scholarly journals 623 Completed Audit Cycle of Indications for Excision of Fibroadenomas At A University Hospital

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Beattie
Keyword(s):  
Surgical Procedures ◽  
Breast Surgery ◽  
University Hospital ◽  
B3 Lesions ◽  
Benign Nature ◽  
Audit Cycle ◽  
One Year ◽  
Surgical Excisions

Abstract Aim This audit looked at indications for excisions of fibroadenomas one year on from the first audit cycle and following intervention of presentation and teaching at local departmental meeting. This audit was motivated by a drive to reduce operations on benign breast conditions including fibroadenoma excisions. ABS (Association of Breast Surgery) guidelines advise excision for fibroepithelial lesions (B3) on biopsy, pain and increasing size. Local consensus is excision of fibroadenomas over 30mm on ultrasound. Method Patients who underwent surgical excisions of fibroadenomas over 6 months at one hospital were analysed for size on ultrasound, biopsy histology and reason for excision, and compared to previous audit results over 24 months. Results Over 6 months, 18 patients underwent excisions. Histology specimens showed 13/18 were fibroadenomas, 4/18 benign phyllodes and 1/18 other benign conditions. This was similar to the previous audit, although there was an increase in the rate of benign phyllodes. Pre-operatively, 11/18 of patients met the ABS criteria for excision (7/11 were B3 lesions, 3/11 for increasing size and 1/11 pain). 11/18 patients met the local criteria. 2/18 patients met neither criteria. This had improved compared to the first audit cycle. Conclusions 88.9% of patients met ABS or local criteria, compared to 83.7% previously, and so this had improved following intervention. One outcome from the first audit cycle was patients need greater reassurance about the benign nature of fibroadenomas to avoid unnecessary morbidity due to surgical procedures, and this appears to have improved on re-audit. Both patients not meeting criteria had histology showing fibroadenomas.

Prospective evaluation for gastrointestinal bleedings at the University Hospital St. Pölten – one year of follow-up

2019 ◽  
Author(s):  
M Stättermayer ◽  
F Riedl ◽  
S Bernhofer ◽  
A Stättermayer ◽  
A Mayer ◽  
...  
Keyword(s):  
University Hospital ◽  
Prospective Evaluation ◽  
One Year ◽  
The University

scholarly journals Collateral damage of the COVID-19 pandemic: an alarming decline in critical procedures in otorhinolaryngology in a German university hospital

2020 ◽  
Author(s):  
Sarah Riemann ◽  
Iva Speck ◽  
Kathrin Gerstacker ◽  
Christoph Becker ◽  
Andreas Knopf
Keyword(s):  
Surgical Procedures ◽  
Elective Surgery ◽  
Diagnostic Procedures ◽  
University Hospital ◽  
Diagnosis And Treatment ◽  
Symptom Duration ◽  
Collateral Damage ◽  
Negative Effects

Abstract Purpose The COVID-19 pandemic has a major impact on the diagnosis and treatment of ENT patients. The aim of this study was to analyze the influence of the pandemic on the number of otolaryngological procedures, particularly for critical diagnoses with potential negative effects due to prolonged symptom duration. Methods We evaluated 10,716 surgical procedures between January 1, 2018 and May 31, 2020, focusing on the 16-week period around March 16, 2020, which includes 1080 observations. We further analyzed subsets of critical procedures. Results We found a decline in critical procedures by 43% although no critical procedures were postponed by the hospital. Meanwhile, the share of critical procedures increased up to 90% caused by the cancellation of elective surgery. Especially worrisome was that diagnostic procedures for suspected malignancies decreased by 41% during the pandemic. Conclusion The decline in critical procedures in otorhinolaryngology as collateral damage of the COVID-19 pandemic is considerable and therefore alarming.

scholarly journals A Minimally-Invasive, Simple, Rapid, and Effective Surgical Technique for the Treatment of Ingrown Toenails: A Reminder of the Original Winograd Procedure

2021 ◽  
Vol 18 (1) ◽  
pp. 278
Author(s):  
Jahyung Kim ◽  
Sanghyeon Lee ◽  
Jeong Seok Lee ◽  
Sung Hun Won ◽  
Dong Il Chun ◽  
...  
Keyword(s):  
Patient Outcomes ◽  
Simple Procedure ◽  
Wedge Resection ◽  
Operation Time ◽  
University Hospital ◽  
Wound Infections ◽  
Germinal Matrix ◽  
One Year ◽  
Ingrown Toenails

(1) Background: Ingrown toenail is a common disorder of the toe that induces severe toe pain and limits daily activities. The Winograd method, the most widely used operative modality for ingrown toenails, has been modified over years to include wedge resection of the nail fold and complete ablation of the germinal matrix. We evaluated the outcomes of original Winograd procedure without wedge resection with electrocautery-aided matrixectomy. (2) Methods: We retrospectively analyzed the outcomes of patients who underwent surgery for ingrown toenails at a university hospital for two years from November 2015 to October 2017. Surgery was performed in 76 feet with a mean operation time of 9.34 min. (3) Results: The minimal interval from surgery to return to regular activities was 13.26 (range 7 to 22) days. Recurrence and postoperative wound infections were found in 3 (3.95%) and 2 (2.63%) patients, respectively. Evaluation of patient satisfaction at one-year follow-up showed that 40 (52.63%) patients were very satisfied, 33 (43.42%) were satisfied, 3 (3.95%) were dissatisfied, and none of them were very dissatisfied. The average follow-up duration was 14.66 (range 12 to 25) months. (4) Conclusions: Therefore, it is believed that this less-invasive and simple procedure could be easily performed by clinicians, with satisfactory patient outcomes.

Use of an optical surface scanner in assessment of outcome following rhinoplasty surgery

2008 ◽  
Vol 122 (9) ◽  
pp. 972-977 ◽  
Author(s):  
H Chau ◽  
R Dasgupta ◽  
V Sauret ◽  
G Kenyon
Keyword(s):  
Surgical Intervention ◽  
University Hospital ◽  
Facial Features ◽  
Optical Surface ◽  
Case Study Analysis ◽  
The Future ◽  
University College London ◽  
One Year ◽  
The Right

AbstractObjective:To demonstrate the use of an optical surface scanner, with associated software, in the assessment of rhinoplasty patients, and to discuss the possible clinical applications of this technology in the future.Design:Case study analysis of pre- and post-operative scans of a patient undergoing septorhinoplasty at Whipps Cross University Hospital, London, UK.Subject:A 21-year-old man undergoing septorhinoplasty underwent pre-operative optical surface scanning of his face. The scans were repeated at one week and one year post-operatively. Software developed at University College London was then used to analyse the scans.Results:The scans clearly showed that the man's dorsal hump had been well reduced and the nose straightened, with a resulting 1600 mm3 gain on the right side and a 1000 mm3 loss on the left side of the nose. Tip projection had also been achieved.Conclusion:This technique allowed objective quantification of facial features and analysis of change. It may well prove useful in the future in predicting change following surgical intervention.

scholarly journals Humanization and Macroergonomics: An Analysis in the Billing Sector of a University Hospital in Paraná

2020 ◽  
Author(s):  
Larissa de Oliveira Matia Leite ◽  
Alexandre Minoru Sasaki ◽  
Rosimeire Sedrez Bitencourt ◽  
Maria Lucia Miyake Okumura ◽  
Osiris Canciglieri Junior
Keyword(s):  
Health Workers ◽  
Work Organization ◽  
University Hospital ◽  
Participatory Ergonomics ◽  
Sociotechnical System ◽  
Work System ◽  
Organizational Constructs ◽  
Sociotechnical Analysis ◽  
Machine Systems ◽  
One Year

The humanization of organizations is a trend in companies that have a vision of the future aligned with the needs of the market. In the health area, this humanization should not be limited to its users, but include the employees involved in the work system. The human aspect and its relations with the work system is a focus of studying ergonomics, which in its macroergomic approach aims at integrating organization-man-machine systems into a sociotechnical and participatory context. This study aims to apply the macroergonomic approach with health workers in order to propose and implement improvements; evidencing the importance of their involvement in better acceptance of the proposed improvements generating greater satisfaction. To this end, a study was conducted in the Billing sector of a Brazilian Hospital. Ergonomic demands were identified in a participatory way through the Macroergonomic Analysis of Work (MAW) method, proposed in [1]. The results were tabulated and divided into constructs: Environment, Biomechanical, Cognitive, Work Organization, Risk, Company and Discomfort/Pain. After one year, a new macroergonomic evaluation was carried out and the improvements implemented included the concept of the sociotechnical system, which were: i) acquisition of new computers; ii) implementation of a new computational system and; iii) implementation of changes in the form of sector management. The results showed an increase of up to 40% in satisfaction with the improvements implemented in the Biomechanical and Organizational constructs, indicating that the application of participatory ergonomics and macroergonomics was fundamental for the changes made to increase satisfaction in aspects of the work performed by them. Finally, this research highlights the importance of employee involvement in sociotechnical analysis for the humanization of organizations and it is suggested for future studies the proposition of improvements related to the Environment and Cognitive constructs and pain/discomforts.

scholarly journals Implementation of an automated cluster alert system into the routine work of infection control and hospital epidemiology: experiences from a tertiary care university hospital

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Seven Johannes Sam Aghdassi ◽  
Britta Kohlmorgen ◽  
Christin Schröder ◽  
Luis Alberto Peña Diaz ◽  
Norbert Thoma ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Median Number ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Infection Prevention And Control ◽  
Alert System ◽  
Related Data ◽  
Healthcare Settings ◽  
Care Systems ◽  
One Year

Abstract Background Early detection of clusters of pathogens is crucial for infection prevention and control (IPC) in hospitals. Conventional manual cluster detection is usually restricted to certain areas of the hospital and multidrug resistant organisms. Automation can increase the comprehensiveness of cluster surveillance without depleting human resources. We aimed to describe the application of an automated cluster alert system (CLAR) in the routine IPC work in a hospital. Additionally, we aimed to provide information on the clusters detected and their properties. Methods CLAR was continuously utilized during the year 2019 at Charité university hospital. CLAR analyzed microbiological and patient-related data to calculate a pathogen-baseline for every ward. Daily, this baseline was compared to data of the previous 14 days. If the baseline was exceeded, a cluster alert was generated and sent to the IPC team. From July 2019 onwards, alerts were systematically categorized as relevant or non-relevant at the discretion of the IPC physician in charge. Results In one year, CLAR detected 1,714 clusters. The median number of isolates per cluster was two. The most common cluster pathogens were Enterococcus faecium (n = 326, 19 %), Escherichia coli (n = 274, 16 %) and Enterococcus faecalis (n = 250, 15 %). The majority of clusters (n = 1,360, 79 %) comprised of susceptible organisms. For 906 alerts relevance assessment was performed, with 317 (35 %) alerts being classified as relevant. Conclusions CLAR demonstrated the capability of detecting small clusters and clusters of susceptible organisms. Future improvements must aim to reduce the number of non-relevant alerts without impeding detection of relevant clusters. Digital solutions to IPC represent a considerable potential for improved patient care. Systems such as CLAR could be adapted to other hospitals and healthcare settings, and thereby serve as a means to fulfill these potentials.

scholarly journals A Staged Treatment of Symptomatic Lumbar Intraspinal Synovial Cysts

2019 ◽  
Vol 5 (22;5) ◽  
pp. E451-E456
Author(s):  
Kyung-Hoon Kim
Keyword(s):  
Minimally Invasive ◽  
Surgical Procedures ◽  
Facet Joint ◽  
University Hospital ◽  
Pain Clinic ◽  
Level Of Evidence ◽  
Endoscopic Surgical Procedures ◽  
Number Of Patients ◽  
Synovial Cysts

Background: Lumbar intraspinal synovial cyst (LISC) refers to a cyst that arises from the zygapophyseal joint capsule of the lumbar spine and contains serous or gelatinous fluid. In cases of LISCs resistant to conservative treatments, various minimally invasive percutaneous spinal techniques (MIPSTs) may be applied prior to open surgery. Objectives: The outcomes of 3-staged MIPSTs for the treatment of symptomatic LISCs resistant to conservative treatments were evaluated. Study Design: An institutional review board approved retrospective chart review. Setting: University hospital inpatients referred to our pain clinic. Methods: Review of charts of all patients who underwent MIPSTs for symptomatic LISCs resistant to conservative treatments during a time period of 13 years at a university hospital pain clinic. Patients with symptomatic LISCs resistant to conservative treatments were treated with 3-staged MIPSTs, including image-guided intraarticular aspiration, cyst distention and rupture, and injection of corticosteroids (ARI), endoscopic cyst enucleation (ECE), and endoscopic superior facetectomy (ESF) by a single pain specialist. A symptom-free period after each intervention was evaluated. Recurrence was defined as the same recurrent symptomatic radicular pain with confirmation of the LISC on magnetic resonance imaging. All patients with a minimum follow-up time of 3 years were included. Results: Of the 40 patients who underwent ARI, 3 patients failed to complete a follow-up and 19 patients (51.4%) who had recurring symptoms received ECE. Ten patients (52.6%) who had rerecurring symptoms after ECE received ESF. There was no recurrence after ESF. Limitations: This retrospective and observational study with a limited number of patients does not represent a high level of evidence. Conclusions: This information provided the recurrence rate after each intervention. Half of the patients who went on to receive ARI experienced recurrence, whereas half of the patients with recurrence who received ECE experienced re-recurrence. ESF treatment resulted in no recurrence within the 3-year study period. Key words: Conservative treatment, endoscopic surgical procedures, facet joint, intraarticular injection, minimally invasive surgical procedures, needle biopsy, nerve root compression, radiculopathy, synovial cysts

scholarly journals Retenção da aprendizagem após treinamento em Suporte Básico de Vida com uso de simulação de baixa fidelidade em uma unidade hospitalar odontológica

2018 ◽  
Vol 28 (1) ◽  
pp. 29410
Author(s):  
Marcelo Nunes de Lima ◽  
Fernanda Drummond Ruas Gaspar ◽  
Túlio Gomes da Silva Mauro ◽  
Márcia Apoliano Mesquita Arruda ◽  
Gardênia da Silva Abbad
Keyword(s):  
Basic Life Support ◽  
Life Support ◽  
University Hospital ◽  
Theoretical Knowledge ◽  
Learning Retention ◽  
Or Practice ◽  
Post Test ◽  
Quasi Experimental ◽  
Research Interviews ◽  
One Year

AIMS: To evaluate the learning retention of participants of a Basic Life Support course in a dental unit of a university hospital.METHODS: This study combined quantitative and qualitative methods in a quasi-experimental design, in which the same subjects were compared before and at two moments after an intervention, which consisted of a training course in Basic Life Support. The participants were employees of the Oral Health Unit of the University Hospital of Brasília. Three evaluations were performed: pre-test, post-test and late post-test, in order to assess participants' learning retention. In a second stage of the research, interviews were conducted with the participants approved in the retention learning test.RESULTS: At all, 66 professionals participated in the course and carried out the theoretical pre-test and the theoretical and practical post-test. One year and five months after the course, 10 participants were submitted to the late post-test, also theoretical and practical. Regarding the theoretical knowledge, the mean was 6.3±2.31 points in the pre-test, 8.3±1.25 points in the post-test and 5.1±1.44 points in the late post-test. Late post-test results revealed also that 70% of participants met the minimum theoretical knowledge requirement for approval (5 of 10 points) but only 20% passed the practical retention assessment. The two participants who passed the practical evaluation had repeated the training after the initial course.CONCLUSIONS: Basic Life Support training based on simulation resulted in practical and theoretical learning in cardiopulmonary resuscitation. However, the effect did not persist after one year and five months, except for participants who repeated the training during this period, indicating that the long term retention of this learning requires more opportunities for training or practice. Further studies are needed to investigate the ideal workload, the number of repetitions required during training and the appropriate frequency of training, as well as to obtain information about the influence of prior knowledge of the participants and the practice after training in retention of skills.

scholarly journals Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

2016 ◽  
Vol 50 (2) ◽  
pp. 302-308 ◽  
Author(s):  
Maynara Fernanda Carvalho Barreto ◽  
Mara Solange Gomes Dellaroza ◽  
Gilselena Kerbauy ◽  
Cintia Magalhães Carvalho Grion
Keyword(s):  
Severe Sepsis ◽  
Public Hospital ◽  
Epidemiological Data ◽  
University Hospital ◽  
Preventive Actions ◽  
Focus Of Infection ◽  
One Year ◽  
A Prospective Study ◽  
The Cost ◽  
Pulmonary Focus

Abstract OBJECTIVE To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. METHOD An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. RESULTS The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. CONCLUSION The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients.

23 Reaudit and Completing the Audit Cycle of Quality of Informed Consent for Surgery on Neck of Femur Fracture in Royal Stoke University Hospital

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
T Khaleeq ◽  
U Hanif ◽  
Y Maqsood ◽  
K Ahmed ◽  
A Patel
Keyword(s):  
Informed Consent ◽  
Femur Fracture ◽  
Limb Length Discrepancy ◽  
University Hospital ◽  
Junior Doctors ◽  
Neck Of Femur ◽  
Audit Cycle ◽  
Neck Of Femur Fracture ◽  
British Orthopaedic Association

Abstract Using guidelines highlighted by the British Orthopaedic Association an reaudit was performed within our department to assess the adequacy of informed consent for NOF fractures to complete the audit cycle. 50 patients were included in the Audit and reaudit. Risk was classified as common, less common, rare and ‘other’. The adequacy of informed consent was evaluated by assessing the quality and accuracy of documentation. Infection, bleeding risks, clots and anaesthetic risks were documented in all patients (100%). Areas of improvement were seen in the documentation of neurovascular injuries (98%), pain (90%) and altered wound healing (87%). There was no significant change in the documentation of failure of surgery (83%) and neurovascular injuries (98%). The Poorly documented risk factors from the initial audit were seen to improve which included mortality (70%), prosthetic dislocation (90%) and limb length discrepancy (50%). There has been a significant improvement in the quality of Informed consent in the department and this could be attributed to the installation of ward posters and verbal dissemination of information to junior doctors. Recommendation for interventions would be to present in the next clinical governance meeting and presenting at the new junior doctors’ induction at August.

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