ABSTRACT
BACKGROUND: Operating room (OR) efficiency is related to minutes spared from surgical time and has been linked to the make up of surgical teams and operating room workplace. The research on the efficiency of surgical nursing staff members is scant. The current study evaluates the effect of ENT trained OR resource nurses on the efficiency of operating time during ENT procedures. METHODS: Five hundred seventy-three ENT surgery cases from 4 surgeons were retrospectively reviewed. Two hundred forty-two cases had ENT OR nursing staff and 331 cases had non-ENT OR nursing staff. Requested operative times (ROT) and true operative times (TOT) were analyzed. The difference between the TOT and ROT was used to measure operating time efficiency. RESULTS: Cases with ROT < 30 min (M = -1.19, SD = 5.01) required 3.34 min less than planned for when an ENT nurse was present compared to those with non-ENT nursing staff which required on average 2.15 min (M = 2.15, SD = 5.68) longer than ROT. Furthermore, cases with ROT > 30 min (M = -4.32, SD = 10.85) required 10.85 min less than planned for when an ENT nurse was present. Conversely with non-ENT nursing staff cases with a ROT > 30 min required on average 6.53 min (M = 6.53, SD = 11.85) longer than ROT. CONCLUSION: ENT resource nurses were shown to improve OR efficiency in cases less than 30 min and greater than 30 min. Cases that were greater than 30 min showed the largest increase in efficiency. Specialized ENT nursing staff improved efficiency during common ENT surgeries.
Subject(s)
Efficiency, Organizational , Operating Room Nursing , Operating Rooms/organization & administration , Analysis of Variance , Humans , Operative Time , Otolaryngology , Patient Care Team , Retrospective StudiesABSTRACT
BACKGROUND: The natural history of patients diagnosed with Eisenmenger's Syndrome typically revolve around the pediatric population. Medical advances have allowed these patients to live longer and present with a different subset of symptoms as a result of the progression of their disease process. CASE PRESENTATION: In this case report, we discuss a 77-year-old Caucasian female with Eisenmenger's Syndrome presenting with hoarseness. Clinical and imaging studies reveal a left vocal cord paralysis secondary to a progressively enlarging patent ductus arteriosus (PDA) and dilation of pulmonary arteries causing mass effect on the left recurrent laryngeal nerve. CONCLUSION: From a clinical perspective, this case highlights the need for otolaryngologists to be aware of the pathophysiology of Eisenmenger's Syndrome as it progresses with age.
Subject(s)
Eisenmenger Complex/physiopathology , Hoarseness/physiopathology , Aged , Eisenmenger Complex/diagnostic imaging , Female , Hoarseness/diagnostic imaging , HumansABSTRACT
Distally impacted chronic tracheobronchial sharp foreign bodies in children are a management challenge that presents with clinical subtlety and extreme variability. The use of image guided techniques, imaginative instrumentation, tracheotomy, thoracotomy, and even extracorporeal membrane oxygneation have been reported. Endoscopy is made difficult by the distal location, inflammatory reaction with granulation tissue formation, and bleeding obscuring the foreign body. Our aim is to describe our experience with two children who had removal of aspirated impacted sharp metallic foreign bodies from the distal airway using rigid bronchoscopy, preceded by maximal medical therapy.
