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British Journal of Hospital Medicine... Apr 2024The anaesthetic training programme in the United Kingdom (UK) spans over seven years and is overseen by the Royal College of Anaesthetists (RCOA). Junior doctors in... (Review)
Review
The anaesthetic training programme in the United Kingdom (UK) spans over seven years and is overseen by the Royal College of Anaesthetists (RCOA). Junior doctors in England are currently striking amid ongoing pay negotiations with the government, and almost all junior doctors are worried about the cost of living. This article provides an overview of the average financial cost of training for doctors in the anaesthetic training programme. The cost incurred by anaesthetic trainees illustrates the level of financial burden faced by trainees across multiple specialities. The cost includes: student loan repayment (with interest rates), compulsory membership fees (including the Royal College of Anaesthetists and General Medical Council), postgraduate examinations (Fellowship of the Royal College of Anaesthetist exams are compulsory to complete training) and medical indemnity. The average trainee spends between 5.6% and 7.4% of their annual salary on non-reimbursable costs. This article delineates for aforementioned expenses and compares them with the training programs in Australia and New Zealand, given their status as frequent emigration destinations for UK doctors.
Topics: Humans; Anesthesiology; United Kingdom; Education, Medical, Graduate; Australia; New Zealand; Salaries and Fringe Benefits
PubMed: 38708973
DOI: 10.12968/hmed.2023.0437 -
Anesthesiology Nov 2023Measuring and comparing clinical productivity of individual anesthesiologists is confounded by anesthesiologist-independent factors, including facility-specific factors... (Review)
Review
Measuring and comparing clinical productivity of individual anesthesiologists is confounded by anesthesiologist-independent factors, including facility-specific factors (case duration, anesthetizing site utilization, type of surgical procedure, and non-operating room locations), staffing ratio, number of calls, and percentage of clinical time providing anesthesia. Further, because anesthesia care is billed with different units than relative value units, comparing work with other types of clinical care is difficult. Finally, anesthesia staffing needs are not based on productivity measurements but primarily the number and hours of operation of anesthetizing sites. The intent of this review is to help anesthesiologists, anesthesiology leaders, and facility leaders understand the limitations of anesthesia unit productivity as a comparative metric of work, how this metric often devalues actual work, and the impact of organizational differences, staffing models and coverage requirements, and effectiveness of surgical case load management on both individual and group productivity.
Topics: Humans; Anesthesiologists; Efficiency; Anesthesiology; Anesthesia; Operating Rooms
PubMed: 37815474
DOI: 10.1097/ALN.0000000000004722 -
Current Pain and Headache Reports Sep 2023The goal of this narrative review is to describe the current understanding of the pathology of Complex Regional Pain Syndrome (CRPS), as well as diagnostic standards and... (Review)
Review
PURPOSE OF REVIEW
The goal of this narrative review is to describe the current understanding of the pathology of Complex Regional Pain Syndrome (CRPS), as well as diagnostic standards and therapeutic options. We will then make the case for early recognition and management.
RECENT FINDINGS
CRPS remains an enigmatic pain syndrome, comprising several subtypes. Recent recommendations clarify diagnostic ambiguities and emphasize the importance of standardized assessment and therapy. Awareness of CRPS should be raised to promote prevention, early detection, and rapid escalation of therapy in refractory cases. Comorbidities and health costs (i.e., the socioeconomic impact) must also be addressed early to prevent negative consequences for patients.
Topics: Humans; Complex Regional Pain Syndromes; Early Diagnosis
PubMed: 37410335
DOI: 10.1007/s11916-023-01124-3 -
Journal of Clinical Medicine May 2024Cardiopulmonary resuscitation (CPR) stands as a cornerstone in emergency care, representing the crucial link between life and death for victims of cardiac arrest [...].
Cardiopulmonary resuscitation (CPR) stands as a cornerstone in emergency care, representing the crucial link between life and death for victims of cardiac arrest [...].
PubMed: 38731246
DOI: 10.3390/jcm13092717 -
World Journal of Clinical Cases Apr 2024Central venous catheter insertion in the internal jugular vein (IJV) is frequently performed in acute care settings, facilitated by its easy availability and increased...
Central venous catheter insertion in the internal jugular vein (IJV) is frequently performed in acute care settings, facilitated by its easy availability and increased use of ultrasound in healthcare settings. Despite the increased safety profile and insertion convenience, it has complications. Herein, we aim to inform readers about the existing literature on the plethora of complications with potentially disastrous consequences for patients undergoing IJV cannulation.
PubMed: 38660082
DOI: 10.12998/wjcc.v12.i10.1714 -
Current Opinion in Anaesthesiology Aug 2023Healthcare is increasingly expanding its view in outcome discussions to integrate patient-reported outcomes such as patient satisfaction. Involving patients in the... (Review)
Review
PURPOSE OF REVIEW
Healthcare is increasingly expanding its view in outcome discussions to integrate patient-reported outcomes such as patient satisfaction. Involving patients in the evaluation of services and the development of quality improvement strategies is paramount, especially in the service-oriented discipline of anaesthesiology.
RECENT FINDINGS
Currently, while the development of validated patient satisfaction questionnaires is well established, the use of rigorously tested scores in research and clinical practice is not standardized. Furthermore, most questionnaires are validated for specific settings, which limits our ability to draw relevant conclusions from them, especially considering the rapidly expanding scope of anaesthesia as a discipline and the addition of same-day surgery.
SUMMARY
For this manuscript, we review recent literature regarding patient satisfaction in the inpatient and ambulatory anaesthesia setting. We discuss ongoing controversies and briefly digress to consider management and leadership science regarding 'customer satisfaction'.
Topics: Humans; Anesthesiology; Patient Satisfaction; Anesthesia; Leadership; Surveys and Questionnaires
PubMed: 37222215
DOI: 10.1097/ACO.0000000000001270 -
Journal of Anaesthesiology, Clinical... 2023
PubMed: 38269172
DOI: 10.4103/joacp.joacp_515_23 -
Anesthesiology Jan 2024The Prevalence of Hepatitis B Markers in Anesthesia Personnel. By Berry AJ, Isaacson IJ, Hunt D, Kane MA. Anesthesiology 1984; 60:6-9 The prevalence of hepatitis B viral...
The Prevalence of Hepatitis B Markers in Anesthesia Personnel. By Berry AJ, Isaacson IJ, Hunt D, Kane MA. Anesthesiology 1984; 60:6-9 The prevalence of hepatitis B viral markers has increased in some groups of medical workers who are exposed to blood from patients carrying the virus, but this has not been studied critically in physicians and others who administer anesthesia. Physician anesthesiologists (M.D.) and nurse anesthetists and anesthesia assistants (non-M.D.) at four university-affiliated hospitals were evaluated for hepatitis B markers as determined by seropositivity for hepatitis B surface antigen, antibody to the hepatitis B surface antigen, or antibody to the hepatitis B core antigen. In the 86 subjects (38 M.D., 48 non-M.D.) who represented 80.4% of possible participants, the overall prevalence of serologic markers of hepatitis B was 23.3%. The frequency did not differ between M.D. (23.7%) and non-M.D. (22.9%) groups or between men (20.3%) and women (26.9%). Of 81 subjects who had no clinical history of hepatitis, 16 (19.8%) had positive serologic markers. The frequency of seropositivity increased with time since graduation from medical school (M.D.) or nursing school or college (non-M.D.). The prevalence of serologic markers of hepatitis B virus in this study of anesthesia personnel is five to eight times that of the general population but is similar to that of other medical workers who frequently are exposed to blood.
Topics: Male; Humans; Female; Hepatitis B Surface Antigens; Hepatitis B; Anesthesiology; Physicians; Anesthesiologists
PubMed: 38085155
DOI: 10.1097/ALN.0000000000004779 -
Joint Commission Journal on Quality and... Aug 2023Anesthesiology provider handoffs are complex, occur frequently, and have been associated with adverse patient outcomes. The authors sought to determine the degree to...
BACKGROUND
Anesthesiology provider handoffs are complex, occur frequently, and have been associated with adverse patient outcomes. The authors sought to determine the degree to which anesthesiology handoff studies with educational interventions incorporated tenets of educational best practices.
METHODS
The research team conducted a systematic review of the peer-reviewed literature focused on handoff studies with education interventions that included anesthesiology providers. Searches were conducted using PubMed, Embase, Scopus, Cochrane, and ERIC (2010-September 2021). Each phase of the article review process included at least two trained independent reviewers. In addition, pairs of trained reviewers abstracted study characteristics RESULTS: Twenty-six articles met inclusion criteria. Two thirds (18/26; 69.2%) were published after 2017, and almost three fourths (19/26; 73.1%) included learners. Education intervention descriptions varied, with only 15.4% (4/26) briefly mentioning education theory, 7.7% (2/26) with clear education objectives, and 7.7% (2/26) assessing curriculum via participant satisfaction. Most (22/26; 84.6%) assessed Kirkpatrick's level 3 (handoff behavior change), and 26.9% (7/26) assessed level 4b (patient outcomes). Medical education quality scores were low (range 6-24, mean 11.3; max 32), with more than half (15/26; 57.7%) receiving scores ≤ 10.
CONCLUSION
Educational interventions demonstrate marked heterogeneity in the use of educational theoretical concepts and established curriculum development best practices. Future studies should report on important aspects of educational interventions, which would allow for comparison across studies, yield the essential data needed to identify handoff education best practices, and improve patient safety.
Topics: Humans; Patient Handoff; Anesthesiology; Curriculum; Patient Safety
PubMed: 36631352
DOI: 10.1016/j.jcjq.2022.12.002 -
Anesthesiology Oct 2023
Topics: Anesthesia; Anesthesiology; Heart; Thorax
PubMed: 37698431
DOI: 10.1097/ALN.0000000000004648