scholarly journals Effective operating room (OR) utilization by performing low-complex surgical procedures during the 2020 corona pandemic

2021 ◽  
Author(s):  
Thomas Vogel ◽  
Dina Schippers ◽  
Balqees Aldarweesh ◽  
Ilaria Pergolini ◽  
Martina Stollreiter ◽  
...  
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Central Venous Access ◽  
Venous Access ◽  
University Hospital ◽  
Group 12 ◽  
Grade Ii ◽  
Complex Surgical Procedures ◽  
Oncologic Treatment ◽  
Low Complex

Abstract Purpose The SARS-CoV-2 pandemic has almost stopped all elective surgical treatment throughout the world. As operating room (OR) capacities are reduced everywhere to ensure availability of intensive care capacities, especially low-complex surgical procedures are often postponed. These include totally implantable central-venous access ports which are important for the oncologic treatment of cancer patients. Methods In our study, we investigated the potential of an outpatient surgical centre (OSC) in terms of workflow effectiveness compared to the central operating room complex (COR) of a university hospital using low-complex surgical procedures as an example. Data of 524 consecutive patients who received a Port-a-cath procedure (422 implantations (80.5%) and 102 explantations (19.5%)) in our department between February 2019 and February 2020 were evaluated. Results A total of 277 patients were operated in outpatient surgical centre (OSC), and 247 patients received the procedure in the central OR (COR) complex. Grade II and III complications according to the Clavien–Dindo classification occurred in 5.2% (OSC) and 7.3% (COR) of patients. Incision-to-suture time was significantly quicker in the OSC group (36 vs. 42 min., p < 0.032). Total OR time (01:08 vs. 01:20 h) and preparation-to-incision time were also shorter in the OSC group (12 vs. 17 min., p < 0.002). Conclusion In order to ensure effective OR utilization especially in times of the corona pandemic, the use of smaller decentralized OR units, e.g., outpatient surgical centres, for performing low-complex surgical cases is beneficial. Our study revealed shorter total OR and preparation-to-incision times.

scholarly journals Complications and Management of Totally Implantable Central Venous Access Ports in Cancer Patients at a University Hospital in Oman

2021 ◽  
Vol 21 (1) ◽  
pp. e103-109
Author(s):  
Philomena C. D'Souza ◽  
Shiyam Kumar ◽  
Annupam Kakaria ◽  
Rashid Al-Sukaiti ◽  
Khalid Al-Baimani ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Cancer Patients ◽  
Infection Rate ◽  
Central Venous Access ◽  
Clinical Stage ◽  
Venous Access ◽  
University Hospital ◽  
Central Venous ◽  
Indwelling Time ◽  
Premature Removal

Objectives: Totally implantable central venous access ports (port-a-caths) are increasingly used for the safe administration of chemotherapy; however, their use is associated with complications. This study reviews patterns of complications, reasons for premature removal and the duration of the use of port-a-caths in patients receiving cancer treatment at Sultan Qaboos University Hospital (SQUH) and compares the infection rate with the literature and the researchers’ experiences. Methods: This retrospective follow-up study included patients who had received cancer treatment through a port-a-cath and were admitted to SQUH between January 2007 and April 2019. Demographic features, underlying diagnosis, clinical stage, treatment, duration of use and the cause of premature removal of the port-a-cath were recorded. Results: A total of 516 port-a-caths were inserted in 482 cancer patients. The majority of devices were implanted by interventional radiologists (n = 459; 89.0%) and the right internal jugular vein was most frequently accessed (n = 396; 76.7%). The mean indwelling time of a port-a-cath was 288 days (range: 3–1,872 days) for patients with complications and 550 days (range: 7–3,123 days) for patients without complications. Port-a-cath-related infection was the main complication (n = 63; 12.2%). Patient age, gender, treatment intent, underlying diagnosis, clinical stage, chemotherapy regimen, number of treatment courses, operator implanting the port, the type of micro-organism isolated from the port-a-cath and body mass index were significant factors affecting catheter indwelling time (P <0.05). On multivariate analysis, however, none of the factors was found to be significant. Conclusion: Infection was the most common complication necessitating port-a-cath removal. The infection rate was much lower than the researchers’ previous experience and compares favorably with several published reports.   KEYWORDS Port-A-Cath; Vascular Access Ports; Catheter-Related Infections; Cancer; Oman.

Operating Room Management In Klaipėda University Hospital: Prospective Analysis In 2009

2016 ◽  
Vol 26 (5) ◽  
pp. 114-119
Author(s):  
Renata Paškevičiūtė ◽  
Geda Klimavičiūtė
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Surgical Procedure ◽  
Operating Rooms ◽  
Turnover Time ◽  
University Hospital ◽  
Time Variability ◽  
Procedure Time ◽  
High Turnover ◽  
Scheduled Time

Summary Background: Klaipeda University Hospital performs about 30000 surgical procedures every year. The operating room (OR) is a major production unit in hospital. The OR is very expensive to construct and to operate. The goal might be thought to be full utilization of all operating rooms during all hours that they are staffed and available for scheduling. Management is the ability to apply a diverse body of knowledge to accomplish planning, organizing, staffing, leading, and controling a work group. Methods: We decided accidentally to choose and to analyze OR utilization. We had analyzed central operating department consisting of 9 ORs with regularly scheduled time 8:00 AM to 4:00 PM (8 h), full staffed in 2009 four months period (78 workdays). Four months (78 workdays) of data were collected from the 9 operating rooms surveys. Holidays and weekends were excluded.The data was analyzed using “ Statistica” version 7.Results: There were performed 1982 surgical procedures (elective – 1807 (91,2%), urgent – 99 (5%), cancelled – 76 (3,8%)) during investigated period regularly scheduled time (8 h). Actually utilized OR time of all 9 ORs was 4648 h (82,76%), it was planned to work 5616 h. Our OR utilization was 82,76% during investigated period. Total under – utilized time was 968 h (17,36%). Surgeon estimated surgical procedure time was longer than actual surgical procedure time, variability of case duration between surgical teams was high. Turnover time mean duration was 28 min. Conclusions: Our study demonstrates that our central operating department have been worked efficiently (OR utilization was 82,76%, case cancellation rate was 3,8%, mean turnover time was 28 min, prolonged turnovers were less than 10%) in 2009 (four month period).

Comparison between sedation room and operating room in central venous catheter positioning in children

2020 ◽  
pp. 112972982093241
Author(s):  
Antonio Chiaretti ◽  
Mauro Pittiruti ◽  
Giovanni Sassudelli ◽  
Giorgio Conti ◽  
Marco Rossi ◽  
...  
Keyword(s):  
Operating Room ◽  
Central Venous Access ◽  
Venous Access ◽  
Central Venous ◽  
Central Venous Access Device ◽  
Access Device ◽  
Group A ◽  
Group B ◽  
Venous Access Device ◽  
Neurosurgical Operation

Background: Placement of central venous access devices is a clinical procedure associated with some risk of adverse events and with a relevant cost. Careful choice of the device, appropriate insertion technique, and proper management of the device are well-known strategies commonly adopted to achieve an optimal clinical result. However, the environment where the procedure takes place may have an impact on the overall outcome in terms of safety and cost-effectiveness. Methods: We carried out a retrospective analysis on pediatric patients scheduled for a major neurosurgical operation, who required a central venous access device in the perioperative period. We divided the patients in two groups: in group A the central venous access device was inserted in the operating room, while in group B the central venous access device was inserted in the sedation room of our Pediatric Intensive Care Unit. We compared the two groups in terms of safety and cost-effectiveness. Results: We analyzed 47 central venous access devices in 42 children. There were no insertion-related complications. Only one catheter-related bloodstream infection was recorded, in group A. However, the costs related to central venous access device insertion were quite different: €330–€540 in group A versus €105–€135 in group B. Conclusion: In the pediatric patient candidate to a major neurosurgical operation, preoperative insertion of the central venous access device in the sedation room rather than in the operating room is less expensive and equally safe.

Quality assurance audit in adult cardiac anaesthesia

2020 ◽  
pp. 1-12
Author(s):  
Syed Shabbir Ahmed ◽  
Mohammad Hamid ◽  
Faisal Junejo ◽  
Admin
Keyword(s):  
Cardiac Surgery ◽  
Central Venous Access ◽  
Venous Access ◽  
University Hospital ◽  
Haemodynamic Instability ◽  
Induction Phase ◽  
Cardiac Anaesthesia ◽  
Related Quality ◽  
Cardiac Intensive Care ◽  
Adult Cardiac Surgery

Abstract Objective: To observe and assess different anaesthesia related quality indicators during adult cardiac surgery. Study design: Clinical audit report. Place and duration of study: The aga khan university hospital karachi, Pakistan, from October 2016 to March 2017. Methodology: Data were collected prospectively from all 264 patients scheduled for cardiac surgery and observe different indicators in pre-induction, pre cardiopulmonary bypass (CPB) period, on CPB, post CPB period and transfer from operating room to cardiac intensive care unit. Results: Total 217 patients included in the study, our compliance of documentation was found to be 82.19%. In pre-induction phase, difficult intravenous and invasive line access in 42 patients (19.3%). Inadvertent Carotid puncture occurred in 7 patients (3.2%) during central venous access. Cardiac arrhythmias were found in 19 patients (8.8%). Inappropriate information in preoperative form found in 6 patients (2.8%). Drug reactions (only rashes) were noted in 4 patients (1.8%). Preoperative drugs for anxiolysis used in 145 patients (66.8%). Ramsey sedation score-2 was found in majority of our patients 100(69%), while Ramsey score-3 was documented only in 22 patients (15.2%). Haemodynamic instability (32 patients) and difficult intubation (17 patients) were main pre-bypass indicators. Haemodynamic issues were again significant in CPB period 15(6.9%). CPB difficulties were seen in 8 (3.6%) patients, which includes unplanned use of inotropic support, prolonged CPB wean off procedure, insertion of IABP post CPB and more than one attempt at CPB weaning included. In post CPB period abnormal ACT was found in 17 patients (7.8%), while haemodynamic instability Continuous...

scholarly journals Cause and incidence of Cancellation of elective surgeries at Gondar University hospital, Ethiopia

2020 ◽  
Author(s):  
Yonas Addisu Nigatu ◽  
Habitu Adane Aytolign
Keyword(s):  
Operating Room ◽  
Surgical Procedures ◽  
Preoperative Assessment ◽  
Economic Loss ◽  
Daily Basis ◽  
University Hospital ◽  
Surgical Patient ◽  
North West ◽  
Elective Surgical Procedures ◽  
Gondar University Hospital

Abstract Background: High rates of cancellation of surgical procedures are common in hospital settings which may subsequently lead to economic loss to hospital besides burden given to patients, their families and medical teams .It is well recognized that cancellation of patients from elective theatre operating lists increases cost, decreases efficiency, duplicates workload and wastes operating room time.Cancellation of elective surgical procedures also causes significantly emotional trauma to the patients as well as their families and the community in general, and its impact on hospital resources is great due to prolonged hospitalization and high cost of health care.The aim of this study was to find the causes and incidence of surgical patient cancellation at Gondar university hospital, North-west Ethiopia.Methods: prospective observational study was conducted from January 10 to April 10, 2019. Information regarding the cancellation of surgeries were collected from various sources including; the operating room daily surgical schedule, preoperative anaesthesia record sheet, primary physicians, the anaesthetist responsible for the preoperative assessment and conducting the case and by communicating patients if required. Data were checked on daily basis for completeness and were entered to Epi info and analyzed using statistical package for social sciences (SPSS) version 20 software.Result: There were 64 causes of case cancellation. The commonest reasons for cancellation were overbooking of elective surgeries (33.13%).Conclusion: Preventable causes of case cancellation were the most prominent.

Successful Long-Term Central Venous Access

1998 ◽  
Vol 2 (1) ◽  
pp. 38-40
Author(s):  
Franco Tesio ◽  
Hamurabi De Baz ◽  
Giacomo Panarello
Keyword(s):  
Central Venous Access ◽  
Venous Access ◽  
Central Venous
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