health; the identification of healthy organization characteristics; and the development of intervention strategies. PMID:9552275

  8. Alternative and Organic Beef Production: Food-Safety Issues

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The sales of organic beef is increasing yearly due to the perception of it being more nutritious, better for the environment, contains minimal levels of pesticides, is produced without growth hormones, is not genetically engineered, and is produced using improved animal welfare practices. Artisan, ...

  9. 76 FR 71346 - Patient Safety Organizations: Voluntary Relinquishment From Peminic Inc. dba The Peminic-Greeley PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-11-17

    ... confidential information regarding the quality and safety of health care delivery. The Patient Safety and... conduct activities to improve patient safety and the quality of health care delivery. HHS issued the... HUMAN SERVICES Agency for Healthcare Research and Quality Patient Safety Organizations:...

  10. Indications, Contraindications, and Complications of Mesh in Surgical Treatment of Pelvic Organ Prolapse

    PubMed Central

    Ellington, David R.; Richter, Holly E.

    2013-01-01

    Women are seeking care for pelvic organ prolapse (POP) in increasing numbers and a significant proportion of them will undergo a second repair for recurrence. This has initiated interest by both surgeons and industry to utilize and design prosthetic mesh materials to help augment longevity of prolapse repairs. Unfortunately, the introduction of transvaginal synthetic mesh kits for use in women was done without the benefit of Level 1 data to determine its utility compared to native tissue repair. This report summarizes the potential benefit/risks of transvaginal synthetic mesh use for POP and recommendations regarding its continued use. PMID:23563869

  11. Organic tanks safety program FY96 waste aging studies

    SciTech Connect

    Camaioni, D.M.; Samuels, W.D.; Linehan, J.C.; Clauss, S.A.; Sharma, A.K.; Wahl, K.L.; Campbell, J.A.

    1996-10-01

    Uranium and plutonium production at the Hanford Site produced large quantities of radioactive by-products and contaminated process chemicals, which are stored in underground tanks awaiting treatment and disposal. Having been made strongly alkaline and then subjected to successive water evaporation campaigns to increase storage capacity, the wastes now exist in the physical forms of salt cakes, metal oxide sludges, and partially saturated aqueous brine solutions. The tanks that contain organic process chemicals mixed with nitrate/nitrite salt wastes may be at risk for fuel- nitrate combustion accidents. The purpose of the Waste Aging Task is to elucidate how chemical and radiological processes will have aged or degraded the organic compounds stored in the tanks. Ultimately, the task seeks to develop quantitative measures of how aging changes the energetic properties of the wastes. This information will directly support efforts to evaluate the hazard as well as to develop potential control and mitigation strategies.

  12. Real-time deformations of organ based on structural mechanics for surgical simulators

    NASA Astrophysics Data System (ADS)

    Nakaguchi, Toshiya; Tagaya, Masashi; Tamura, Nobuhiko; Tsumura, Norimichi; Miyake, Yoichi

    2006-03-01

    This research proposes the deformation model of organs for the development of the medical training system using Virtual Reality (VR) technology. First, the proposed model calculates the strains of coordinate axis. Secondly, the deformation is obtained by mapping the coordinate of the object to the strained coordinate. We assume the beams in the coordinate space to calculate the strain of the coordinate axis. The forces acting on the object are converted to the forces applied to the beams. The bend and the twist of the beams are calculated based on the theory of structural mechanics. The bend is derived by the finite element method. We propose two deformation methods which differ in the position of the beams in the coordinate space. One method locates the beams along the three orthogonal axes (x, y, z). Another method locates the beam in the area where the deformation is large. In addition, the strain of the coordinate axis is attenuated in proportion to the distance from the point of action to consider the attenuation of the stress which is a viscoelastic feature of the organs. The proposed model needs less computational cost compared to the conventional deformation method since our model does not need to divide the object into the elasticity element. The proposed model was implemented in the laparoscopic surgery training system, and a real-time deformation can be realized.

  13. Lethal and sublethal effects of cadmium on marine organisms: a critical discussion about ''safety levels''

    SciTech Connect

    Sperling, K.R.

    1983-12-01

    The applicability of terms such as ''safety level'' and ''safety factor'' for the purpose of risk assessment in the frame of the marine dumping conventions is discussed. In view of a series of experiments on sublethal effects of cadmium on marine organisms it is stated that the dose-response relationships cover a range of 10(4), and that there is no indication that the lowest level found so far is actually just above a no-effect threshold.

  14. Development of AR Surgical Navigation Systems for Multiple Surgical Regions.

    PubMed

    Suzuki, Naoki; Hattori, Asaki; Iimura, Jiro; Otori, Nobuyoshi; Onda, Shinji; Okamoto, Tomoyoshi; Yanaga, Katsuhiko

    2014-01-01

    The purpose of our research is to develop surgical navigation systems to enhance surgical safety. Our systems make use of augmented reality technology to superimpose, on the surgery screen on a real time basis, patients' organ models reconstructed in 3D from their X-ray CT data taken before surgery. By doing so, the systems display anatomical risk materials, tumors and blood vessels which surgeons cannot see with their naked eyes. This will in turn lead to surgeons intuitively grasping the inner structures of the operational fields. We so far have been developing navigation systems that can conduct surgeries in various fields. The basic structure of the navigation systems are the same. The navigation systems uses different peripheral equipment and different methods to display navigation images which best meet the demands of each type of surgery. In this thesis, we report on our navigation systems for 2 types of surgery - endoscopic sinus surgery and hepatobilialy-pancreatic surgery. PMID:24732545

  15. The Vaccine Safety Datalink: immunization research in health maintenance organizations in the USA.

    PubMed Central

    Chen, R. T.; DeStefano, F.; Davis, R. L.; Jackson, L. A.; Thompson, R. S.; Mullooly, J. P.; Black, S. B.; Shinefield, H. R.; Vadheim, C. M.; Ward, J. I.; Marcy, S. M.

    2000-01-01

    The Vaccine Safety Datalink is a collaborative project involving the National Immunization Program of the Centers for Disease Control and Prevention and several large health maintenance organizations in the USA. The project began in 1990 with the primary purpose of rigorously evaluating concerns about the safety of vaccines. Computerized data on vaccination, medical outcome (e.g. outpatient visits, emergency room visits, hospitalizations, and deaths) and covariates (e.g. birth certificates, census data) are prospectively collected and linked under joint protocol at multiple health maintenance organizations for analysis. Approximately 6 million persons (2% of the population of the USA) are now members of health maintenance organizations participating in the Vaccine Safety Datalink, which has proved to be a valuable resource providing important information on a number of vaccine safety issues. The databases and infrastructure created for the Vaccine Safety Datalink have also provided opportunities to address vaccination coverage, cost-effectiveness and other matters connected with immunization as well as matters outside this field. PMID:10743283

  16. Safety evaluation for packaging for onsite transfer of B Plant organic waste

    SciTech Connect

    Mercado, M.S.

    1996-10-07

    This safety evaluation for packaging authorizes the use of a 17,500-L (4,623-gal) tank manufactured by Brenner Tank, Incorporated, to transport up to 16,221 L (4,285 gal) of radioactive organic liquid waste. The waste will be transported from the organic loading pad to a storage pad. Both pads are within the B Plant complex, but approximately 4 mi apart.

  17. Who is Using Telehealth in Primary Care? Safety Net Clinics and Health Maintenance Organizations (HMOs).

    PubMed

    Coffman, Megan; Moore, Miranda; Jetty, Anuradha; Klink, Kathleen; Bazemore, Andrew

    2016-01-01

    Despite rapid advancements in telehealth services, only 15% of family physicians in a 2014 survey reported using telehealth; use varied widely according to the physician's practice setting or designation. Users were significantly more likely than nonusers to work in federally designated "safety net" clinics and health maintenance organizations (HMOs) but not more likely than nonusers to report working in a patient-centered medical home (PCMH) or accountable care organization. PMID:27390373

  18. The role for leaders of health care organizations in patient safety.

    PubMed

    Clarke, John R; Lerner, Jeffrey C; Marella, William

    2007-01-01

    We review what leaders of health care systems, including chief executive officers and board members, need to know to have "patient safety literacy" and do to make their systems safe. High reliability organizations produce reliable results that are not dependent on providers being perfect. Their characteristics include the commitment of leadership to safety as a system responsibility, with a culture of safety that decreases variability with standardized care and does not condone "at-risk behavior." A business case can be made for investing resources into systems that produce good outcomes reliably. Leaders must see patient safety problems as problems with their system, not with their employees. Leaders need to give providers information to make and monitor system progress. All medical errors, including near misses, and processes associated with all adverse events may provide information for system improvement. Improving systems should produce better long-term results than educating workers to be more careful. PMID:17804390

  19. OVERVIEW OF SAFETY OF MICROBIAL INSECTICIDES TO ESTUARINE AND MARINE ORGANISMS

    EPA Science Inventory

    The chapter presents an overview of safety tests of microbial insecticides to estuarine and marine organisms that have been performed to date. Approaches and experimental design, species of MPCAs tested, systems used, and endpoints and results evaluated for determination of risks...

  20. Continuing Education Meets the Learning Organization: The Challenge of a Systems Approach to Patient Safety.

    ERIC Educational Resources Information Center

    Eisenberg, John M.

    2000-01-01

    Increased attention to medical errors and patient safety highlights the importance of quality improvement in continuing medical education. Ways to enhance quality include informatics, clinical practice guidelines, learning from opinion leaders and patients, learning organizations, and just-in-time and point-of-care delivery of continuing…

  1. The SAFER guides: empowering organizations to improve the safety and effectiveness of electronic health records.

    PubMed

    Sittig, Dean F; Ash, Joan S; Singh, Hardeep

    2014-05-01

    Electronic health records (EHRs) have potential to improve quality and safety of healthcare. However, EHR users have experienced safety concerns from EHR design and usability features that are not optimally adapted for the complex work flow of real-world practice. Few strategies exist to address unintended consequences from implementation of EHRs and other health information technologies. We propose that organizations equipped with EHRs should consider the strategy of "proactive risk assessment" of their EHR-enabled healthcare system to identify and address EHR-related safety concerns. In this paper, we describe the conceptual underpinning of an EHR-related self-assessment strategy to provide institutions a foundation upon which they could build their safety efforts. With support from the Office of the National Coordinator for Health Information Technology (ONC), we used a rigorous, iterative process to develop a set of 9 self-assessment tools to optimize the safety and safe use of EHRs. These tools, referred to as the Safety Assurance Factors for EHR Resilience (SAFER) guides, could be used to self-assess safety and effectiveness of EHR implementations, identify specific areas of vulnerability, and create solutions and culture change to mitigate risks. A variety of audiences could conduct these assessments, including frontline clinicians or care teams in different practices, or clinical, quality, or administrative leaders within larger institutions. The guides use a multifaceted systems-based approach to assess risk and empower organizations to work with internal or external stakeholders (eg, EHR developers) on optimizing EHR functionality and using EHRs to drive improvements in the quality and safety of healthcare. PMID:25181570

  2. The Safety and Acceptance of the PrePex Device for Non-Surgical Adult Male Circumcision in Rakai, Uganda. A Non-Randomized Observational Study

    PubMed Central

    Kigozi, Godfrey; Musoke, Richard; Watya, Stephen; Kighoma, Nehemia; Nkale, James; Nakafeero, Mary; Namuguzi, Dan; Serwada, David; Nalugoda, Fred; Sewankambo, Nelson; Wawer, Maria Joan; Gray, Ronald Henry

    2014-01-01

    Objectives To assess the safety and acceptance of the PrePex device for medical male circumcision (MMC) in rural Uganda. Methods In an observational study, HIV-uninfected, uncircumcised men aged 18 and older who requested elective MMC were informed about the PrePex and dorsal slit methods and offered a free choice of their preferred procedure. 100 men received PrePex to assess preliminary safety (aim 1). An additional 329 men, 250 chose PrePex and 79 chose Dorsal slit, were enrolled following approval by the Safety Monitoring Committee (aim 2). Men were followed up at 7 days to assess adverse events (AEs) and to remove the PrePex device. Wound healing was assessed at 4 weeks, with subsequent weekly follow up until completed healing. Results The PrePex device was contraindicated in 5.7% of men due to a tight prepuce or phimosis/adhesions. Among 429 enrolled men 350 (82.0%) got the PrePex device and 79 (18.0%) the dorsal slit procedure. 250 of 329 men (76.0%) who were invited to choose between the 2 procedures chose Prepex. There were 9 AEs (2.6%) with the PrePex, of which 5 (1.4%) were severe complications, 4 due to patient self-removal of the device leading to edema and urinary obstruction requiring emergency surgical circumcision, and one due to wound dehiscence following device removal. 71.8% of men reported an unpleasant odor prior to PrePex removal. Cumulative rates of completed wound healing with the PrePex were 56.7% at week 4, 84.8% week 5, 97.6% week 6 and 98.6% week 7, compared to 98.7% at week 4 with dorsal slit (p<0.0001). Conclusion The PrePex device was well accepted, but healing was slower than with dorsal slit surgery. Severe complications, primarily following PrePex self-removal, required rapid access to emergency surgical facilities. The need to return for removal and delayed healing may increase Program cost and client burden. PMID:25144194

  3. Resolving the safety issue for radioactive waste tanks with high organic content

    SciTech Connect

    Babad, H.; Crippen, M.D.; Turner, D.A. ); Gerber, M.A. )

    1993-02-01

    An overview of the Waste Tank Safety Organic Program is provided. The overview discusses the history of the wastes containing high concentrations of organics, existing safety criteria associated with those tanks, and details of thermodynamic studies by Westinghouse Hanford Company bounding potential reactivity. The program to be discussed contains the elements of the collection and analysis of tank historical information; reevaluation of organic tank-listing criteria; the performance of detailed studies on simulated waste; completion of waste characterization for each affected tank; and, as part of issue closure, the preparation of short-term and long-term safety and risk assessments based on results from characterization and the waste simulant studies. This document reports on a number of simplified thermodynamic calculations that were performed to ascertain combustion limits for simple surrogates of organic materials in a nitrate-nitrite containing alkaline waste. For expected waste species, the results of these calculations indicate that the range of reactivity encompasses energies that vary only by a factor of three over the range of normal paraffin hydrocarbon (NPH) (a fuel rich solvent) to sodium oxalate (a degradation product resulting from in situ organic complexant destruction in Hanford Site wastes).

  4. The changing organization of work and the safety and health of working people: a commentary.

    PubMed

    Landsbergis, Paul A

    2003-01-01

    Recent trends in the organization of work may affect worker health through a variety of pathways--by increasing the risk of stress-related illnesses, such as cardiovascular disease, musculoskeletal disorders, and psychological disorders, by increasing exposure to hazardous substances and violence on the job, or by affecting occupational health services and training programs. Much remains to be learned about the nature of changes in work organization, and how they affect worker health and safety. While available evidence is limited, such evidence suggests that recent trends in work organization may be increasing the risk of occupational illnesses. In a groundbreaking publication, the National Institute for Occupational Safety and Health has provided a concise summary of available knowledge and a detailed agenda for research and development. PMID:12553180

  5. Safety subcultures in health-care organizations and managing medical error.

    PubMed

    Sirriyeh, Reema; Lawton, Rebecca; Armitage, Gerry; Gardner, Peter; Ferguson, Sally

    2012-02-01

    Leadership has been proposed as a key latent factor influencing the safety culture of an organization, the likelihood of errors occurring and the way in which these are managed. Therefore, when an error occurs, managers have an integral role to ensure that the most desirable outcomes are achieved for patients, health-care staff and their organization. Semistructured interviews were conducted in a large UK teaching hospital to explore the perspectives of staff who are tasked in some way with managing patient safety. Data from 26 transcripts were analysed using an adapted version of Spencer's (2003) qualitative framework, which revealed five primary themes. This paper reports findings from two overarching primary themes, described as being management and safety subcultures. These themes describe experiences of managing medical errors and the subgroup variations between professions, ranks and specialties in attitudes and behaviours towards error, and its management in a large National Health Service Trust. We discuss implications for health-care managers and health professionals in developing a stronger and more unified safety culture in their organizations, along with considerations for academic researchers when undertaking health services research. PMID:22323667

  6. Safety analysis of exothermic reaction hazards associated with the organic liquid layer in tank 241-C-103

    SciTech Connect

    Postma, A.K.; Bechtold, D.B.; Borsheim, G.L.; Grisby, J.M.; Guthrie, R.L.; Kummerer, M.; Turner, D.A.; Plys, M.G.

    1994-03-01

    Safety hazards associated with the interim storage of a potentially flammable organic liquid in waste Tank C-103 are identified and evaluated. The technical basis for closing the unreviewed safety question (USQ) associated with the floating liquid organic layer in this tank is presented.

  7. Early experience of a safety net provider reorganizing into an accountable care organization.

    PubMed

    Hacker, Karen; Santos, Palmira; Thompson, Douglas; Stout, Somava S; Bearse, Adriana; Mechanic, Robert E

    2014-08-01

    Although safety net providers will benefit from health insurance expansions under the Affordable Care Act, they also face significant challenges in the postreform environment. Some have embraced the concept of the accountable care organization to help improve quality and efficiency while addressing financial shortfalls. The experience of Cambridge Health Alliance (CHA) in Massachusetts, where health care reform began six years ago, provides insight into the opportunities and challenges of this approach in the safety net. CHA's strategies include care redesign, financial realignment, workforce transformation, and development of external partnerships. Early results show some improvement in access, patient experience, quality, and utilization; however, the potential efficiencies will not eliminate CHA's current operating deficit. The patient population, payer mix, service mix, cost structure, and political requirements reduce the likelihood of financial sustainability without significant changes in these factors, increased public funding, or both. Thus the future of safety net institutions, regardless of payment and care redesign success, remains at risk. PMID:24842968

  8. Organized labor and the origins of the Occupational Safety and Health Act.

    PubMed

    Asher, Robert

    2014-11-01

    New Solutions is republishing this 1991 article by Robert Asher, which reviews the history of organized labor's efforts in the United States to secure health and safety protections for workers. The 1877 passage of the Massachusetts factory inspection law and the implementation of primitive industrial safety inspection systems in many states paralleled labor action for improved measures to protect workers' health and safety. In the early 1900s labor was focusing on workers' compensation laws. The New Deal expanded the federal government's role in worker protection, supported at least by the Congress of Industrial Organizations (CIO), but challenged by industry and many members of the U.S. Congress. The American Federation of Labor (AFL) and the CIO backed opposing legal and inspection strategies in the late 1940s and through the 1950s. Still, by the late 1960s, several unions were able to help craft the Occupational Safety and Health Act of 1970 and secure new federal protections for U.S. workers. PMID:25261023

  9. Nonsteroidal Anti-Inflammatory Drugs: A survey of practices and concerns of pediatric medical and surgical specialists and a summary of available safety data

    PubMed Central

    2010-01-01

    Objectives To examine the prescribing habits of NSAIDs among pediatric medical and surgical practitioners, and to examine concerns and barriers to their use. Methods A sample of 1289 pediatricians, pediatric rheumatologists, sports medicine physicians, pediatric surgeons and pediatric orthopedic surgeons in the United States and Canada were sent an email link to a 22-question web-based survey. Results 338 surveys (28%) were completed, 84 were undeliverable. Of all respondents, 164 (50%) had never prescribed a selective cyclooxygenase-2 (COX-2) NSAID. The most common reasons for ever prescribing an NSAID were musculoskeletal pain, soft-tissue injury, fever, arthritis, fracture, and headache. Compared to traditional NSAIDs, selective COX-2 NSAIDs were believed to be as safe (42%) or safer (24%); have equal (52%) to greater efficacy (20%) for pain; have equal (59%) to greater efficacy (15%) for inflammation; and have equal (39%) to improved (44%) tolerability. Pediatric rheumatologists reported significantly more frequent abdominal pain (81% vs. 23%), epistaxis (13% vs. 2%), easy bruising (64% vs. 8%), headaches (21% vs. 1%) and fatigue (12% vs. 1%) for traditional NSAIDs than for selective COX-2 NSAIDs. Prescribing habits of NSAIDs have changed since the voluntary withdrawal of rofecoxib and valdecoxib; 3% of pediatric rheumatologists reported giving fewer traditional NSAID prescriptions, and while 57% reported giving fewer selective COX-2 NSAIDs, 26% reported that they no longer prescribed these medications. Conclusions Traditional and selective COX-2 NSAIDs were perceived as safe by pediatric specialists. The data were compared to the published pediatric safety literature. PMID:20181090

  10. Waste Tank Organic Safety Program: Analytical methods development. Progress report, FY 1994

    SciTech Connect

    Campbell, J.A.; Clauss, S.A.; Grant, K.E.

    1994-09-01

    The objectives of this task are to develop and document extraction and analysis methods for organics in waste tanks, and to extend these methods to the analysis of actual core samples to support the Waste Tank organic Safety Program. This report documents progress at Pacific Northwest Laboratory (a) during FY 1994 on methods development, the analysis of waste from Tank 241-C-103 (Tank C-103) and T-111, and the transfer of documented, developed analytical methods to personnel in the Analytical Chemistry Laboratory (ACL) and 222-S laboratory. This report is intended as an annual report, not a completed work.

  11. Hanford Site organic waste tanks: History, waste properties, and scientific issues. Hanford Tank Safety Project

    SciTech Connect

    Strachan, D.M.; Schulz, W.W.; Reynolds, D.A.

    1993-01-01

    Eight Hanford single-shell waste tanks are included on a safety watch list because they are thought to contain significant concentrations of various organic chemical. Potential dangers associated with the waste in these tanks include exothermic reaction, combustion, and release of hazardous vapors. In all eight tanks the measured waste temperatures are in the range 16 to 46{degree}C, far below the 250 to 380{degree}C temperatures necessary for onset of rapid exothermic reactions and initiation of deflagration. Investigation of the possibility of vapor release from Tank C-103 has been elevated to a top safety priority. There is a need to obtain an adequate number of truly representative vapor samples and for highly sensitive and capable methods and instruments to analyze these samples. Remaining scientific issues include: an understanding of the behavior and reaction of organic compounds in existing underground tank environments knowledge of the types and amounts of organic compounds in the tanks knowledge of selected physical and chemical properties of organic compounds source, composition, quality, and properties of the presently unidentified volatile organic compound(s) apparently evolving from Tank C-103.

  12. Factors in the Growth and Decline of System Safety within Organizations

    SciTech Connect

    GANTER, JOHN H.; STORAGE, WILLIAM K.

    1999-08-16

    System safety as a technical field faces numerous opportunities, and some challenges, in the high technology, low cost future. As a relatively small field best known in high consequence domains (defense, aviation, space) it may have to tailor its messages and approaches to influence organizations (both private and public) pressured by incessant competition and ''Internet time.'' We present a model of organizations as cultures that carefully ration attention and reward personnel who successfully pursue goals. These evolving goals result from a fusing of both external influences (market share: regulation) and internal influences (dominant group identities such as marketers or engineers). In the context of organizational goals, these same influences cause people to search narrowly and quickly for technologies and ideas that can fit through ''influence gates'' in the organization and that will likely grow there. System safety must thus compete with all manner of cost-cutting and quality management approaches, in an environment currently obsessed with short-term value and return on investment. From this model we develop some ideas for the communication and promotion of system safety that could increase the net impact and effectiveness of the field.

  13. Application of the risk-based strategy to the Hanford tank waste organic-nitrate safety issue

    SciTech Connect

    Hunter, V.L.; Colson, S.D.; Ferryman, T.; Gephart, R.E.; Heasler, P.; Scheele, R.D.

    1997-12-01

    This report describes the results from application of the Risk-Based Decision Management Approach for Justifying Characterization of Hanford Tank Waste to the organic-nitrate safety issue in Hanford single-shell tanks (SSTs). Existing chemical and physical models were used, taking advantage of the most current (mid-1997) sampling and analysis data. The purpose of this study is to make specific recommendations for planning characterization to help ensure the safety of each SST as it relates to the organic-nitrate safety issue. An additional objective is to demonstrate the viability of the Risk-Based Strategy for addressing Hanford tank waste safety issues.

  14. Safety.

    ERIC Educational Resources Information Center

    Education in Science, 1996

    1996-01-01

    Discusses safety issues in science, including: allergic reactions to peanuts used in experiments; explosions in lead/acid batteries; and inspection of pressure vessels, such as pressure cookers or model steam engines. (MKR)

  15. Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

    PubMed

    Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; O'Keeffe, Daniel F

    2015-01-01

    Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have a role in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now. PMID:25857371

  16. Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

    PubMed

    Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; OʼKeeffe, Daniel F

    2015-05-01

    Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have a role in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now. PMID:25932832

  17. Transforming communication and safety culture in intrapartum care: a multi-organization blueprint.

    PubMed

    Lyndon, Audrey; Johnson, M Christina; Bingham, Debra; Napolitano, Peter G; Joseph, Gerald; Maxfield, David G; O'Keeffe, Daniel F

    2015-01-01

    Effective, patient-centered communication facilitates interception and correction of potentially harmful conditions and errors. All team members, including women, their families, physicians, midwives, nurses, and support staff, have roles in identifying the potential for harm during labor and birth. However, the results of collaborative research studies conducted by organizations that represent professionals who care for women during labor and birth indicate that health care providers may frequently witness, but may not always report, problems with safety or clinical performance. Some of these health care providers felt resigned to the continuation of such problems and fearful of retribution if they tried to address them. Speaking up to address safety and quality concerns is a dynamic social process. Every team member must feel empowered to speak up about concerns without fear of put-downs, retribution, or receiving poor-quality care. Patient safety requires mutual accountability: individuals, teams, health care facilities, and professional associations have a shared responsibility for creating and sustaining environments of mutual respect and engaging in highly reliable perinatal care. Defects in human factors, communication, and leadership have been the leading contributors to sentinel events in perinatal care for more than a decade. Organizational commitment and executive leadership are essential to creating an environment that proactively supports safety and quality. The problem is well-known; the time for action is now. PMID:25851413

  18. Exploring the state of health and safety management system performance measurement in mining organizations

    PubMed Central

    Haas, Emily Joy; Yorio, Patrick

    2016-01-01

    Complex arguments continue to be articulated regarding the theoretical foundation of health and safety management system (HSMS) performance measurement. The culmination of these efforts has begun to enhance a collective understanding. Despite this enhanced theoretical understanding, however, there are still continuing debates and little consensus. The goal of the current research effort was to empirically explore common methods to HSMS performance measurement in mining organizations. The purpose was to determine if value and insight could be added into the ongoing approaches of the best ways to engage in health and safety performance measurement. Nine site-level health and safety management professionals were provided with 133 practices corresponding to 20 HSMS elements, each fitting into the plan, do, check, act phases common to most HSMS. Participants were asked to supply detailed information as to how they (1) assess the performance of each practice in their organization, or (2) would assess each practice if it were an identified strategic imperative. Qualitative content analysis indicated that the approximately 1200 responses provided could be described and categorized into interventions, organizational performance, and worker performance. A discussion of how these categories relate to existing indicator frameworks is provided. The analysis also revealed divergence in two important measurement issues; (1) quantitative vs qualitative measurement and reporting; and (2) the primary use of objective or subjective metrics. In lieu of these findings we ultimately recommend a balanced measurement and reporting approach within the three metric categories and conclude with suggestions for future research. PMID:26823642

  19. Food safety in free-range and organic livestock systems: risk management and responsibility.

    PubMed

    Kijlstra, A; Meerburg, B G; Bos, A P

    2009-12-01

    Animal production systems that offer outdoor access to the animals have become increasingly popular in the Western world due to the growing general discontent of consumers with conventional bioindustrial farming practices. These open production systems offer improved animal welfare but may create new problems for animal health, resulting in increased food safety risks from bacterial, viral, or parasitic infections or environmental contaminants. Examples of these new problems include increased Toxoplasma gondii infections in pigs and high dioxin levels in eggs from free-range hens. In this review, the relation between positive and negative points of free-range and organic livestock production systems is discussed with reference to production in The Netherlands. We investigated how proponents of more animal welfare friendly systems deal with potential negative issues in public and whether any risk communication is used. Generally, we found that the existence of a dilemma is disputed or avoided in communication with the consumer. This avoidance could be detrimental for public trust in alternative animal production systems, should problems occur. To prevent future problems, it will be necessary to communicate about the relevant types and sources of the food safety risks to the consumers. The responsibility for protecting food safety should be properly divided among the various parties involved: producers, processors, governments, nongovernmental organizations, and consumers. PMID:20003752

  20. Surgical Instrument Restraint in Weightlessness

    NASA Technical Reports Server (NTRS)

    Campbell, Mark R.; Dawson, David L.; Melton, Shannon; Hooker, Dona; Cantu, Hilda

    2000-01-01

    Performing a surgical procedure during spaceflight will become more likely with longer duration missions in the near future. Minimal surgical capability has been present on previous missions as the definitive medical care time was short and the likelihood of surgical events too low to justify surgical hardware availability. Early demonstrations of surgical procedures in the weightlessness of parabolic flight indicated the need for careful logistical planning and restraint of surgical hardware. The consideration of human ergonomics also has more impact in weightlessness than in the conventionall-g environment. Three methods of surgical instrument restraint - a Minor Surgical Kit (MSK), a Surgical Restraint Scrub Suit (SRSS), and a Surgical Tray (ST) were evaluated in parabolic flight surgical procedures. The Minor Surgical Kit was easily stored, easily deployed, and demonstrated the best ability to facilitate a surgical procedure in weightlessness. Important factors in this surgical restraint system include excellent organization of supplies, ability to maintain sterility, accessibility while providing secure restraint, ability to dispose of sharp items and biological trash, and ergonomical efficiency.

  1. The safety assessment of food ingredients derived from plant cell, tissue and organ cultures: a review.

    PubMed

    Murthy, Hosakatte Niranjana; Georgiev, Milen I; Park, So-Young; Dandin, Vijayalaxmi S; Paek, Kee-Yoeup

    2015-06-01

    Plant cell, tissue and organ cultures (PCTOC) have become an increasingly attractive alternative for the production of various high molecular weight molecules which are used as flavourings, fragrances, colouring agents and food additives. Although PCTOC products are cultivated in vitro in a contamination free environment, the raw material produced from PCTOC may contain many components apart from the target compound. In some cases, PCTOC raw materials may also carry toxins, which may be naturally occurring or accumulated during the culture process. Assessment of the safety of PCTOC products is, therefore, a priority of the biotech industries involved in their production. The safety assessment involves the evaluation of starting material, production process and the end product. Before commercialisation, PCTOC products should be evaluated for their chemical and biological properties, as well as for their toxicity. In this review, measures and general criteria for biosafety evaluation of PCTOC products are addressed and thoroughly discussed. PMID:25624252

  2. Organic food: buying more safety or just peace of mind? A critical review of the literature.

    PubMed

    Magkos, Faidon; Arvaniti, Fotini; Zampelas, Antonis

    2006-01-01

    Consumer concern over the quality and safety of conventional food has intensified in recent years, and primarily drives the increasing demand for organically grown food, which is perceived as healthier and safer. Relevant scientific evidence, however, is scarce, while anecdotal reports abound. Although there is an urgent need for information related to health benefits and/or hazards of food products of both origins, generalized conclusions remain tentative in the absence of adequate comparative data. Organic fruits and vegetables can be expected to contain fewer agrochemical residues than conventionally grown alternatives; yet, the significance of this difference is questionable, inasmuch as actual levels of contamination in both types of food are generally well below acceptable limits. Also, some leafy, root, and tuber organic vegetables appear to have lower nitrate content compared with conventional ones, but whether or not dietary nitrate indeed constitutes a threat to human health is a matter of debate. On the other hand, no differences can be identified for environmental contaminants (e.g. cadmium and other heavy metals), which are likely to be present in food from both origins. With respect to other food hazards, such as endogenous plant toxins, biological pesticides and pathogenic microorganisms, available evidence is extremely limited preventing generalized statements. Also, results for mycotoxin contamination in cereal crops are variable and inconclusive; hence, no clear picture emerges. It is difficult, therefore, to weigh the risks, but what should be made clear is that 'organic' does not automatically equal 'safe.' Additional studies in this area of research are warranted. At our present state of knowledge, other factors rather than safety aspects seem to speak in favor of organic food. PMID:16403682

  3. Preliminary safety criteria for organic watch list tanks at the Hanford site

    SciTech Connect

    Webb, A.B.; Stewart, J.L.; Turner, O.A.; Plys, M.G.; Malinovic, B.; Grigsby, J.M.; Camaioni, D.M.; Heasler, P.G.; Samuels, W.O.; Toth, J.J.

    1995-11-01

    Condensed-phase, rapid reactions of organic salts with nitrates/nitrites in Hanford High Level Radioactive Waste single-shell tanks could lead to structural failure of the tanks resulting in significant releases of radionuclides and toxic materials. This report establishes appropriate preliminary safety criteria to ensure that tank wastes will be maintained safe. These criteria show that if actual dry wastes contain less than 1.2 MJ/kg of reactants reaction energy or less 4.5 wt % of total organic carbon, then the waste will be safe and will not propagate if ignited. Waste moisture helps to retard reactions; when waste moisture exceeds 20 wt %, rapid reactions are prevented, regardless of organic carbon concentrations. Aging and degradation of waste materials has been considered to predict the types and amounts to organic compounds present in the waste. Using measurements of 3 waste phases (liquid, salt cake, and sludge) obtained from tank waste samples analyzed in the laboratory, analysis of variance (ANOVA) models were used to estimate waste states for unmeasured tanks. The preliminary safety criteria are based upon calorimetry and propagation testing of likely organic compounds which represent actual tank wastes. These included sodium salts of citrate, formate, acetate and hydroxyethylethylenediaminetricetate (HEDTA). Hot cell tests of actual tank wastes are planned for the future to confirm propagation tests performed in the laboratory. The effects of draining liquids from the tanks which would remove liquids and moisture were considered because reactive waste which is too dry may propagate. Evaporation effects which could remove moisture from the tanks were also calculated. The various ways that the waste could be heated or ignited by equipment failures or tank operations activities were considered and appropriate monitoring and controls were recommended.

  4. Surgical Airway

    PubMed Central

    Patel, Sapna A; Meyer, Tanya K

    2014-01-01

    Close to 3% of all intubation attempts are considered difficult airways, for which a plan for a surgical airway should be considered. Our article provides an overview of the different types of surgical airways. This article provides a comprehensive review of the main types of surgical airways, relevant anatomy, necessary equipment, indications and contraindications, preparation and positioning, technique, complications, and tips for management. It is important to remember that the placement of a surgical airway is a lifesaving procedure and should be considered in any setting when one “cannot intubate, cannot ventilate”. PMID:24741501

  5. Surgical Simulation

    PubMed Central

    Sutherland, Leanne M.; Middleton, Philippa F.; Anthony, Adrian; Hamdorf, Jeffrey; Cregan, Patrick; Scott, David; Maddern, Guy J.

    2006-01-01

    Objective: To evaluate the effectiveness of surgical simulation compared with other methods of surgical training. Summary Background Data: Surgical simulation (with or without computers) is attractive because it avoids the use of patients for skills practice and provides relevant technical training for trainees before they operate on humans. Methods: Studies were identified through searches of MEDLINE, EMBASE, the Cochrane Library, and other databases until April 2005. Included studies must have been randomized controlled trials (RCTs) assessing any training technique using at least some elements of surgical simulation, which reported measures of surgical task performance. Results: Thirty RCTs with 760 participants were able to be included, although the quality of the RCTs was often poor. Computer simulation generally showed better results than no training at all (and than physical trainer/model training in one RCT), but was not convincingly superior to standard training (such as surgical drills) or video simulation (particularly when assessed by operative performance). Video simulation did not show consistently better results than groups with no training at all, and there were not enough data to determine if video simulation was better than standard training or the use of models. Model simulation may have been better than standard training, and cadaver training may have been better than model training. Conclusions: While there may be compelling reasons to reduce reliance on patients, cadavers, and animals for surgical training, none of the methods of simulated training has yet been shown to be better than other forms of surgical training. PMID:16495690

  6. Surgical revolutions.

    PubMed

    Toledo-Pereyra, Luis H

    2008-01-01

    Many surgical revolutions distinguish the history and evolution of surgery. They come in different sizes and exert a variable effect on the development and practice of the discipline. As science and technology rapidly evolve, so too does the creation of new paradigms, ideas and innovations or discoveries for the improvement of the surgical sciences. Surgical revolutions are not new, and have existed for centuries even though they have been more frequently recognized since the middle of the 19th century, 20th century and down to the present. Surgical revolutionaries are indispensable in the conception and completion of any surgical revolution. However, scientific and technological advances have supported the culmination of each revolution. PMID:18615311

  7. The Patient's Voice in Pharmacovigilance: Pragmatic Approaches to Building a Patient-Centric Drug Safety Organization.

    PubMed

    Smith, Meredith Y; Benattia, Isma

    2016-09-01

    Patient-centeredness has become an acknowledged hallmark of not only high-quality health care but also high-quality drug development. Biopharmaceutical companies are actively seeking to be more patient-centric in drug research and development by involving patients in identifying target disease conditions, participating in the design of, and recruitment for, clinical trials, and disseminating study results. Drug safety departments within the biopharmaceutical industry are at a similar inflection point. Rising rates of per capita prescription drug use underscore the importance of having robust pharmacovigilance systems in place to detect and assess adverse drug reactions (ADRs). At the same time, the practice of pharmacovigilance is being transformed by a host of recent regulatory guidances and related initiatives which emphasize the importance of the patient's perspective in drug safety. Collectively, these initiatives impact the full range of activities that fall within the remit of pharmacovigilance, including ADR reporting, signal detection and evaluation, risk management, medication error assessment, benefit-risk assessment and risk communication. Examples include the fact that manufacturing authorization holders are now expected to monitor all digital sources under their control for potential reports of ADRs, and the emergence of new methods for collecting, analysing and reporting patient-generated ADR reports for signal detection and evaluation purposes. A drug safety department's ability to transition successfully into a more patient-centric organization will depend on three defining attributes: (1) a patient-centered culture; (2) deployment of a framework to guide patient engagement activities; and (3) demonstrated proficiency in patient-centered competencies, including patient engagement, risk communication and patient preference assessment. Whether, and to what extent, drug safety departments embrace the new patient-centric imperative, and the methods and

  8. Biodegradable scaffold with built-in vasculature for organ-on-a-chip engineering and direct surgical anastomosis

    NASA Astrophysics Data System (ADS)

    Zhang, Boyang; Montgomery, Miles; Chamberlain, M. Dean; Ogawa, Shinichiro; Korolj, Anastasia; Pahnke, Aric; Wells, Laura A.; Massé, Stéphane; Kim, Jihye; Reis, Lewis; Momen, Abdul; Nunes, Sara S.; Wheeler, Aaron R.; Nanthakumar, Kumaraswamy; Keller, Gordon; Sefton, Michael V.; Radisic, Milica

    2016-06-01

    We report the fabrication of a scaffold (hereafter referred to as AngioChip) that supports the assembly of parenchymal cells on a mechanically tunable matrix surrounding a perfusable, branched, three-dimensional microchannel network coated with endothelial cells. The design of AngioChip decouples the material choices for the engineered vessel network and for cell seeding in the parenchyma, enabling extensive remodelling while maintaining an open-vessel lumen. The incorporation of nanopores and micro-holes in the vessel walls enhances permeability, and permits intercellular crosstalk and extravasation of monocytes and endothelial cells on biomolecular stimulation. We also show that vascularized hepatic tissues and cardiac tissues engineered by using AngioChips process clinically relevant drugs delivered through the vasculature, and that millimetre-thick cardiac tissues can be engineered in a scalable manner. Moreover, we demonstrate that AngioChip cardiac tissues implanted with direct surgical anastomosis to the femoral vessels of rat hindlimbs establish immediate blood perfusion.

  9. Guidance for implementing an environmental, safety, and health-assurance program. Volume 15. A model plan for line organization environmental, safety, and health-assurance programs

    SciTech Connect

    Ellingson, A.C.; Trauth, C.A. Jr.

    1982-01-01

    This is 1 of 15 documents designed to illustrate how an Environmental, Safety and Health (ES and H) Assurance Program may be implemented. The generic definition of ES and H Assurance Programs is given in a companion document entitled An Environmental, Safety and Health Assurance Program Standard. This particular document presents a model operational-level ES and H Assurance Program that may be used as a guide by an operational-level organization in developing its own plan. The model presented here reflects the guidance given in the total series of 15 documents.

  10. Safety Evaluation of Osun River Water Containing Heavy Metals and Volatile Organic Compounds (VOCs) in Rats.

    PubMed

    Azeez, L; Salau, A K; Adewuyi, S O; Osineye, S O; Tijani, K O; Balogun, R O

    2015-01-01

    This study evaluated the pH, heavy metals and volatile organic compounds (VOCs) in Osun river water. It also evaluated its safety in rats. Heavy metals were determined by atomic absorption spectrophotometry (AAS) while VOCs were determined by gas chromatography coupled with flame ionization detector (GC-FID). Male and female rats were exposed to Osun river water for three weeks and then sacrificed. The abundance of heavy metals in Osun river followed the trend Pb > Cd > Zn > Fe > Cr > Cu while VOCs followed the trend benzene < ethylbenzene < toluene < xylene. The concentrations of Pb, Cd and benzene were higher than the permissible limits of Standards Organization of Nigeria (SON) and World Health Organization (WHO) respectively. Rats exposed to Osun river water for three weeks had increased WBC, thiobarbituric acid reactive substances (TBARS), serum proteins and serum aminotransferases. There were also significant decreases in HCT, PLT, liver aminotransferases and liver glutathione compared to the control. These results show that the pollutants in Osun river water are capable of inducing hematological imbalance and liver cell injury. The toxicity induced in blood was sex-dependent affecting female rats more than male rats. PMID:27506174

  11. Surgical Technologists

    MedlinePlus

    ... in place during the procedure, or set up robotic surgical equipment. Technologists also may handle specimens taken ... sterilization techniques, how to set up technical or robotic equipment, and preventing and controlling infections. In addition ...

  12. Waste Tank Safety Program. Annual status report for FY 1993, Task 3: Organic chemistry

    SciTech Connect

    Lucke, R.B.; Clauss, T.T.W.; Hoheimer, R.; Goheen, S.C.

    1994-02-01

    This task supports the tank-vapor project, mainly by providing organic analytical support and by analyzing Tank 241-C-103 (Tank C-103) vapor-space samples, collected via SUMMA{trademark} canisters, by gas chromatography (GC) and GC/mass spectrometry (MS). In the absence of receiving tank-vapor samples, we have focused our efforts toward validating the normal paraffin hydrocarbon (NPH) sampling and analysis methods and preparing the SUMMA{trademark} laboratory. All required milestones were met, including a report on the update of phase I sampling and analysis on August 15, 1993. This update described the work involved in preparing to analyze phase I samples (Appendix A). This report describes the analytical support provided by Pacific Northwest Laboratory (PNL){sup (a)} to the Hanford Tank Safety Vapor Program.

  13. Hydrogen Safety Project chemical analysis support task: Window C'' volatile organic analysis

    SciTech Connect

    Gillespie, B.M.; Stromatt, R.W.; Ross, G.A.; Hoope, E.A.

    1992-01-01

    This data package contains the results obtained by Pacific Northwest Laboratory (PNL) staff in the characterization of samples for the 101-SY Hydrogen Safety Project. The samples were submitted for analysis by Westinghouse Hanford Company (WHC) under the Technical Project Plan (TPP) 17667 and the Quality Assurance Plan MCS-027. They came from a core taken during Window C'' after the May 1991 gas release event. The analytical procedures required for analysis were defined in the Test Instructions (TI) prepared by the PNL 101-SY Analytical Chemistry Laboratory (ACL) Project Management Office in accordance with the TPP and the QA Plan. The requested analysis for these samples was volatile organic analysis. The quality control (QC) requirements for each sample are defined in the Test Instructions for each sample. The QC requirements outlined in the procedures and requested in the WHC statement of work were followed.

  14. Hydrogen Safety Project chemical analysis support task: Window ``C`` volatile organic analysis

    SciTech Connect

    Gillespie, B.M.; Stromatt, R.W.; Ross, G.A.; Hoope, E.A.

    1992-01-01

    This data package contains the results obtained by Pacific Northwest Laboratory (PNL) staff in the characterization of samples for the 101-SY Hydrogen Safety Project. The samples were submitted for analysis by Westinghouse Hanford Company (WHC) under the Technical Project Plan (TPP) 17667 and the Quality Assurance Plan MCS-027. They came from a core taken during Window ``C`` after the May 1991 gas release event. The analytical procedures required for analysis were defined in the Test Instructions (TI) prepared by the PNL 101-SY Analytical Chemistry Laboratory (ACL) Project Management Office in accordance with the TPP and the QA Plan. The requested analysis for these samples was volatile organic analysis. The quality control (QC) requirements for each sample are defined in the Test Instructions for each sample. The QC requirements outlined in the procedures and requested in the WHC statement of work were followed.

  15. Biomechanical properties of synthetic surgical meshes for pelvic prolapse repair.

    PubMed

    Todros, S; Pavan, P G; Natali, A N

    2015-03-01

    Synthetic meshes are widely used for surgical repair of different kind of prolapses. In the light of the experience of abdominal wall repair, similar prostheses are currently used in the pelvic region, to restore physiological anatomy after organ prolapse into the vaginal wall, that represent a recurrent dysfunction. For this purpose, synthetic meshes are surgically positioned in contact with the anterior and/or posterior vaginal wall, to inferiorly support prolapsed organs. Nonetheless, while mesh implantation restores physiological anatomy, it is often associated with different complications in the vaginal region. These potentially dangerous effects induce the surgical community to reconsider the safety and efficacy of mesh transvaginal placement. For this purpose, the evaluation of state-of-the-art research may provide the basis for a comprehensive analysis of mesh compatibility and functionality. The aim of this work is to review synthetic surgical meshes for pelvic organs prolapse repair, taking into account the mechanics of mesh material and structure, and to relate them with pelvic and vaginal tissue biomechanics. Synthetic meshes are currently available in different chemical composition, fiber and textile conformations. Material and structural properties are key factors in determining mesh biochemical and mechanical compatibility in vivo. The most significant results on vaginal tissue and surgical meshes mechanical characterization are here reported and discussed. Moreover, computational models of the pelvic region, which could support the surgeon in the evaluation of mesh performances in physiological conditions, are recalled. PMID:26615384

  16. 77 FR 42737 - Patient Safety Organizations: Delisting for Cause for The Steward Group PSO

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-20

    ... whose mission and primary activity is to conduct activities to improve patient safety and the quality of health care delivery. HHS issued the Patient Safety and Quality Improvement Final Rule (Patient Safety..., aggregate, and analyze confidential information regarding the quality and safety of health care...

  17. Biodegradable scaffold with built-in vasculature for organ-on-a-chip engineering and direct surgical anastomosis.

    PubMed

    Zhang, Boyang; Montgomery, Miles; Chamberlain, M Dean; Ogawa, Shinichiro; Korolj, Anastasia; Pahnke, Aric; Wells, Laura A; Massé, Stéphane; Kim, Jihye; Reis, Lewis; Momen, Abdul; Nunes, Sara S; Wheeler, Aaron R; Nanthakumar, Kumaraswamy; Keller, Gordon; Sefton, Michael V; Radisic, Milica

    2016-06-01

    We report the fabrication of a scaffold (hereafter referred to as AngioChip) that supports the assembly of parenchymal cells on a mechanically tunable matrix surrounding a perfusable, branched, three-dimensional microchannel network coated with endothelial cells. The design of AngioChip decouples the material choices for the engineered vessel network and for cell seeding in the parenchyma, enabling extensive remodelling while maintaining an open-vessel lumen. The incorporation of nanopores and micro-holes in the vessel walls enhances permeability, and permits intercellular crosstalk and extravasation of monocytes and endothelial cells on biomolecular stimulation. We also show that vascularized hepatic tissues and cardiac tissues engineered by using AngioChips process clinically relevant drugs delivered through the vasculature, and that millimetre-thick cardiac tissues can be engineered in a scalable manner. Moreover, we demonstrate that AngioChip cardiac tissues implanted with direct surgical anastomosis to the femoral vessels of rat hindlimbs establish immediate blood perfusion. PMID:26950595

  18. Biodegradable scaffold with built-in vasculature for organ-on-a-chip engineering and direct surgical anastomosis

    PubMed Central

    Zhang, Boyang; Montgomery, Miles; Chamberlain, M. Dean; Ogawa, Shinichiro; Korolj, Anastasia; Pahnke, Aric; Wells, Laura A.; Massé, Stéphane; Kim, Jihye; Reis, Lewis; Momen, Abdulah; Nunes, Sara S.; Wheeler, Aaron; Nanthakumar, Kumaraswamy; Keller, Gordon; Sefton, Michael V.; Radisic, Milica

    2016-01-01

    We report the fabrication of a scaffold (hereafter referred to as AngioChip) that supports the assembly of parenchymal cells on a mechanically tunable matrix surrounding a perfusable, branched, three-dimensional microchannel network coated with endothelial cells. The design of AngioChip decouples the material choices for the engineered vessel network and for cell seeding in the parenchyma, enabling extensive remodelling while maintaining an open-vessel lumen. The incorporation of nanopores and micro-holes in the vessel walls enhances permeability, and permits intercellular crosstalk and extravasation of monocytes and endothelial cells on biomolecular stimulation. We also show that vascularized hepatic tissues and cardiac tissues engineered by using AngioChips process clinically relevant drugs delivered through the vasculature, and that millimeter-thick cardiac tissues can be engineered in a scalable manner. Moreover, we demonstrate that AngioChip cardiac tissues implanted via direct surgical anastomosis to the femoral vessels of rat hindlimbs establish immediate blood perfusion. PMID:26950595

  19. Hazardous organic compounds in biogas plant end products--soil burden and risk to food safety.

    PubMed

    Suominen, K; Verta, M; Marttinen, S

    2014-09-01

    The end products (digestate, solid fraction of the digestate, liquid fraction of the digestate) of ten biogas production lines in Finland were analyzed for ten hazardous organic compounds or compound groups: polychlorinated dibenzo-p-dioxins and furans (PCDD/Fs), polychlorinated biphenyls (PCB(7)), polyaromatic hydrocarbons (PAH(16)), bis-(2-ethylhexyl) phthalate (DEHP), perfluorinated alkyl compounds (PFCs), linear alkylbenzene sulfonates (LASs), nonylphenols and nonylphenol ethoxylates (NP+NPEOs), polybrominated diphenyl ethers (PBDEs), hexabromocyclododecane (HBCD) and tetrabromobisphenol A (TBBPA). Biogas plant feedstocks were divided into six groups: municipal sewage sludge, municipal biowaste, fat, food industry by-products, animal manure and others (consisting of milling by-products (husk) and raw former foodstuffs of animal origin from the retail trade). There was no clear connection between the origin of the feedstocks of a plant and the concentrations of hazardous organic compounds in the digestate. For PCDD/Fs and for DEHP, the median soil burden of the compound after a single addition of digestate was similar to the annual atmospheric deposition of the compound or compound group in Finland or other Nordic countries. For PFCs, the median soil burden was somewhat lower than the atmospheric deposition in Finland or Sweden. For NP+NPEOs, the soil burden was somewhat higher than the atmospheric deposition in Denmark. The median soil burden of PBDEs was 400 to 1000 times higher than the PBDE air deposition in Finland or in Sweden. With PBDEs, PFCs and HBCD, the impact of the use of end products should be a focus of further research. Highly persistent compounds, such as PBDE- and PFC-compounds may accumulate in agricultural soil after repeated use of organic fertilizers containing these compounds. For other compounds included in this study, agricultural use of biogas plant end products is unlikely to cause risk to food safety in Finland. PMID:24593894

  20. Surgical exposures of the hand.

    PubMed

    Watt, Andrew J; Chung, Kevin C

    2014-11-01

    Surgical approaches to the hand are commonly executed in the treatment of fractures, ligament injuries, and less commonly in the resection of bony tumors. Careful design and execution of these surgical approaches translates into superior functional and aesthetic outcomes. We have provided a thorough review of commonly used approaches to the hand by evaluating each of these approaches in the context of core principles including safety, versatility, preservation of stability, and aesthetic outcomes. PMID:25440073

  1. [Pulmonary Echinococcosis: Surgical Aspects].

    PubMed

    Eichhorn, M E; Hoffmann, H; Dienemann, H

    2015-10-01

    Pulmonary cystic echinococcosis is a very rare disease in Germany. It is caused by the larvae of the dog tapeworm (echinococcus granulosus). The liver is the most affected organ, followed by the lungs. Surgery remains the main therapeutic approach for pulmonary CE. Whenever possible, parenchyma-preserving lung surgery should be preferred over anatomic lung resections. To ensure best therapeutic results, surgery needs to be performed under precise consideration of important infectiological aspects and patients should be treated in specialised centres based on interdisciplinary consensus. In addition to surgical aspects, this review summarises special infectiological features of this disease, which are crucial to the surgical approach. PMID:26351761

  2. Surgical Procedures for Vestibular Dysfunction

    MedlinePlus

    ... Rated Nonprofit! Volunteer. Donate. Review. Surgical Procedures for Vestibular Dysfunction When is surgery necessary? When medical treatment ... organ (cochlea) is also sacrificed with this procedure. Vestibular nerve section A vestibular nerve section is a ...

  3. Effect of organic acid treatments on microbial safety and overall acceptability of fresh-cut melon cubes

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There is much interest in developing effective minimal processing methodologies for fruits and vegetables that would enhance the microbial safety and not change overall acceptability. In this study, several organic acids (EDTA, nisin, sorbic acid and sodium lactate) generally regarded as safe (GRAS)...

  4. A systematic review of minimally invasive surgical treatment for atrial fibrillation: a comparison of the Cox-Maze procedure, beating-heart epicardial ablation, and the hybrid procedure on safety and efficacy.

    PubMed

    Je, Hyung Gon; Shuman, Deborah J; Ad, Niv

    2015-10-01

    There is a growing trend to perform off-bypass surgical ablation for atrial fibrillation (AF) because it is perceived to be safer and more effective than the Cox-Maze procedure with cardiopulmonary bypass (CPB) support. In this systematic review, we compared three minimally invasive stand-alone surgical ablation procedures for AF: the endocardial Cox-Maze procedure, epicardial surgical ablation and a hybrid epicardial surgical and catheter-based endocardial ablation procedure (hybrid procedure). Relevant studies were identified in MEDLINE and the Cochrane Database of Systematic Reviews according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From 565 initial studies, 37 were included in this review. The total number of patients across all studies was 1877 (range 10-139). Two studies reported on endocardial Cox-Maze procedures (n = 145), 26 reported on epicardial surgical ablation (n = 1382) and 9 reported on hybrid surgical ablation (n = 350). For minimally invasive Cox-Maze, epicardial and hybrid groups, operative mortality rates were 0, 0.5 and 0.9%, perioperative permanent pacemaker insertion rates were 3.5, 2.7 and 1.5%, incidence of conversion to median sternotomy was 0, 2.4 and 2.5%, and reoperation for bleeding was 1.0, 1.5 and 2.2%, with mean length of stay (days) of 5.4, 6.0 and 4.6, respectively. At 12 months, rates of sinus rhythm restoration were 93, 80 and 70%, and sinus restoration without anti-arrhythmic medications was 87, 72 and 71%, for Cox-Maze, epicardial and hybrid procedures, respectively. Of the three procedures, the minimally invasive Cox-Maze procedure with CPB support was most effective for the treatment of stand-alone AF and had important safety advantages in conversion to sternotomy and major bleeding. The minimally invasive Cox-Maze procedure with CPB support also demonstrated the potential for a higher success rate 12 months following the procedure. PMID:25567961

  5. Survival Analyses for Patients With Surgically Resected Pancreatic Neuroendocrine Tumors by World Health Organization 2010 Grading Classifications and American Joint Committee on Cancer 2010 Staging Systems

    PubMed Central

    Yang, Min; Ke, Neng-wen; Zeng, Lin; Zhang, Yi; Tan, Chun-lu; Zhang, Hao; Mai, Gang; Tian, Bo-le; Liu, Xu-bao

    2015-01-01

    Abstract In 2010, World Health Organization (WHO) reclassified pancreatic neuroendocrine tumors (p-NETs) into 4 main groups: neuroendocrine tumor G1 (NET G1), neuroendocrine tumor G2 (NET G2), neuroendocrine carcinoma G3 (NEC G3), mixed adeno and neuroendocrine carcinoma (MANEC). Clinical value of these newly updated WHO grading criteria has not been rigorously validated. The authors aimed to evaluate the clinical consistency of the new 2010 grading classifications by WHO and the 2010 tumor-node metastasis staging systems by American Joint Committee on Cancer (AJCC) on survivals for patients with surgically resected p-NETs. Moreover, the authors would validate the prognostic value of both criteria for p-NETs. The authors retrospectively collected the clinicopathologic data of 120 eligible patients who were all surgically treated and histopathologically diagnosed as p-NETs from January 2004 to February 2014 in our single institution. The new WHO criteria were assigned to 4 stratified groups with a respective distribution of 62, 35, 17, and 6 patients. Patients with NET G1 or NET G2 obtained a statistically better survival compared with those with NEC G3 or MANEC (P < 0.001). Survivals of NET G1 was also better than those of NET G2 (P = 0.023), whereas difference of survivals between NEC G3 and MANEC present no obvious significance (P = 0.071). The AJCC 2010 staging systems were respectively defined in 61, 36, 12, and 11 patients for each stage. Differences of survivals of stage I with stage III and IV were significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001); whereas comparisons of stage I with stage II and stage III with IV were not statistically significant (P = 0.129, P = 0.286; respectively). Together with radical resection, these 2 systems were both significant in univariate and multivariate analysis (P < 0.05). The newly updated WHO 2010 grading classifications and the AJCC 2010 staging systems could

  6. Survival Analyses for Patients With Surgically Resected Pancreatic Neuroendocrine Tumors by World Health Organization 2010 Grading Classifications and American Joint Committee on Cancer 2010 Staging Systems.

    PubMed

    Yang, Min; Ke, Neng-wen; Zeng, Lin; Zhang, Yi; Tan, Chun-lu; Zhang, Hao; Mai, Gang; Tian, Bo-le; Liu, Xu-bao

    2015-12-01

    In 2010, World Health Organization (WHO) reclassified pancreatic neuroendocrine tumors (p-NETs) into 4 main groups: neuroendocrine tumor G1 (NET G1), neuroendocrine tumor G2 (NET G2), neuroendocrine carcinoma G3 (NEC G3), mixed adeno and neuroendocrine carcinoma (MANEC). Clinical value of these newly updated WHO grading criteria has not been rigorously validated. The authors aimed to evaluate the clinical consistency of the new 2010 grading classifications by WHO and the 2010 tumor-node metastasis staging systems by American Joint Committee on Cancer (AJCC) on survivals for patients with surgically resected p-NETs. Moreover, the authors would validate the prognostic value of both criteria for p-NETs.The authors retrospectively collected the clinicopathologic data of 120 eligible patients who were all surgically treated and histopathologically diagnosed as p-NETs from January 2004 to February 2014 in our single institution. The new WHO criteria were assigned to 4 stratified groups with a respective distribution of 62, 35, 17, and 6 patients. Patients with NET G1 or NET G2 obtained a statistically better survival compared with those with NEC G3 or MANEC (P < 0.001). Survivals of NET G1 was also better than those of NET G2 (P = 0.023), whereas difference of survivals between NEC G3 and MANEC present no obvious significance (P = 0.071). The AJCC 2010 staging systems were respectively defined in 61, 36, 12, and 11 patients for each stage. Differences of survivals of stage I with stage III and IV were significant (P < 0.001), as well as those of stage II with III and IV (P < 0.001); whereas comparisons of stage I with stage II and stage III with IV were not statistically significant (P = 0.129, P = 0.286; respectively). Together with radical resection, these 2 systems were both significant in univariate and multivariate analysis (P < 0.05).The newly updated WHO 2010 grading classifications and the AJCC 2010 staging systems could consistently reflect the clinical outcome

  7. Improving surgical weekend handover

    PubMed Central

    Culwick, Caroline; Devine, Chris; Coombs, Catherine

    2014-01-01

    Effective handovers are vital to patient safety and continuity of care, and this is recognised by several national bodies including the GMC. The existing model at Great Western Hospital (GWH) involved three general surgical teams and a urology team placing their printed patient lists, complete with weekend jobs, in a folder for the on-call team to collect at the weekend. We recognised a need to reduce time searching for patients, jobs and reviews, and to streamline weekend ward rounds. A unified weekend list ordering all surgical patients by ward and bed number was introduced. Discrepancies in the layout of each team's weekday list necessitated the design of a new weekday list to match the weekend list to facilitate the easy transfer of information between the two lists. A colour coding system was also used to highlight specific jobs. Prior to this improvement project only 7.1% of those polled were satisfied with the existing system, after a series of interventions satisfaction increased to 85.7%. The significant increase in overall satisfaction with surgical handover following the introduction of the unified weekend list is promising. Locating patients and identifying jobs is easier and weekend ward rounds can conducted in a more logical and timely fashion. It has also helped facilitate the transition to consultant ward rounds of all surgical inpatients at the weekends with promising feedback from a recent consultants meeting. PMID:26734294

  8. [Safe surgery checklist: analysis of the safety and communication of teams from a teaching hospital].

    PubMed

    Pancieri, Ana Paula; Santos, Bruna Pegorer; de Avila, Marla Andréia Garcia; Braga, Eliana Mara

    2013-03-01

    This study aimed to apply the WHO surgical safety checklist in the surgical specialties of a university hospital and to evaluate the opinion of the team regarding the influence of its application on the safety of the surgical process and on the interpersonal communication of the team. It is a descriptive, analytical qualitative field study conducted in the surgical center of a university hospital Data were collected by applying the checklist in a total of 30 surgeries. The researcher conducted its application in three phases, and then members of the surgical team were invited to voluntarily participate in the study, signifying their agreement to participate by signing an informed consent form and answering guiding questions. Bardin's Content Analysis Method was used to organize and analyze the data. The subjects did not notice any changes in their interpersonal communication when using the checklist; however, they gave suggestions and reported that its use provided greater safety to the procedure. PMID:23781726

  9. [Management, quality of health and occupational safety and hospital organization: is integration possible?].

    PubMed

    Corrao, Carmela Romana Natalina

    2011-01-01

    The evolution of the national and European legislation has progressively transformed the working environments into organized environments. Specific models for its management are being proposed, which should be integrated into general management strategies. In the case of hospitals this integration should consider the peculiar organizational complexity, where the management of the occupational risk needs to be integrated with clinical risk management and economic risk management. Resources management should also consider that Occupational Medicine has not a direct monetary benefit for the organisation, but only indirect health consequences in terms of reduction of accidents and occupational diseases. The deep and simultaneous analysis of the current general management systems and the current management methods of occupational safety and health protection allows one to hyphotesise a possible integration between them. For both of them the Top Management is the main responsible of the quality management strategies and the use of specific documents in the managerial process, such as the document of risks evaluation in the occupational management and the quality manual in the general management, is of paramount importance. An integrated management has also the scope to pursue a particular kind of quality management, where ethics and job satisfaction are innovative, as established by recent European guidelines, management systems and national legislations. PMID:21468157

  10. [Emission characteristics and safety evaluation of volatile organic compounds in manufacturing processes of automotive coatings].

    PubMed

    Zeng, Pei-Yuan; Li, Jian-Jun; Liao, Dong-Qi; Tu, Xiang; Xu, Mei-Ying; Sun, Guo-Ping

    2013-12-01

    Emission characteristics of volatile organic compounds (VOCs) were investigated in an automotive coating manufacturing enterprise. Air samples were taken from eight different manufacturing areas in three workshops, and the species of VOCs and their concentrations were measured by gas chromatography-mass spectrometry (GC-MS). Safety evaluation was also conducted by comparing the concentration of VOCs with the permissible concentration-short term exposure limit (PC-STEL) regulated by the Ministry of Health. The results showed that fifteen VOCs were detected in the indoor air of the automotive coatings workshop, including benzene, toluene, ethylbenzene, xylene, ethyl acetate, butyl acetate, methyl isobutyl ketone, propylene glycol monomethyl ether acetate, trimethylbenzene and ethylene glycol monobutyl ether, Their concentrations widely ranged from 0.51 to 593.14 mg x m(-3). The concentrations of TVOCs were significantly different among different manufacturing processes. Even in the same manufacturing process, the concentrations of each component measured at different times were also greatly different. The predominant VOCs of indoor air in the workshop were identified to be ethylbenzene and butyl acetate. The concentrations of most VOCs exceeded the occupational exposure limits, so the corresponding control measures should be taken to protect the health of the workers. PMID:24640895

  11. Flammable Gas Safety Program: actual waste organic analysis FY 1996 progress report; Flammable Gas Safety Program: actual waste organic analysis FY 1996 progress report

    SciTech Connect

    Clauss, S.A.; Grant, K.E.; Hoopes, V.; Mong, G.M.; Rau, J.; Steele, R.; Wahl, K.H.

    1996-09-01

    This report describes the status of optimizing analytical methods to account for the organic components in Hanford waste tanks, with emphasis on tanks assigned to the Flammable Gas Watch List. The methods developed are illustrated by their application to samples from Tanks 241-SY-103 and 241-S-102. Capability to account for organic carbon in Tank SY-101 was improved significantly by improving techniques for isolating organic constituents relatively free from radioactive contamination and by improving derivatization methodology. The methodology was extended to samples from Tank SY-103 and results documented in this report. Results from analyzing heated and irradiated SY-103 samples (Gas Generation Task) and evaluating methods for analyzing tank waste directly for chelators and chelator fragments are also discussed.

  12. Organic Tank Safety Project: development of a method to measure the equilibrium water content of Hanford organic tank wastes and demonstration of method on actual waste

    SciTech Connect

    Scheele, R.D.; Bredt, P.R.; Sell, R.L.

    1996-09-01

    Some of Hanford`s underground waste storage tanks contain Organic- bearing high level wastes that are high priority safety issues because of potentially hazardous chemical reactions of organics with inorganic oxidants in these wastes such as nitrates and nitrites. To ensure continued safe storage of these wastes, Westinghouse Hanford Company has placed affected tanks on the Organic Watch List and manages them under special rules. Because water content has been identified as the most efficient agent for preventing a propagating reaction and is an integral part of the criteria developed to ensure continued safe storage of Hanford`s organic-bearing radioactive tank wastes, as part of the Organic Tank Safety Program the Pacific Northwest National Laboratory developed and demonstrated a simple and easily implemented procedure to determine the equilibrium water content of these potentially reactive wastes exposed to the range of water vapor pressures that might be experienced during the wastes` future storage. This work focused on the equilibrium water content and did not investigate the various factors such as @ ventilation, tank surface area, and waste porosity that control the rate that the waste would come into equilibrium, with either the average Hanford water partial pressure 5.5 torr or other possible water partial pressures.

  13. Surgical Simulation and Competency.

    PubMed

    Kim-Fine, Shunaha; Brennand, Erin A

    2016-09-01

    Simulation in surgical training is playing an increasingly important role as postgraduate medical education programs navigate an environment of increasing costs of education, increased attention on patient safety, and new duty hour restrictions. In obstetrics and gynecology, simulation has been used to teach many procedures; however, it lacks a standardized curriculum. Several different simulators exist for teaching various routes and aspects of hysterectomy. This article describes how a formal framework of increasing levels of competencies can be applied to simulation in teaching the procedure of hysterectomy. PMID:27521885

  14. Thoracoscopy: a collaborative surgical approach.

    PubMed

    Brand, A F

    1995-07-01

    Perioperative nurses, surgeons, anesthesiologists, certified registered nurse anesthetists, and pharmacists are meeting the challenge of decreasing thoracic surgical patients' length of hospital stay with thoracoscopy. This innovative alternative to traditional thoracotomy procedures has been achieved through an attentive team approach using the fundamental perioperative skills of assessment, positioning, safety, and sharing of knowledge. PMID:7647761

  15. The Surgical Treatment of Mycetoma

    PubMed Central

    Suleiman, Suleiman Hussein; Wadaella, EL Sammani; Fahal, Ahmed Hassan

    2016-01-01

    Surgical intervention is an integral component in the diagnosis and management of mycetoma. Surgical treatment is indicated for small, localised lesions and massive lesions to reduce the mycetoma load and to enable better response to medical therapy. It is also a life-saving procedure in patients with massive disease and sepsis. Surgical options for mycetoma treatment range from a wide local surgical excision to repetitive debridement excisions to amputation of the affected part. Adequate anaesthesia, a bloodless field, wide local excision with adequate safety margins in a suitable surgical facility, and expert surgeons are mandatory to achieve the best surgical outcome. Surgical intervention in mycetoma is associated with considerable morbidity, deformities, and disabilities, particularly in advanced disease. These complications can be reduced by educating patients to seek medical advice earlier when the lesion is small, localised, and amenable to surgery. There is no evidence for mycetoma hospital cross infection. This communication is based on the authors’ experience in managing over 7,200 mycetoma patients treated at the Mycetoma Research Centre, University of Khartoum, Sudan. PMID:27336736

  16. Credentialing of surgical skills centers.

    PubMed

    Sachdeva, Ajit K

    2011-01-01

    Major imperatives regarding quality of patient care and patient safety are impacting surgical care and surgical education. Also, significant emphasis continues to be placed on education and training to achieve proficiency, expertise, and mastery in surgery. Simulation-based surgical education and training can be of immense help in acquiring and maintaining surgical skills in safe environments without exposing patients to risk. Opportunities for repetition of tasks can be provided to achieve pre-established standards, and knowledge and skills can be verified using valid and reliable assessment methods. Also, expertise and mastery can be attained through repeated practice, specific feedback, and establishment of progressively higher learning goals. Simulation-based education and training can help surgeons maintain their skills in infrequently performed procedures and regain proficiency in procedures they have not performed for a period of time. In addition, warm-ups and surgical rehearsals in simulated environments should enhance performance in real settings. Major efforts are being pursued to advance the field of simulation-based surgical education. New education and training models involving validation of knowledge and skills are being designed for practicing surgeons. A competency-based national surgery resident curriculum was recently launched and is undergoing further enhancements to address evolving education and training needs. Innovative simulation-based surgical education and training should be offered at state-of-the-art simulation centers, and credentialing and accreditation of these centers are key to achieving their full potential. PMID:21549986

  17. Driving Surgical Quality Using Operative Video.

    PubMed

    O'Mahoney, Paul R A; Yeo, Heather L; Lange, Marilyne M; Milsom, Jeffrey W

    2016-08-01

    Recent evidence suggests surgical quality may be demonstrated and evaluated using video capture during surgery. Operative video documentation may also aid in quality improvement initiatives. We discuss how operative video has the potential to help improve patient outcomes and increase professional accountability, patient safety, and surgical quality. PMID:27076573

  18. Field Test of the World Health Organization Multi-Professional Patient Safety Curriculum Guide

    PubMed Central

    Farley, Donna; Zheng, Hao; Rousi, Eirini; Leotsakos, Agnès

    2015-01-01

    Introduction Although the importance of training in patient safety has been acknowledged for over a decade, it remains under-utilized and under-valued in most countries. WHO developed the Multi-professional Patient Safety Curriculum Guide to provide schools with the requirements and tools for incorporating patient safety in education. It was field tested with 12 participating schools across the six WHO regions, to assess its effectiveness for teaching patient safety to undergraduate and graduate students in a global variety of settings. Methods The evaluation used a combined prospective/retrospective design to generate formative information on the experiences of working with the Guide and summative information on the impacts of the Guide. Using stakeholder interviews and student surveys, data were gathered from each participating school at three times: the start of the field test (baseline), soon after each school started teaching, and soon after each school finished teaching. Results Stakeholders interviewed were strongly positive about the Guide, noting that it emphasized universally important patient safety topics, was culturally appropriate for their countries, and gave credibility and created a focus on patient safety at their schools. Student perceptions and attitudes regarding patient safety improved substantially during the field test, and their knowledge of the topics they were taught doubled, from 10.7% to 20.8% of correct answers on the student survey. Discussion This evaluation documented the effectiveness of the Curriculum Guide, for both ease of use by schools and its impacts on improving the patient safety knowledge of healthcare students. WHO should be well positioned to refine the contents of the Guide and move forward in encouraging broader use of the Guide globally for teaching patient safety. PMID:26406893

  19. A Registry for Evaluation of Efficiency and Safety of Surgical Treatment of Cartilage Defects: The German Cartilage Registry (KnorpelRegister DGOU)

    PubMed Central

    2016-01-01

    Background The need for documentation in cartilage defects is as obvious as in other medical specialties. Cartilage defects can cause significant pain, and lead to reduced quality of life and loss of function of the affected joint. The risk of developing osteoarthritis is high. Therefore, the socioeconomic burden of cartilage defects should not be underestimated. Objective The objective of our study was to implement and maintain a registry of all patients undergoing surgical treatment of cartilage defects. Methods We designed this multicenter registry for adults whose cartilage defects of a knee, ankle, or hip joint are treated surgically. The registry consists of two parts: one for the physician and one for the patient. Data for both parts will be gathered at baseline and at 6-, 12-, 24-, 36-, 60-, and 120-month follow-ups. Results To date, a wide range of German, Swiss, and Austrian trial sites are taking part in the German Cartilage Registry, soon to be followed by further sites. More than 2124 (as of January 31, 2016) cases are already documented and the first publications have been released. Conclusions The German Cartilage Registry addresses fundamental issues regarding the current medical care situation of patients with cartilage defects of knee, ankle, and hip joints. In addition, the registry will help to identify various procedure-specific complications, along with putative advantages and disadvantages of different chondrocyte products. It provides an expanding large-scale, unselected, standardized database for cost and care research for further retrospective studies. Trial Registration German Clinical Trials Register: DRKS00005617; https://drks-neu.uniklinik-freiburg.de/ drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00005617 (Archived by WebCite at http://www.webcitation.org/6hbFqSws0) PMID:27357998

  20. Developing Natural Solutions to Reducing Food Safety Pathogens in Organically Raised Poultry

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Organic poultry production is one of the fastest growing segments of organic agriculture with a 20% increase/yr since the establishment of the National Organic Program (NOP). Restrictions on prophylactic antibiotics used for conventional poultry production raise unique challenges for organic produce...

  1. Patient Safety in Interventional Radiology: A CIRSE IR Checklist

    SciTech Connect

    Lee, M. J.; Fanelli, F.; Haage, P.; Hausegger, K.; Lienden, K. P. Van

    2012-04-15

    Interventional radiology (IR) is an invasive speciality with the potential for complications as with other invasive specialities. The World Health Organization (WHO) produced a surgical safety checklist to decrease the morbidity and mortality associated with surgery. The Cardiovascular and Interventional Society of Europe (CIRSE) set up a task force to produce a checklist for IR. Use of the checklist will, we hope, reduce the incidence of complications after IR procedures. It has been modified from the WHO surgical safety checklist and the RAD PASS from Holland.

  2. Improving produce safety by stabilizing chlorine in washing solutions with high organic loads

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The need for technologies to protect our nation’s food supply and support sustained growth of the produce industry has never been more urgent. The produce industry currently faces a major potential food safety problem, since the chlorine needed to prevent pathogen survival is depleted during commer...

  3. 77 FR 26280 - Patient Safety Organizations: Voluntary Relinquishment From CareRise LLC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-05-03

    ... Relinquishment From CareRise LLC AGENCY: Agency for Healthcare Research and Quality (AHRQ), HHS. ACTION: Notice of Delisting. SUMMARY: AHRQ has accepted a notification of voluntary relinquishment from CareRise LLC... quality of health care delivery. HHS issued the Patient Safety and Quality Improvement Final Rule...

  4. Improving Cardiac Surgical Care: A Work Systems Approach

    PubMed Central

    Wiegmann, Douglas A.; Eggman, Ashley A.; ElBardissi, Andrew W.; Henrickson, Sarah E.; Sundt, Thoralf M.

    2010-01-01

    Over the past 50 years, significant improvements in cardiac surgical care have been achieved. Nevertheless, surgical errors that significantly impact patient safety continue to occur. In order to further improve surgical outcomes, patient safety programs must focus on rectifying work system factors in the operating room (OR) that negatively impact the delivery of reliable surgical care. The goal of this paper is to provide an integrative review of specific work system factors in the OR that may directly impact surgical care processes, as well as the subsequent recommendations that have been put forth to improve surgical outcomes and patient safety. The important role that surgeons can play in facilitating work system changes in the OR is also discussed. The paper concludes with a discussion of the challenges involved in assessing the impact that interventions have on improving surgical care. Opportunities for future research are also highlighted throughout the paper. PMID:20202623

  5. Improving cardiac surgical care: a work systems approach.

    PubMed

    Wiegmann, Douglas A; Eggman, Ashley A; Elbardissi, Andrew W; Parker, Sarah Henrickson; Sundt, Thoralf M

    2010-09-01

    Over the past 50 years, significant improvements in cardiac surgical care have been achieved. Nevertheless, surgical errors that significantly impact patient safety continue to occur. In order to further improve surgical outcomes, patient safety programs must focus on rectifying work system factors in the operating room (OR) that negatively impact the delivery of reliable surgical care. The goal of this paper is to provide an integrative review of specific work system factors in the OR that may directly impact surgical care processes, as well as the subsequent recommendations that have been put forth to improve surgical outcomes and patient safety. The important role that surgeons can play in facilitating work system changes in the OR is also discussed. The paper concludes with a discussion of the challenges involved in assessing the impact that interventions have on improving surgical care. Opportunities for future research are also highlighted throughout the paper. PMID:20202623

  6. Safety and efficacy of levobupivacaine for postoperative pain relief after the surgical removal of impacted third molars: a comparison with lignocaine and adrenaline.

    PubMed

    Rood, J P; Coulthard, P; Snowdon, A T; Gennery, B A

    2002-12-01

    In a randomised, double-blind placebo-controlled single-centre study we compared the efficacy and safety of 0.75% levobupivacaine (without vasoconstrictor) with 2% lignocaine (with adrenaline 1:80,000) and with placebo for postoperative pain relief in 93 patients having day surgery under general anaesthesia for the removal of impacted mandibular third molars. Premedication and preoperative analgesics were not prescribed, although a short-acting opioid analgesic agent was allowed if required during the anaesthetic procedure. Patients were asked to keep a diary card for 2 days after discharge from hospital. The primary endpoint was the number of patients who requested analgesia within 2 h of completion of the operation. In total, 16 (53%) of patients given levobupivacaine requested analgesia compared with 22 (71%) given lignocaine and 23 (72%) given placebo. Patients given levobupivacaine had lower maximum visual analogue pain scores (VAS) and took longer to request rescue medication (P=0.045 compared with lignocaine). Fewer patients after levobupivacaine n=20 (7%) than after lignocaine n=7 (23%) or placebo n=5 (16%) experienced adverse events. Levobupivacaine seems to be a suitable alternative local anaesthetic to lignocaine with adrenaline for pain control after oral operations. PMID:12464207

  7. Animal study assessing safety of an acoustic coupling fluid that holds the potential to avoid surgically induced artifacts in 3D ultrasound guided operations

    PubMed Central

    2014-01-01

    Background Use of ultrasound in brain tumor surgery is common. The difference in attenuation between brain and isotonic saline may cause artifacts that degrade the ultrasound images, potentially affecting resection grades and safety. Our research group has developed an acoustic coupling fluid that attenuates ultrasound energy like the normal brain. We aimed to test in animals if the newly developed acoustic coupling fluid may have harmful effects. Methods Eight rats were included for intraparenchymal injection into the brain, and if no adverse reactions were detected, 6 pigs were to be included with injection of the coupling fluid into the subarachnoid space. Animal behavior, EEG registrations, histopathology and immunohistochemistry were used in assessment. Results In total, 14 animals were included, 8 rats and 6 pigs. We did not detect any clinical adverse effects, seizure activity on EEG or histopathological signs of tissue damage. Conclusion The novel acoustic coupling fluid intended for brain tumor surgery appears safe in rats and pigs under the tested circumstances. PMID:24666721

  8. Organic tank safety project: Preliminary results of energetics and thermal behavior studies of model organic nitrate and/or nitrite mixtures and a simulated organic waste

    SciTech Connect

    Scheele, R.D.; Sell, R.L.; Sobolik, J.L.; Burger, L.L.

    1995-08-01

    As a result of years of production and recovery of nuclear defense materials and subsequent waste management at the Hanford Site, organic-bearing radioactive high-level wastes (HLW) are currently stored in large (up to 3. ML) single-shell storage tanks (SSTs). Because these wastes contain both fuels (organics) and the oxidants nitrate and nitrite, rapid energetic reactions at certain conditions could occur. In support of Westinghouse Hanford Company`s (WHC) efforts to ensure continued safe storage of these organic- and oxidant-bearing wastes and to define the conditions necessary for reactions to occur, we measured the thermal sensitivities and thermochemical and thermokinetic properties of mixtures of selected organics and sodium nitrate and/or nitrite and a simulated Hanford organic-bearing waste using thermoanalytical technologies. These thermoanalytical technologies are used by chemical reactivity hazards evaluation organizations within the chemical industry to assess chemical reaction hazards.

  9. The Efficacy and Safety of Knotless Barbed Sutures in the Surgical Field: A Systematic Review and Meta-analysis of Randomized Controlled Trials

    PubMed Central

    Lin, Yifei; Lai, Sike; Huang, Jin; Du, Liang

    2016-01-01

    The knotless barbed suture is an innovative type of suture that can accelerate the placement of sutures and eliminate knot tying. However, the outcomes of previous studies are still confounding. This study reviewed the application of different types of barbed sutures in different surgeries. We searched PubMed, EMBASE, CENTRAL and ClinicalTrials.gov to identify randomized controlled trials (RCTs) addressing the application of barbed sutures up to Feb. 2015. Two reviewers independently screened the literature and assessed the risk of bias of included studies. Then meta-analysis was performed using RevMan 5.3 software. Sensitivity analysis and subgroup analysis was performed. Seventeen RCTs (low to moderate risk of bias) involving 1992 patients were included. Compared with conventional sutures, the barbed suture could reduce suture time (SMD=−0.95, 95%CI −1.43 to −0.46, P = 0.0001) and the operative time (SMD=−0.28, 95%CI −0.46 to −0.10, P = 0.003), not significantly increase the estimated blood loss (SMD=−0.09, 95%CI −0.52 to 0.35, P = 0.70), but could lead to more postoperative complications (OR = 1.43, 95%CI 1.05 to 1.96, P = 0.03), These results varied in subgroups. Thus, barbed sutures are effective in reducing the suture and operative time, but the safety evidences are still not sufficient. It need be evaluated based on special surgeries and suture types before put into clinical practice. PMID:27005688

  10. How trust in institutions and organizations builds general consumer confidence in the safety of food: a decomposition of effects.

    PubMed

    de Jonge, J; van Trijp, J C M; van der Lans, I A; Renes, R J; Frewer, L J

    2008-09-01

    This paper investigates the relationship between general consumer confidence in the safety of food and consumer trust in institutions and organizations. More specifically, using a decompositional regression analysis approach, the extent to which the strength of the relationship between trust and general confidence is dependent upon a particular food chain actor (for example, food manufacturers) is assessed. In addition, the impact of specific subdimensions of trust, such as openness, on consumer confidence are analyzed, as well as interaction effects of actors and subdimensions of trust. The results confirm previous findings, which indicate that a higher level of trust is associated with a higher level of confidence. However, the results from the current study extend on previous findings by disentangling the effects that determine the strength of this relationship into specific components associated with the different actors, the different trust dimensions, and specific combinations of actors and trust dimensions. The results show that trust in food manufacturers influences general confidence more than trust in other food chain actors, and that care is the most important trust dimension. However, the contribution of a particular trust dimension in enhancing general confidence is actor-specific, suggesting that different actors should focus on different trust dimensions when the purpose is to enhance consumer confidence in food safety. Implications for the development of communication strategies that are designed to regain or maintain consumer confidence in the safety of food are discussed. PMID:18450326