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The implementation and efficacy of the Northwestern High Risk Spine Protocol.

Publication ,  Journal Article
Zeeni, C; Carabini, LM; Gould, RW; Bebawy, JF; Hemmer, LB; Moreland, NC; Koski, TR; Koht, A; Schafer, MF; Ondra, SL; Gupta, DK
Published in: World Neurosurg
December 2014

OBJECTIVE: The aims of this study were to determine the efficacy and feasibility of implementation of the intraoperative component of a high risk spine (HRS) protocol for improving perioperative patient safety in complex spine fusion surgery. METHODS: In this paired availability study, the total number of red blood cell units transfused was used as a surrogate marker for our management protocol efficacy, and the number of protocol violations was used as a surrogate marker for protocol compliance. RESULTS: The 548 patients (284 traditional vs. 264 HRS protocol) were comparable in all demographics, coexisting diseases, preoperative medications, type of surgery, and number of posterior levels instrumented. However, the surgical duration was 70 minutes shorter in the new group (range, 32-108 minutes shorter; P < 0.0001) and the new protocol patients received a median of 1.1 units less of total red blood cell units (range, 0-2.4 units less; P = 0.006). There were only 7 (2.6%) protocol violations in the new protocol group. CONCLUSIONS: The intraoperative component of the HRS protocol, based on two Do-Confirm checklists that focused on 1) organized communication between intraoperative team members and 2) active maintenance of oxygen delivery and hemostasis appears to maintain a safe intraoperative environment and was readily implemented during a 3-year period.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

December 2014

Volume

82

Issue

6

Start / End Page

e815 / e823

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Risk
  • Perioperative Period
  • Oxygen Inhalation Therapy
  • Neurosurgical Procedures
  • Middle Aged
  • Male
  • Interdisciplinary Communication
  • Humans
 

Citation

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Zeeni, C., Carabini, L. M., Gould, R. W., Bebawy, J. F., Hemmer, L. B., Moreland, N. C., … Gupta, D. K. (2014). The implementation and efficacy of the Northwestern High Risk Spine Protocol. World Neurosurg, 82(6), e815–e823. https://doi.org/10.1016/j.wneu.2014.06.020
Zeeni, Carine, Louanne M. Carabini, Robert W. Gould, John F. Bebawy, Laura B. Hemmer, Natalie C. Moreland, Tyler R. Koski, et al. “The implementation and efficacy of the Northwestern High Risk Spine Protocol.World Neurosurg 82, no. 6 (December 2014): e815–23. https://doi.org/10.1016/j.wneu.2014.06.020.
Zeeni C, Carabini LM, Gould RW, Bebawy JF, Hemmer LB, Moreland NC, et al. The implementation and efficacy of the Northwestern High Risk Spine Protocol. World Neurosurg. 2014 Dec;82(6):e815–23.
Zeeni, Carine, et al. “The implementation and efficacy of the Northwestern High Risk Spine Protocol.World Neurosurg, vol. 82, no. 6, Dec. 2014, pp. e815–23. Pubmed, doi:10.1016/j.wneu.2014.06.020.
Zeeni C, Carabini LM, Gould RW, Bebawy JF, Hemmer LB, Moreland NC, Koski TR, Koht A, Schafer MF, Ondra SL, Gupta DK. The implementation and efficacy of the Northwestern High Risk Spine Protocol. World Neurosurg. 2014 Dec;82(6):e815–e823.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

December 2014

Volume

82

Issue

6

Start / End Page

e815 / e823

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Spine
  • Risk
  • Perioperative Period
  • Oxygen Inhalation Therapy
  • Neurosurgical Procedures
  • Middle Aged
  • Male
  • Interdisciplinary Communication
  • Humans