Development of a Surgical Safety Training Program and Checklist for Conversion during Robotic Partial Nephrectomies.
Urology
; 109: 38-43, 2017 Nov.
Article
em En
| MEDLINE
| ID: mdl-28827196
ABSTRACT
OBJECTIVE:
To evaluate the impact of standardized training and institutional checklists on improving teamwork during complications requiring open conversion from robotic-assisted partial nephrectomy (RAPN). MATERIALS ANDMETHODS:
Participants to a surgical team safety training program were randomly divided into 2 groups. A total of 20 emergencies were simulated group 1 performed simulations followed by a 4-hour theoretical training; group 2 underwent 4-hour training first and then performed simulations. All simulations were recorded and scored by 2 independent physicians. Time to conversion (TC) and procedural errors were analyzed and compared between the 2 groups. A correlation analysis between the number of previous conversion simulations, total errors number, and TC was performed for each group.RESULTS:
Group 1 showed a higher TC than group 2 (116.5 vs 86.5 seconds, P = .0.53). As the number of simulation increased, the numbers of errors declined in both groups. The 2 groups tend to converge toward 0 errors after 9 simulations; however, the linear correlation was more pronounced in group 1 (R2 = 0.75). TC shows a progressive decline for both groups as the number of simulations increases (group 1, R2 = 0.7 and group 2, R2 = 0.61), but it remains higher for group 1. Lack of task sequence and accidental falls or loss of sterility were higher in group 1.CONCLUSION:
OC is a rare but potentially dramatic event in the setting of RAPN, and every robotic team should be prepared to manage intraoperative emergencies. Training protocols can effectively improve teamwork and facilitate timely conversions to open surgery in the event of intraoperative emergencies during RAPN. Further studies are needed to confirm if such protocols may translate into an actual safety improvement in clinical settings.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Erros Médicos
/
Lista de Checagem
/
Conversão para Cirurgia Aberta
/
Procedimentos Cirúrgicos Robóticos
/
Nefrectomia
Tipo de estudo:
Clinical_trials
/
Guideline
/
Observational_studies
Limite:
Humans
Idioma:
En
Ano de publicação:
2017
Tipo de documento:
Article