ABSTRACT
INTRODUCTION: The coronavirus disease 2019 (COVID-19) pandemic led to increased demand nationwide for dialysis equipment, including supplies and machines. To meet the demand in our institution, our surge plan included rapid mobilization of a novel continuous renal replacement treatment (CRRT) machine named SAMI. The SAMI is a push-pull filtration enhanced dialysis machine that can conjugate extremely high single-pass solute removal efficiency with very precise fluid balance control. MATERIAL AND METHODS: Machine assembly was conducted on-site by local biomedical engineers with remote assistance by the vendor. One 3-h virtual training session of 3 dialysis nurses was conducted before SAMI deployment. The SAMI was deployed in prolonged intermittent replacement therapy (PIRRT) mode to maximize patients covered per machine per day. Live on-demand vendor support was provided to troubleshoot any issues for the first few cases. After 4 weeks of the SAMI implementation, data on treatments with the SAMI were collected, and a questionnaire was provided to the nurse trainees to assess device usability. RESULTS: On-site installation of the SAMI was accomplished with remote assistance. Delivery of remote training was successfully achieved. 23 PIRRT treatments were conducted in 10 patients. 7/10 of patients had CO-VID-19. The median PIRRT dose was 50 mL/kg/h (IQR [interquartile range] 44 - 62 mL/kg/h), and duration of the treatment was 8 h (IQR 6.3 - 8 h). Solute control was adequate. The user response was favorable to the set of usability questions involving user interface, on-screen instructions, machine setup, troubleshooting, and the ease of moving the machine. CONCLUSION: Assembly of the SAMI and training of nurses remotely are possible when access to vendor employees is restricted during states of emergency. The successful deployment of the SAMI in our institution during the pandemic with only 3-h virtual training supports that operating the SAMI is simple and safe.
Subject(s)
Acute Kidney Injury/therapy , COVID-19/complications , Continuous Renal Replacement Therapy/instrumentation , Hemodialysis Units, Hospital/organization & administration , Intermittent Renal Replacement Therapy/instrumentation , Pandemics , SARS-CoV-2 , Acute Kidney Injury/blood , Acute Kidney Injury/etiology , Anticoagulants/administration & dosage , Attitude of Health Personnel , Continuous Renal Replacement Therapy/methods , Continuous Renal Replacement Therapy/nursing , Data Collection , Dialysis Solutions/administration & dosage , Disposable Equipment , Education, Nursing, Continuing , Equipment Design , Equipment Failure , Heparin/administration & dosage , Humans , Intermittent Renal Replacement Therapy/methods , Intermittent Renal Replacement Therapy/nursing , Maintenance and Engineering, Hospital/organization & administration , Medical Waste Disposal , Prescriptions , Robotics , Surveys and Questionnaires , Virtual RealityABSTRACT
Estratégias para implantação, definições, limitações de tratos culturais e noções de cultivo de plantas medicinais, metabolismo de síntese de princípios ativos das plantas medicinais, cuidados no armazenamento e na aquisição do plantas medicinais. Plantas medicinais como fonte de renda, programa de Vitória.
Subject(s)
Complementary Therapies/methods , Complementary Therapies/education , Mind-Body Therapies/education , Maintenance and Engineering, Hospital/organization & administration , Plants, Medicinal , Pesticide Utilization , Maintenance and Engineering, Hospital/standardsABSTRACT
OBJECTIVE: To describe an integral system of notification and management of incidents, created by the Primary Care Team of Guineueta, as well as the main results after 18 months of implementation. MATERIAL AND METHOD: Using a simple online form, health professionals notified any type of, already categorised, incident. Each of them were distributed to an improvement team that assessed and performed the necessary actions. In addition, the Quality Committee immediately assessed the ones that affected patient safety, as well as the most relevant or repetitive ones every 6 months. RESULTS: During the first 18 months of operation of the system, the health professionals reported 1,267 incidents, most notably informatics, maintenance/technical assistance, and errors in scheduling, in internal circuits and protocols. Eight of them were considered to significantly affect patient safety. CONCLUSIONS: The implementation of the described system has been consolidated into our team, facilitating the detection of problems, the accomplishment of improvement actions and involving the professionals in the improvement of the quality.
Subject(s)
Patient Safety , Primary Health Care/organization & administration , Quality Improvement/organization & administration , Risk Management/organization & administration , Safety Management/organization & administration , Appointments and Schedules , Equipment and Supplies, Hospital/standards , Humans , Maintenance and Engineering, Hospital/organization & administration , Medical Errors/prevention & control , Medical Errors/statistics & numerical data , Medication Errors/prevention & control , Medication Errors/statistics & numerical data , Online Systems , Risk Management/methods , SpainSubject(s)
Biomedical Engineering/standards , Equipment Failure Analysis/standards , Equipment and Supplies/standards , Guideline Adherence/organization & administration , Joint Commission on Accreditation of Healthcare Organizations/organization & administration , Maintenance and Engineering, Hospital/organization & administration , United StatesSubject(s)
Biomedical Engineering/organization & administration , Confidentiality , Guideline Adherence/organization & administration , Joint Commission on Accreditation of Healthcare Organizations/organization & administration , Maintenance and Engineering, Hospital/organization & administration , Quality Assurance, Health Care/organization & administration , United StatesSubject(s)
Biomedical Engineering/standards , Equipment Failure Analysis/standards , Equipment and Supplies/standards , Guideline Adherence/organization & administration , Joint Commission on Accreditation of Healthcare Organizations/organization & administration , Maintenance and Engineering, Hospital/organization & administration , United StatesSubject(s)
Biomedical Engineering/organization & administration , Biomedical Technology/organization & administration , Contract Services/organization & administration , Models, Organizational , Outsourced Services/organization & administration , Financial Management, Hospital/organization & administration , Interinstitutional Relations , Maintenance and Engineering, Hospital/organization & administration , United StatesABSTRACT
Paul Briars, North West regional director for independent engineering, IT, and facilities services business, NG Bailey (pictured), discusses the company's part in a major redevelopment at one of the UK's top orthopaedic hospitals, Wrightington Hospital in Lancashire --famous as the site, in the early 1960s, of first ever hip replacement operations, by pioneering surgeon, Professor Sir John Charnley (HEJ --April 2013).
