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Record W4402768181 · doi:10.1136/rapm-2024-esra.456

P063 Enhancing patient safety in regional anesthesia: lessons learned from wrong-side block events

2024· article· en· W4402768181 on OpenAlexaff
Ana Larissa Guerrero, Mohammad Misurati, Deepti Vissa, Rodrigo Monteiro Da Silva, Kevin Armstrong, R. Motwani

Bibliographic record

Venuenot available
Typearticle
Languageen
FieldMedicine
TopicCardiac, Anesthesia and Surgical Outcomes
Canadian institutionsWestern University
Fundersnot available
KeywordsPatient safetyBlock (permutation group theory)Regional anesthesiaComputer scienceMedicineAnesthesiaHealth carePolitical science

Abstract

fetched live from OpenAlex

Please confirm that an ethics committee approval has been applied for or granted: Not relevant (see information at the bottom of this page) Background and Aims Wrong-side blocks (WSBs) are a rare but serious complication in regional anesthesia. Anesthesia providers at our institution performed an average of 5,000 regional blocks annually across four block rooms. Acknowledging the grave repercussions of inadvertent WSBs, this quality improvement project focuses on investigating contributing factors and proposes preventive strategies, aiming to enhance patient safety. Methods An anonymous survey assessed WSB occurrences and near-miss events within our institution over the past three years. We analyzed the data to identify potential root causes. Results Despite safety protocols, four WSBs occurred, all deemed avoidable. Time pressure (32%), increased time between checklist and block (20%), change of assisting nurse (20%), checklist by another person (16%), and change of block performer (12%) were identified as contributing factors. Notably, one WSB resulted from unfamiliar prone positioning practices affecting landmark and ultrasound usage. Conclusions Factors such as time constraints, communication breakdowns, and procedural variations potentially contribute to the risk of WSB incidents. To mitigate these, we advocate for the implementation of a standardized safety checklist, documented electronically. It is imperative to allocate sufficient time for each procedural block to alleviate time constraints. Additionally, improving communication through handoff protocols and reducing the duration between checklist completion and block execution is paramount. Furthermore, comprehensive WSB prevention training should be imparted to all block room members. These strategies are designed to minimize the occurrence of WSB incidents and optimize patient safety.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.014
metaresearch head score (Gemma)0.070
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: none
Teacher disagreement score0.014
Threshold uncertainty score0.075

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0140.070
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.001
Science and technology studies0.0020.002
Scholarly communication0.0050.008
Open science0.0030.004
Research integrity0.0040.006
Insufficient payload (model declined to judge)0.0140.004

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.037
GPT teacher head0.301
Teacher spread0.263 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2024
Admission routes1
Has abstractyes

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