AORN journal
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Preparing for surgical separation of conjoined twins involves coordination, communication, and multidisciplinary planning by several specialties. This article discusses the embryology, etiology, and incidence of conjoined twins and provides a historical perspective of the different types of conjoined twins. A case study describes the perioperative management of conjoined twins at Texas Children's Hospital's, Houston. Team members' roles are discussed, and the perioperative care of conjoined twins detailed.
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Quality health care is associated with the absence of negative outcomes in patients. Institutions realize that quality cannot be assured but it can be assessed and methods can be developed to improve patient care. Many heath care institutions, therefore, have begun the conceptual transition from quality assurance model to principles of continuous quality improvement (CQI). ⋯ The project involved three phases: development of a survey tool, implementation of an environmental assessment and monitoring model, and transfer of the model to OR staff members. Five months after implementation of the model, the chi-square test revealed there was a significant improvement in compliance (chi 2 = 5.0, P < .03). After 22 months of using the model, compliance to infection control standards remains high and OR staff members have taken ownership of the model by incorporating it into their departmental CQI process.