Transcript Presentation - Minor procedures

MINOR PROCEDURES
SOME TEACHING TIPS THAT WORK FOR US
CHUCK ADAMSON
DAVID PONKA
BRUYERE MINOR PROCEDURES
 Minor procedures are things that we do sporadically.
 The human memory is the weak point in a lot of systems.
 Atul Gawande’s book the Checklist Manifesto is a worthwhile read on this subject.
“We need a different strategy for overcoming failure, one
that builds on experience and takes advantage of the
knowledge people have but somehow also makes up for our
inevitable human inadequacies. And there is such a strategy—
though it will seem almost ridiculous in its simplicity, maybe
even crazy to those of us who have spent years carefully
developing ever more advanced skills and technologies.
It is a checklist ”
THE CHECKLIST
 Indications
 Contraindications
 Informed consent (document risks discussed)
 Equipment
 Send any sample
 Document (including precise amounts used, approach, result)
MSK CLINIC: JOINT INJECTIONS
INDICATIONS
CONTRAINDICATIONS
 OA (mechanism)
 Allergy
 RA
 Infected skin
 Gout
 Hardware
 Diagnostic
 3/6/12 (relative)
MINOR SURGICAL PROCEDURES
 In the OR pick lists are used to make sure that all the equipment needed for the
procedure is available.
 We have produced pick lists for the most common minor procedures.
 We have a procedure cart whose drawers are listed on the pick lists as the places to find
various items.
THE CHECKLIST
 Remembering the proper sequences for preparation, procedure, clean up and follow up
are also important.
 We have prepared a two-pager to summarize key points which we encourage residents
to review before starting the session.
THEORY FIRST:
WE START WITH A GROUP SESSION USING PLASTIC BLOCKS
GETTING THE DIAGNOSIS RIGHT
WE SPEND AN HOUR IN SIMULATION BEFORE
EACH CLINIC
LIMBSANDTHINGS.COM
WE FOCUS ON PREPARATION AND STERILE
TECHNIQUE
TRANSFERRABLE PRINCIPLES
 Antisepsis
 Muscle memory including prepping the equipment
 Anatomy: Positioning (distraction), landmarking, approach
 Post procedure care
 A checklist approach
OUR PROCEDURE ROOM
We are delighted to now have a room with
adequate lighting, an electric bed, a patient
lift and room to get around the bed.
TEACHING
RESOURCES
CFP VIDEO SERIES
PROCEDUCATE
• https://www.youtube.com/watch?v=GetDLl62Bl0