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 stu...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 havebeen unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stake-holders 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 bring these team members together and influence the emergence of a safer OR.展开更多
The authors did not obtain permission to use some of the data from Prof.Hiroyuki Isobe,who supervised the reported study in itsearlystages.The concept of cyclo[n]helicenes was initiated by Prof.Hiroyuki Isobe(The Univ...The authors did not obtain permission to use some of the data from Prof.Hiroyuki Isobe,who supervised the reported study in itsearlystages.The concept of cyclo[n]helicenes was initiated by Prof.Hiroyuki Isobe(The University of Tokyo),then at Tohoku University.Specifically,the molecules 1-a,1-t,2-c,and 2-r were synthesized by Yong Yang who was employed with the funding of Professor Isobe,and the crystal data,CCDC 2306989-2306991 and 2306993,were obtained and analyzed by Sota Sato who was working in Professor Isobe’s group.The necessary expenses for these parts of the work were covered by JST ERATO(JPMJER1301,H.I.).The concept of cyclo[n]helicenes was initiated years ago by Prof.Isobe,when Dr.Yong Yang was a postdoc and Dr.Sota Sata was also a member of the group.The starting materials used in this work,[4]CH and[5]CH,were synthesized by Dr.Yang and structurally characterized by Dr.Sato in the group.展开更多
文摘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 havebeen unsuccessful so hospitals now have to take a systematic approach to implementing safer processes and providing the resources for surgeons and other stake-holders 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 bring these team members together and influence the emergence of a safer OR.
文摘The authors did not obtain permission to use some of the data from Prof.Hiroyuki Isobe,who supervised the reported study in itsearlystages.The concept of cyclo[n]helicenes was initiated by Prof.Hiroyuki Isobe(The University of Tokyo),then at Tohoku University.Specifically,the molecules 1-a,1-t,2-c,and 2-r were synthesized by Yong Yang who was employed with the funding of Professor Isobe,and the crystal data,CCDC 2306989-2306991 and 2306993,were obtained and analyzed by Sota Sato who was working in Professor Isobe’s group.The necessary expenses for these parts of the work were covered by JST ERATO(JPMJER1301,H.I.).The concept of cyclo[n]helicenes was initiated years ago by Prof.Isobe,when Dr.Yong Yang was a postdoc and Dr.Sota Sata was also a member of the group.The starting materials used in this work,[4]CH and[5]CH,were synthesized by Dr.Yang and structurally characterized by Dr.Sato in the group.
