The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Jun 2020
ReviewBotulinum toxin in the management of temporomandibular disorders: a systematic review.
The aim of this review was to critically investigate and assess the evidence relating to the use and efficacy of botulinum toxin (BTX) in the management of temporomandibular joint disorders (TMD) and masticatory myofascial pain. A comprehensive search was conducted of PubMed, Scopus, Embase, and Cochrane CENTRAL, to find relevant studies from the last 30 years up to the end of July 2018. Seven were identified. ⋯ A meta-analysis was not possible because of the considerable variation in the studies' designs, the heterogeneity between the groups, and the different assessment tools used. Despite showing benefits, consensus on the therapeutic benefit of BTX in the management of myofascial TMD is lacking. Further randomised controlled trials with larger sample sizes, minimal bias, and longer follow-up periods are now needed.
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Br J Oral Maxillofac Surg · May 2020
ReviewLeading article: What can we do to improve individual and team situational awareness to benefit patient safety?
It is increasingly being recognised that human factors can contribute to error in complex safety systems. Healthcare, however, has a long way to go before the promotion of training in, and awareness of, human factors will catch up with other high-risk organisations. A critical component that is deemed essential both for improving clinical performance and reducing medical error is situational awareness (SA). ⋯ We therefore give an overview of SA and show how it can easily be reduced. We also suggest some simple but effective ways to improve it and in turn improve patient safety. We emphasise the importance of clinical teams looking out for each other, particularly in the operating theatre.
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Br J Oral Maxillofac Surg · May 2020
Implementation of "local safety standards for invasive procedures (LocSSIPs)" policy: not merely a tick-box exercise in patient safety.
The importance of patient safety in medicine and dentistry cannot be understated. Wrong tooth extractions account for approximately 25% of wrong-site surgery, and the implications for the patient, the team, and the institution can be profound. The development of national safety standards for invasive procedures (NatSSIPs) has led to the introduction of specialty-specific local safety standards for invasive procedures (LocSSIPs), with the aim of improving safety further. ⋯ Feedback from a staff survey six months after its introduction was positive from both clinicians and nursing staff. Since its implementation 18 months ago no serious incidents have been reported and staff think that safety has improved. The reporting of incidents, for example, missing clinical notes and faulty equipment, has become more common (showing better awareness) and the development of a team-led approach has improved the running of the department.