Paediatric anaesthesia
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Paediatric anaesthesia · Jul 2013
Video observation of anesthesia practice: a useful and reliable tool for quality improvement initiatives.
Patients with central venous catheters who are transferred out of the Intensive Care Unit to the care of an anesthesiology team for an operation or interventional radiology procedure had excessive rates of catheter associated blood stream infection (CABSI). ⋯ Although video recording has been used to evaluate adherence to resuscitation protocols in both trauma and in neonatal resuscitation, (Pediatric Emergency Care, 26, 2010, 803; Pediatrics, 117, 2006, 658; Pediatrics, 106, 2000, 654) we believe this is the first time that video has been used to record before and after behaviors for an anesthesia quality improvement initiative.
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Paediatric anaesthesia · Jul 2013
Handoff checklists improve the reliability of patient handoffs in the operating room and postanesthesia care unit.
Ineffective communications among healthcare providers are common and increases the risk of medical errors. During the perioperative period, multiple handoffs occur within a short period of time, and failure to convey important patient information can compromise safety. We used quality improvement methodology to improve the reliability of our handoffs in the operating room and postanesthesia care unit (PACU). ⋯ We utilized quality improvement methodology to develop and implement standardized checklists for handoffs of care in the operating room and PACU. Acceptance of and adherence to the standardized handoff protocols dramatically increased the quality and reliability of our handoff process.
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Paediatric anaesthesia · Jul 2013
Modification of anesthesia practice reduces catheter-associated bloodstream infections: a quality improvement initiative.
A major strategic hospital goal is the prevention of catheter associated bloodstream infections (CABSI). In 2009, at our institution, the CABSI rate for patients who traveled out of the ICU to the operating room and other procedural areas under the care of an anesthesiologist was increased compared to patients who remained on the unit. ⋯ Practice modification by anesthesiology providers in the operating room can decrease workspace contamination and is associated with decreased CABSI rates.
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Paediatric anaesthesia · Jul 2013
Incidence and causes of perioperative endotracheal reintubation in children: a review of 28,208 anesthetics.
To determine the incidence, risk factors, and causes of endotracheal reintubation in children and identify methods to reduce the occurrence. ⋯ The incidence of endotracheal reintubation in children is low, but can result in significant morbidity. Because of the high frequency of inadvertent extubation, a significant number of reintubations could be prevented with greater care during transfer of patients with endotracheal tubes, and in procedures near the airway. Increased vigilance in younger children is also recommended as children under 3 years old required the majority of the reintubations.
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Paediatric anaesthesia · Jul 2013
Biography Historical ArticleTom Allen and the Adelaide Childrens Hospital.