scholarly journals Audit on induction time delays in operating room at Kibogora District Hospital: A quality improvement project

2021 ◽  
Vol 9 (2) ◽  
pp. 163-168
Author(s):  
Jean Claude Uwimana
Keyword(s):  
Operating Room ◽  
Induction Time ◽  
Time Delays ◽  
High Rate ◽  
Improvement Project ◽  
Study Results ◽  
Induction Times ◽  
Or Team ◽  
Causes Of Delays ◽  
Operating Unit

Background: Induction time delays in Operating room (OR) is an issue that affects the productivity of an operating unit especially in a setting with limited resources. It can also results in providing inappropriate services to the patients and their families. The aim of this study was to determine the causes of induction time delays and to propose solutions on how to avoid the reasons of delays. Methods: A prospective observational study was conducted. It focused on elective general surgeries and orthopedic surgeries as they were mainly being performed during the study period. The data on the type of operation, the type of anesthesia, delay or no delay of induction (DOI) of anesthesia, causes of DOI were collected. DOI was considered as the time between the previous patient out of the OR and the next one in of more than 30 minutes. Emergency surgeries and elective obstetric surgeries were excluded from the study. Results: 24.8% of surgeries were done after delays of induction of anesthesia as opposed to 75.2% surgeries for which anesthesia was induced without delay. 48.6% of delays of induction to anesthesia were due to the hospital issues followed by anesthesia provision related issues. (40.0%). The surgery related and patient related issues accounted each one 5.7%. Conclusions: There was a high rate of surgeries that had delays in induction times. The OR managers need to work more with the hospital administration and the OR team to correct causes of delays.

scholarly journals Current practice and perceptions of safety protocols for the use of intraperitoneal chemotherapy in the operating room: results of the IP-OR international survey

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Daniel Clerc ◽  
Martin Hübner ◽  
K.R. Ashwin ◽  
S.P. Somashekhar ◽  
Beate Rau ◽  
...  
Keyword(s):  
Operating Room ◽  
Intraperitoneal Chemotherapy ◽  
Current Practice ◽  
High Volume ◽  
International Survey ◽  
Protection Measures ◽  
Team Members ◽  
Cleaning Staff ◽  
The Individual ◽  
Or Team

Abstract Objectives To assess the risk perception and the uptake of measures preventing environment-related risks in the operating room (OR) during hyperthermic intraperitoneal chemotherapy (HIPEC) and pressurized intraperitoneal aerosol chemotherapy (PIPAC). Methods A multicentric, international survey among OR teams in high-volume HIPEC and PIPAC centers: Surgeons (Surg), Scrub nurses (ScrubN), Anesthesiologists (Anest), Anesthesiology nurses (AnesthN), and OR Cleaning staff (CleanS). Scores extended from 0–10 (maximum). Results Ten centers in six countries participated in the study (response rate 100%). Two hundred and eleven responses from 68 Surg (32%), 49 ScrubN (23%), 45 Anest (21%), 31 AnesthN (15%), and 18 CleanS (9%) were gathered. Individual uptake of protection measures was 51.4%, similar among professions and between HIPEC and PIPAC. Perceived levels of protection were 7.57 vs. 7.17 for PIPAC and HIPEC, respectively (p<0.05), with Anesth scoring the lowest (6.81). Perceived contamination risk was 4.19 for HIPEC vs. 3.5 for PIPAC (p<0.01). Information level was lower for CleanS and Anesth for HIPEC and PIPAC procedures compared to all other responders (6.48 vs. 4.86, and 6.48 vs. 5.67, p<0.01). Willingness to obtain more information was 86%, the highest among CleanS (94%). Conclusions Experience with the current practice of safety protocols was similar during HIPEC and PIPAC. The individual uptake of protection measures was rather low. The safety perception was better for PIPAC, but the perceived level of protection remained relatively low. The willingness to obtain more information was high. Intensified, standardized training of all OR team members involved in HIPEC and PIPAC is meaningful.

Summative usability evaluation of the YLB113 etanercept biosimilar autoinjector via simulation

2021 ◽  
Vol 10 (2) ◽  
pp. 61-67
Author(s):  
Kelly Canham ◽  
Claire Newcomb
Keyword(s):  
Healthcare Providers ◽  
Evaluation Study ◽  
Usability Evaluation ◽  
High Rate ◽  
Injection Site Reactions ◽  
Study Results ◽  
Factor Inhibitor ◽  
Injection Methods ◽  
Dose Accuracy ◽  
Effective Use

Introduction/Study Objectives: Etanercept is a tumour necrosis factor inhibitor indicated for the treatment of several inflammatory disorders. Patients with these diseases may experience manual dexterity challenges. Autoinjectors may improve dose accuracy, treatment adherence and quality of life; and reduce injection-site reactions. Studies have indicated patients prefer autoinjectors to other injection methods, however, patients must be able to demonstrate safe and effective use of an autoinjector for it to be a viable option. The YLB113 etanercept autoinjector may be a substitutable biosimilar to reference etanercept (Pfizer Manufacturing, Puurs, Belgium). This study sought to confirm intended users of the YLB113 etanercept autoinjector could demonstrate safe and effective use. Methods: The evaluation was performed among 79 participants representative of intended YLB113 etanercept autoinjector users; and included patients, caregivers and healthcare providers (HCPs). Results: All participants successfully delivered two simulated doses of etanercept into the foam pad using the autoinjector. Some participants experienced user errors, use difficulties, or close calls while simulating injection or answering knowledge questions. Discussion: In this usability evaluation, study patients, caregivers and HCPs demonstrated a high rate of injection success using the YLB113 etanercept autoinjector. Conclusions: The study results support demonstration of safe and effective use of the YLB113 etanercept autoinjector, a substitutable biosimilar to reference etanercept.

scholarly journals The Use of Drone Photo Material to Classify the Purity of Photovoltaic Panels Based on Statistical Classifiers

Sensors ◽  
2022 ◽  
Vol 22 (2) ◽  
pp. 483
Author(s):  
Tomasz Czarnecki ◽  
Kacper Bloch
Keyword(s):  
Renewable Energy Sources ◽  
Base Material ◽  
Weather Conditions ◽  
High Rate ◽  
Solar Panels ◽  
Soil Dust ◽  
Photovoltaic Panels ◽  
Statistical Classifiers ◽  
Study Results ◽  
The Subject

The subject of this work is the analysis of methods of detecting soiling of photovoltaic panels. Environmental and weather conditions affect the efficiency of renewable energy sources. Accumulation of soil, dust, and dirt on the surface of the solar panels reduces the power generated by the panels. This paper presents several variants of the algorithm that uses various statistical classifiers to classify photovoltaic panels in terms of soiling. The base material was high-resolution photos and videos of solar panels and sets dedicated to solar farms. The classifiers were tested and analyzed in their effectiveness in detecting soiling. Based on the study results, a group of optimal classifiers was defined, and the classifier selected that gives the best results for a given problem. The results obtained in this study proved experimentally that the proposed solution provides a high rate of correct detections. The proposed innovative method is cheap and straightforward to implement, and allows use in most photovoltaic installations.

scholarly journals Prescribing Analgesics to Older People: A Challenge for GPs

2020 ◽  
Vol 17 (11) ◽  
pp. 4017
Author(s):  
Ljiljana Trtica Majnarić ◽  
Thomas Wittlinger ◽  
Dunja Stolnik ◽  
František Babič ◽  
Zvonimir Bosnić ◽  
...  
Keyword(s):  
Older People ◽  
Chronic Diseases ◽  
Musculoskeletal Diseases ◽  
Age Groups ◽  
Treatment Strategies ◽  
Opioid Analgesics ◽  
Psychotropic Medications ◽  
High Rate ◽  
Increased Risk ◽  
Study Results

Background: Due to population aging, there is an increase in the prevalence of chronic diseases, and in particular musculoskeletal diseases. These trends are associated with an increased demand for prescription analgesics and an increased risk of polypharmacy and adverse medication reactions, which constitutes a challenge, especially for general practitioners (GPs), as the providers who are most responsible for the prescription policy. Objectives: To identify patterns of analgesics prescription for older people in the study area and explore associations between a long-term analgesic prescription and comorbidity patterns, as well as the prescription of psychotropic and other common medications in a continuous use. Methods: A retrospective study was conducted in 2015 in eastern Croatia. Patients were GP attenders ≥40 years old (N = 675), who were recruited during their appointments (consecutive patients). They were divided into two groups: those who have been continuously prescribed analgesics (N = 432) and those who have not (N = 243). Data from electronic health records were used to provide information about diagnoses of musculoskeletal and other chronic diseases, as well as prescription rates for analgesics and other medications. Exploratory methods and logistic regression models were used to analyse the data. Results: Analgesics have been continuously prescribed to 64% of the patients, mostly to those in the older age groups (50–79 years) and females, and they were indicated mainly for dorsalgia symptoms and arthrosis. Non-opioid analgesics were most common, with an increasing tendency to prescribe opioid analgesics to older patient groups aged 60–79 years. The study results indicate that there is a high rate of simultaneous prescription of analgesics and psychotropic medications, despite the intention of GPs to avoid prescribing psychotropic medications to patients who use any option with opioid analgesics. In general, receiving prescription analgesics does not exceed the prescription for chronic diseases over the rates that can be found in patients who do not receive prescription analgesics. Conclusion: Based on the analysis of comorbidities and parallel prescribing, the results of this study can improve GPs’ prescription and treatment strategies for musculoskeletal diseases and chronic pain conditions.

scholarly journals Assessment of Dental Implants with Modified Calcium-Phosphate Surface in a Multicenter, Prospective, Non-Interventional Study: Results up to 50 Months of Follow-Up

2019 ◽  
Vol 10 (1) ◽  
pp. 5
Author(s):  
Carles Subirà-Pifarré ◽  
Cristina Masuet-Aumatell ◽  
Carlos Rodado Alonso ◽  
Ricardo Medina Madrid ◽  
Cosimo Galletti
Keyword(s):  
Clinical Practice ◽  
Survival Rate ◽  
Calcium Phosphate ◽  
Observational Study ◽  
Dental Implants ◽  
Daily Practice ◽  
High Rate ◽  
Osseointegrated Implants ◽  
Study Results

Prescription of implant treatments is very widespread at present, mainly due to the low rate of annual loss and, to date, few studies have assessed their survival in the routine clinical practice of dentistry. The purpose of this observational study was to evaluate the effectiveness of dental implants with a calcium-phosphate surface in the daily practice of dental clinics. A multicenter, prospective, non-interventional, observational study was performed, in which three experienced practitioners (one maxillofacial and two oral surgeons) inserted implants using standard external and internal hexagon connections in adult patients requiring ≥1 osseointegrated implants to replace missing teeth. Follow-up was performed for 24 months after implant loading. Two hundred and twelve subjects were included (51.5% men), with a mean age of 51.2 ± 11.90 years, in whom 544 implants were inserted. 87.2% of the patients received 1–4 implants. The preferred connection system was internal hexagon (73.5%). There were nine failures, with an interval survival rate (ISR) at 24 months of 100% and a cumulative survival rate (CSR) of 98.3%. In conclusion, implants with a modified calcium-phosphate surface are associated with a high rate of survival and may be considered a method of choice in clinical practice.

scholarly journals Quality Initiative Using Theory of Change and Visual Analytics to Improve Controlled Substance Documentation Discrepancies in the Operating Room

2019 ◽  
Vol 10 (03) ◽  
pp. 543-551
Author(s):  
Jenny E. Dolan ◽  
Hannah Lonsdale ◽  
Luis M. Ahumada ◽  
Amish Patel ◽  
Jibin Samuel ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Operating Room ◽  
Visual Analytics ◽  
Theory Of Change ◽  
Free Standing ◽  
Model Framework ◽  
Improvement Project ◽  
Audit Data ◽  
Framework Approach ◽  
Controlled Substance

Background Discrepancies in controlled substance documentation are common and can lead to legal and regulatory repercussions. We introduced a visual analytics dashboard to assist in a quality improvement project to reduce the discrepancies in controlled substance documentation in the operating room (OR) of our free-standing pediatric hospital. Methods Visual analytics were applied to collected documentation discrepancy audit data and were used to track progress of the project, to motivate the OR team, and in analyzing where further improvements could be made. This was part of a seven-step improvement plan based on the Theory of Change with a logic model framework approach. Results The introduction of the visual analytics dashboard contributed a 24% improvement in controlled substance documentation discrepancy. The project overall reduced documentation errors by 71% over the studied period. Conclusion We used visual analytics to simultaneously analyze, monitor, and interpret vast amounts of data and present them in an appealing format. In conjunction with quality-improvement principles, this led to a significant improvement in controlled substance documentation discrepancies.

PD-Type ILC Algorithm Research with Forgetting Factor for a Class of Linear Systems with Multiple Time Delays

2012 ◽  
Vol 220-223 ◽  
pp. 1125-1130 ◽  
Author(s):  
Hong Yang ◽  
Sheng Ming Li
Keyword(s):  
Linear Systems ◽  
Iterative Learning Control ◽  
Time Delays ◽  
Learning Control ◽  
Iterative Learning ◽  
Multiple Time ◽  
Forgetting Factor ◽  
Convergence Conditions ◽  
Multiple Time Delays ◽  
Study Results

Based on iterative learning control (ILC) algorithm with forgetting factor, the thought that the forgetting factor is a function of iteration numbers is proposed in this paper, which has simplified the convergence conditions. And the convergence analysis is given. Then, the study results of this paper are applied to a class of linear systems with multiple time delays and simulation results show that, under the improvements of the convergence conditions and the reasonable choice of forgetting factor function, the PD-type iterative learning control algorithm with forgetting factor applied to the linear systems with multiple time delays in this paper has effectiveness and superiority.

Auditing of operating room times: A quality improvement project

2014 ◽  
Vol 78 (5) ◽  
pp. 782-786 ◽  
Author(s):  
Jonathan N. Perkins ◽  
Tendy Chiang ◽  
Amanda G. Ruiz ◽  
Jeremy D. Prager
Keyword(s):  
Quality Improvement ◽  
Operating Room ◽  
Quality Improvement Project ◽  
Improvement Project

scholarly journals Crossmatch to Transfusion Ratios in the Operating Room with an Expanding Hospital Footprint

2021 ◽  
Vol 156 (Supplement_1) ◽  
pp. S159-S159
Author(s):  
M S Virk
Keyword(s):  
Operating Room ◽  
Blood Product ◽  
Qualitative Interviews ◽  
The United States ◽  
Blood Bank ◽  
University Hospital ◽  
Post Intervention ◽  
Improvement Project ◽  
Surgical Subspecialty ◽  
Surgical Teams

Abstract Introduction/Objective The crossmatch to transfusion (CT) ratio is one of several metrics used to assess the efficiency of blood product utilization. A ratio of 2:1 has been suggested as a hospitalwide limit that indicates appropriate use of red blood cells (RBCs), and the Q Probe Study found that the average CT ratio for hospitals in the United States is 1.85:1. This ratio can vary widely from one patient location to another due to anticipatory or unknown needs within the operating room (OR) compared to laboratory or symptomatic based orders for patients on the floor. Following a recent hospital expansion at Stanford University Hospital that led to the creation of multiple adult OR locations and a move of our blood bank, we monitored the CT ratios of various OR locations and surgical subspecialties to assess the drivers of increased blood product utilization and interventions that could improve these metrics. Methods/Case Report This quality improvement project involved the collection of blood product order information through our LIS (SafeTrace) and clinical system (EPIC), creation of an on-demand report to provide constant updates to that data, qualitative interviews with OR staff, and process mapping for multiple subspecialties. Results (if a Case Study enter NA) Prior to our hospital expansion there was an appropriate CT ratio of 2.1:1 in our adult ORs. Post-expansion, this ratio has been between 3-5:1, depending on the OR location. This led us to focus our efforts on the OR locations that were furthest from the blood bank and existed prior to the hospital expansion. In discussions with our OR colleagues, we found that the major driver for this increased ratio was a longer travel path for blood products and delays in delivery which led to larger amounts of anticipatory orders. In addition, these concerns caused duplicative efforts in the OR with surgical teams and Anesthesiologists placing pre-operative orders for the same cases. To address this concern, remote blood product dispensing was implemented. To address duplicative ordering workflows, we partnered with Anesthesiology to determine the blood ordering workflow agreements with each surgical subspecialty to ensure appropriate division of roles and responsibilities. Evaluation of CT ratios after these interventions is ongoing, but early data suggests a significant reduction. Conclusion Post-intervention phase ongoing and will be updated with additional data & conclusions prior to conference.

scholarly journals The profile of patients’ complaints in a tertiary care hospital in South India

2018 ◽  
Vol 5 (8) ◽  
pp. 3567
Author(s):  
Mohammed Jezeel Nalakath ◽  
P. M. Thasneem ◽  
K. V. Deepak ◽  
N. A. Uvais
Keyword(s):  
Medical Staff ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
High Standard ◽  
Cross Sectional Study ◽  
High Rate ◽  
Care Hospital ◽  
Cross Sectional ◽  
Study Results ◽  
Research Population

Background: Complaints from patients and their carers are important indicators of problems in a healthcare system and provide valuable insights into safety-related problems within healthcare organisations. The objectives of the present study are to identify the frequency distribution of the people complained about, the units complained about and the total number of complaints.Methods: We employed a descriptive, cross-sectional study to conduct this research. The research population included cases registered at the complaints unit of a tertiary care hospitals in selected months of May 2017 to August 2017. The data were collected through observation of available documents. Excel software program was used for data analysis.Results: The administration received 692 complaints between the study period. The highest rate of complaints was filed against admission process (30.06%) and the lowest rate of complaints are filed against staff (2.51%). Our study results showed a significantly less complaints against nursing staff and no complaints against medical staff, indicates that the nursing and medical staff of the hospital might be observing medical ethics and professional commitment to a high standard and communicating well with the patients. High rate of complaints against admission unit, house keeping unit and high billing amount indicates the unrealistic expectations prevailing in the minds of clients from the health care provider.Conclusions: The current study generated the profile of patient’s complaints in a tertiary care hospital running in a charitable model. Such data can be utilised to identify common problems and to plan strategies. 

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