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Related Concept Videos

Guidelines and Strategies for Safe Computer Charting01:18

Guidelines and Strategies for Safe Computer Charting

The guidelines and strategies provided by the American Nurses Association (ANA) and the Canadian Nurses Association (CNA) offer essential principles for ensuring safe and secure computer charting systems in healthcare settings. Let's break down each recommendation:
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Guidelines for Nursing Documentation I01:30

Guidelines for Nursing Documentation I

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Formats for Nursing Documentation

Nursing documentation encompasses various formats designed to capture precise patient data, facilitate communication among healthcare team members, and ensure comprehensive and accurate patient records. Let's explore each of these formats in detail:
Nursing Assessment Form:
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Methods of Documentation V: CBE01:23

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Charting by Exception, or CBE, is a method of documentation used in healthcare, particularly in nursing, that focuses on documenting only significant or abnormal findings rather than recording every detail. This approach aims to streamline the documentation process, improve efficiency, and ensure that healthcare providers can quickly identify deviations from normalcy in patient assessments.
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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Broad clinical utilization of NOTES: is it safe?

Santiago Horgan1, Ozanan R Meireles, Garth R Jacobsen

  • 1Division of Minimally Invasive Surgery, Department of Surgery, University of California San Diego, San Diego, CA, USA. shorgan@ucsd.edu

Surgical Endoscopy
|March 13, 2013
PubMed
Summary

Natural orifice transluminal endoscopic surgery (NOTES) is a safe and feasible surgical alternative. This study shows successful clinical application of NOTES for various conditions, with minimal complications and short hospital stays.

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Area of Science:

  • Minimally Invasive Surgery
  • Gastroenterology
  • Surgical Innovation

Background:

  • Natural orifice transluminal endoscopic surgery (NOTES) offers a less invasive approach compared to conventional laparoscopy for intracavitary organ access.
  • Despite advancements in animal studies, clinical adoption of NOTES remains limited.
  • This study reports on the clinical experience with NOTES procedures from 2007 to 2010, following 2 years of laboratory experience.

Purpose of the Study:

  • To evaluate the clinical feasibility, safety, and outcomes of Natural orifice transluminal endoscopic surgery (NOTES) procedures.
  • To assess the application of NOTES for a variety of gastrointestinal and abdominal pathologies.
  • To document the learning curve and procedural success rates in a clinical setting.

Main Methods:

  • 104 patients were enrolled in UCSD institutional review board-approved trials between 2007 and 2010.
  • NOTES procedures were offered as an alternative to conventional treatments for conditions including cholelithiasis, appendicitis, ventral hernias, morbid obesity, and achalasia.
  • Access routes utilized included transgastric (TG), transvaginal (TV), transesophageal (TE), and perirectal (PR).

Main Results:

  • 94 out of 104 patients proceeded with a NOTES approach after initial laparoscopy.
  • Common NOTES procedures included transvaginal cholecystectomies (n=48), transgastric sleeve gastrectomies (n=18), and transesophageal endoscopic myotomies (n=5).
  • No intraoperative complications or conversions to standard laparoscopy were reported; average hospital stay was 1-2 days, with one patient requiring an ED visit for nausea/vomiting.

Conclusions:

  • Natural orifice transluminal endoscopic surgery (NOTES) is demonstrated to be safe, feasible, and reproducible with adequate training and a dedicated team.
  • The technique shows promise for various surgical indications, with good patient outcomes.
  • Further prospective randomized studies with larger patient populations are needed to confirm long-term results.