Wyatt 1b

•Descargar como PPT, PDF•

1 recomendación•520 vistas

MedicineAndHealthResearch

Salud y medicina

Wrong Site Surgery: The myths, the realities, the solutions J. Robert Wyatt, MD, MBA Otolaryngology – Head & Neck Surgery Baylor Health System Dallas, Texas Glenn Rothman, MD Chairman, Department of Surgery Head & Neck Oncology Banner Desert Medical Center Mesa, Arizona

Agenda ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Surgeon background ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Your surgeon makes errors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Fundamentals of errors Stop, teach decision making skills Faulty strategy to solve problem Unfamiliar situation, no rule, problem solving task Knowledge-based errors Educate, critical thinking, accountability Wrong rule, misapplication of correct rule, non-compliant with rule Act requiring application of rules to familiar event Rule-based errors Pay attention Slips, lapses Familiar act, little attention Skill-based errors Prevention Example Description Error Type

Learning from the experts ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Wrong site surgery: The frequency debate ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Impact of wrong site cases ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Joint Commission mandate ,[object Object],[object Object],[object Object],[object Object],[object Object]

Has JCAHO solved wrong site? ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Factors contributing to failures ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 1: Correct and incorrect sites both marked ,[object Object],[object Object],[object Object],[object Object]

Case 2: Wrong site marked ,[object Object],[object Object],[object Object],[object Object]

Case 3: Imprecise site mark ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 4: Authorship of site mark unclear ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 5: Site mark washed off ,[object Object],[object Object],[object Object]

A new solution… ,[object Object],[object Object],[object Object]

The solution: Key requirements ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Stamp benefits: Consistency ,[object Object],[object Object]

Stamp benefits: Unambiguous ,[object Object],[object Object],[object Object]

Stamp benefits: Withstanding the prep ,[object Object],[object Object],[object Object]

Stamp benefits: Reduced infection risk ,[object Object],[object Object],[object Object],[object Object]

Stamp benefits: Reduced complexity ,[object Object],[object Object],[object Object]

JCAHO requirements ,[object Object],[object Object]

Case 1: Correct and incorrect sites both marked ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 2: Wrong site marked ,[object Object],[object Object],[object Object],[object Object],[object Object]

Case 3: Imprecise site mark ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 4: Authorship of site mark unclear ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Case 5: Site mark washed off ,[object Object],[object Object],[object Object],[object Object]

Conclusion ,[object Object],[object Object],[object Object]

Más contenido relacionado

Similar a Wyatt 1b

STH 2017_Day 3_Track 1_Session 1_Caralis_Preventing Medical Errors Compatibil...

Benghie Hyacinthe

surgical errors and SSC

AmalElfiky

Medical error health bizindia april-11-page-1

Dr.Ashok Khandelwal

Surgical safety checklist

Shailendra Veerarajapura

Patient Satisfaction, Patient Reported Outcomes, Safety, and Quality of Care

Yana Puckett, MD, MPH, MS

Bariatric surgery and copra ossicon 2016 presentation

Abhishek Katakwar

Running Head: QUALITY IMPROVEMENT CHART 1 QUALITY IMPROVEMENT CHART 2 Quality Improvement Chart Quality Improvement Activity Schedule Standards Severity of Risk Performance Indicator Level of Performance / Threshold Compliance in Percent Status Plan of Correction Qtr 1 Qtr 2 Qtr 3 Qtr 4 Provision of Care, Treatment, and Services High Risk Provision of care, treatment and service is the core accountability of health care institutions and precisely the surgical department. Proper care means that doctors should take great care while operating on patients and be sure of all the procedures before conducting them. A performance indicator here will be having more patients claiming that they have received proper care and they are satisfied with the services. The level of performance threshold should be 52%. This is the average and performance should not go below this point. 33% 43% 52% 80% Josephine has been experiencing a lot of pain while taking short calls. She has been to many hospital facilities and has not received any ultimate solutions. She visited a personal doctor who recommended an examination of her kidneys. The results of the examination revealed that all of her kidneys was spoiled and needed to be removed. This required a surgical operation. The doctors in removing the damaged kidneys damaged the joint between the urethra and the bladder. Consequently after one month from the time of the transplant of the new kidney she experienced urine leakage through the surgical incision that was made in her abdomen.This delayed the healing of the wound and had to go back for further surgery to seal the leak. This illustrates the risk of damaging the nearby organs while carrying out an operation on the adjacent organ. It is a common risk associated with the surgical operation of organs. The plan for correction in this case involves increment of better services. The doctors should be more careful in their provision of services sot that they do a good job. When doctors offer poor services on surgeries and make mistakes, complications are more likely to develop which may make situation even worse. Ethics, Rights, and Responsibilities High Risk Ethics, Rights and Responsibilities are what guide what the doctors do. When the doctors do not fulfill their responsibilities mistakes are more likely to be made. For the case of Josephine, the doctors did not fulfill their responsibilities and that resulted to some serious problems. A performance indicator for this standard would be having majority of the patients coming for surgery and their problems are solved once and for all without complication developing later. The level of performance threshold should be 52%. This is the average and performance should not go below this point. 33% 43% 52% 80% On ethics, doctors should not go to the operation rooms when they are not sure of what wil.

Running Head QUALITY IMPROVEMENT CHART .docx

charisellington63520

Risk Management and Patient Safety Evolution and Progress

Plan de Calidad para el SNS

October 27, 2016 Concurrent, or overlapping, surgeries involve the simultaneous scheduling of substantial portions of two or more surgeries under the supervision of a single surgeon, requiring delegation of responsibility to trainees and assistants if necessary. The practice is not uncommon, especially at teaching hospitals, but patients often have no idea that their doctor may also be operating on someone else at the same time. This panel discussion described the practice, its risks and benefits, and recommended approaches to preserve patient trust and safety. Panelists - Jonathan Saltzman, Reporter, The Boston Globe Spotlight Team (contributor to “Clash in the Name of Care”) - Setting the Stage: Key issues and concerns raised by concurrent surgeries, patient experiences and outcomes - Griffith R. Harsh IV, MD, MA, MBA, FACS, Professor of Neurosurgery and Associate Dean, Postgraduate Medical Education, Stanford University - Surgeon’s Perspective: Pros and cons of concurrent scheduling, pressures to schedule this way, potential impact on patients, and the recent statement by the American College of Surgeons - I. Glenn Cohen, JD, Professor, Harvard Law School; Faculty Director, Petrie-Flom Center - Legal and ethical perspectives: Institutional risk, medical malpractice, informed consent, and applicable regulations - Moderator: Robert Truog, MD, Frances Glessner Lee Professor of Medical Ethics, Anaesthesia, & Pediatrics and Director, Center for Bioethics, Harvard Medical School; Executive Director, Institute for Professionalism & Ethical Practice and Senior Associate in Critical Care Medicine, Boston Children's Hospital This event was free and open to the public. Sponsored by the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School and the Center for Bioethics at Harvard Medical School, with support from the Oswald DeN. Cammann Fund.

Griffith Harsh, Surgeon's Perspective on Concurrent Surgeries

The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics

Consent paper Ara Darzi

Rob Macadam

Consent paper 2016 (1)

Rob Macadam

notes on EMR

Mohamed David Anthony Jabbie

Process The Forgotten Continuum - An Ethnographic Research Study

J. Bryan Bennett, MBA, CPA, LSSGB

Fattore umano in chirurgia

Gentile Warschauer Emilio

NSQIP 9-2007 Noel Eldridge FINAL 92407 for 925.pptx

Noel Eldridge

By this point in time, approximately 80 percent of orthopedic practices and health systems have made conversions to electronic medical records. Regardless of the vendor, the change is always challenging, and creates problems that are magnified in high volume and high margin specialties like orthopedics. The implementation of an electronic medical record should drive your practice or department to adapt, and subsequently adopt new mechanisms of service delivery. These changes not only help your practice or department meet the challenges created by the electronic medical record, but will also help prepare you for the challenges of tomorrow. About the Speaker: Joe Greene is currently the Program Manager of Outreach and Development for the University of Wisconsin Hospital and Clinics in the Department of Orthopedics and Rehabilitation. In this role, Joe coordinates business and philanthropic development activities for the UW Hospital department and University of Wisconsin Department of Orthopedics and Rehabilitation. He represents the needs of all orthopedic subspecialties and has worked for the UW since 1991 when he initiated his career there as an athletic trainer and clinician. He has worked in management and administration across the Department since 1997. In addition to his role with the UW Hospital, Joe also is the CEO and Owner of OrthoVise. OrthoVise is an Orthopedic advisory firm that assists orthopedic practices of all types with operational and business development needs. His experiences have allowed him and his advisors the opportunity to consult formally with orthopedic practices since 2010. He has particular areas of interest that include Orthopedic and Sports Medicine Program Business Development, Service Line Development, Health Information Technology and EMR Operational Optimization for Orthopedics, Innovative Service Delivery Implementation, Smart Staffing, and Workflow Enhancement.

Optimize your EMR for Orthopedics: Essential Strategies that Drive Physician ...

Wellbe

Medical errors, negligence, and litigation

MedicineAndHealth

Battling-Wrong-Site-Surgery-PPT.ppt

MANENDERSINGLA1

Presentatie Philips 2009

tangkau

Anesthesia Business Consultants Communique Spring 2014 Edition

Anesthesia Business Consultants

Similar a Wyatt 1b (20)

STH 2017_Day 3_Track 1_Session 1_Caralis_Preventing Medical Errors Compatibil...

surgical errors and SSC

Medical error health bizindia april-11-page-1

Surgical safety checklist

Patient Satisfaction, Patient Reported Outcomes, Safety, and Quality of Care

Bariatric surgery and copra ossicon 2016 presentation

Running Head QUALITY IMPROVEMENT CHART .docx

Risk Management and Patient Safety Evolution and Progress

Griffith Harsh, Surgeon's Perspective on Concurrent Surgeries

Consent paper Ara Darzi

Consent paper 2016 (1)

notes on EMR

Process The Forgotten Continuum - An Ethnographic Research Study

Fattore umano in chirurgia

NSQIP 9-2007 Noel Eldridge FINAL 92407 for 925.pptx

Optimize your EMR for Orthopedics: Essential Strategies that Drive Physician ...

Medical errors, negligence, and litigation

Battling-Wrong-Site-Surgery-PPT.ppt

Presentatie Philips 2009

Anesthesia Business Consultants Communique Spring 2014 Edition

Más de MedicineAndHealthResearch

8737 Coclia 84 Glottic Ans Subglottic Stenosis

MedicineAndHealthResearch

Benefits Orientation Presentation

MedicineAndHealthResearch

Diapo Bourgain

MedicineAndHealthResearch

Mccaig Woodwell2

MedicineAndHealthResearch

A174 Prezentacja Sztokholm

MedicineAndHealthResearch

Aro2004 Jasko

MedicineAndHealthResearch

Cogs General Assembly

MedicineAndHealthResearch

Guide To The Match 2006

MedicineAndHealthResearch

145d Coclia99 Grafts And Flaps

MedicineAndHealthResearch

Ef73 Coclia 86 Neonatal Respiratory Distress

MedicineAndHealthResearch

4354 Scc Of Oral Tongue

MedicineAndHealthResearch

Cap Sinusitis Pharyngitis Im0306.Ppt

MedicineAndHealthResearch

Cead Melas Bsno

MedicineAndHealthResearch

784cdysphonia[1]

MedicineAndHealthResearch

Cd6e Coclia86 Neonatal Resp Distress

MedicineAndHealthResearch

F081 Coclia 75 Phonosurgery

MedicineAndHealthResearch

6ad4moletijasa2003

MedicineAndHealthResearch

5749 Endoscopic Laser Surgery For Subglottic Stenosis In Wegeners Granulomatosis

MedicineAndHealthResearch

232b Coclia 97 98 Eyelid Reconstruction, Facial Reanimation

MedicineAndHealthResearch

Ee3a Coclia70 Sinus Surgery

MedicineAndHealthResearch

Más de MedicineAndHealthResearch (20)

8737 Coclia 84 Glottic Ans Subglottic Stenosis

Benefits Orientation Presentation

Diapo Bourgain

Mccaig Woodwell2

A174 Prezentacja Sztokholm

Aro2004 Jasko

Cogs General Assembly

Guide To The Match 2006

145d Coclia99 Grafts And Flaps

Ef73 Coclia 86 Neonatal Respiratory Distress

4354 Scc Of Oral Tongue

Cap Sinusitis Pharyngitis Im0306.Ppt

Cead Melas Bsno

784cdysphonia[1]

Cd6e Coclia86 Neonatal Resp Distress

F081 Coclia 75 Phonosurgery

6ad4moletijasa2003

5749 Endoscopic Laser Surgery For Subglottic Stenosis In Wegeners Granulomatosis

232b Coclia 97 98 Eyelid Reconstruction, Facial Reanimation

Ee3a Coclia70 Sinus Surgery

Último

Top Rated Bangalore Call Girls Mg Road ⟟ ⟟ Call Me For Genuine Sex Service At Affordable Rate Booking Contact Details Whatsapp Chat :+91- These professional and Call girls in Bangalore can satisfy your every desire - be it sensual massage or an erotic shower, they are always more than willing to meet them. Furthermore, they pay close attention to body language cues to ensure you enjoy every minute spent in their company - both in-call and outcall services are offered. Is an excellent choice for anyone seeking an exciting and thrilling night of fun and excitement The Oberoi, Bengaluru Taj West End The Leela Palace Bengaluru JW Marriott Hotel Bengaluru The Ritz-Carlton, Bangalore Sheraton Grand Bangalore Hotel at Brigade Gateway Conrad Bengaluru ITC Gardenia, Bengaluru Renaissance Bengaluru Race Course Hotel The Lalit Ashok Bangalore

Most Beautiful Call Girl in Bangalore Contact on Whatsapp

Inaaya Sharma

🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In Hyderabad Escorts Service Escorts Service Available Whatsapp Chaya ☎️ : [+91-9352852248 ] Escorts Service Hyderabad are always ready to make their clients happy. Their exotic looks and sexy personalities are sure to turn heads. You can enjoy with them, including massages and erotic encounters.#P12Our area Escorts are young and sexy, so you can expect to have an exotic time with them. They are trained to satiate your naughty nerves and they can handle anything that you want. They are also intelligent, so they know how to make you feel comfortable and relaxed SERVICE ✅ ❣️ ⭐➡️HOT & SEXY MODELS // COLLEGE GIRLS HOUSE WIFE RUSSIAN , AIR HOSTES ,VIP MODELS . AVAILABLE FOR COMPLETE ENJOYMENT WITH HIGH PROFILE INDIAN MODEL AVAILABLE HOTEL & HOME ★ SAFE AND SECURE HIGH CLASS SERVICE AFFORDABLE RATE ★ SATISFACTION,UNLIMITED ENJOYMENT. ★ All Meetings are confidential and no information is provided to any one at any cost. ★ EXCLUSIVE PROFILes Are Safe and Consensual with Most Limits Respected ★ Service Available In: - HOME & HOTEL Star Hotel Service .In Call & Out call SeRvIcEs : ★ A-Level (star escort) ★ Strip-tease ★ BBBJ (Bareback Blowjob)Receive advanced sexual techniques in different mode make their life more pleasurable. ★ Spending time in hotel rooms ★ BJ (Blowjob Without a Condom) ★ Completion (Oral to completion) ★ Covered (Covered blowjob Without condom ★ANAL SERVICES.

🌹Attapur⬅️ Vip Call Girls Hyderabad 📱9352852248 Book Well Trand Call Girls In...

Call Girls In Delhi Whatsup 9873940964 Enjoy Unlimited Pleasure

Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Rajasthan Booking Details Are here 06-May-2024( Mj) Click On WhatsApp Chat +91-9521753030 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion

Call Girls Service Jaipur {9521753030} ❤️VVIP RIDDHI Call Girl in Jaipur Raja...

Sheetaleventcompany

☑️░ 9630942363 ░ CALL GIRLS ░ VIP ░ ESCORT ░ SERVICES ░ AGENCY ░ 9630942363 THE GENUINE ESCORT AGENCY VIP LUXURY CALL GIRLS HIGH CLASS MODELS CALL GIRLS GENUINE ESCORT BOOK BOOK APPOINTMENT - 9630942363 THE GENUINE ESCORT AGENCY BEST VIP CALL GIRLS & ESCORTS SERVICE 9630942363 VIP CALL GIRLS ALL TYPE WOMEN AVAILABLE INCALL & OUTCALL BOTH AVAILABLE BOOK NOW 9630942363 VIP GENUINE INDEPENDENT ESCORT AGENCY VIP PRIVATE AUNTIES BEAUTIFUL LOOKING HOT AND SEXT GIRLS AND PARTY TYPE GIRLS YOU WANT SERVICE THEN CALL THIS NUMBER 9630942363 ROOM ALSO PROVIDE HOME & HOTELS SERVICE FULL SAFE AND SECURE WORK WITHOUT CONDOMS, ORAL, SUCKING, LIP TO LIP, ANAL, BACK SHOTS, SEX 69, WITHOUT BLOWJOB AND MUCH MORE FOR BOOKING 9630942363

Call Girls Hosur Just Call 9630942363 Top Class Call Girl Service Available

GENUINE ESCORT AGENCY

Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time Call Mr Chirag Ji +91-6378878445 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls, Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In 03-May-2024 (chd) Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 6378878445 !! Thank you for Visiting.

Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time

Call Girls Delhi

Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Profile Most Luxurious Call Girl With Real Photos Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion

Independent Call Girls In Jaipur { 8445551418 } ✔ ANIKA MEHTA ✔ Get High Prof...

parulsinha

Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service Available Our agency presents a selection of young, charming call girls #J11 available for bookings at Oyo Hotels. Experience high-class escort services at pocket-friendly rates, with our female escorts exuding both beauty and a delightful personality, ready to meet your desires. Whether it's Housewives,#J11 College girls, Russian girls, Muslim girls, or any other preference, we offer a diverse range of options to cater to your tastes. We provide both in-call and out-call services for your convenience. Our in-call location in Lucknow ensures cleanliness, hygiene, and 100% safety, while our out-call services offer doorstep delivery for added ease. We value your time and money, hence we kindly request pic collectors, time-passers, and bargain hunters to refrain from contacting us. Our services feature various packages at competitive rates: One shot: ₹2000/in-call, ₹5000/out-call Two shots with one girl: ₹3500/in-call, ₹6000/out-call Body to body massage with sex: ₹3000/in-call Full night for one person: ₹7000/in-call, ₹10000/out-call Full night for more than 1 person: Contact us at 🔝 7877925207 🔝. for details Operating 24/7, we serve various locations in Lucknow, including Green Park, near metro stations. For premium call girl services in Lucknow 🔝 7877925207 🔝. Thank you for considering us!

Russian Call Girls Lucknow Just Call 👉👉7877925207 Top Class Call Girl Service...

adilkhan87451

Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Hyderabad Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Hyderabad Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Hyderabad Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.

Call Girls Hyderabad Just Call 8250077686 Top Class Call Girl Service Available

Dipal Arora

(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Celebrity for 5* Hotels Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion

(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...

parulsinha

Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 9004268417 Neha Thakur Booking Contact Details WhatsApp Chat: +91-9004268417 Mumbai Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant;$S2 making an impressionable. Independent Escorts Mumbai understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.

Jogeshwari ! Call Girls Service Mumbai - 450+ Call Girl Cash Payment 90042684...

Anamika Rawat

Call Girls Madurai Just Call 9630942363 Top Class Call Girl Service Available

GENUINE ESCORT AGENCY

Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Rishikesh Escorts Call girls are ready and waiting to provide the quality essentialness that will help ease away life's tensions Rishikesh Escorts are regular companions of elite gentlemen and can take them places they could only dream of visiting. These ladies take great care in maintaining themselves to look appealing; visiting salons and spas regularly keeps them looking their best; their portfolios can be found online via an escort’s agency website. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Rishikesh Escort Service are adept at performing wild anal sex, deep throat sex and cum eating - perfect for satisfying all your sexual needs and playing any game imaginable. Affordable professional assistants are readily available and ready to assist with any situation - be it romantic date or solo night. Their beautiful appearances and striking personalities will leave you speechless, while they can accompany you to restaurants or bars where their presence will surely leave an impression.

Call Girls Rishikesh Just Call 8250077686 Top Class Call Girl Service Available

Dipal Arora

Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Girl UKHBET Escorts Service Available ✔ All Day And Night Booking Details Are here 05-May-2024( Mj) Click On WhatsApp Chat +91-8445551418 Jaipur Escorts Make You Feel Like Royalty Jaipur Escorts catering to high profile clients are available 24-7 to meet their clients' needs and are also available for dinner dates, business conferences, foreign travel trips and clubbing activities. Their customers are contacted directly through in order to prevent risky situations from developing.is home to some of India's most beautiful women. These girls come highly educated with great backgrounds; furthermore they are extremely beautiful and will make you feel like royalty if hired for hours or days! Siya Khan | FOR BOOKING CALL Our All Services :- 1 )★ (Oral to consummation) bjnonCovered 2 )★ Special Massage 3 )★ O-Level (Oral sex) 4 )★ Blow Job; 5 )★ COB (Come On Body) 6 )★. Extraball (Have sex ordinarily) 7 )★ A-Level (5 star escort) 8 )★ Strip-bother 9 )★ BBBJ (Bareback Blowjob) 10 )★ Spending time in my rooms 11 )★ BJ (Blowjob Without a Condom) 12 )★ COF (Come On Face) 13 )★ Completion

Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...

parulsinha

Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available Easy & Fast Booking Procedure Of Rishikesh Escorts Call girls are available to provide the quality essentialness that will ease away life's tensions. Rishikesh Escorts are regular companions of elite gentlemen. It is possible to take them to places they would never have dreamed of visiting otherwise. Their portfolios can be found online through escort agencies; they maintain themselves to look attractive by visiting salons and spas regularly. EXCITING OPTIONS AVAILABLE AT OUR INDEPENDENT ESCORTS Candlelight dinner Evening date Night clubs or parties Hotels or your flats Business trip Business party Stripping party Rishikesh Escort Service are skilled at performing wild anal sex, deep throat sex and cum eating - ideal for satisfying all your sexual needs and playing any game possible. Professional assistants are readily available and ready to assist in any situation - romantic date or solo outing. They can accompany you to restaurants or bars where their presence will surely leave an impression with their beautiful appearances and striking personalities.

Call Girls Rishikesh Just Call 9667172968 Top Class Call Girl Service Available

perfect solution

Call Girls Raipur Just Call 9630942363 Top Class Call Girl Service Available

GENUINE ESCORT AGENCY

Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy Bhabi Ready For Sex At Your Doorstep Booking Contact Details Whatsapp Chat :+91-6297143586 These professional and Call girls in Bangalore can satisfy your every desire - be it sensual massage or an erotic shower, they are always more than willing to meet them. Furthermore, they pay close attention to body language cues to ensure you enjoy every minute spent in their company - both in-call and outcall services are offered. Is an excellent choice for anyone seeking an exciting and thrilling night of fun and excitement The Oberoi, Bengaluru Taj West End The Leela Palace Bengaluru JW Marriott Hotel Bengaluru The Ritz-Carlton, Bangalore Sheraton Grand Bangalore Hotel at Brigade Gateway Conrad Bengaluru ITC Gardenia, Bengaluru Renaissance Bengaluru Race Course Hotel The Lalit Ashok Bangalore 1-may-24

Manyata Tech Park ( Call Girls ) Bangalore ✔ 6297143586 ✔ Hot Model With Sexy...

vidya singh

Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 Star Hotel Service Available Booking Contact Details WhatsApp Chat: +91-8617370543 Patna Escort Service includes providing maximum physical satisfaction to their clients as well as engaging conversation that keeps your time enjoyable and entertaining. Plus they look fabulously elegant; making an impressionable Independent Escorts Patna understands the value of confidentiality and discretion - they will go the extra mile to meet your needs. Simply contact them via text messaging or through their online profiles; they'd be more than delighted to accommodate any request or arrange a romantic date or fun-filled night together. We provide - Flexibility Choices and options Lists of many beauty fantasies Turn your dream into reality Perfect companionship Cheap and convenient In-call and Out-call services And many more.

Best Rate (Patna ) Call Girls Patna ⟟ 8617370543 ⟟ High Class Call Girl In 5 ...

Dipal Arora

Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Service Available Call Mrs Leela Ji +91-8005736733 We offer all types of girls of your choice with space. Our escorts are fully cooperative and understand your needs. All types of call girls like Housewives, College girls,#J11 Russian girls, Muslim girls, Afghani girls, Bengali girls, Working girls, south Indian girls, Punjabi girls, etc. In-Call: — You Can Reach At Our Place in Kolkata Our place Which Is Very Clean Hygienic 100% safe Accommodation. Out-Call: — Service for Out Call You have To Come Pick The Girl From My Place We Also Provide Door-Step Services Hygienic: — Full Ac Neat And Clean Rooms Available In Hotel 24 * 7 Hrs In Kolkata C010524HD Our Services and Rates: – One Shot — 2500/in call (time ½ hour), 5000/out call Two shot with one girl — 5000/in call (time 1 hour), 6000/out call Body to body massage with sex- 3000/in call (time 1 hour) full night for one person– 8000/in call, 10000/out call (shot limit 4 shot) We are available 24*7 all days of the year Call us — 8005736733 !! Thank you for Visiting.

Call Girls Kolkata Kalikapur 💯Call Us 🔝 8005736733 🔝 💃 Top Class Call Girl Se...

Namrata Singh

Call Girls Vasai Virar Just Call 9630942363 Top Class Call Girl Service Avail...

GENUINE ESCORT AGENCY

Pondicherry Call Girls Book Now 9630942363 Top Class Pondicherry Escort Servi...

GENUINE ESCORT AGENCY

Wyatt 1b

1. Wrong Site Surgery: The myths, the realities, the solutions J. Robert Wyatt, MD, MBA Otolaryngology – Head & Neck Surgery Baylor Health System Dallas, Texas Glenn Rothman, MD Chairman, Department of Surgery Head & Neck Oncology Banner Desert Medical Center Mesa, Arizona

7. Fundamentals of errors Stop, teach decision making skills Faulty strategy to solve problem Unfamiliar situation, no rule, problem solving task Knowledge-based errors Educate, critical thinking, accountability Wrong rule, misapplication of correct rule, non-compliant with rule Act requiring application of rules to familiar event Rule-based errors Pay attention Slips, lapses Familiar act, little attention Skill-based errors Prevention Example Description Error Type

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24. The Sitemarx stamp

25.

26.

27.

28.

29.

30.

31.

32.

33.

34.

35.

36.

37.

38.

Wyatt 1b

Recomendados

Recomendados

Más contenido relacionado

Similar a Wyatt 1b

Similar a Wyatt 1b (20)

Más de MedicineAndHealthResearch

Más de MedicineAndHealthResearch (20)

Último

Último (20)

Wyatt 1b