Surgical Specimen Management in the Preanalytic Phase: Perioperative Nursing Implications

AORN Journal ◽  
2019 ◽  
Vol 110 (3) ◽  
pp. 237-250 ◽  
Author(s):  
Tabitha S. Kinlaw ◽  
Dawn Whiteside
Keyword(s):  
Surgical Specimen ◽  
Perioperative Nursing ◽  
Specimen Management

scholarly journals Surgical Specimen Management: A Descriptive Study of 648 Adverse Events and Near Misses

2016 ◽  
Vol 140 (12) ◽  
pp. 1390-1396 ◽  
Author(s):  
Victoria M. Steelman ◽  
Tamara L. Williams ◽  
Marilyn K. Szekendi ◽  
Amy L. Halverson ◽  
Suzanne M. Dintzis ◽  
...  
Keyword(s):  
Health Care ◽  
Adverse Events ◽  
Additional Treatment ◽  
Health Care Facilities ◽  
Contributing Factors ◽  
Surgical Specimen ◽  
Specimen Handling ◽  
Near Misses ◽  
Starting Point ◽  
Specimen Management

Context.— Surgical specimen adverse events can lead to delays in treatment or diagnosis, misdiagnosis, reoperation, inappropriate treatment, and anxiety or serious patient harm. Objectives.— To describe the types and frequency of event reports associated with the management of surgical specimens, the contributing factors, and the level of harm associated with these events. Design.— A retrospective review was undertaken of surgical specimen adverse events and near misses voluntarily reported in the University HealthSystem Consortium Safety Intelligence Patient Safety Organization database by more than 50 health care facilities during a 3-year period (2011–2013). Event reports that involved surgical specimen management were reviewed for patients undergoing surgery during which tissue or fluid was sent to the pathology department. Results.— Six hundred forty-eight surgical specimen events were reported in all stages of the specimen management process, with the most common events reported during the prelaboratory phase and, specifically, with specimen labeling, collection/preservation, and transport. The most common contributing factors were failures in handoff communication, staff inattention, knowledge deficit, and environmental issues. Eight percent of the events (52 of 648) resulted in either the need for additional treatment or temporary or permanent harm to the patient. Conclusions.— All phases of specimen handling and processing are vulnerable to errors. These results provide a starting point for health care organizations to conduct proactive risk analyses of specimen handling procedures and to design safer processes. Particular attention should be paid to effective communication and handoffs, consistent processes across care areas, and staff training. In addition, organizations should consider the use of technology-based identification and tracking systems.

scholarly journals Radiomic and Artificial Intelligence Analysis with Textural Metrics, Morphological and Dynamic Perfusion Features Extracted by Dynamic Contrast-Enhanced Magnetic Resonance Imaging in the Classification of Breast Lesions

2021 ◽  
Vol 11 (4) ◽  
pp. 1880
Author(s):  
Roberta Fusco ◽  
Adele Piccirillo ◽  
Mario Sansone ◽  
Vincenza Granata ◽  
Paolo Vallone ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Artificial Intelligence ◽  
Feature Selection ◽  
Resonance Imaging ◽  
Dynamic Features ◽  
Surgical Specimen ◽  
Dce Mri ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Malignant Lesions

Purpose: The aim of the study was to estimate the diagnostic accuracy of textural, morphological and dynamic features, extracted by dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) images, by carrying out univariate and multivariate statistical analyses including artificial intelligence approaches. Methods: In total, 85 patients with known breast lesion were enrolled in this retrospective study according to regulations issued by the local Institutional Review Board. All patients underwent DCE-MRI examination. The reference standard was pathology from a surgical specimen for malignant lesions and pathology from a surgical specimen or fine needle aspiration cytology, core or Tru-Cut needle biopsy for benign lesions. In total, 91 samples of 85 patients were analyzed. Furthermore, 48 textural metrics, 15 morphological and 81 dynamic parameters were extracted by manually segmenting regions of interest. Statistical analyses including univariate and multivariate approaches were performed: non-parametric Wilcoxon–Mann–Whitney test; receiver operating characteristic (ROC), linear classifier (LDA), decision tree (DT), k-nearest neighbors (KNN), and support vector machine (SVM) were utilized. A balancing approach and feature selection methods were used. Results: The univariate analysis showed low accuracy and area under the curve (AUC) for all considered features. Instead, in the multivariate textural analysis, the best performance (accuracy (ACC) = 0.78; AUC = 0.78) was reached with all 48 metrics and an LDA trained with balanced data. The best performance (ACC = 0.75; AUC = 0.80) using morphological features was reached with an SVM trained with 10-fold cross-variation (CV) and balanced data (with adaptive synthetic (ADASYN) function) and a subset of five robust morphological features (circularity, rectangularity, sphericity, gleaning and surface). The best performance (ACC = 0.82; AUC = 0.83) using dynamic features was reached with a trained SVM and balanced data (with ADASYN function). Conclusion: Multivariate analyses using pattern recognition approaches, including all morphological, textural and dynamic features, optimized by adaptive synthetic sampling and feature selection operations obtained the best results and showed the best performance in the discrimination of benign and malignant lesions.

scholarly journals Neonatal cardiogenic shock revealing obstructive cardiac Hibernoma: case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Rym Gribaa ◽  
Marwen Kacem ◽  
Sami Ouannes ◽  
Wiem Majdoub ◽  
Houssem Thabet ◽  
...  
Keyword(s):  
Cardiogenic Shock ◽  
Transthoracic Echocardiography ◽  
Right Atrium ◽  
Benign Tumors ◽  
Histopathological Analysis ◽  
Tricuspid Valve Repair ◽  
Flow Measurements ◽  
Surgical Specimen ◽  
Eosinophilic Cytoplasm ◽  
The Right

Abstract Background Cardiac Hibernomas are very rare benign tumors and usually remain asymptomatic. Neonatal cardiogenic shock due to cardiac tumors is extremely very rare. Until this date a few cases of cardiac hibernoma have been reported in the literature. Transthoracic echocardiography help in the differential diagnosis, but the definitive diagnosis is histological. The management strategy is not clearly codified. The Aim is to report and discuss the clinical features of a cardiac Hibernoma and review the relevant literature. Case presentation We describe a case of a 2-day-old Caucasian full-term male neonate admitted in neonate intensive care with cardiogenic shock, having fluid resuscitation and inotropic drugs. Ventilatory support was started immediately with the subsequent reestablishment of normal blood pressure. Then he was transferred to the echocardiography laboratory. Transthoracic echocardiography showed two echogenic masses in the right atrium and right ventricle. The masses were extended to the pulmonary trunk. Pulmonary artery flow measurements showed the presence of pulmonary and tricuspid obstruction. Surgery was rapidly considered since the baby was hemodynamically unstable. Intraoperative evaluation showed a mass embedded in the interventricular septum that occupy the right ventricular cavity and the right atrium. The tumor involved also the chordae of the tricuspid. Partial resection was done. Tricuspid valve repair was performed by construction of new chordae from the autologous pericardium. The specimen was sent for histopathological analysis. The baby died immediately after surgery. Histological examination of the surgical specimen revealed clear multivacuolated cells filled with lipid droplets and granular intense eosinophilic cytoplasm which confirms the diagnosis of Hibernoma. Conclusion Cardiac Hibernomas are rare benign tumors. The prognosis and treatment strategy is closely dependent on the location, initial clinical presentation and possible complications. The prognosis can be unfavorable if the tumor was obstructive and infiltrate the myocardium.

Specimen Management

AORN Journal ◽  
2021 ◽  
Vol 113 (5) ◽  
pp. 505-513
Author(s):  
Lisa Spruce
Keyword(s):  
Specimen Management

The role of the registered nurse first assistant within the perioperative setting

2021 ◽  
Vol 30 (3) ◽  
pp. 148-153
Author(s):  
Roland Pika ◽  
Brid O'Brien ◽  
Jill Murphy ◽  
Kathleen Markey ◽  
Claire O'Donnell
Keyword(s):  
Registered Nurse ◽  
Healthcare Sector ◽  
Review Of The Literature ◽  
Surgical Interventions ◽  
Medical Practitioners ◽  
Nursing Role ◽  
Perioperative Nursing ◽  
Recent Emergence ◽  
Provision Of Care

Perioperative setting registered nurse first assistants (RNFAs) are described as non-medical practitioners who perform surgical interventions during surgery. They provide medical care to perioperative patients under the supervision of a consultant surgeon. First assistants in surgery can be an expanded perioperative nursing role. A review of the literature illuminates the need for continuous learning in developing skills in becoming competent RNFA practitioners and how they utilise acquired skills to assist, mentor and teach their colleagues within the perioperative setting. The RNFA is an advanced and expanded practice role. RNFAs contribute significantly to the provision of care within all phases of perioperative care (preoperative, intraoperative, postoperative). There is little literature on the role of the RNFA due to its relatively recent emergence in the healthcare sector and the small number of countries where it is implemented.

scholarly journals Concurrent Bowen’s Disease of the Nipple and Breast Cancer

2020 ◽  
Vol 13 (3) ◽  
pp. 1410-1414
Author(s):  
Kei Yamaguchi ◽  
Ryoichi Matsunuma ◽  
Toko Kumeta ◽  
Sae Imada ◽  
Ryosuke Hayami ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Squamous Cell Carcinoma ◽  
Carcinoma In Situ ◽  
Histopathological Examination ◽  
Careful Examination ◽  
Bowen’S Disease ◽  
Ipsilateral Breast ◽  
Surgical Specimen ◽  
Bowen's Disease

Bowen’s disease is a squamous cell carcinoma in situ that commonly develops on the trunk, arms, or legs and has not spread beyond the top layer of skin. It seldom develops on the nipple. We report a patient who presented with Bowen’s disease of the nipple and had a concurrent breast cancer identified in the ipsilateral breast after careful examination. Histopathological examination of the surgical specimen after mastectomy confirmed the diagnoses.

scholarly journals Retropubic, laparoscopic, and robot-assisted radical prostatectomy: a multi-institutional comparative study

2020 ◽  
Vol 26 (1) ◽  
Author(s):  
Amr A. Faddan ◽  
Mahmoud M. Shalaby ◽  
Mohamed Gadelmoula ◽  
Younis Alshamsi ◽  
Daniar K. Osmonov ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Complication Rate ◽  
Perioperative Complications ◽  
Statistical Significance ◽  
Operating Time ◽  
Perioperative Outcomes ◽  
Academic Institutions ◽  
Robot Assisted ◽  
Surgical Specimen ◽  
Significant Difference

Abstract Background The standard surgical treatment of localized prostate cancer (PCa) has been rapidly changed along the last two decades from open to laparoscopic and finally robot-assisted techniques. Herein, we compare the three procedures for radical prostatectomy (RP), namely radical retropubic (RRP), laparoscopic (LRP), and robot-assisted laparoscopic (RALRP) regarding the perioperative clinical outcome and complication rate in four academic institutions. Methods A total of 394 patients underwent RP between January 2016 and December 2018 in four academic institutions; their records were reviewed. We recorded the patient age, BMI, PSA level, Gleason score and TNM stage, type of surgery, the pathological data from the surgical specimen, the perioperative complications, unplanned reoperating, and readmission rates within 3 months postoperatively. Statistical significance was set at (P < 0.05). All reported P values are two-sided. Results A total of 123 patients underwent RALRP, 220 patients underwent RRP, and 51 underwent LRP. There was no statistically significant difference between the three groups regarding age, BMI, prostatic volume, and preoperative PSA. However, there were statistically significant differences between them regarding the operating time (P < .0001), catheterization period (P < .001), hospital stay (P < .0001), and overall complications rate (P = .023). Conclusions The minimally invasive procedures (RALRP and LRP) are followed by a significantly lower complication rate. However, the patients’ factors and surgical experience likely impact perioperative outcomes and complications.

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