The AHRQ Patient Safety Indicators (PSI) capture the quality and safety in inpatient care and identify potential complications. This study compares the incidence of PSI-12 (perioperative venous thromboembolism (VTE)) in patients with and without acute COVID-19 infection. Patients with acute COVID-19 infection were at increased risk for meeting the criteria for PSI-12, despite receiving appropriate care. The researchers suggest taking this into consideration and updating PSIs, as appropriate.
Tham N, Fazio T, Johnson D, et al. World J Surg. 2022;46:1249-1258.
The COVID-19 pandemic led to changes in infection control and prevention measures to limit nosocomial spread. This retrospective cohort study found that escalations in infection prevention and control practices due to the COVID-19 pandemic did not affect the incidence of other hospital-acquired infections among surgical patients at one Australian hospital. The authors posit that this may be due to high compliance with existing infection prevention and control practices pre-pandemic.
Etheridge JC, Moyal-Smith R, Sonnay Y, et al. Int J Surg. 2022;98:106210.
Non-technical skills such as communication, teamwork, decision-making, and situational awareness are responsible for a significant proportion of surgical errors. The COVID-19 pandemic increased the stress in the operating room, associated with increased risk of exposure and shortage of resources. This study compared pre- and post-COVID direct observations during live operations and found that non-technical skills were equivalent; there was a small, but statistically significant, improvement in teamwork and cooperation skills.
In 2020, the World Health Organization prioritized healthcare worker safety as a way to maintain patient safety. This article describes several initiatives aimed at protecting surgeons, patients and healthcare workers implemented since the beginning of the COVID-19 pandemic.
Ellis R, Hardie JA, Summerton DJ, et al. Surg. 2021;59:752-756.
Many non-urgent, non-cancer surgeries were postponed or canceled during COVID-19 surges resulting in a potential loss of surgeons’ “currency”. This commentary discusses the benefits of, and barriers to, dual surgeon operating as a way to increase currency as elective surgeries are resumed.
Weiner-Lastinger LM, Pattabiraman V, Konnor RY, et al. Infect Control Hosp Epidemiol. 2022;43:12-25.
Using data reported to the National Healthcare Safety Network, this study identified significant increases in the incidence of healthcare-associated infections from 2019 to 2020. The authors conclude that these findings suggest a need to return to conventional infection control and prevention practices and prepare for future pandemics.
Masonbrink AR, Harris M, Hall M, et al. Hosp Pediatr. 2021;11(6):e95-e100.
This study analyzed Pediatric Quality Indicators (PDIs) to compare pediatric safety events before and during the COVID-19 pandemic. Results indicate an increased risk for overall PDIs, but only postoperative sepsis showed increased odds. Given the continuing nature of the COVID-19 pandemic, and risk of future pandemics, more efforts are needed to ensure the safety of pediatric patients.
Brown NJ, Wilson B, Szabadi S, et al. Patient Saf Surg. 2021;15:19.
At the start of the COVID-19 pandemic, many elective surgical procedures were canceled or postponed due to limited resources (e.g., personal protective equipment, diagnostic tests, redeployment of healthcare personnel). This commentary discusses the implications of rationed non-urgent surgical care within the context of medical ethics: beneficence, non-maleficence, justice, and autonomy. The authors developed an algorithm to guide surgical teams through the decision-making process of delaying non-urgent surgical procedures, if necessary, in the future.
Lee G, Clough OT, Walker JA, et al. Patient Safety Surg. 2021;15:11.
In an effort to continue planned and elective procedures during the COVID-19 pandemic, the National Health Service utilized alternate “clean” hospital sites which did not admit or treat patients with COVID-19. This study found that although patient concerns about undergoing elective procedures during the COVID-19 pandemic were common, the majority of these patients reported high levels of confidence and satisfaction in the precautions in place at these “clean” sites to protect their safety.
Panda N, Etheridge JC, Singh T, et al. World J Surg. 2021;45:1293-1296.
The World Health Organization (WHO) surgical safety checklist is widely used in surgical settings to prevent errors. This multinational panel representing multiple clinical specialties identified 16 recommendations for checklist content modification and implementation during the COVID-19 pandemic. These recommendations exemplify how the checklist can be adapted to meet urgent and emerging needs of surgical units by targeting important processes and encouraging critical discussions.
Chaudhry H, Nadeem S, Mundi R. Clin Orthop Relat Res. 2021;479:47-56.
The COVID-19 pandemic has dramatically increased the use of telehealth across various medical specialties.This systematic review did not identify any differences in patient or surgeon satisfaction or patient-reported outcomes with telehealth for orthopedic care delivery as compared to in-person visits.However, the authors note that the included studies did not adequately capture or report safety endpoints, such as complications or missed diagnoses.
Britton CR, Hayman G, Stroud N. J Perioper Pract. 2021;31:44-50.
The COVID-19 pandemic has highlighted the crucial role that team and human factors play in healthcare delivery. This article describes the impact of a human factors education and training program focused on non-technical skills and teamwork (the ONSeT project) – on operating room teams during the pandemic. Results indicate that the project improved team functioning and team leader responsiveness.
Purnell S, Zheng F. Surg Clin North Am. 2020;101:109-119.
COVID-19 restrictions and patient concerns have expanded access to telemedicine worldwide. This review examines the use of telemedicine in surgical services. The authors found it to be a safe care modality for low-risk patients receiving low-risk procedures. They found that telemedicine in surgical services evidence base is expanding and its value is built on local, real-time approaches that involve services designed to consider patient needs and comfort.
This article describes strategies implemented by one hospital to help ensure patient and staff member safety during the COVID-19 pandemic, including use of personal protective equipment, decontamination efforts, mass temperature screenings, universal preprocedure testing, procedure prioritization, and modified workflows, as well as mental health support for front line clinicians and staff.
Borshoff DC, Sadleir P. Curr Opin Anaesthesiol. 2020;33:554-560.
The COVID-19 pandemic has resulted in the delivery of anesthesia outside of operating rooms, such as in emergency departments, intensive care units, and makeshift field hospitals. This review examines challenges in maintaining patient safety while providing anesthesia services in nontraditional operating room environments.
Dexter F, Parra MC, Brown JR, et al. Anesth Analg. 2020;131:37-42.
The authors describe eight empirical recommendations for optimizing infection control and operating room (OR) management during the COVID-19 pandemic. Recommendations address (1) hand hygiene, (2) environmental cleaning, (3) patient decolonization, (4) vascular care, (5) surveillance of pathogen transmission, (6) efficient use of personal protective equipment (7) OR scheduling, and (8) postoperative recovery settings.
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