A workable plan for OR quality assurance.
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By following these guidelines, a pregnant woman working in the OR can maintain her health despite an erratic schedule, constant periods of standing, and exposure to radiation. Part II of this article will focus on infectious diseases and chemicals, what could happen with maternal exposure, and preventative measures.
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Thoracoscopy cannot be performed on all patients, but it is the latest application of endoscopy techniques and has many advantages over conventional thoracotomy. Because the procedure is new, not every surgeon may willing to try it, nor are all who try it skilled in the procedure. When successfully performed, it provides the surgical team with the means to eliminate the discomfort and disability patients encounter with a conventional thoracotomy while shortening surgical, anesthesia, and recovery time, and reducing overall patient costs.
According to a 1990 study, 88% of the patients assessed their postoperative result as excellent or good after two years of follow up. One disadvantage to this repair is the need for a second arthroscopy for compression screw removal; however, this allows the surgeon an opportunity to assess healing. Surgeons are continuing to advance arthroscopic surgery by using supplemental bone grafts, with or without compression screw fixation. Arthroscopic compression screw fixation of osteochondritis dissecans is a progressive alternative for patients who may otherwise have been candidates for an open-knee arthrotomy.
One purpose of this survey was to determine how receptive hospital administrators and health care professionals in central Texas are to the concept of RNFAs. In review of the data presented here, it appears that this region is only minimally aware and supportive of the RNFA position. Many of the negative responses collected at this time may be due to fears that the RNFA would completely remove the physician first assistant by taking over the duties, responsibilities, and salaries. Survey comments that supported this idea included, "In our community where many physicians are still building a practice, assisting at surgery is seen as a helpful source of income," and "The current economic situation in Austin does not allow most general surgeons the luxury of an RNFA . . . this would also take income away from the surgeons." Even so, less than 21% of the responding surgeons with active practices were negative in their overall view of the RNFA. Thirty-six of the 72 physicians (50%) provided favorable views and encouraging comments regarding increased use of RNFAs. The balance of the surgeons either were neutral about the use of the RN first assistant or did not favor such practice. One surgeon summarized his experience with first assistants this way: "After 35 years of practice, I have come to the conclusion that good first assistants are 90% born, 10% trained, and 100% untrained common sense."(ABSTRACT TRUNCATED AT 250 WORDS)
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