ABSTRACT
Manual counting is considered the gold standard for device day recording by the National Health Safety Network. We describe the development of a process for an electronic count of central line days across our ten-hospital health care system. Our validation process identified discordance between the electronic count and the manual count for 71% of patient care units. Adjudication of the count differences by chart review identified the electronic count to be correct 97% of the time.
Subject(s)
Bacteremia/prevention & control , Catheterization, Central Venous/statistics & numerical data , Central Venous Catheters , Electronic Health Records/statistics & numerical data , Catheter-Related Infections/prevention & control , Electronic Data Processing , Hospital Administration/methods , Humans , Intensive Care Units , Population Surveillance/methods , Risk Factors , Time FactorsSubject(s)
Antibiotic Prophylaxis , Surgical Wound Infection/prevention & control , Blood Glucose/metabolism , Body Temperature , Hair Removal , Humans , Hypoglycemic Agents/therapeutic use , Risk Factors , Surgical Procedures, Operative , Surgical Wound Infection/epidemiology , Terminology as TopicABSTRACT
BACKGROUND: This prospective study was undertaken to determine the safest means of supplemental oxygen delivery for patients undergoing facial cosmetic surgery under conscious sedation. Two common methods of oxygen delivery were used in 20 patients: (1) a nasal cannula and (2) a red rubber nasopharyngeal tube through which the cut ends of the nasal cannula were passed into the posterior pharynx. METHODS: The project was carried out in two parts. In part one, each subject was placed supine and oxygen supplementation at 3 liters/minute was applied through the nasal cannula. The oxygen concentration at 24 different set locations around the patient's face was analyzed using the random access mass spectrometer unit, starting at the right and left alar rim and then at 2-cm intervals laterally, superiorly, and inferiorly. The procedure in part one was repeated with oxygen being delivered by passing the cut cannula end through a red rubber nasopharyngeal tube into the posterior pharynx. RESULTS: Statistical analysis has showed that in all sites at or above the nasal area, the difference between the nasal cannula and red rubber nasopharyngeal tube is significantly greater than 0, indicating that higher concentrations are observed with the nasal cannula than with the red rubber nasopharyngeal tube (p = 0.004). CONCLUSION: The authors' study demonstrates a significant reduction in oxygen concentration, to levels consistent with ambient air, even at points extremely close to the oxygen source, when the nasopharyngeal tube system was used.
Subject(s)
Cosmetic Techniques , Face/surgery , Fires/prevention & control , Intubation/methods , Operating Rooms , Oxygen/administration & dosage , Plastic Surgery Procedures , Safety , Equipment Design , Humans , Intubation/instrumentation , Nose , Pharynx , Prospective StudiesABSTRACT
The evaluation of patients before surgery is a component of anesthesia practice that must be performed to ensure the safe delivery of anesthesia for every patient. How an anesthesia group performs this evaluation differs from institution to institution as the structure of preoperative clinics in hospitals across the country can be quite variable. However, the major question that anesthesiologists must ask when approaching this area of practice is: "Can a system for preoperative evaluation that uses the expertise of anesthesiologists,surgeons, and internists to deliver high quality, cost conscious, and efficient patient preparation for surgery be developed.
