Standard Operating Procedures
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Aim: The aim of the research was to determine the fulfilment of the standard operating procedure - "Care of patients with increased risk levelˮ incorporating the JCI AOP 1.7 standard "Patients and their loved ones are investigated and reinvestigated due to their individualized needsˮ by healthcare professionals of the selected healthcare facility. Design: A cross-sectional study. Methods: A quantitative survey was selected for data collection. The data were obtained through structured interviews with selected healthcare professionals from the designated facilities conducted by hospital management and recorded in writing in a pre-prepared record sheet. The research sample consisted of 78 respondents, of whom 36 were physicians and 42 were nurses, from 14 facilities. The research was conducted from 15. 1. - 31. 12. 2018. Results: From the interviews, we found that respondents regarded terminal patients and their loved ones holistically, but failed to record the information obtained. We also found that there was no difference in the evaluation of the patient and his / her loved ones according to the profession of the respondents, the length of their medical practice, or their workplace. In terms of the respondentsʼ workplace, there was no difference in perceptions of the quality of palliative care provided in the selected hospital. Conclusion: Respondents perceive patients holistically and they are assessed as a bio-psycho-socio-spiritual unit, and their loved ones are included in the assessment. However, the information obtained is not fully documented in written form.
- MeSH
- dodržování směrnic MeSH
- kvalita zdravotní péče statistika a číselné údaje MeSH
- lidé MeSH
- paliativní péče * metody normy psychologie statistika a číselné údaje MeSH
- péče o umírající metody normy psychologie statistika a číselné údaje MeSH
- rozhovory jako téma MeSH
- zdravotnický personál psychologie MeSH
- Check Tag
- lidé MeSH
- Geografické názvy
- Česká republika MeSH
Hospital face increased resource constraints and competition. This escalates the need for efficiency optimization especially in resource-intense areas, such as the Operating Room (OR). Efficiency cannot happen at expenses of patient outcomes. Innovative digital support systems (DSS) have been introduced into the market to support established standardization methods of intraoperative workflows further. This review aimed to analyze whether applied standardization methods and implemented DSS of intraoperative surgical workflows lead to increasing efficiency and demonstrate economic improvements. A systematic review of intraoperative surgical workflows standardization and digitalization was performed. Journal articles and reviews from 2000 to 2023 were retrieved from EBSCO, PubMed, and Scopus databases, as well as the internal database of Johnson & Johnson. 17 articles showed a significant increase in efficiency through standardization, which led to cost reductions between $70.20 to $3,516 per case without negatively impacting quality. Five additional articles on DSS demonstrated a significant positive impact on efficiency and quality. Reduction in OR-time between 6 to 22% per case was one main contributor. No literature on DSS revealed any correlated economic impact. Selected standardization methods and introduced DSS for intraoperative surgical workflows effectively increase efficiency while maintaining or even improving quality. Demonstrated cost-effectiveness of non-digital standardization methods across surgical areas requires more research on complex and resource-intensive procedures and the economic value of DSS to support hospital management's strategic decisions to overcome the increasing economic burden.
- MeSH
- analýza nákladové efektivity MeSH
- lidé MeSH
- nemocnice MeSH
- operační sály * MeSH
- výkonnost MeSH
- zákroky plastické chirurgie * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
- systematický přehled MeSH
This commentary discusses particularities of application of the EuroFlow standardization of flow cytometric analyses on three different flow cytometers. The EuroFlow consortium developed a fully standardized approach for flow cytometric immunophenotyping of hematological malignancies and primary immunodeficiencies. Standardized instrument setup is an essential part of EuroFlow standardization. Initially, the EuroFlow Consortium developed and optimized a step-by-step standard operating procedure (SOP) to setup 8-color BD FACSCanto II flow cytometer (Canto), with the later inclusion of Navios (Beckman Coulter) and BD FACSLyric (Lyric). Those SOPs were developed to enable standardized and fully comparable fluorescence measurements in the three flow cytometers. In Canto and Navios, mean fluorescence intensity (MFI) of a reference peak of Rainbow beads calibration particles is used to set up photomultiplier (PMT) voltages for each detector channel in individual instruments to reach the same MFI across distinct instruments. In turn, a new feature of Lyric instruments allows to share collection of attributes that are used to place the positive population at the same position among instruments in the form of assays, as one of its components integrated in the Cytometer Setup and Tracking (CS&T) module. The EuroFlow Lyric assays thus allow for standardized acquisition of 8-color EuroFlow panels on Lyric without the need to setup the PMT voltages on the individual instruments manually. In summary, the standardized instrument setup developed by EuroFlow enables cross-platform inter- and intra-laboratory standardization of flow cytometric measurements. This commentary provides a perspective on the modifications of the standardized EuroFlow instrument setup of Canto, Navios and Lyric instruments that are described in detail in individual instrument-specfic SOPs available at the EuroFlow website.
- MeSH
- imunofenotypizace přístrojové vybavení normy MeSH
- lidé MeSH
- průtoková cytometrie přístrojové vybavení normy MeSH
- referenční standardy MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
1st ed. xi, 177 s.
- Klíčová slova
- parametrické hodnocení, standardizace,
- MeSH
- chirurgická onkologie MeSH
- chirurgické operační výkony normy MeSH
- lidé MeSH
- nádory chirurgie mortalita patologie MeSH
- Check Tag
- lidé MeSH
5th ed. XIII, 200 s. : il. ; 28 cm
Cíl: Cílem práce bylo zjistit, jak je bezpečnostní proces prováděn na kardiochirurgických operačních sálech ve vybraném zdravotnickém zařízení. Metodika: Metodou sběru dat bylo pozorování kardiochirurgického operačního personálu při provádění bezpečnostního procesu ve všech třech jeho fázích a zápisů šetření do auditního listu vlastní konstrukce, který vychází z ošetřovatelského standardu Fakultní nemocnice Ostrava – Univerzální protokol prevence záměny pacienta, místa operace či prováděného výkonu. Počet kardiochirurgických operací, které byly náhodně vybrány v období od 1. 2. 2014 do 30. 10. 2014, kdy auditní šetření probíhalo, bylo 145. Výsledky: V první fázi bezpečnostního procesu při předávání pacienta mezi sestrami byla identifikace pacienta, předání jeho kompletní dokumentace a zápis do formuláře bezpečnostního procesu provedena u většiny akutních i plánovaných operací. Identifikace pacienta v druhé fázi těsně před přípravou k operaci nebyla provedena perioperační sestrou pouze v jednom případě. Ve dvou případech nebyl proveden dotaz o celkové připravenosti pacienta k operačnímu týmu před chirurgickým řezem, obě tyto operace byly urgentní. Třetí fáze bezpečnostního procesu po skončení operace byla ve všech bodech splněna u všech 145 operací. Závěr: Bezpečnostní proces na kardiochirurgických operačních sálech FNO je prováděn personálem ve všech jeho fázích včas a dle ošetřovatelského standardu FNO. Výjimkou úplného nebo částečného neprovedení bezpečnostního procesu jsou výkony prováděné v časové tísni, tedy operace akutní, kdy je veškerá činnost zdravotníků směřována na záchranu lidského života.
Aim: The aim of this work was to find out how the safety processes are performed on cardiac operating theatres in the choosen health care facility. Methods: The data collection method was the observation of cardiac operations personnel during the implementation of the safety processes in all three phases, and records of the investigation into the audit worksheet own design, which is based on the standard of nursing University Hospital Ostrava (FNO) – Universal protocol to prevent confusion of the patient, the surgical site and conducted performance. The number of cardiac surgeries, which were randomly selected during the period from 01/02/2014 until 30/10/2014, when the survey was conducted was 145. Results: During the first phase of safety process, in the time of a transmission between the patient's nurses was patient's identification, transfer of his complete documentation, and registration in the form of safety process performed by the both, acute, and also planned operations. In two cases, the question of the overall readiness of the patient for the planned operation before surgical incision was not performed, both of these operations were urgent. The third phase of the safety process – after an operation, has been completed at all points for all 145 operations. Conclusion: The safety process at cardiosurgical operating theaters of FNO is being carried out by personnel in its all phases on time, and according to nursing standards of FNO. Exceptions for incompletition, or partial failure of the fullfillment of the safety process are surgical procedures performed under a time pressure, i.e. acute operations, where all activities of health professionals is geared to save human life.
- MeSH
- bezpečnost pacientů * MeSH
- kardiochirurgické výkony MeSH
- lidé MeSH
- operační sály * MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- abstrakt z konference MeSH
Cíl studie: Zhodnocení extubace na operačním sále (EOS) pro rutinní postup vedení anestézie u kardiochirurgických operací. Metodika: Do prospektivní studie bylo zařazeno h2 nemocných bez omezujících kritérií výběru. Průměrný věk nemocných byl h2 let (4(x78). Nemocní se podrobili revaskularizačním operacím srdce, v 73,8 % bez použití mimotělníleo obe~eu (MO), náhradám aortální chlopně a reoperacím. Průměrná doba operace byla 178 minut (90-300). Nemocní byli premedikováni pethidinem s atropinem, anestézie byla vedena remifentanilem a propofolem spolu s volatilními anestetiky, k myorelaxaci bylo použito atracurium. Sledovali jsme časné pooperační komplikace (plicní, neurologické, renální), výskyt pooperační ischémie myokardu a četnost pooperační fibrilace síní a doba hospitalizace. Výsledky: Ze sledovaného souboru bylo 59 nemocných (95,2 %) extubováno do S minut po ukončení operace. U 3 nemocných (4,8 %) byla během operace provedena konverze na zde standardně užívanou anestézii. Důvodem konverzí byly intraoperační obtíže. Žádný nemocný nebyl reintubován. Žádný nemocný nezemřel. Výskyt časných pooperačních komplikací byl srovnatelný s klasickými metodami kardioanestezie. Průměrná doba hospitalizace byla 6,7 dne (3-12). Závěr: Anestézie s EOS je rutinně použitelný způsob vedení kardioanestezie. EOS je zatížena minimem komplikací, předpokládá však dokonalou spolupráci zkušeného chirurga a anesteziologa.
Objective: To evaluate extubation in the operating room as a routine practice in cardiac anaesthesia. Method: The prospective study enrolled h2 patients without any limitation. The average age was h2 years (4(x78). The surgery procedures includes revascularization procedures (in 73.8% cases without cardiopulmonary bypass), replacements of aortic valve and „redo" operations. The average duration of the operation was 178 minutes (90-300). Pethidine and atropine were used in the premedication. The anaesthesia was maintained with remifentanil, propofol and inhalation anaesthetics. Atracurium was used as a neuromuscular blocking agent. Early postoperative complications (pulmonary, neurologie and renal), postoperative myocardial ischemia, the freyuency of atrial fibrillation and the hospitalization duration of were observed. Results: 59 patients (95.2%) were extubated within S minutes after the end of the operation. In 3 patients (4.8%) we changed the course to the standard anaesthesia practice of our department. The causes of the conversion were intraoperative problems. No patient needs reintubation. There was not observed any death. The rate of early postoperative complications was comparable with the standard cardiac anaesthesia practice. The average duration of hospitalization was h.7 days (3-12).
