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Cases & Commentaries
- Web M&M
Kay Ball, RN, MSA ; October 2004
While repositioning the trocar, a surgeon places the laparoscope on a tray sitting on the patient. When she picks it back up, she notices that the drape has melted and the patient has a second-degree burn.
Journal Article > Commentary
ACOG Committee on Patient Safety and Quality Improvement. Obstet Gynecol. 2010;116:786-790.
This revision of the 2006 committee statement provides a series of recommendations responding to issues that contribute to errors within the operative theater and highlights checklists as one approach to improvement.
Journal Article > Review
Kryger ZB, Dumanian GA, Howard MA. Int J Gynaecol Obstet. 2007;99;257-263.
This article reviews the unique risks when combining gynecologic and plastic surgery and offers strategies to optimize safety for these patients.
Journal Article > Study
Rothschild JM, Keohane CA, Rogers S, et al. JAMA. 2009;302:1565-1572.
Limitations on housestaff duty hours were implemented with the intent of protecting patients by reducing errors made by fatigued residents. Indeed, prior studies have shown that sleep-deprived residents are more prone to committing errors and inadvertently sustaining needlestick injuries. However, comparatively little attention has been paid to the effect of fatigue on attending physicians. Conducted at a single academic medical center, this study evaluated the relationship between sleep deprivation (defined as having operated the night before the scheduled procedure) and complication rates for a range of surgical, obstetric, and gynecologic procedures. There was no overall link between fatigue and complications, but the complication rate was increased for surgeons who had the opportunity to sleep less than 6 hours. Other studies have found that fatigue is influenced by many factors other than hours worked, and therefore further reductions in shift length (as called for in a recent Institute of Medicine report) may not significantly improve patient safety.