tailieunhanh - Safer Surgery part 28

Safer Surgery part 28. There have been few research investigations into how highly trained doctors and nurses work together to achieve safe and efficient anaesthesia and surgery. While there have been major advances in surgical and anaesthetic procedures, there are still significant risks for patients during operations and adverse events are not unknown. Due to rising concern about patient safety, surgeons and anaesthetists have looked for ways of minimising adverse events. | 244 Safer Surgery We also observed 45 handovers of which 35 took place in the recovery room 6 in the operating theatre and 2 in the theatre corridor leading to the recovery room. These involved 17 anaesthetists 9 consultants 7 trainees and one non-consultant career grade and 15 recovery nurses Smith et al. 2008 . Illustrative quotes have been selected from this larger pool of data. Transitions We noted a number of transitions. There were transitions related to physical movement - from ward to anaesthetic room into theatre into recovery and then back to the ward. There was also movement of the patient from his her bed onto trolleys then onto the operating table and back. There were corresponding movements in terms of responsibility for patient care as the patient passes from the nurse to in the UK at least a doctor during the period of anaesthesia then back to the care of the nurse. There were changes of consciousness from awake to anaesthetized and back to awake with some time also spent in liminal interstates especially in the recovery room. The changes in consciousness are accompanied by the loss of control as patients surrender the management of their vital functions to others then regain that control on awakening. There are social transitions too as patients lose their personality and social identity and become more of a physiological object whilst anaesthetized. Along with this goes a degree of intimacy which in normal life would be quite out of place and ways of interacting which treat patients as less competent and or passive. Induction of Anaesthesia We noted three main styles of communication during induction evocative descriptive and functional. These three categories arose from the data early in the analysis suggesting that we reached data saturation readily and examples of each are given below. Evocative These communications seem intended to invoke reassuringly pleasant or familiar images. The effects of sedative or analgesic drugs given before .