Best practice & research. Clinical anaesthesiology
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Best Pract Res Clin Anaesthesiol · Aug 2022
ReviewTechnical skills in the operating room: Implications for perioperative leadership and patient outcomes.
Today's effective leaders create opportunities for their teams to develop both technical and non-technical skills. In the perioperative arena, the focus until now mainly has been on improving non-technical skills, with only few studies analyzing the relationship between technical skills and patient outcomes. Technical competence requires assessment of one's own strengths and weaknesses, inclusion of deliberate goal-oriented practice, objective structured feedback assessment, and a focus on best practice and improved patient outcomes. In this article, we address the prerequisites, assessment, and implications of technical skills for perioperative leadership, and provide key metrics impacting patient outcomes and leadership development.
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Best Pract Res Clin Anaesthesiol · Aug 2022
ReviewAdministrative structures: Options for achieving success in perioperative medicine.
Without the appropriate administrative structure, even well-thought-out strategic plans or detailed process improvement initiatives will fail. Developing a strong foundation for governance and leadership is a critical element of any high-functioning organization, and it applies just as well in the perioperative setting. ⋯ Frequently, reliable management of the perioperative process is lacking. We aim to provide an overview of the structural and elemental components and roles of perioperative management teams, as well as the administrative structure that guides them, since effective perioperative care teams and OR leaders are of paramount importance for any successful hospital.
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Leading causes of intensive care unit (ICU) admission include hemorrhage, hypertensive disorders of pregnancy, and sepsis. Although the incidence of ICU admission in pregnancy may be low, this does not account for critical illness in labor and delivery or maternity unit suites, which is as high as 1-3%. ⋯ Recently, comorbidity-based screening tools, which quantify a patient's medical comorbidity burden, have been developed and validated in predicting ICU admission and death. Noninvasive ultrasonography such as point-of-care ultrasonography becomes essential in determining hemodynamic status, guides resuscitation, and manages cardiovascular dysfunction.
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Worldwide, the most performed surgical intervention is cesarean section. Hence, post-cesarean pain is a common problem with significant health and economic impact on the individual patient and society. ⋯ To facilitate recovery and temper the side effects of potent analgesic drugs such as opioids, multimodal analgesia is currently advocated, and clear international guidelines and recommendations have recently been described. In the present overview, we will discuss the most recent guidelines and evaluate various analgesic interventions.