Browsing by Subject "Operating room"

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    Comparison of Anesthesia for Dental/Oral Surgery by Office-based Dentist Anesthesiologists versus Operating Room-based Physician Anesthesiologists
    (Allen Press, 2017) Saxen, Mark A.; Urman, Richard D.; Yepes, Juan F.; Gabriel, Rodney A.; Jones, James E.; Oral Pathology, Medicine and Radiology, School of Dentistry
    Few studies have examined the practice characteristics of dentist anesthesiologists and compared them to other anesthesia providers. Using outcomes from the National Anesthesia Clinical Outcomes Registry and the Society for Ambulatory Anesthesia Clinical Outcomes Registry for dental/oral surgery procedures, we compared 7133 predominantly office-based anesthetics by dentist anesthesiologists to 106,420 predominantly operating room anesthetics performed by physician anesthesia providers. These encounters were contrasted with 34,191 previously published encounters from the practices of oral and maxillofacial surgeons. Children younger than 6 years received the greatest proportion of general anesthetic services rendered by both dentist anesthesiologists and hospital-based anesthesia providers. These general anesthesia services were primarily provided for complete dental rehabilitation for early childhood caries. Overall treatment time for complete dental rehabilitation in the office-based setting by dentist anesthesiologists was significantly shorter than comparable care provided in the hospital operating room and surgery centers. The anesthesia care provided by dentist anesthesiologists was found to be separate and distinct from anesthesia care provided by oral and maxillofacial surgeons, which was primarily administered to adults for very brief surgical procedures. Cases performed by dentist anesthesiologists and hospital-based anesthesia providers were for much younger patients and of significantly longer duration when compared with anesthesia administered by oral and maxillofacial surgeons. Despite the limited descriptive power of the current registries, office-based anesthesia rendered by dentist anesthesiologists is clearly a unique and efficient mode of anesthesia care for dentistry.
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    Operating Room Improvements Based on Environmental Quality Index Risk Prediction can help Reduce Surgical Site Infections
    (European Society of Medicine, 2022) Wagner, Jennifer; Gormley, Thomas; Markel, Troy A.; Greeley, Damon; Surgery, School of Medicine
    Importance: The role of the operating room (OR) airborne environment in the incidence of surgical site infections (SSI) has ranked behind patient and perioperative team-related factors associated with risk for SSI. Emerging evidence demonstrates that the design and performance of the OR environment impacts the airborne microbiome both within the sterile field and at tables where instruments and implants are exposed. However, the correlation between OR air quality and the risk of SSI continues to be challenged. Objective: To determine if improving the asepsis of the airborne environment in ORs contributes to reduced SSI rates. Design: The performance of air delivery systems in fourteen operating rooms was evaluated using the Environmental Quality Indicator (EQI) risk picture method to identify potential improvements to airflow management that reduce airborne contamination and operating costs. SSI rates for colon and abdominal hysterectomy procedures were tracked in these ORs for 39 months before and after improvements were implemented. SSI rates were also tracked for the same time frame for six control ORs in which no improvements were made. Airborne microbial data was collected. Setting: Twenty ORs in an academic medical center, Midwest USA. A convenience sample of all surgical patients, de-identified, was used in the twenty ORs studied. Results: SSI rate was reduced from 8.4% to 5.7% (p=.0039) in ORs in which improvements were implemented. Reduction of SSI rate in control ORs was not significant (p=.76). Fewer airborne microbes were detected in areas of OR with improvements (p<.0001). Conclusion: Areas for environmental quality improvement in ORs was identified and mapped by relative risk of contamination. Implementation of these improvements resulted in decreased microbial contamination and contributed to significant reduction in surgical site infection.