Pascience L. Kibatala

Bio: Pascience L. Kibatala is an academic researcher from Saint Francis University. The author has contributed to research in topics: WHO Surgical Safety Checklist & Checklist. The author has an hindex of 2, co-authored 2 publications receiving 4770 citations.

A Surgical Safety Checklist to Reduce Morbidity and Mortality in a Global Population

Abstract: The rate of death was 1.5% before the checklist was introduced and declined to 0.8% afterward (P = 0.003). Inpatient complications occurred in 11.0% of patients at baseline and in 7.0% after introduction of the checklist (P<0.001). Conclusions Implementation of the checklist was associated with concomitant reductions in the rates of death and complications among patients at least 16 years of age who were undergoing noncardiac surgery in a diverse group of hospitals.

Changes in safety attitude and relationship to decreased postoperative morbidity and mortality following implementation of a checklist-based surgical safety intervention

Abstract: Objectives To assess the relationship between changes in clinician attitude and changes in postoperative outcomes following a checklist-based surgical safety intervention. Design Pre- and post intervention survey. Setting Eight hospitals participating in a trial of a WHO surgical safety checklist. Participants Clinicians actively working in the designated study operating rooms at the eight hospitals. Survey instrument Modified operating-room version Safety Attitudes Questionnaire (SAQ). Main outcome measures Change in mean safety attitude score and correlation between change in safety attitude score and change in postoperative outcomes, plus clinician opinion of checklist efficacy and usability. Results Clinicians in the preintervention phase (n=281) had a mean SAQ score of 3.91 (on a scale of 1 to 5, with 5 representing better safety attitude), while the postintervention group (n=257) had a mean of 4.01 (p=0.0127). The degree of improvement in mean SAQ score at each site correlated with a reduction in postoperative complication rate (r=0.7143, p=0.0381). The checklist was considered easy to use by 80.2% of respondents, while 19.8% felt that it took a long time to complete, and 78.6% felt that the programme prevented errors. Overall, 93.4% would want the checklist used if they were undergoing operation. Conclusions Improvements in postoperative outcomes were associated with improved perception of teamwork and safety climate among respondents, suggesting that changes in these may be partially responsible for the effect of the checklist. Clinicians held the checklist in high regard and the overwhelming majority would want it used if they were undergoing surgery themselves.

The Clavien-Dindo classification of surgical complications: five-year experience.

Abstract: Background and Aims:The lack of consensus on how to define and grade adverse postoperative events has greatly hampered the evaluation of surgical procedures. A new classification of complications, initiated in 1992, was updated 5 years ago. It is based on the type of therapy needed to correct the co

2014 ESC/ESA Guidelines on non-cardiac surgery: cardiovascular assessment and management: The Joint Task Force on non-cardiac surgery: cardiovascular assessment and management of the European Society of Cardiology (ESC) and the European Society of Anaesthesiology (ESA).

Abstract: AAA : abdominal aortic aneurysm ACEI : angiotensin converting enzyme inhibitor ACS : acute coronary syndromes AF : atrial fibrillation AKI : acute kidney injury AKIN : Acute Kidney Injury Network ARB : angiotensin receptor blocker ASA : American Society of Anesthesiologists b.i.d. : bis in diem (twice daily) BBSA : Beta-Blocker in Spinal Anesthesia BMS : bare-metal stent BNP : B-type natriuretic peptide bpm : beats per minute CABG : coronary artery bypass graft CAD : coronary artery disease CARP : Coronary Artery Revascularization Prophylaxis CAS : carotid artery stenting CASS : Coronary Artery Surgery Study CEA : carotid endarterectomy CHA2DS2-VASc : cardiac failure, hypertension, age ≥75 (doubled), diabetes, stroke (doubled)-vascular disease, age 65–74 and sex category (female) CI : confidence interval CI-AKI : contrast-induced acute kidney injury CKD : chronic kidney disease CKD-EPI : Chronic Kidney Disease Epidemiology Collaboration Cmax : maximum concentration CMR : cardiovascular magnetic resonance COPD : chronic obstructive pulmonary disease CPG : Committee for Practice Guidelines CPX/CPET : cardiopulmonary exercise test CRP : C-reactive protein CRT : cardiac resynchronization therapy CRT-D : cardiac resynchronization therapy defibrillator CT : computed tomography cTnI : cardiac troponin I cTnT : cardiac troponin T CVD : cardiovascular disease CYP3a4 : cytochrome P3a4 enzyme DAPT : dual anti-platelet therapy DECREASE : Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress Echocardiography DES : drug-eluting stent DIPOM : DIabetic Post-Operative Mortality and Morbidity DSE : dobutamine stress echocardiography ECG : electrocardiography/electrocardiographically/electrocardiogram eGFR : estimated glomerular filtration rate ESA : European Society of Anaesthesiology ESC : European Society of Cardiology EVAR : endovascular abdominal aortic aneurysm repair FEV1 : Forced expiratory volume in 1 second HbA1c : glycosylated haemoglobin HF-PEF : heart failure with preserved left ventricular ejection fraction HF-REF : heart failure with reduced left ventricular ejection fraction ICD : implantable cardioverter defibrillator ICU : intensive care unit IHD : ischaemic heart disease INR : international normalized ratio IOCM : iso-osmolar contrast medium KDIGO : Kidney Disease: Improving Global Outcomes LMWH : low molecular weight heparin LOCM : low-osmolar contrast medium LV : left ventricular LVEF : left ventricular ejection fraction MaVS : Metoprolol after Vascular Surgery MDRD : Modification of Diet in Renal Disease MET : metabolic equivalent MRI : magnetic resonance imaging NHS : National Health Service NOAC : non-vitamin K oral anticoagulant NSQIP : National Surgical Quality Improvement Program NSTE-ACS : non-ST-elevation acute coronary syndromes NT-proBNP : N-terminal pro-BNP O2 : oxygen OHS : obesity hypoventilation syndrome OR : odds ratio P gp : platelet glycoprotein PAC : pulmonary artery catheter PAD : peripheral artery disease PAH : pulmonary artery hypertension PCC : prothrombin complex concentrate PCI : percutaneous coronary intervention POBBLE : Peri-Operative Beta-BLockadE POISE : Peri-Operative ISchemic Evaluation POISE-2 : Peri-Operative ISchemic Evaluation 2 q.d. : quaque die (once daily) RIFLE : Risk, Injury, Failure, Loss, End-stage renal disease SPECT : single photon emission computed tomography SVT : supraventricular tachycardia SYNTAX : Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery TAVI : transcatheter aortic valve implantation TdP : torsades de pointes TIA : transient ischaemic attack TOE : transoesophageal echocardiography TOD : transoesophageal doppler TTE : transthoracic echocardiography UFH : unfractionated heparin VATS : video-assisted thoracic surgery VHD : valvular heart disease VISION : Vascular Events In Noncardiac Surgery Patients Cohort Evaluation VKA : vitamin K antagonist VPB : ventricular premature beat VT : ventricular tachycardia Guidelines summarize and evaluate all available evidence, at the time of the writing process, on a particular issue with the aim of assisting health professionals in selecting the best management strategies for an individual patient with a given condition, taking into account the impact on outcome, as well as the risk–benefit ratio of particular diagnostic …

Best Care at Lower Cost: The Path to Continuously Learning Health Care in America

Abstract: America's health care system has become too complex and costly to continue business as usual. Best Care at Lower Cost explains that inefficiencies, an overwhelming amount of data, and other economic and quality barriers hinder progress in improving health and threaten the nation's economic stability and global competitiveness. According to this report, the knowledge and tools exist to put the health system on the right course to achieve continuous improvement and better quality care at a lower cost.The costs of the system's current inefficiency underscore the urgent need for a systemwide transformation. About 30 percent of health spending in 2009--roughly $750 billion--was wasted on unnecessary services, excessive administrative costs, fraud, and other problems. Moreover, inefficiencies cause needless suffering. By one estimate, roughly 75,000 deaths might have been averted in 2005 if every state had delivered care at the quality level of the best performing state. This report states that the way health care providers currently train, practice, and learn new information cannot keep pace with the flood of research discoveries and technological advances.About 75 million Americans have more than one chronic condition, requiring coordination among multiple specialists and therapies, which can increase the potential for miscommunication, misdiagnosis, potentially conflicting interventions, and dangerous drug interactions. Best Care at Lower Cost emphasizes that a better use of data is a critical element of a continuously improving health system, such as mobile technologies and electronic health records that offer significant potential to capture and share health data better. In order for this to occur, the National Coordinator for Health Information Technology, IT developers, and standard-setting organizations should ensure that these systems are robust and interoperable. Clinicians and care organizations should fully adopt these technologies, and patients should be encouraged to use tools, such as personal health information portals, to actively engage in their care.This book is a call to action that will guide health care providers; administrators; caregivers; policy makers; health professionals; federal, state, and local government agencies; private and public health organizations; and educational institutions.