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  1. Article ; Online: Monochorionic twin pregnancy in a patient with type III osteogenesis imperfecta: a multidisciplinary challenge.

    Lee, Kai Wei / Mok, May Un Sam / Chai, Hui Zhong / Yang, Liying

    BMJ case reports

    2023  Volume 16, Issue 11

    Abstract: A woman with severe type III osteogenesis imperfecta spontaneously conceived a monochorionic, diamniotic twin pregnancy. Due to the severity of her condition, her pregnancy required close follow-up involving a multidisciplinary team, including high-risk ... ...

    Abstract A woman with severe type III osteogenesis imperfecta spontaneously conceived a monochorionic, diamniotic twin pregnancy. Due to the severity of her condition, her pregnancy required close follow-up involving a multidisciplinary team, including high-risk obstetricians, anaesthetists, pulmonologists and respiratory therapists. Eventually, the twins were delivered via caesarean section at 26 weeks' gestation.We discuss the challenges and considerations in managing her high-risk pregnancy, highlighting the importance of multidisciplinary care in achieving a safe outcome for mother and babies.
    MeSH term(s) Pregnancy ; Humans ; Female ; Pregnancy, Twin ; Cesarean Section ; Osteogenesis Imperfecta/complications ; Twins ; Pregnancy Outcome ; Retrospective Studies
    Language English
    Publishing date 2023-11-15
    Publishing country England
    Document type Case Reports ; Journal Article
    ISSN 1757-790X
    ISSN (online) 1757-790X
    DOI 10.1136/bcr-2023-255738
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  2. Article ; Online: Improving compliance with personal protective equipment among anaesthetists through behaviour-changing interventions during the coronavirus disease 2019(COVID-19) pandemic.

    Chia, Pamela / Tang, Leonard / Tse, Gerald / How, Molly / Wong, Loong Tat / Mok, May / Chong, Shin Yuet

    International journal for quality in health care : journal of the International Society for Quality in Health Care

    2024  Volume 36, Issue 1

    Abstract: Since 2020, the coronavirus disease 2019 (COVID-19) pandemic has seen many changes in our daily infection prevention behaviours so as to reduce healthcare-associated transmission of COVID-19 in patients and healthcare workers. In the early phases of the ... ...

    Abstract Since 2020, the coronavirus disease 2019 (COVID-19) pandemic has seen many changes in our daily infection prevention behaviours so as to reduce healthcare-associated transmission of COVID-19 in patients and healthcare workers. In the early phases of the COVID-19 pandemic of 2020, there was much emphasis on compliant personal protective equipment utilization in the operating theatres (OTs) for COVID-19-positive patients. However, during this period, there was a lack of international validated protocols on the appropriate handling and subsequent storage of personal protective equipment in the context of aerosol-generating procedures in OTs for asymptomatic antigen rapid test (ART)-negative patients. Given the potential for transmission even with a negative ART due to the incubation period, our team developed a checklist of eye protection (e.g. goggles/face shield) and N95 mask handling and storage in non-isolation OTs for these patients. We sought to improve the compliance of best practices from 20% to 80% amongst junior anaesthetists in Singapore General Hospital so as to prevent infection transmission and cross-contamination in the OT through education and behaviour-changing interventions. This quality improvement project took place over 19 weeks from June to October 2020 by our team of anaesthetists and nurse clinicians in the non-isolation OT setting. To analyse the problem, we performed a root cause analysis to understand attitudes and beliefs driving their behaviour. The top 80% of cited root causes for non-compliance then guided prioritization of resources for subsequent behaviour-changing interventions. Using the comprehensive infection control checklist, we conducted several plan-do-study-act cycles while implementing this new checklist amongst junior anaesthetists. A total of 227 assessments of junior anaesthetists were made in the care of asymptomatic ART-negative patients. Compliance with correctly handling goggles post-intubation started out as 33.3% in Week 1, which improved to 78.5% by Week 19. Compliance with goggle storage and face shield disposal started out at 13.6% in Week 1 and increased to 78.6% by Week 19. We attributed this improvement to education and behaviour-changing interventions. This quality improvement project focusing on improving compliance with personal protective equipment utilization during the COVID-19 pandemic in the management of asymptomatic ART-negative patients in non-isolation OTs demonstrated the importance of interventions of education, persuasion, modelling, and training in effecting and sustaining organizational behaviour change in physicians and other healthcare personnel.
    MeSH term(s) Humans ; Anesthetists ; COVID-19/epidemiology ; COVID-19/prevention & control ; Health Personnel ; Pandemics/prevention & control ; Personal Protective Equipment ; SARS-CoV-2 ; Guideline Adherence
    Language English
    Publishing date 2024-01-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 1194150-9
    ISSN 1464-3677 ; 1353-4505
    ISSN (online) 1464-3677
    ISSN 1353-4505
    DOI 10.1093/intqhc/mzae003
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  3. Article ; Online: Supraglottic Airway-Guided Intubation During the COVID-19 Pandemic: A Closed Technique.

    Wong, Patrick / Lim, Wan Yen / Mok, May

    Anesthesia and analgesia

    2020  Volume 131, Issue 2, Page(s) e120–e121

    MeSH term(s) Betacoronavirus ; Bronchoscopy/instrumentation ; Bronchoscopy/methods ; COVID-19 ; Coronavirus Infections/prevention & control ; Coronavirus Infections/transmission ; Humans ; Intubation, Intratracheal/instrumentation ; Intubation, Intratracheal/methods ; Laryngeal Masks ; Manikins ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/transmission ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-05-05
    Publishing country United States
    Document type Letter
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000004951
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  4. Article ; Online: "Closed" Supraglottic Airway-Guided Intubation During the COVID-19 Pandemic: A Glo Germ Follow-up.

    Chua, Henry / Lim, Wan Yen / Mok, May / Wong, Patrick

    Anesthesia and analgesia

    2020  Volume 131, Issue 3, Page(s) e168–e169

    MeSH term(s) Airway Management ; Betacoronavirus ; COVID-19 ; Coronavirus Infections ; Follow-Up Studies ; Humans ; Laryngeal Masks ; Pandemics ; Pneumonia, Viral ; SARS-CoV-2
    Keywords covid19
    Language English
    Publishing date 2020-06-01
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ANE.0000000000005032
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  5. Article ; Online: Developing clinical skills bundles.

    Mok, May / Ker, Jean

    The clinical teacher

    2015  Volume 12, Issue 6, Page(s) 403–407

    Abstract: Background: This article describes an innovative method of learning clinical skills. A care bundle is defined as a small set of evidence-based interventions that, when implemented together, results in significantly better patient outcomes than when ... ...

    Abstract Background: This article describes an innovative method of learning clinical skills. A care bundle is defined as a small set of evidence-based interventions that, when implemented together, results in significantly better patient outcomes than when implemented individually. Care bundles improve the consistency of standards of care delivered, and hence reduce harm.
    Context: In 2007 The Scottish Clinical Skills Strategy identified the use of simulation-based education to ensure all health care staff can deliver a consistently high standard of clinical skills practice throughout the National Health Service in Scotland (NHS Scotland).
    Innovation: Clinical skills bundles were developed to underpin a number of evidence-based care bundles. Grouping the clinical skills together and learning them as a clinical skills bundle may improve the reliability of skills delivery for each care bundle. Three groups were recruited and asked to identify a consensus of the essential technical and non-technical skills for clinical skills bundle for a central venous catheter (CVC) maintenance care bundle. As a pilot, six clinical skills bundle workshops were held for junior doctors, nursing and medical students, and clinical skills educators. The aims of the workshops were to introduce the concepts of clinical skills bundles and to give participants a chance to practice the underpinning clinical skills bundle for a care bundle using simulation. The majority of participants rated the workshop as excellent or good. Self-reported learning included refreshing their clinical skills in a different context. Care bundles improve the consistency of standards of care delivered
    Implication: Learning skills together as a bundle may enhance the reliability of clinical skills performance for care bundles, and may also reinforce the use of care bundles.
    MeSH term(s) Clinical Competence/standards ; Education, Medical/methods ; Evidence-Based Practice/education ; Evidence-Based Practice/methods ; Humans ; Reproducibility of Results
    Language English
    Publishing date 2015-12
    Publishing country England
    Document type Journal Article
    ZDB-ID 2151518-9
    ISSN 1743-498X ; 1743-4971
    ISSN (online) 1743-498X
    ISSN 1743-4971
    DOI 10.1111/tct.12332
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  7. Article ; Online: Supraglottic Airway–Guided Intubation During the COVID-19 Pandemic

    Wong, Patrick / Lim, Wan Yen / Mok, May

    Anesthesia & Analgesia

    A Closed Technique

    2020  Volume 131, Issue 2, Page(s) e120–e121

    Keywords Anesthesiology and Pain Medicine ; covid19
    Language English
    Publisher Ovid Technologies (Wolters Kluwer Health)
    Publishing country us
    Document type Article ; Online
    ZDB-ID 80032-6
    ISSN 1526-7598 ; 0003-2999
    ISSN (online) 1526-7598
    ISSN 0003-2999
    DOI 10.1213/ane.0000000000004951
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  8. Article: Anaesthetic management of acute airway obstruction.

    Wong, Patrick / Wong, Jolin / Mok, May Un Sam

    Singapore medical journal

    2016  Volume 57, Issue 3, Page(s) 110–117

    Abstract: The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the ... ...

    Abstract The acutely obstructed airway is a medical emergency that can potentially result in serious morbidity and mortality. Apart from the latest advancements in anaesthetic techniques, equipment and drugs, publications relevant to our topic, including the United Kingdom's 4th National Audit Project on major airway complications in 2011 and the updated American Society of Anesthesiologists' difficult airway algorithm of 2013, have recently been published. The former contained many reports of adverse events associated with the management of acute airway obstruction. By analysing the data and concepts from these two publications, this review article provides an update on management techniques for the acutely obstructed airway. We discuss the principles and factors relevant to the decision-making process in formulating a logical management plan.
    MeSH term(s) Acute Disease ; Airway Management/methods ; Airway Obstruction/therapy ; Anesthesia/methods ; Anesthetics/therapeutic use ; Humans
    Chemical Substances Anesthetics
    Language English
    Publishing date 2016-03
    Publishing country Singapore
    Document type Journal Article ; Review
    ZDB-ID 604319-7
    ISSN 0037-5675
    ISSN 0037-5675
    DOI 10.11622/smedj.2016050
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