Dataset Information

Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic.

ABSTRACT: OBJECTIVES:The current study aims at assessing the effectiveness of the guidelines set up by our clinic for the protection of patients and staff which enabled us to proceed with urgent and oncological surgery after the outbreak of the Covid-19 pandemic. MATERIAL AND METHODS:Our ENT department devised specific equipment to be worn by the staff for personal protection when dealing with Covid-19 patients both in aerosol generating and non-generating procedures. Moreover, restrictive measures were enforced both for the outpatient department and for the ward where only urgent practices were carried out and visitors were not allowed, while non-urgent elective surgery was postponed. A codified scheme was followed to perform tracheostomy procedure in Covid-19 positive testing patients on the part of 3 specific teams of 2 surgeons each, while the resident educational program was reorganized to limit the spread of the infection. RESULTS:In about a couple of months (from March 8th to May 3rd) a relevant amount of medical tests and surgical procedures were carried out on non COVID-19 patients and a certain number of tracheostomies were performed on COVID-19 patients. Consequently, all the ENT personnel were checked and found negative. Also, all the patients in the ward were swab tested and chest X-rayed, only one had a positive outcome and was adequately handled and treated. CONCLUSION:Our ENT guidelines regarding personal protection equipment and multiple simultaneous diagnostic procedures have proved to be an essential instrument for the management of patients with both known and unknown COVID-19 status.

SUBMITTER: Marchioni D

PROVIDER: S-EPMC7425677 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic.

Marchioni Daniele D Bisi Nicola N Molteni Gabriele G Rubini Alessia A

American journal of otolaryngology 20200813 6

<h4>Objectives</h4>The current study aims at assessing the effectiveness of the guidelines set up by our clinic for the protection of patients and staff which enabled us to proceed with urgent and oncological surgery after the outbreak of the Covid-19 pandemic.<h4>Material and methods</h4>Our ENT department devised specific equipment to be worn by the staff for personal protection when dealing with Covid-19 patients both in aerosol generating and non-generating procedures. Moreover, restrictive ...[more]

PMID: 32836042

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Project description:ObjectivesTo investigate the airway management equipment and clinical practice in emergency department wards in China, and to explore the factors that influenced the nurses' airway management practice.DesignCross-sectional study.SettingA nationwide survey covering the seven administrative regions of China (North China, Northeast China, East China, Central China, South China, Southwest China and Northwest China).ParticipantsThe nurses had to be registered nurses who worked in adult emergency department wards of the selected hospitals.MeasuresAn online survey was designed, piloted and distributed to the members of the Emergency Medicine Committee of the Chinese Nursing Association, and the nurses from the members' hospitals were invited to participate. The questionnaire was used to determine nurses' clinical practice scores of airway management in emergency wards.ResultsFinally, we collected 995 valid questionnaires from 31 provinces and 143 districts in China. Among them, 361 (36.28%) nurses responded that their departments used open suction system (OSS) in clinical work, the major barrier for closed suction system (CSS) reported by 630 respondents (63.32%) was cost. Significant differences in all three scores were found in age, nursing experience years, technical title, airway management training experience and nursing specialist (all p<0.05). Correlations were found among airway management attitude, practice of sputum aspiration and practice of ventilator care bundles (r=0.655, r=0.543 and r=0.763, all p<0.001).ConclusionsChinese emergency department managers need to identify better methods for assessing equipment availability in OSS. CSS can be a choice when costs, status of the individual patient and severity of disease are comprehensively considered. Emergency department nurses' scores of airway management practice were affected by demographic and job-related characteristics; regular training should be encouraged, and equipment and resources should be guaranteed to improve airway management quality and optimise patient outcomes.

Project description:BackgroundSince operating rooms are a major bottleneck resource and an important revenue driver in hospitals, it is important to use these resources efficiently. Studies estimate that between 60 and 70% of hospital admissions are due to surgeries. Furthermore, staffing cannot be changed daily to respond to changing demands. The resulting high complexity in operating room management necessitates perpetual process evaluation and the use of decision support tools. In this study, we evaluate several management policies and their consequences for the operating theater of the University Hospital Augsburg.MethodsBased on a data set with 12,946 surgeries, we evaluate management policies such as parallel induction of anesthesia with varying levels of staff support, the use of a dedicated emergency room, extending operating room hours reserved as buffer capacity, and different elective patient sequencing policies. We develop a detailed simulation model that serves to capture the process flow in the entire operating theater: scheduling surgeries from a dynamically managed waiting list, handling various types of schedule disruptions, rescheduling and prioritizing postponed and deferred surgeries, and reallocating operating room capacity. The system performance is measured by indicators such as patient waiting time, idle time, staff overtime, and the number of deferred surgeries.ResultsWe identify significant trade-offs between expected waiting times for different patient urgency categories when operating rooms are opened longer to serve as end-of-day buffers. The introduction of parallel induction of anesthesia allows for additional patients to be scheduled and operated on during regular hours. However, this comes with a higher number of expected deferrals, which can be partially mitigated by employing additional anesthesia teams. Changes to the sequencing of elective patients according to their expected surgery duration cause expectable outcomes for a multitude of performance indicators.ConclusionsOur simulation-based approach allows operating theater managers to test a multitude of potential changes in operating room management without disrupting the ongoing workflow. The close collaboration between management and researchers in the design of the simulation framework and the data analysis has yielded immediate benefits for the scheduling policies and data collection efforts at our practice partner.

Dataset Information

Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic.

Publications

Covid-19 and ENT practice: Our experience: ENT outpatient department, ward and operating room management during the SARS-CoV-2 pandemic.

Similar Datasets

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