giovedì, febbraio 11, 2010

come scegliere

You Are Here: AHRQ Home > Consumers & Patients > Having Surgery? What You Need to Know
Making Sure Your Surgery is Safe
Check with your insurance company to find out if you may choose a surgeon or hospital or if you must use ones selected by the insurer. Ask your doctor about which hospital has the best care and results for your condition if you have more than one hospital to choose from. Studies show that for some types of surgery, numbers count—using a surgeon or hospital that does more of a particular type of surgery can improve your chance of a good result.
If You Do Have a Choice of Surgeon or Hospital, Ask the Surgeon the Following Questions
What are your qualifications?
You will want to know that your surgeon is experienced and qualified to perform the operation. Many surgeons have taken special training and passed exams given by a national board of surgeons. Ask if your surgeon is "board certified" in surgery. Some surgeons also have the letters F.A.C.S. after their name. This means they are Fellows of the American College of Surgeons and have passed another review by surgeons of their surgical skills.
How much experience do you have doing this operation?
One way to reduce the risks of surgery is to choose a surgeon who has been well trained to do the surgery and has plenty of experience doing it. You can ask your surgeon about his or her recent record of successes and complications with this surgery. If it is easier for you, you can discuss the surgeon's qualifications with your primary care doctor. (Select for more information about finding out surgeons' qualifications.)
At which hospital will the operation be done?
Most surgeons work at one or two local hospitals. Find out where your surgery will be done and how often the same operation is done there. Research shows that patients often do better when they have surgery in hospitals with more experience in the operation.
Ask your doctor about the success rate at the hospitals you can choose between.
The success rate is the number of patients who improve divided by all patients having that operation at a hospital. If your surgeon suggests using a hospital with a lower success rate for your surgery, find out why.
Ask the Surgeon How Long You Will Be in the Hospital
Until recently, most patients who had surgery stayed in the hospital overnight for 1 or more days. Today, many patients have surgery done as an outpatient in a doctor's office, a special surgical center, or a day surgery unit of a hospital. These patients have an operation and go home the same day. Outpatient surgery is less expensive because you do not have to pay for staying in a hospital room.
Ask whether your operation will be done in the hospital or in an outpatient setting, and ask which of these is the usual way the surgery is done.
If your doctor recommends that you stay overnight in the hospital (have inpatient surgery) for an operation that is usually done as outpatient surgery—or
recommends outpatient surgery that is usually done as inpatient surgery—ask why. You want to be in the right place for your operation.
Have the Surgeon Mark the Site He or She Will Operate On
Rarely, surgeons will make a mistake and operate on the wrong part of the body. A number of groups of surgeons now urge their members to use a marking pen to show the place that they will operate on. The surgeons do this by writing directly on the patient's skin on the day of surgery. Don't be afraid to ask your surgeon to do this to make your surgery safer.
Quick Questions for Your Doctor
Take this list of questions with you when you go to your doctor or surgeon to discuss your surgery:
 What operation are you recommending?
 Why do I need the operation?
 Are there alternatives to surgery?
 What are the benefits of having the operation?
 What are the risks of having the operation?
 What if I don’t have this operation?
 Where can I get a second opinion?
 What is your training and experience to do this kind of surgery?
 Where will the operation be done?
 Will I have to stay overnight in the hospital?
 What kind of anesthesia will I need?
 How long will it take me to recover?
 How much will the operation cost?
 Can you please mark the part of my body you will operate on?

domenica, febbraio 07, 2010

lo pneumotorace spontaneo nell'adulto, 10 Aprile 2010, Firenze (pneumothorax-pnx)

Egregi colleghi,

vi comunico, con preghiera di diffusione, che il 10 Aprile 2010 si terra'

a Firenze, presso l'aula Muntoni dell'ospedale "San Giovanni di Dio",

il corso di aggiornamento su "Lo pneumotorace spontaneo nell'adulto".

Il corso e' a numero chiuso, 50 posti sono riservati ai medici e 50 agli infermieri.

Sono stati richiesti i crediti ECM.

Lo pneumotorace spontaneo nell'adulto e' frequente e non sempre si hanno idee chiare sull'argomento.
Il corso ha come obiettivo di aggiornare le conoscenze sull'argomento, in particolare puntualizzare il percorso diagnostico-terapeutico utilizzando come strumento l'uso di linee-guida.
Molte figure professionali sono coinvolte nella diagnosi e trattamento dello pneumotorace spontaneo nell'adulto:
· il medico di famiglia,
· l'infermiere del DEA,
· il medico del DEA,
· l'infermiere del reparto di medicina interna,
· il medico del reparto di medicina interna,
· il chirurgo,
· l'infermiere del reparto di chirurgia,
· l'infermiere di sala operatoria.

Il fulcro dell'argomento e' il drenaggio toracico e la sua gestione perche' la maggior parte dei casi si risolvono con questa procedura.
L'autonomia professionale dell'infermiere pone il problema di quali sono le competenze sull'argomento e su quali azioni c'e' piena autonomia decisionale.
Nel 2004 si e' svolto il primo corso di aggiornamento sull'argomento, nel 2010 si rinnova il corso a 6 anni di distanza per evidenziare lo stato dell'arte e riflettere sulle novita' intercorse negli ultimi 5 anni.

Sito web del programma:

Lo pneumotorace spontaneo nell'adulto, 2010

Cordiali saluti,

Dott. Felice Apicella