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https://www.readbyqxmd.com/read/28107301/implementation-of-a-pediatric-orthopaedic-bundle-to-reduce-surgical-site-infections
#1
Jan Schriefer, James Sanders, Julie Michels, Kori Wolcott, Connor Ruddy, Jenna Hanson
Surgical site infections (SSIs) cost an estimated $27,288 per case. An analysis of the National Surgical Quality Improvement Program data at the University of Rochester Medical Center suggested that rates of SSIs could be lowered in comparison with both peers and baseline. The aim of this study was to reduce the number of SSIs to zero through the implementation of a "bundle" or a combination of practices. Meetings were held with the multidisciplinary care team that includes surgeons and staff from pediatric pharmacy, pediatric infectious diseases, anesthesia, and nursing to create a care bundle for all pediatric orthopaedic surgery patients...
January 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28106681/using-simulation-to-model-improvements-in-pediatric-bed-placement-in-an-acute-care-hospital
#2
Judith Lambton, Theresa Roeder, Robert Saltzman, Lila Param, Roxanne Fernandes
OBJECTIVE: The objective of this project was to use an interdisciplinary approach to analyze strategies through simulation technology for improving patient flow in a pediatric hospital. BACKGROUND: Various statistics have been offered on the number of children admitted annually to hospitals. For administrators, particularly in smaller systems, the financial burden of equipping and staffing pediatric units often outweighs the moral desire to maintain a pediatric unit as a viable option for patients and pediatricians...
February 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28102949/simultaneous-pet-mr-imaging-with-a-radio-frequency-penetrable-pet-insert
#3
Alexander M Grant, Brian J Lee, Chen-Ming Chang, Craig S Levin
PURPOSE: A brain sized radio frequency (RF)-penetrable PET insert has been designed for simultaneous operation with MRI systems. This system takes advantage of electro-optical coupling and battery power to electrically float the PET insert relative to the MRI ground, permitting RF signals to be transmitted through small gaps between the modules that form the PET ring. This design facilitates the use of the built-in body coil for RF transmission and thus could be inserted into any existing MR site wishing to achieve simultaneous PET/MR imaging...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28096573/prolonged-patient-emergence-time-among-clinical-anesthesia-resident-trainees
#4
L McLean House, Nathan H Calloway, Warren S Sandberg, Jesse M Ehrenfeld
BACKGROUND AND AIMS: Emergence time, or the duration between incision closure and extubation, is costly nonoperative time. Efforts to improve operating room efficiency and identify trainee progress make such time intervals of interest. We sought to calculate the incidence of prolonged emergence (i.e., >15 min) for patients under the care of clinical anesthesia (CA) residents. We also sought to identify factors from resident training, medical history, anesthetic use, and anesthesia staffing, which affect emergence...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28090509/innovations-in-surgery-simulation-a-review-of-past-current-and-future-techniques
#5
REVIEW
Ido Badash, Karen Burtt, Carlos A Solorzano, Joseph N Carey
As a result of recent work-hours limitations and concerns for patient safety, innovations in extraclinical surgical simulation have become a desired part of residency education. Current simulation models, including cadaveric, animal, bench-top, virtual reality (VR) and robotic simulators are increasingly used in surgical training programs. Advances in telesurgery, three-dimensional (3D) printing, and the incorporation of patient-specific anatomy are paving the way for simulators to become integral components of medical training in the future...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28079581/assessing-the-impact-of-the-anesthesia-medication-template-on-medication-errors-during-anesthesia-a-prospective-study
#6
Eliot B Grigg, Lizabeth D Martin, Faith J Ross, Axel Roesler, Sally E Rampersad, Charles Haberkern, Daniel K W Low, Kristen Carlin, Lynn D Martin
BACKGROUND: Medication errors continue to be a significant source of patient harm in the operating room with few concrete countermeasures. The organization and identification of medication syringes may have an impact on the commission of medication errors in anesthesia, so a team of physicians and designers at the University of Washington created the Anesthesia Medication Template (AMT) to define a formal way of organizing the anesthesia workspace. The purpose of this study is to assess the ability of the AMT to reduce perioperative medication errors by anesthesia providers...
January 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28061421/low-cost-and-facile-fabrication-of-a-paper-based-capillary-electrophoresis-microdevice-for-pathogen-detection
#7
Jee Won Lee, Dohwan Lee, Yong Tae Kim, Eun Yeol Lee, Do Hyun Kim, Tae Seok Seo
This paper describes the development of a novel paper-based capillary electrophoresis (pCE) microdevice using mineral paper, which is durable, oil and tear resistant, and waterproof. The pCE device is inexpensive (~$1.6 per device for materials), simple to fabricate, lightweight, and disposable, so it is more adequate for point-of-care (POC) pathogen diagnostics than a conventional CE device made of glass, quartz, silicon or polymer. In addition, the entire fabrication process can be completed within 1h without using expensive clean room facilities and cumbersome photolithography procedures...
December 28, 2016: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28060233/single-anesthetic-versus-staged-bilateral-total-hip-arthroplasty-a-matched-cohort-study
#8
Matthew T Houdek, Cody C Wyles, Chad D Watts, Eric R Wagner, Rafael J Sierra, Robert T Trousdale, Michael J Taunton
BACKGROUND: There is debate regarding the role of single-anesthetic versus staged bilateral total hip arthroplasty (THA) for patients with end-stage bilateral osteoarthritis. Studies have shown that single-anesthetic bilateral THA is associated with systemic complications, but there are limited data comparing patient outcomes in a matched setting of bilateral THA. METHODS: We identified 94 patients (188 hips) who underwent single-anesthetic bilateral THA. Fifty-seven percent of the patients were male...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28060232/a-dedicated-orthopaedic-trauma-operating-room-improves-efficiency-at-a-pediatric-center
#9
Christopher M Brusalis, Apurva S Shah, Xianqun Luan, Meaghan K Lutts, Wudbhav N Sankar
BACKGROUND: Dedicated orthopaedic trauma operating rooms have improved operating room efficiency, physician schedules, and patient outcomes in adult populations. The purpose of this study was to determine if a dedicated orthopaedic trauma operating room was associated with improved patient flow and cost savings at a level-I pediatric trauma center. METHODS: A retrospective analysis was performed for two 3-year intervals before and after implementation of a weekday, unbooked operating room reserved for orthopaedic trauma cases...
January 4, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28052905/commentary-on-a-comparison-of-two-fat-grafting-methods-on-operating-room-efficiency-and-costs
#10
Bruce A Mast
No abstract text is available yet for this article.
February 2017: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/28044343/computer-aided-detection-of-retained-surgical-needles-from-postoperative-radiographs
#11
Aunnasha Sengupta, Lubomir Hadjiiski, Heang-Ping Chan, Kenny Cha, Nikolaos Chronis, Theodore C Marentis
PURPOSE: Foreign objects, such as surgical sponges, needles, sutures, and other surgical instruments, retained in the patient's body can have dire consequences in terms of patient mortality as well as legal and financial penalties. We propose computer-aided detection (CAD) on postoperative radiographs as a potential solution to reduce the chance of retained foreign objects (RFOs) after surgery, thus alleviating one of the major concerns for patient safety in the operation room. A CAD system can function as a second pair of eyes or a prescreener for the surgeon and radiologist, depending on the CAD system design and the workflow...
January 2017: Medical Physics
https://www.readbyqxmd.com/read/28034587/factors-that-affect-cost-and-clinical-outcome-of-endovascular-aortic-repair-for-abdominal-aortic-aneurysm
#12
Monica S O'Brien-Irr, Linda M Harris, Hasan H Dosluoglu, Gregory S Cherr, Mariel Rivero, Sonya Noor, G Richard Curl, Maciej L Dryjski
OBJECTIVE: This study evaluated the effect of indication for use (IFU), additional graft components, and percutaneous closure of endovascular aortic repair (PEVAR) on clinical outcomes and cost of endovascular aortic repair (EVAR). METHODS: Clinical and financial data were obtained for all elective EVARs completed at a university-affiliated medical center between January 2012 and June 2013. Data were analyzed by χ(2), Student t-test for independent samples, and Kaplan-Meier survival...
December 26, 2016: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28034412/does-adoption-of-electronic-health-records-improve-organizational-performances-of-hospital-surgical-units-results-from-the-french-e-si-preps-sips-study
#13
Morgane Plantier, Nathalie Havet, Thierry Durand, Nicolas Caquot, Camille Amaz, Irène Philip, Pierre Biron, Lionel Perrier
BACKGROUND: Electronic health records (EHR) are increasingly being adopted by healthcare systems worldwide. In France, the "Hôpital numérique 2012-2017" program was implemented as part of a strategic plan to modernize health information technology (HIT), including promotion of widespread EHR use. With significant upfront investment costs as well as ongoing operational expenses, it is important to assess this system in terms of its ability to result in improvements in hospital performances...
February 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28027240/gastrostomy-placement-rates-in-infants-with-pierre-robin-sequence-a-comparison-of-tongue-lip-adhesion-and-mandibular-distraction-osteogenesis
#14
Srinivas M Susarla, Gerhard S Mundinger, Christopher C Chang, Edward W Swanson, Denver Lough, S Alex Rottgers, Richard J Redett, Anand R Kumar
BACKGROUND: This study was conducted to compare the gastrostomy rates in infants with Pierre Robin sequence treated with tongue-lip adhesion or mandibular distraction osteogenesis. METHODS: This was a retrospective study of symptomatic plastic and reconstructive surgery patients treated over an 8-year period. The primary predictor variable was surgical intervention (tongue-lip adhesion or distraction osteogenesis). Secondary predictor variables were categorized as demographic and clinical factors...
January 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28026107/a-hierarchical-task-analysis-of-shoulder-arthroscopy-for-a-virtual-arthroscopic-tear-diagnosis-and-evaluation-platform-vatdep
#15
Doga Demirel, Alexander Yu, Seth Cooper-Baer, Aditya Dendukuri, Tansel Halic, Sinan Kockara, Nizamettin Kockara, Shahryar Ahmadi
BACKGROUND: Shoulder arthroscopy is a minimally invasive surgical procedure for diagnosis and treatment of a shoulder pathology. The procedure is performed with a fiber optic camera, called arthroscope, and instruments inserted through very tiny incisions made around the shoulder. The confined shoulder space, unintuitive camera orientation and constrained instrument motions complicates the procedure. Therefore, surgical competence in arthroscopy entails extensive training especially for psychomotor skills development...
December 27, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
https://www.readbyqxmd.com/read/28025507/effects-of-operating-temperature-on-droplet-casting-of-flexible-polymer-multi-walled-carbon-nanotube-composite-gas-sensors
#16
Jin-Chern Chiou, Chin-Cheng Wu, Yu-Chieh Huang, Shih-Cheng Chang, Tse-Mei Lin
This study examined the performance of a flexible polymer/multi-walled carbon nanotube (MWCNT) composite sensor array as a function of operating temperature. The response magnitudes of a cost-effective flexible gas sensor array equipped with a heater were measured with respect to five different operating temperatures (room temperature, 40 °C, 50 °C, 60 °C, and 70 °C) via impedance spectrum measurement and sensing response experiments. The selected polymers that were droplet cast to coat a MWCNT conductive layer to form two-layer polymer/MWCNT composite sensing films included ethyl cellulose (EC), polyethylene oxide (PEO), and polyvinylpyrrolidone (PVP)...
December 22, 2016: Sensors
https://www.readbyqxmd.com/read/28017974/expectations-for-endoscopic-training-during-gynaecological-specialty-training-results-of-a-germany-wide-survey
#17
L Gabriel, E Solomayer, S Schott, A von Heesen, J Radosa, D Wallwiener, S Rimbach, I Juhasz-Böss
Question: Endoscopy is an integral part of surgical gynaecology and is playing an increasingly important role in ensuring adequate gynaecological training in the context of specialty training in general. At present, little is known about the expectations and notions of young junior doctors with respect to endoscopic training. For this reason, junior doctors throughout Germany were surveyed on this topic and asked to share their opinions. Methods: Using an anonymized standardized survey, the following information was elicited: importance of endoscopic training, willingness to take courses, expectations for instructors and the hospital, ideas about the number of required operations, both as a surgical assistant and as a surgeon, as well as satisfaction with the current status of training...
December 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/28011033/cost-savings-and-patient-experiences-of-a-clinic-based-wide-awake-hand-surgery-program-at-a-military-medical-center-a-critical-analysis-of-the-first-100-procedures
#18
Peter C Rhee, Michelle M Fischer, Laura S Rhee, Ha McMillan, Anthony E Johnson
PURPOSE: Wide-awake, local anesthesia, no tourniquet (WALANT) hand surgery was developed to improve access to hand surgery care while optimizing medical resources. Hand surgery in the clinic setting may result in substantial cost savings for the United States Military Health Care System (MHS) and provide a safe alternative to performing similar procedures in the operating room. METHODS: A prospective cohort study was performed on the first 100 consecutive clinic-based WALANT hand surgery procedures performed at a military medical center from January 2014 to September 2015 by a single hand surgeon...
December 20, 2016: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28007224/efficacy-of-surgical-safety-checklist-assessing-orthopaedic-surgical-implant-readiness
#19
Benjamin G Thomasson, David Fuller, John Mansour, Robert Marburger, Erin Pukenas
INTRODUCTION: Our institution employs a Surgical Universal Protocol Preoperative Checklist in accordance with World Health Organization guidelines to promote patient safety. It is used in part to evaluate orthopaedic surgical equipment and implant readiness prior to the initiation of each surgical case. Our goal is to measure the preoperative checklist's efficacy in assessing orthopaedic equipment readiness preoperatively and its ability to prevent orthopaedic equipment failures (OEF)...
December 2016: Healthcare
https://www.readbyqxmd.com/read/28004102/toluene-methanol-and-benzaldehyde-removal-from-gas-streams-by-adsorption-onto-natural-clay-and-faujasite-y-type-zeolite
#20
Hicham Zaitan, Elham F Mohamed, Héctor Valdés, Mostafa Nawdali, Salah Rafqah, Marie Hélène Manero
A great number of pollution problems come as a result of the emission of Volatile Organic Compounds (VOCs) into the environment and their control becomes a serious challenge for the global chemical industry. Adsorption is a widely used technique for the removal of VOCs due to its high efficiency, low cost, and convenient operation. In this study, the feasibility to use a locally available clay, as adsorbent material to control VOCs emissions is evaluated. Natural clay is characterised by different physical-chemical methods and adsorptive interaction features between VOCs and natural clay are identified...
December 2016: Acta Chimica Slovenica
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