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Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques.

ABSTRACT: Purpose:Wide variability persists in the preparation and storage of common anesthetic medications despite the recognition of anesthesia workspace standardization as a national quality improvement priority. Syringe contamination and medication swaps continue to pose significant hazards to patient safety. Methods:We assessed differences in practice related to the availability of commonly prepared anesthetic medications. Using baseline provider surveys (n?=?87) and anesthesia workspace audits (n?=?80), we designed a custom syringe organization device using 3D printing techniques to serve as a cognitive aid and organizational tool. We iteratively tested and then deployed this device in all 60 operating rooms at a single institution, and then, repeated postintervention surveys (n?=?79) and workspace audits (n?=?75) one year after introduction. Results:Implementation was associated with significant improvements in provider-reported medication availability during coverage and handoff situations (43.7% versus 76.2% reporting 95% confidence preintervention versus postintervention, p < 0.001). This was substantiated by audits of the anesthesia workspace which demonstrated reduced variability in the location (p < 0.001) and availability (p < 0.001) of key medications. Provider confidence in the cleanliness of syringes was also improved (p=0.01). A high degree of acceptance and compliance with the intervention was reported, with 80.4% of syringes observed to be stored in the device one year after implementation and approximately 95% of respondents reporting positive measures of usability and convenience. Conclusion:Use of a simple organizational device for syringes in the anesthesia workspace has numerous safety benefits. 3D printing offers improvements in adaptability and affordability compared with prior approaches.

SUBMITTER: Long DR

PROVIDER: S-EPMC6636519 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques.

Long Dustin R DR Doney Allison A Bartels Devan L DL Tan Crystal E CE Sayal Puneet K PK Anderson Thomas A TA Agarwala Aalok V AV

Anesthesiology research and practice 20190701

<h4>Purpose</h4>Wide variability persists in the preparation and storage of common anesthetic medications despite the recognition of anesthesia workspace standardization as a national quality improvement priority. Syringe contamination and medication swaps continue to pose significant hazards to patient safety.<h4>Methods</h4>We assessed differences in practice related to the availability of commonly prepared anesthetic medications. Using baseline provider surveys (<i>n</i> = 87) and anesthesia ...[more]

PMID: 31354811

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Project description:BackgroundIt is known that a number of parameters can influence the post-printing properties of bone tissue scaffolds. Previous research has primarily focused on the effect of parameters associated with scaffold design (e.g., scaffold porosity) and specific scaffold printing processes (e.g., printing pressure). To our knowledge, no studies have investigated variations in post-printing properties attributed to the techniques used to synthesize the materials for printing (e.g., melt-blending, powder blending, liquid solvent, and solid solvent).MethodsFour material preparation techniques were investigated to determine their influence on scaffold properties. Polycaprolactone/nano-hydroxyapatite 30% (wt.) materials were synthesized through melt-blending, powder blending, liquid solvent, and solid solvent techniques. The material printability and the properties of printed scaffolds, in terms of swelling/degradation, mechanical strength, morphology, and thermal properties, were examined and compared to one another using Kruskal-Wallis nonparametric statistical analysis.ResultsMaterial prepared through the liquid solvent technique was found to have limited printability, while melt-blended material demonstrated the highest degree of uniformity and lowest extent of swelling and degradation. Scaffolds prepared with powder-blended material demonstrated the highest Young's modulus, yield strength, and modulus of resilience; however, they also demonstrated the highest degree of variability. The higher degree of inhomogeneity in the material was further supported by thermal gravimetric analysis. While scaffolds printed from melt-blended, powder-blended, and solid solvent materials demonstrated a high degree of micro-porosity, the liquid solvent material preparation technique resulted in minimal micro-porosity.ConclusionsStudy results indicate that specific techniques used to prepare materials influence the printing process and post-printing scaffold properties. Among the four techniques examined, melt-blended materials were found to be the most favorable, specifically when considering the combination of printability, consistent mechanical properties, and efficient preparation. Techniques determined to be favourable based on the properties investigated should undergo further studies related to biological properties and time-dependent properties beyond 21-days.

Project description:BackgroundBracket failure increases the treatment time of orthodontic therapy and burdens patients with unnecessary costs, increased chair time, and possible new appointments.ObjectiveTo compare the bond failures of different orthodontic materials based on the results of available clinical studies.Search methodsA systematic search of clinical trials was performed in the Cochrane, Embase, and Pubmed databases with no limitations. The list of investigated techniques contained conventional acid-etch primer (CM-AEP), self-etch primer (SEP), self-cure resin (SCR), and simple or resin-modified glass ionomer (RM-GIC) materials and procedures.Selection criteriaClinical studies reporting the failure rate of bonded brackets after using direct adhesive techniques on buccal sites of healthy teeth were included.Data collection and analysisBracket failure rates from eligible studies were extracted by two authors independently. Risk ratios (RRs) were pooled using the random-effects model with DerSimonian-Laird estimation.ResultsThirty-four publications, involving 1221 patients, were included. Our meta-analysis revealed no significant difference in the risk of bracket failures between SEP and CM-AEP. After 6, 12, and 18 months of bonding, the values of RR were 1.04 [95% confidence interval (CI), 0.67-1.61], 1.37 (95% CI, 0.98-1.92), and 0.93 (95% CI, 0.72-1.20), respectively. At 18 months, bracket failure was 4.9 and 5.2% for SEP and CM-AEP, respectively. Heterogeneity was good or moderate (I2 < 42.2%). The results of RM-GIC at 12 months indicated a 57% lower risk of bracket failure using SCR as compared with RM-GIC (RR: 0.38; 95% CI, 0.24-0.61). At 18 months, bracket failures for SCR and RM-GIC were 15.8 and 36.6%, respectively (RR: 0.44; 95% CI, 0.37-0.52, I2 = 78.9%), demonstrating three to six times higher failure rate than in the case of etching primer applications.LimitationsA major limitation of the present work is that the included clinical trials, with no exceptions, showed variable levels of risk of bias. Another possible problem affecting the outcome is the difference between the clustering effects of the split mouth and the parallel group bracket allocation methods.Conclusions and implicationsThe results revealed no significant difference between SEP and CM-AEP up to 18 months after application. RM-GIC had much worse failure rates than acid-etching methods; additionally, the superiority of SCR over RM-GIC was evident, indicating strong clinical relevance.RegistrationProspero with CRD42020163362.

Dataset Information

Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques.

Publications

Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques.

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