Pub Date : 2026-01-04DOI: 10.1016/j.pcorm.2026.100611
Karen L. Posner , Adam Claessens , Richard D. Urman , Shawn Mincer , Karen B. Domino
Traditional methods to investigate adverse events incompletely identify events that may cause patient harm. Trigger tool methodology uses surveillance algorithms of patient-level data to flag patterns consistent with adverse events. This methodology can be adapted to non-operating room anesthesia (NORA) and the need for prospective action to prevent patient harm. The first step is to use retrospective data to develop a trigger tool for use in preoperative case planning. This case control study used NORA gastroenterology (GI) cases from the Anesthesia Closed Claims Project as cases with adverse events and from the National Anesthesia Clinical Outcomes Registry as controls (procedures not associated with adverse events). Structured analysis of detailed narrative information from cases was used to identify additional triggers. Cases were more likely to be American Society of Anesthesiologists Physical Status 3–5 (71 %) than controls (43 %, OR 3.17, p < 0.001), conducted on an emergency basis (12 % cases vs. 0.4 % controls, OR 30.3, p < 0.001), involved monitored anesthesia care (88 % cases vs. 49 % controls, OR 7.55, p < 0.001), and more commonly performed on inpatients (OR 1.725, p = 0.042). Structured narrative analysis identified triggers in 84 % of cases. The most common triggers were ASA PS 3–5 (69 %), cardiovascular comorbidities (46 %), gastrointestinal conditions (37 %), and morbid obesity (30 %). Injuries were more severe in cases with triggers than cases without triggers (p = 0.003). Reducing the risk of severe complications with use of a pre-procedure trigger tool for NORA with resultant change in anesthetic plan could potentially reduce preventable harm in thousands of patients per year in the United States.
调查不良事件的传统方法不能完全识别可能对患者造成伤害的事件。触发工具方法使用患者级数据的监测算法来标记与不良事件一致的模式。这种方法可以适用于非手术室麻醉（NORA）和预防患者伤害的前瞻性行动的需要。第一步是使用回顾性数据开发用于术前病例规划的触发工具。本病例对照研究使用来自麻醉封闭索赔项目的NORA胃肠病学（GI）病例作为不良事件的病例，并将来自国家麻醉临床结果登记处的病例作为对照（与不良事件无关的程序）。对病例的详细叙述信息进行结构化分析，以确定其他触发因素。病例更有可能是美国麻醉医师协会身体状态3-5(71%)，而不是对照组（43%,OR 3.17, p < 0.001），在急诊基础上进行（12%病例对0.4%对照，OR 30.3, p < 0.001），涉及麻醉监护（88%病例对49%对照，OR 7.55, p < 0.001），更常在住院患者中进行（OR 1.725, p = 0.042）。结构化叙事分析确定了84%的病例的诱因。最常见的诱发因素是ASA PS 3-5（69%）、心血管合并症（46%）、胃肠道疾病（37%）和病态肥胖（30%）。有触发器组损伤较无触发器组严重（p = 0.003）。使用手术前触发工具降低NORA严重并发症的风险，从而改变麻醉计划，可以潜在地减少美国每年数千名患者的可预防伤害。
{"title":"A study of preoperative triggers to prospectively identify cases at risk of adverse events in non-operating room anesthesia","authors":"Karen L. Posner , Adam Claessens , Richard D. Urman , Shawn Mincer , Karen B. Domino","doi":"10.1016/j.pcorm.2026.100611","DOIUrl":"10.1016/j.pcorm.2026.100611","url":null,"abstract":"<div><div>Traditional methods to investigate adverse events incompletely identify events that may cause patient harm. Trigger tool methodology uses surveillance algorithms of patient-level data to flag patterns consistent with adverse events. This methodology can be adapted to non-operating room anesthesia (NORA) and the need for prospective action to prevent patient harm. The first step is to use retrospective data to develop a trigger tool for use in preoperative case planning. This case control study used NORA gastroenterology (GI) cases from the Anesthesia Closed Claims Project as cases with adverse events and from the National Anesthesia Clinical Outcomes Registry as controls (procedures not associated with adverse events). Structured analysis of detailed narrative information from cases was used to identify additional triggers. Cases were more likely to be American Society of Anesthesiologists Physical Status 3–5 (71 %) than controls (43 %, OR 3.17, <em>p</em> < 0.001), conducted on an emergency basis (12 % cases vs. 0.4 % controls, OR 30.3, <em>p</em> < 0.001), involved monitored anesthesia care (88 % cases vs. 49 % controls, OR 7.55, <em>p</em> < 0.001), and more commonly performed on inpatients (OR 1.725, <em>p</em> = 0.042). Structured narrative analysis identified triggers in 84 % of cases. The most common triggers were ASA PS 3–5 (69 %), cardiovascular comorbidities (46 %), gastrointestinal conditions (37 %), and morbid obesity (30 %). Injuries were more severe in cases with triggers than cases without triggers (<em>p</em> = 0.003). Reducing the risk of severe complications with use of a pre-procedure trigger tool for NORA with resultant change in anesthetic plan could potentially reduce preventable harm in thousands of patients per year in the United States.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100611"},"PeriodicalIF":1.0,"publicationDate":"2026-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Postoperative pneumonia after esophageal cancer surgery increases mortality. Although pneumonia is known to cause delirium, it remains unclear whether delirium can cause pneumonia.
Objectives
To investigate the relationship between postoperative delirium and pneumonia in esophageal cancer patients, specifically focusing on "temporality" and "strength" to clarify the nature of their association.
Methods
A medical record survey was conducted in adult esophageal cancer patients who underwent esophagectomy at a university hospital in Japan during a 5-year period. The relationship between pneumonia and delirium was investigated based on Hill's criteria, specifically examining the time between onset (temporality) and multivariate analysis (strength).
Results
Of the 278 study patients, four developed delirium before pneumonia, 14 developed pneumonia and delirium at the same time, and three developed pneumonia before delirium. Logistic regression analysis showed that the odds ratio of developing pneumonia when delirium occurred first was 0.27 (odds ratio 95 % confidence interval, 0.08–0.76). This indicates that antecedent delirium was associated with a reduced risk of postoperative pneumonia, rather than being a risk factor.
Conclusion
Although a direct causal relationship where delirium induces pneumonia was not established, an inverse association was observed. This suggests that intensive nursing care provided for delirium, such as early mobilization and pain control, may have effectively prevented the development of postoperative pneumonia. Therefore, nursing interventions typically targeted at delirium management may also serve as effective strategies for preventing postoperative pneumonia.
{"title":"Does delirium cause postoperative pneumonia in patients after esophageal cancer surgery?","authors":"Hitomi Masutani , Mayumi Aminaka , Namiko Mori , Tomohiko Takahashi , Shunsuke Uno , Hirofumi Kawakubo , Naoki Hasegawa , Midori Nishioka","doi":"10.1016/j.pcorm.2025.100608","DOIUrl":"10.1016/j.pcorm.2025.100608","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pneumonia after esophageal cancer surgery increases mortality. Although pneumonia is known to cause delirium, it remains unclear whether delirium can cause pneumonia.</div></div><div><h3>Objectives</h3><div>To investigate the relationship between postoperative delirium and pneumonia in esophageal cancer patients, specifically focusing on \"temporality\" and \"strength\" to clarify the nature of their association.</div></div><div><h3>Methods</h3><div>A medical record survey was conducted in adult esophageal cancer patients who underwent esophagectomy at a university hospital in Japan during a 5-year period. The relationship between pneumonia and delirium was investigated based on Hill's criteria, specifically examining the time between onset (temporality) and multivariate analysis (strength).</div></div><div><h3>Results</h3><div>Of the 278 study patients, four developed delirium before pneumonia, 14 developed pneumonia and delirium at the same time, and three developed pneumonia before delirium. Logistic regression analysis showed that the odds ratio of developing pneumonia when delirium occurred first was 0.27 (odds ratio 95 % confidence interval, 0.08–0.76). This indicates that antecedent delirium was associated with a reduced risk of postoperative pneumonia, rather than being a risk factor.</div></div><div><h3>Conclusion</h3><div>Although a direct causal relationship where delirium induces pneumonia was not established, an inverse association was observed. This suggests that intensive nursing care provided for delirium, such as early mobilization and pain control, may have effectively prevented the development of postoperative pneumonia. Therefore, nursing interventions typically targeted at delirium management may also serve as effective strategies for preventing postoperative pneumonia.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100608"},"PeriodicalIF":1.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-25DOI: 10.1016/j.pcorm.2025.100601
Bingqing Xu , Qibin Ke , Yang Xiao , Jianfeng Wang , Wei Kang , Xiaojuan Luo , Danlong Ma , Bo Zhang , Changchang You , Chun Chen
Background
In clinical practice, bronchial blockers and double-lumen tubes are commonly used airway management tools for thoracic surgery. Although several studies have compared bronchial blockers and double-lumen tubes in patients undergoing thoracic surgery, their conclusions varied widely. This study aims to compare the effects of bronchial blockers and double-lumen tubeson recovery quality in patients undergoing lobectomy.
Methods
Sixty adult patients undergoing lobectomy at the Yichang Central People's Hospital from January 2025 to June 2025 were selected and randomly divided into two groups: the observation group (Group B) and the control group (Group D), with 30 patients in each group. During the operation, Group B received one-lung ventilation using bronchial blockers, while Group D received one-lung ventilation using double-lumen tubes. The first intubation success rate, intubation positioning time, and lung collapse quality were compared between the two groups. Additionally, the operation time, anesthesia time, awakening time, and recovery time of the two groups were recorded. Complications (sore throat, hoarseness, airway injury) and the Steward anesthetic recovery score were compared upon leaving the recovery room. Hospitalization time and costs were compared between the two groups.
Results
There were no statistically significant differences between the two groups in general condition, operation time, and anesthesia time (P> 0.05). The first intubation success rate and lung collapse quality were not significantly different between the two groups (P> 0.05); The intubation positioning time was significantly shorter in Group B than in Group D (116.8 ± 6.06s vs 185.93 ± 6.97 s, P < 0.001). The incidence of postoperative complications (sore throat, hoarseness, airway injury) in Group B was lower than in Group D (16.77 % vs 46.77 %, P < 0.05). The awakening time and recovery time were shorter in Group B compared with Group D (24.87 ± 2.56 min vs 33 ± 3.01 min, P < 0.05),(55.67 ± 3.36 min vs 67.9 ± 4.49 min, P < 0.05). The Steward score upon leaving the recovery room was higher in Group B than in Group D (5.43 ± 0.11 vs 4.9 ± 0.12, P < 0.05). The hospitalization time was shorter in Group B than in Group D(10.7 ± 0.70days vs 15.37 ± 1.21days, P < 0.05) and the hospitalization costs of patients inGroup B were less than those in group D(4018.39 ± 1389.76dollars vs 5557.34 ± 2110.65dollars, P < 0.05).
Conclusion
Compared to double-lumen tubes, bronchial blockers effectively reduce intubation complications, enhance the quality of postoperative recovery, and reduce the hospitalization costs of patients.
在临床实践中，支气管阻滞剂和双腔管是胸外科手术中常用的气道管理工具。虽然有几项研究比较了支气管阻滞剂和双腔管在胸外科手术患者中的应用，但他们的结论差异很大。本研究旨在比较支气管阻滞剂和双腔管在肺叶切除术患者中的恢复质量。方法选择2025年1月~ 2025年6月宜昌市中心人民医院行肺叶切除术的成人患者60例，随机分为观察组（B组）和对照组（D组），每组各30例。术中B组采用支气管阻滞剂进行单肺通气，D组采用双腔管进行单肺通气。比较两组患者首次插管成功率、插管定位时间及肺萎陷质量。记录两组患者手术时间、麻醉时间、苏醒时间、恢复时间。出院时比较并发症（喉咙痛、声音嘶哑、气道损伤）和Steward麻醉恢复评分。比较两组患者住院时间和费用。结果两组患者一般情况、手术时间、麻醉时间比较，差异均无统计学意义（P> 0.05）。两组首次插管成功率和肺萎陷质量比较，差异无统计学意义（P> 0.05）；B组插管定位时间明显短于D组（116.8±6.06s vs 185.93±6.97 s, P < 0.001）。B组术后并发症（咽痛、声音嘶哑、气道损伤）发生率低于D组（16.77% vs 46.77%, P < 0.05）。B组苏醒时间和恢复时间较D组短（24.87±2.56 min vs 33±3.01 min, P < 0.05），（55.67±3.36 min vs 67.9±4.49 min, P < 0.05）。B组患者出院时Steward评分高于D组（5.43±0.11 vs 4.9±0.12,P < 0.05）。B组患者住院时间短于D组（10.7±0.70 D∶15.37±1.21 D, P < 0.05），住院费用低于D组（4018.39±1389.76美元∶5557.34±2110.65美元，P < 0.05）。结论与双腔管相比，支气管阻滞剂可有效减少插管并发症，提高术后恢复质量，降低患者住院费用。
{"title":"Effects of bronchial blockers and double-lumen tubes on recovery quality in patients undergoing lobectomy: A randomized controlled trial","authors":"Bingqing Xu , Qibin Ke , Yang Xiao , Jianfeng Wang , Wei Kang , Xiaojuan Luo , Danlong Ma , Bo Zhang , Changchang You , Chun Chen","doi":"10.1016/j.pcorm.2025.100601","DOIUrl":"10.1016/j.pcorm.2025.100601","url":null,"abstract":"<div><h3>Background</h3><div>In clinical practice, bronchial blockers and double-lumen tubes are commonly used airway management tools for thoracic surgery. Although several studies have compared bronchial blockers and double-lumen tubes in patients undergoing thoracic surgery, their conclusions varied widely. This study aims to compare the effects of bronchial blockers and double-lumen tubeson recovery quality in patients undergoing lobectomy.</div></div><div><h3>Methods</h3><div>Sixty adult patients undergoing lobectomy at the Yichang Central People's Hospital from January 2025 to June 2025 were selected and randomly divided into two groups: the observation group (Group B) and the control group (Group D), with 30 patients in each group. During the operation, Group B received one-lung ventilation using bronchial blockers, while Group D received one-lung ventilation using double-lumen tubes. The first intubation success rate, intubation positioning time, and lung collapse quality were compared between the two groups. Additionally, the operation time, anesthesia time, awakening time, and recovery time of the two groups were recorded. Complications (sore throat, hoarseness, airway injury) and the Steward anesthetic recovery score were compared upon leaving the recovery room. Hospitalization time and costs were compared between the two groups.</div></div><div><h3>Results</h3><div>There were no statistically significant differences between the two groups in general condition, operation time, and anesthesia time (<em>P</em>> 0.05). The first intubation success rate and lung collapse quality were not significantly different between the two groups (<em>P</em>> 0.05); The intubation positioning time was significantly shorter in Group B than in Group D (116.8 ± 6.06s vs 185.93 ± 6.97 s, <em>P</em> < 0.001). The incidence of postoperative complications (sore throat, hoarseness, airway injury) in Group B was lower than in Group D (16.77 % vs 46.77 %, <em>P</em> < 0.05). The awakening time and recovery time were shorter in Group B compared with Group D (24.87 ± 2.56 min vs 33 ± 3.01 min, <em>P</em> < 0.05),(55.67 ± 3.36 min vs 67.9 ± 4.49 min, <em>P</em> < 0.05). The Steward score upon leaving the recovery room was higher in Group B than in Group D (5.43 ± 0.11 vs 4.9 ± 0.12, <em>P</em> < 0.05). The hospitalization time was shorter in Group B than in Group D(10.7 ± 0.70days vs 15.37 ± 1.21days, <em>P</em> < 0.05) and the hospitalization costs of patients inGroup B were less than those in group D(4018.39 ± 1389.76dollars vs 5557.34 ± 2110.65dollars, <em>P</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>Compared to double-lumen tubes, bronchial blockers effectively reduce intubation complications, enhance the quality of postoperative recovery, and reduce the hospitalization costs of patients.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100601"},"PeriodicalIF":1.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Adult cardiac surgery continues to be linked with significant morbidity, mortality, and financial strain, notwithstanding technical advancements. Hybrid operating rooms (HORs) merge surgical sterility with sophisticated real-time imaging, facilitating the integration of open and catheter-based procedures. Their capacity to enhance clinical precision, safety, and results has garnered growing interest; nonetheless, the current evidence remains inconsistent.
Methods
In accordance with PRISMA 2020 recommendations, we conducted a systematic evaluation of studies comparing HORs with conventional operating rooms in adult cardiac surgery. Eligible studies encompassed randomized, non-randomized, cohort, and observational designs. Data were independently extracted by two reviewers, with quality evaluated using RoB 2 and ROBINS-I. Narrative synthesis was utilized because of the variability in study designs, participants, and outcomes. Quantitative meta-analysis was deemed inappropriate due to predominantly observational evidence and substantial clinical and methodological heterogeneity.
Results
Twenty-four studies encompassing 11 to 12,121 patients, published from 2010 to 2024, were included. The utilization of HORs was consistently linked to advantages in high-risk environments. In acute type A aortic dissection, HOR methods enhanced survival by facilitating prompt imaging and endovascular intervention. In transvenous lead extraction, HORs virtually eradicated procedure-related mortality. In TAVR/TAVI, HORs diminished the risk of infective endocarditis, whereas minimalist catheterization lab techniques enhanced efficiency and reduced costs without jeopardizing survival. Intraoperative angiography during CABG identified and permitted the rectification of graft flaws, while HOR-assisted hybrid coronary revascularization resulted in favorable long-term outcomes. In elective surgeries like standard-risk TAVR and aortic arch repair, death and complication rates were similar between HOR and conventional methods.
Discussion
HORs augment safety, technical accuracy, and survival rates in urgent and intricate cardiac surgeries, although offer minimal advantages in elective situations. The existing evidence is predominantly observational and susceptible to bias, highlighting the necessity for randomized trials, cost-effectiveness analyses, and patient-reported outcomes to elucidate the appropriate function of HORs in adult cardiac surgery.
{"title":"Clinical and structural outcomes of hybrid operating rooms in adult cardiac surgery: a systematic review","authors":"Bahador Pourdel, Seyed Abolfazl Hosseini, Erfan Rajabi","doi":"10.1016/j.pcorm.2025.100607","DOIUrl":"10.1016/j.pcorm.2025.100607","url":null,"abstract":"<div><h3>Background</h3><div>Adult cardiac surgery continues to be linked with significant morbidity, mortality, and financial strain, notwithstanding technical advancements. Hybrid operating rooms (HORs) merge surgical sterility with sophisticated real-time imaging, facilitating the integration of open and catheter-based procedures. Their capacity to enhance clinical precision, safety, and results has garnered growing interest; nonetheless, the current evidence remains inconsistent.</div></div><div><h3>Methods</h3><div>In accordance with PRISMA 2020 recommendations, we conducted a systematic evaluation of studies comparing HORs with conventional operating rooms in adult cardiac surgery. Eligible studies encompassed randomized, non-randomized, cohort, and observational designs. Data were independently extracted by two reviewers, with quality evaluated using RoB 2 and ROBINS-I. Narrative synthesis was utilized because of the variability in study designs, participants, and outcomes. Quantitative meta-analysis was deemed inappropriate due to predominantly observational evidence and substantial clinical and methodological heterogeneity.</div></div><div><h3>Results</h3><div>Twenty-four studies encompassing 11 to 12,121 patients, published from 2010 to 2024, were included. The utilization of HORs was consistently linked to advantages in high-risk environments. In acute type A aortic dissection, HOR methods enhanced survival by facilitating prompt imaging and endovascular intervention. In transvenous lead extraction, HORs virtually eradicated procedure-related mortality. In TAVR/TAVI, HORs diminished the risk of infective endocarditis, whereas minimalist catheterization lab techniques enhanced efficiency and reduced costs without jeopardizing survival. Intraoperative angiography during CABG identified and permitted the rectification of graft flaws, while HOR-assisted hybrid coronary revascularization resulted in favorable long-term outcomes. In elective surgeries like standard-risk TAVR and aortic arch repair, death and complication rates were similar between HOR and conventional methods.</div></div><div><h3>Discussion</h3><div>HORs augment safety, technical accuracy, and survival rates in urgent and intricate cardiac surgeries, although offer minimal advantages in elective situations. The existing evidence is predominantly observational and susceptible to bias, highlighting the necessity for randomized trials, cost-effectiveness analyses, and patient-reported outcomes to elucidate the appropriate function of HORs in adult cardiac surgery.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100607"},"PeriodicalIF":1.0,"publicationDate":"2025-12-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-24DOI: 10.1016/j.pcorm.2025.100606
Adile Savsar , Zehra Yıldız , Canan Bakan , Ceren Rabia Yılmaz , Serap Bar , Filiz Ogce Aktas
Background
Perception of patient safety is a crucial component of quality improvement. Nurses play a critical role in ensuring patient safety. This study aims to determine the patient safety perceptions of nurses working in operating rooms and surgical intensive care units.
Methods
This descriptive and cross-sectional study was conducted with 377 nurses working in the intensive care and operating room units of five hospitals in Izmir. Data were collected between February 8 and July 25, 2023, using the “Socio-demographic and Occupational Characteristics Form” and the “Leiden Operating Room and Intensive Care Safety Scale- LOTICS”. The scale consists of five sub-dimensions: Teamwork and Awareness, Resource Management and Planning, Employee Resources and Audit, Teamwork Instructions and Preparations, and Training and Access to Information. A higher score on the scale indicates a more positive perception of working conditions. The data were analyzed using independent groups t-test, Mann-Whitney U, One Way ANOVA, Kruskal-Wallis test, and multiple linear regression.
Results
The total patient safety perception score for intensive care nurses (ICN) was significantly higher (106.03±15.93; min-max: 67–151) than that of operating room nurses (ORN) (101.81±14.24; min-max: 43–132). ICN perceived the sub-dimensions of “Resource Management and Planning”, “Teamwork and Awareness”, and “Teamwork Instructions and Preparations” more positively than ORN. Additionally, being married, being ICN, and having received training in team collaboration predicted nurses' perceptions of patient safety.
Conclusion
Intensive care nurses exhibited higher patient safety perception scores than operating room nurses. Married nurses reported higher perception scores than single nurses, and those who received training on team collaboration had better perceptions than those who did not. Therefore, their perceptions of working conditions were more positive. Providing patient safety training to nurses in operating rooms and surgical intensive care units, where systemic risk factors can be high, is essential for enhancing perceptions in this area.
{"title":"Patient safety perceptions of operating room nurses and surgical intensive care nurses: A multicenter study","authors":"Adile Savsar , Zehra Yıldız , Canan Bakan , Ceren Rabia Yılmaz , Serap Bar , Filiz Ogce Aktas","doi":"10.1016/j.pcorm.2025.100606","DOIUrl":"10.1016/j.pcorm.2025.100606","url":null,"abstract":"<div><h3>Background</h3><div>Perception of patient safety is a crucial component of quality improvement. Nurses play a critical role in ensuring patient safety. This study aims to determine the patient safety perceptions of nurses working in operating rooms and surgical intensive care units.</div></div><div><h3>Methods</h3><div>This descriptive and cross-sectional study was conducted with 377 nurses working in the intensive care and operating room units of five hospitals in Izmir. Data were collected between February 8 and July 25, 2023, using the “Socio-demographic and Occupational Characteristics Form” and the “Leiden Operating Room and Intensive Care Safety Scale- LOTICS”. The scale consists of five sub-dimensions: Teamwork and Awareness, Resource Management and Planning, Employee Resources and Audit, Teamwork Instructions and Preparations, and Training and Access to Information. A higher score on the scale indicates a more positive perception of working conditions. The data were analyzed using independent groups <em>t</em>-test, Mann-Whitney U, One Way ANOVA, Kruskal-Wallis test, and multiple linear regression.</div></div><div><h3>Results</h3><div>The total patient safety perception score for intensive care nurses (ICN) was significantly higher (106.03±15.93; min-max: 67–151) than that of operating room nurses (ORN) (101.81±14.24; min-max: 43–132). ICN perceived the sub-dimensions of “Resource Management and Planning”, “Teamwork and Awareness”, and “Teamwork Instructions and Preparations” more positively than ORN. Additionally, being married, being ICN, and having received training in team collaboration predicted nurses' perceptions of patient safety.</div></div><div><h3>Conclusion</h3><div>Intensive care nurses exhibited higher patient safety perception scores than operating room nurses. Married nurses reported higher perception scores than single nurses, and those who received training on team collaboration had better perceptions than those who did not. Therefore, their perceptions of working conditions were more positive. Providing patient safety training to nurses in operating rooms and surgical intensive care units, where systemic risk factors can be high, is essential for enhancing perceptions in this area.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100606"},"PeriodicalIF":1.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.pcorm.2025.100604
Hany Bauiomy , Neveen A. Kohaf , Ahmed Abdelhamed Hassan
Background
Peribulbar block is the method of choice for ophthalmic surgeries. A combination of local anaesthetics and hyaluronidase is usually used to help in the diffusion of the drugs and speed up the onset of ocular akinesia. Herein, we present an extremely rare case of severe anaphylaxis after a peribulbar block that was successfully managed.
Case presentation
A 55-year-old Egyptian female patient was admitted for phacoemulsification as a day-case surgery. The patient received a peribulbar block composed of 5 mL of lidocaine 2% + 5 mL of bupivacaine 0.5% + 30 IU/mL of hyaluronidase, with a total volume of 8 mL, administered in two locations: the inferior and medial canthus. After 15 minutes, the akinesia score was successfully achieved, and the patient was shifted to the operating theatre. Thirty minutes after the block and before starting the surgical procedure, the patient exhibited tearing and a runny nose, which was not present when the surgeon assessed the patient preoperatively. At this time, the patient complained of difficulty breathing, which was initially attributed to claustrophobia or anxiety. However, with increasing complaints of dyspnea, the surgeon decided not to proceed with the case. Accidentally, after removing the surgical drape, the anesthesiologist noticed marked swelling of the whole face and oedema in both eyes. As symptoms aggravated, he called for help and administered 100 micrograms of adrenaline intravenously and 8 mg of dexamethasone intravenously. He also started an infusion of 500 mL of Ringer's lactate. After the patient's condition stabilized, the anesthesiologist recorded the patient's vital data, documenting no hypotension or skin rash. The patient improved and was admitted for 12 hours for fear of relapse. After 12 hours, the patient was discharged with written documentation and information for future surgery under local anaesthesia.
Conclusions
Anesthesiologists should always be alert and ready for such fatal complications.
背景：眼球周围阻滞是眼科手术的首选方法。通常使用局部麻醉和透明质酸酶的组合来帮助药物的扩散和加速眼动症的发作。在此，我们提出了一个极其罕见的病例严重的过敏反应后，一个成功的管理球周阻滞。病例介绍：一名55岁的埃及女性患者接受了超声乳化手术。患者接受5 mL 2%利多卡因+ 5 mL 0.5%布比卡因+ 30 IU/mL透明质酸酶组成的球周阻滞，总容积为8 mL，分别在下眦和内眦两个部位给药。15分钟后，肌无力评分成功达到，患者被转移到手术室。阻断后30分钟，手术开始前，患者表现出撕裂和流鼻涕，这是外科医生术前评估患者时没有出现的。此时，患者主诉呼吸困难，最初归因于幽闭恐惧症或焦虑。然而，随着越来越多的呼吸困难的抱怨，外科医生决定不继续进行该病例。意外地，在移除手术纱布后，麻醉师注意到整个面部明显肿胀，双眼水肿。随着症状加重，他打电话求助，并静脉注射了100微克肾上腺素和8毫克地塞米松。他还开始注射500毫升乳酸林格氏液。患者病情稳定后，麻醉师记录了患者的重要数据，无低血压或皮疹记录。患者病情好转，因担心复发住院12小时。12小时后，患者在局部麻醉下出院，并留下书面文件和未来手术的信息。结论对此类致命并发症，麻醉师应时刻保持警惕。
{"title":"Severe anaphylaxis after peribulbar block: Extremely rare event a lesson to expect the unexpected: a case report","authors":"Hany Bauiomy , Neveen A. Kohaf , Ahmed Abdelhamed Hassan","doi":"10.1016/j.pcorm.2025.100604","DOIUrl":"10.1016/j.pcorm.2025.100604","url":null,"abstract":"<div><h3>Background</h3><div>Peribulbar block is the method of choice for ophthalmic surgeries. A combination of local anaesthetics and hyaluronidase is usually used to help in the diffusion of the drugs and speed up the onset of ocular akinesia. Herein, we present an extremely rare case of severe anaphylaxis after a peribulbar block that was successfully managed.</div></div><div><h3>Case presentation</h3><div>A 55-year-old Egyptian female patient was admitted for phacoemulsification as a day-case surgery. The patient received a peribulbar block composed of 5 mL of lidocaine 2% + 5 mL of bupivacaine 0.5% + 30 IU/mL of hyaluronidase, with a total volume of 8 mL, administered in two locations: the inferior and medial canthus. After 15 minutes, the akinesia score was successfully achieved, and the patient was shifted to the operating theatre. Thirty minutes after the block and before starting the surgical procedure, the patient exhibited tearing and a runny nose, which was not present when the surgeon assessed the patient preoperatively. At this time, the patient complained of difficulty breathing, which was initially attributed to claustrophobia or anxiety. However, with increasing complaints of dyspnea, the surgeon decided not to proceed with the case. Accidentally, after removing the surgical drape, the anesthesiologist noticed marked swelling of the whole face and oedema in both eyes. As symptoms aggravated, he called for help and administered 100 micrograms of adrenaline intravenously and 8 mg of dexamethasone intravenously. He also started an infusion of 500 mL of Ringer's lactate. After the patient's condition stabilized, the anesthesiologist recorded the patient's vital data, documenting no hypotension or skin rash. The patient improved and was admitted for 12 hours for fear of relapse. After 12 hours, the patient was discharged with written documentation and information for future surgery under local anaesthesia.</div></div><div><h3>Conclusions</h3><div>Anesthesiologists should always be alert and ready for such fatal complications.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100604"},"PeriodicalIF":1.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145840935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Operating room nurses frequently encounter ethically demanding situations in their daily practice that call for moral courage. The level of moral courage among nurses can be shaped by their spiritual well-being and their experiences of moral distress. Understanding the relationships among these factors is essential to improve ethical practice and nurse well-being. However, limited research has explored these associations in the context of Iranian hospitals.
Methods
This cross-sectional study was conducted from January to November 2023 among 372 operating room nurses in six educational hospitals in Shiraz, Iran. Stratified proportional random sampling was used to select participants. Data were collected using a demographic form, the Nurses’ Moral Courage Questionnaire, the Spiritual Well-Being Scale (SWBS), and Hamric's Moral Distress Scale-Revised (MDS-R). Descriptive statistics, Chi-square tests, Pearson correlation, independent t-tests, ANOVA, and multiple linear regression were performed using SPSS v22, with p < 0.05 considered statistically significant.
Results
The mean age of the participants in the study was 33.5 ± 7.61 years, of which 226 were women. Operating room nurses showed moderate moral courage (371.23 ± 98.42), average spiritual well-being (89.15 ± 18.56), and low moral distress (56.52 ± 19.74). Most participants had high moral courage (51.3 %), moderate spiritual well-being (58.1 %), and low moral distress (93.8 %). Correlation analysis indicated a positive relationship between moral courage and spiritual well-being (r = 0.171, p = 0.001) and a negative relationship with moral distress (r = –0.159, p = 0.002). Regression analysis showed that gender, employment status, work experience, spiritual well-being, and moral distress significantly influenced moral courage. Men, permanently employed nurses, and those with over 20 years of experience scored higher, while higher moral distress reduced moral courage.
Conclusion
Moral courage in operating room nurses is influenced by gender, employment type, work experience, spiritual well-being, and moral distress. Men, permanently employed nurses, and those with longer experience show higher moral courage, while moral distress lowers it and spiritual well-being boosts it. Enhancing nurses’ spiritual well-being and reducing moral distress may help promote their moral courage in the operating room.”
手术室护士在日常工作中经常遇到道德要求高的情况，需要道德勇气。护士的道德勇气水平可以通过他们的精神健康和道德痛苦的经历来塑造。了解这些因素之间的关系对于提高道德实践和护士福祉至关重要。然而，有限的研究在伊朗医院的背景下探讨了这些关联。方法对伊朗设拉子地区6所教育医院的372名手术室护士于2023年1 - 11月进行横断面调查。采用分层比例随机抽样的方法选择参与者。数据收集使用人口统计表格，护士道德勇气问卷，精神幸福量表（SWBS）和Hamric道德痛苦量表-修订（MDS-R）。采用SPSS v22进行描述性统计、卡方检验、Pearson相关检验、独立t检验、方差分析和多元线性回归，p <； 0.05认为有统计学意义。结果研究对象平均年龄为33.5±7.61岁，其中女性226人。手术室护士道德勇气（371.23±98.42）为中等，精神幸福感（89.15±18.56）为中等，道德窘迫（56.52±19.74）为低。大多数参与者有很高的道德勇气（51.3%），适度的精神幸福（58.1%）和低道德痛苦（93.8%）。相关分析显示，道德勇气与精神幸福感呈正相关（r = 0.171, p = 0.001），与道德苦恼呈负相关（r = -0.159, p = 0.002）。回归分析显示，性别、就业状况、工作经历、精神幸福感和道德困境对道德勇气有显著影响。男性、全职护士和有超过20年工作经验的人得分更高，而更高的道德困境会降低道德勇气。结论手术室护士道德勇气受性别、就业类型、工作经历、精神幸福感和道德困境的影响。男性、全职护士和经验较长的人表现出更高的道德勇气，而道德上的痛苦会降低道德勇气，精神上的幸福会提高道德勇气。提高护士的精神幸福感和减少道德困境可能有助于提高他们在手术室的道德勇气。”
{"title":"Examining the correlation of moral courage with spiritual well-being and moral distress in operating room nurses in Iran: A cross-sectional study","authors":"Armin Fereidouni , Shaghayegh Garmanjani , Zahra Padam , Zahra Maleki , Sadegh Miraki , Esmaeil Teymoori","doi":"10.1016/j.pcorm.2025.100602","DOIUrl":"10.1016/j.pcorm.2025.100602","url":null,"abstract":"<div><h3>Introduction</h3><div>Operating room nurses frequently encounter ethically demanding situations in their daily practice that call for moral courage. The level of moral courage among nurses can be shaped by their spiritual well-being and their experiences of moral distress. Understanding the relationships among these factors is essential to improve ethical practice and nurse well-being. However, limited research has explored these associations in the context of Iranian hospitals.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted from January to November 2023 among 372 operating room nurses in six educational hospitals in Shiraz, Iran. Stratified proportional random sampling was used to select participants. Data were collected using a demographic form, the Nurses’ Moral Courage Questionnaire, the Spiritual Well-Being Scale (SWBS), and Hamric's Moral Distress Scale-Revised (MDS-R). Descriptive statistics, Chi-square tests, Pearson correlation, independent <em>t</em>-tests, ANOVA, and multiple linear regression were performed using SPSS v22, with <em>p</em> < 0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>The mean age of the participants in the study was 33.5 ± 7.61 years, of which 226 were women. Operating room nurses showed moderate moral courage (371.23 ± 98.42), average spiritual well-being (89.15 ± 18.56), and low moral distress (56.52 ± 19.74). Most participants had high moral courage (51.3 %), moderate spiritual well-being (58.1 %), and low moral distress (93.8 %). Correlation analysis indicated a positive relationship between moral courage and spiritual well-being (<em>r</em> = 0.171, <em>p</em> = 0.001) and a negative relationship with moral distress (<em>r</em> = –0.159, <em>p</em> = 0.002). Regression analysis showed that gender, employment status, work experience, spiritual well-being, and moral distress significantly influenced moral courage. Men, permanently employed nurses, and those with over 20 years of experience scored higher, while higher moral distress reduced moral courage.</div></div><div><h3>Conclusion</h3><div>Moral courage in operating room nurses is influenced by gender, employment type, work experience, spiritual well-being, and moral distress. Men, permanently employed nurses, and those with longer experience show higher moral courage, while moral distress lowers it and spiritual well-being boosts it. Enhancing nurses’ spiritual well-being and reducing moral distress may help promote their moral courage in the operating room.”</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100602"},"PeriodicalIF":1.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-20DOI: 10.1016/j.pcorm.2025.100603
Neelesh Anand , Amrita Rath , Vrushali Ponde
Point-of-care ultrasound (POCUS) has become integral to bedside assessment in pediatric emergency, intensive care, and perioperative settings. The triple-domain POCUS assessment is a focused, rapid bedside protocol integrating cardiac (focused echocardiography), lung ultrasound, and inferior vena cava (IVC) assessment. It provides a pragmatic, physiologic snapshot of circulatory and respiratory status. In children, where clinical signs of shock and respiratory compromise are often subtle and imaging resources may be limited, an integrated triple-point approach improves diagnostic accuracy, shortens time-to-decision, and guides targeted resuscitation. Venous congestion i.e. elevated right-sided pressures transmitted to organ venous beds, is a key and under-recognised driver of multi-organ dysfunction in critically ill children. The Venous Excess Ultrasound (VExUS) approach grades systemic venous congestion by integrating inferior vena cava (IVC) size with Doppler waveforms from the hepatic, portal and intrarenal veins. This narrative review summarizes the physiologic rationale, technical approach, interpretation algorithms, clinical applications, evidence base, limitations, training considerations, and future directions for triple-domain POCUS and VExUS in pediatric practice, particularly in Pediaric Intensive Care Units (PICU) and postoperative patients.
{"title":"Beyond the stethoscope: Triple-domain POCUS and venous excess ultrasound (VExUS) in pediatric patients- an integrated approach to hemodynamic and respiratory assessment","authors":"Neelesh Anand , Amrita Rath , Vrushali Ponde","doi":"10.1016/j.pcorm.2025.100603","DOIUrl":"10.1016/j.pcorm.2025.100603","url":null,"abstract":"<div><div>Point-of-care ultrasound (POCUS) has become integral to bedside assessment in pediatric emergency, intensive care, and perioperative settings. The triple-domain POCUS assessment is a focused, rapid bedside protocol integrating cardiac (focused echocardiography), lung ultrasound, and inferior vena cava (IVC) assessment. It provides a pragmatic, physiologic snapshot of circulatory and respiratory status. In children, where clinical signs of shock and respiratory compromise are often subtle and imaging resources may be limited, an integrated triple-point approach improves diagnostic accuracy, shortens time-to-decision, and guides targeted resuscitation. Venous congestion i.e. elevated right-sided pressures transmitted to organ venous beds, is a key and under-recognised driver of multi-organ dysfunction in critically ill children. The Venous Excess Ultrasound (VExUS) approach grades systemic venous congestion by integrating inferior vena cava (IVC) size with Doppler waveforms from the hepatic, portal and intrarenal veins. This narrative review summarizes the physiologic rationale, technical approach, interpretation algorithms, clinical applications, evidence base, limitations, training considerations, and future directions for triple-domain POCUS and VExUS in pediatric practice, particularly in Pediaric Intensive Care Units (PICU) and postoperative patients.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100603"},"PeriodicalIF":1.0,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145884511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-06DOI: 10.1016/j.pcorm.2025.100599
Dr. Kristan Baird , Dr. Jessica Kim , Dr. Kathleen Sarber , Dr. Kelly Ivins-O’Keefe , Dr. Jennifer Walters , Dr. Angela McElrath
Background
Prior research has demonstrated that increased auditory and visual distractions during induction of anesthesia have a detrimental effect on the critical thinking skills and work performance of the anesthesia provider. The aim of this quality improvement initiative was to use the Plan-Do-Study-Act (PDSA) framework with the goal to reduce the total number of distractions by 15% during induction of anesthesia in operating rooms without affecting flow or efficiency through implementation of a distraction-free induction zone with a verbal cue in the operating room to draw attention to the initiation of induction.
Methods
The initiative was introduced with two separate surgical departments separated by a period of twelve months. Total counts of distractions and their associated loudness as measured in decibels, as well as operating room efficiency times, were compared pre- and post-intervention.
Results
The total number of distractions decreased significantly in both surgical departments following the intervention with a reduction from 48.7 to 22 (p < 0.001) seen in the otolaryngology department and a reduction from 70.3 to 26 (p < 0.001) seen in the orthopedic surgery department. This reduction was not associated with a decrease in operating room efficiency.
Conclusions
Reducing distractions during the critical induction portion of anesthesia is a feasible goal that does not impede the workflow or efficiency of the operating room. A distraction-free induction zone is an effective safety intervention that prioritizes the multidisciplinary culture of safety in the operating room during induction of anesthesia.
{"title":"Decreasing distractions during induction of anesthesia: A quality improvement initiative","authors":"Dr. Kristan Baird , Dr. Jessica Kim , Dr. Kathleen Sarber , Dr. Kelly Ivins-O’Keefe , Dr. Jennifer Walters , Dr. Angela McElrath","doi":"10.1016/j.pcorm.2025.100599","DOIUrl":"10.1016/j.pcorm.2025.100599","url":null,"abstract":"<div><h3>Background</h3><div>Prior research has demonstrated that increased auditory and visual distractions during induction of anesthesia have a detrimental effect on the critical thinking skills and work performance of the anesthesia provider. The aim of this quality improvement initiative was to use the Plan-Do-Study-Act (PDSA) framework with the goal to reduce the total number of distractions by 15% during induction of anesthesia in operating rooms without affecting flow or efficiency through implementation of a distraction-free induction zone with a verbal cue in the operating room to draw attention to the initiation of induction.</div></div><div><h3>Methods</h3><div>The initiative was introduced with two separate surgical departments separated by a period of twelve months. Total counts of distractions and their associated loudness as measured in decibels, as well as operating room efficiency times, were compared pre- and post-intervention.</div></div><div><h3>Results</h3><div>The total number of distractions decreased significantly in both surgical departments following the intervention with a reduction from 48.7 to 22 (<em>p</em> < 0.001) seen in the otolaryngology department and a reduction from 70.3 to 26 (<em>p</em> < 0.001) seen in the orthopedic surgery department. This reduction was not associated with a decrease in operating room efficiency.</div></div><div><h3>Conclusions</h3><div>Reducing distractions during the critical induction portion of anesthesia is a feasible goal that does not impede the workflow or efficiency of the operating room. A distraction-free induction zone is an effective safety intervention that prioritizes the multidisciplinary culture of safety in the operating room during induction of anesthesia.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100599"},"PeriodicalIF":1.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-06DOI: 10.1016/j.pcorm.2025.100600
Daniel Belisle
Background
The increasing availability of healthcare data has created opportunities for improved clinical, operational, and strategic decision-making. However, many organizations struggle to convert this data into actionable insights.
Objective
This paper proposes a four-level data maturity framework to help perioperative leaders and healthcare organizations progressively enhance their use of data—from basic accuracy to outcome influence.
Methods
A structured framework was developed based on operational best practices, clinical data needs, and emerging trends in AI readiness.
Results
The framework consists of four sequential levels: (1) Collecting Accurate Data, (2) Tracking and Trending Historical Data, (3) Predicting Future Outcomes, and (4) Influencing Outcomes. Each level includes key subcomponents and perioperative examples.
Conclusion
A staged approach to data maturity enhances operational effectiveness and clinical quality in perioperative settings. This framework supports organizations in building data fluency while preparing for AI integration and predictive analytics.
{"title":"The four levels of data maturity in healthcare: A framework for driving outcomes in perioperative care","authors":"Daniel Belisle","doi":"10.1016/j.pcorm.2025.100600","DOIUrl":"10.1016/j.pcorm.2025.100600","url":null,"abstract":"<div><h3>Background</h3><div>The increasing availability of healthcare data has created opportunities for improved clinical, operational, and strategic decision-making. However, many organizations struggle to convert this data into actionable insights.</div></div><div><h3>Objective</h3><div>This paper proposes a four-level data maturity framework to help perioperative leaders and healthcare organizations progressively enhance their use of data—from basic accuracy to outcome influence.</div></div><div><h3>Methods</h3><div>A structured framework was developed based on operational best practices, clinical data needs, and emerging trends in AI readiness.</div></div><div><h3>Results</h3><div>The framework consists of four sequential levels: (1) Collecting Accurate Data, (2) Tracking and Trending Historical Data, (3) Predicting Future Outcomes, and (4) Influencing Outcomes. Each level includes key subcomponents and perioperative examples.</div></div><div><h3>Conclusion</h3><div>A staged approach to data maturity enhances operational effectiveness and clinical quality in perioperative settings. This framework supports organizations in building data fluency while preparing for AI integration and predictive analytics.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"42 ","pages":"Article 100600"},"PeriodicalIF":1.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145737848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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