ABSTRACT
El objetivo es conocer la duración de nuestras intervenciones, tiempos intermedios y rendimiento quirúrgico. Con ello elaborar una lista de espera virtual para aplicar un programa matemático que realice la programación con rendimiento idóneo máximo. Material y métodos. Revisión retrospectiva de 49 sesiones quirúrgicas obteniendo el retraso en la hora de comienzo, el tiempo intermedio y el rendimiento quirúrgico. Revisión retrospectiva de 4.045 intervenciones realizadas en los 3 últimos años para obtener la duración media de cada tipo de cirugía. Elaboración de una lista de espera virtual de 700 pacientes para realizar programaciones virtuales mediante el MIQCP-P hasta obtener el rendimiento óptimo. Resultados. Nuestro rendimiento quirúrgico con programación manual es del 75,9%, finalizando el 22,4% más tarde de las 15h. El rendimiento en las jornadas sin suspensiones es del 78,4%. El retraso en la hora de comienzo es de 9,7min. El rendimiento óptimo es del 77,5%, con una confianza de terminar antes de las 15h del 80,6%. La lista de espera se ha programado en 254 sesiones. Discusión. Nuestro rendimiento quirúrgico manual sin suspensiones (78,4%) es superior al idóneo (77,5%) generando jornadas finalizadas más tarde de las 15h y suspensiones. Las posibilidades de mejora son lograr la puntualidad en la hora de comienzo y ajustar la programación al rendimiento idóneo. La programación virtual nos ha permitido obtener nuestro rendimiento idóneo y conocer el número de quirófanos necesarios para resolver la lista de espera creada. Conclusiones. Los datos obtenidos en la programación matemática virtual son lo suficientemente fiables como para implantar este modelo con garantías (AU)
The objective is to establish the duration of our interventions, intermediate times and surgical performance. This will create a virtual waiting list to apply a mathematical programme that performs programming with maximum performance. Material and methods. Retrospective review of 49 surgical sessions obtaining the delay in start time, intermediate time and surgical performance. Retrospective review of 4,045 interventions performed in the last 3 years to obtain the average duration of each type of surgery. Creation of a virtual waiting list of 700 patients in order to perform virtual programming through the MIQCP-P until achieving optimal performance. Results. Our surgical performance with manual programming was 75.9%, ending 22.4% later than 3pm. The performance in the days without suspensions was 78.4%. The delay at start time was 9.7min. The optimum performance was 77.5% with a confidence of finishing before 15h of 80.6%. The waiting list has been scheduled in 254 sessions. Discussion. Our manual surgical performance without suspensions (78.4%) was superior to the optimal (77.5%), generating days finished later than 3pm and suspensions. The possibilities for improvement are to achieve punctuality at the start time and adjust the schedule to the ideal performance. The virtual programming has allowed us to obtain our ideal performance and to establish the number of operating rooms necessary to solve the waiting list created. Conclusions. The data obtained in virtual mathematical programming are reliable enough to implement this model with guarantees (AU)
Subject(s)
Humans , Health Programs and Plans/trends , Surgical Procedures, Operative/methods , Quality of Health Care/trends , Quality Improvement , Retrospective Studies , Waiting Lists , Operating Rooms/organization & administration , Treatment OutcomeABSTRACT
The objective is to establish the duration of our interventions, intermediate times and surgical performance. This will create a virtual waiting list to apply a mathematical programme that performs programming with maximum performance. MATERIAL AND METHODS: Retrospective review of 49 surgical sessions obtaining the delay in start time, intermediate time and surgical performance. Retrospective review of 4,045 interventions performed in the last 3 years to obtain the average duration of each type of surgery. Creation of a virtual waiting list of 700 patients in order to perform virtual programming through the MIQCP-P until achieving optimal performance. RESULTS: Our surgical performance with manual programming was 75.9%, ending 22.4% later than 3pm. The performance in the days without suspensions was 78.4%. The delay at start time was 9.7min. The optimum performance was 77.5% with a confidence of finishing before 15h of 80.6%. The waiting list has been scheduled in 254 sessions. DISCUSSION: Our manual surgical performance without suspensions (78.4%) was superior to the optimal (77.5%), generating days finished later than 3pm and suspensions. The possibilities for improvement are to achieve punctuality at the start time and adjust the schedule to the ideal performance. The virtual programming has allowed us to obtain our ideal performance and to establish the number of operating rooms necessary to solve the waiting list created. CONCLUSIONS: The data obtained in virtual mathematical programming are reliable enough to implement this model with guarantees.
Subject(s)
Efficiency, Organizational/standards , Operating Rooms/organization & administration , Operative Time , Orthopedic Procedures/standards , Quality Improvement/organization & administration , Humans , Quality Assurance, Health Care , Retrospective Studies , Waiting ListsABSTRACT
El objetivo de este trabajo es estudiar una nuevatecnología de fisioterapia que se incorporó a lostratamientos de pacientes deportistas en Argentina.En 1988 fue desarrollado el Láser de Alta Potencia,que sobre la base de una desfocalización de un Láserquirúrgico de Nd-YAG se logró llevar la emisiónláser dentro de la ventana terapéutica, pero con unaemisión de 6,55 hasta 35 watts de potencia, ademásde emitir en diferentes longitudes de onda: 1064 nmy en su variante FP3 de: 808, 940 y 980 nm.Entre sus efectos se destacan el aumento de:temperatura del tejido, micro circulación capilar,metabolismo celular mitocondrial, síntesisde proteínas y colágeno y liberación de endorfinas(AU)
The objective of tis paper is to study a new tecnologiecadvance in physical therapy, appeared in Argentinain 1988, The High Powwer Laser is based upondefocalization of an surgical Laser (Nd-Y-AG),obtaining a laser emision from 6,55 to 35 watss,of power, with differents waves (1,064 nm, andwith model FP. from 808 to 980 nm.Effects demonstrated are increasing tissue temperature,increasing microcirculation, mitochondrial methabolism,proteins synthesis and endorfines liberation(AU)
Subject(s)
Humans , Laser Therapy/methods , Physical Therapy Modalities , Athletic Injuries/therapy , Lasers, Solid-State , EndorphinsABSTRACT
Unpleasant vocalizations are prevalent among cognitively impaired elders and often are considered disruptive and problematic by their families and caregivers. However, another way to perceive such challenging vocalizations is as a communication attempt by these patients to make their needs and feelings known. This article identifies possible meanings underlying these vocal behaviors and suggests strategies to help reduce their occurrence.
Subject(s)
Cognition Disorders/complications , Communication Disorders/etiology , Communication Disorders/nursing , Geriatric Nursing/methods , Verbal Behavior , Aged , Communication Disorders/psychology , Humans , Nurse-Patient Relations , Patient Care PlanningABSTRACT
Retinal detachment occurring in late stages of retinopathy of prematurity may appear spontaneous when a short oxygen therapy in low birthweight infant has been failed to recognized. As it is initially a tractional detachment the understanding of underlying pathogenic mechanisms is still important to choose adequate treatment which will determine the success of the surgery. Six patients with R.D. were recognised as having late complication of R.P. on the aspect of pathological posterior retinal vasculature and typical history of prematurity and oxygen therapy. All cases were treated successfully by different procedures varying with the severity of the disease. Use of vitrectomy can be advised in some cases but, is still a dangerous procedure, especially in this peculiar condition.
Subject(s)
Retinal Detachment/etiology , Retinopathy of Prematurity/complications , Adolescent , Adult , Child, Preschool , Female , Humans , Male , Myopia/etiology , Retinal Detachment/surgery , Time FactorsABSTRACT
We have studied 93 cases of trabeculectomy, most of them performed on primary chronic open angle glaucomas, with a follow up of 2 to 11 years. Reviewing of the results point out that intraocular pressure stabilization over a long time period is correlated to the existence of an effective subconjunctival filtering bleb. Recurrence of hypertension increases with time, but most of the cases are stabilized by medical treatment, or by laser trabeculoplasty, when it is possible. Cataract producing concerns 46% of the cases, happening within one to three years in most of them. It is greatly influenced by patients age. On the other hand, effective subconjunctival filtering bleb and transient post operative athalamy are not major factors.
