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Id_original

207964

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http://hospitecnia.com/?p=207964

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Literature Review of Staff Thermal Comfort and Patient ?Thermal Risks? in Operating Rooms

info@anyma.io — Fri, 23 Jan 2009 00:00:00 +0000

Literature Review of Staff Thermal Comfort and Patient ?Thermal Risks? in Operating Rooms Vie, 23/01/2009 - 00:00

Páginas: 4 págs.Autores:

M.A. Melhado, J.L.M. Hensen and M. Loomans
Technical University of Eindhoven, Netherlands

Abstract:

This paper discusses the thermal comfort of Staff and the ?thermal risks? for the patient in operating rooms. Staff has often reported thermal discomfort during surgery. Factors which affect the thermal comfort include physiological and psychological perception, climate, the level and type of physical activity, and the types of clothes worn. Evaluating the ?thermal risks? of the patient is very important in order to know how to prevent him/her from suffering hypothermia. The results will show that there is a strong need for future research and also which areas need to be focused on.Melhado, M.A.; Hensen, J.L.M.; Loomans, M.

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Id_original

207962

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http://hospitecnia.com/?p=207962

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Review of ventilation systems in operating rooms in view of infection control

info@anyma.io — Fri, 23 Jan 2009 00:00:00 +0000

Review of ventilation systems in operating rooms in view of infection control Vie, 23/01/2009 - 00:00

Páginas: 10 págs.Autores:

M.A. Melhado, J.L.M. Hensen
1Center for Building and Systems, Technische Universiteit Eindhoven, The Netherlands

M. Loomans
Nederlandse Organisatie voor toegepast-natuurwetenschappelijk onderzoek (TNO), Netherlands

Abstract

The Postoperative Infection Rate (PIR) generally depends on factors such as the type of surgery, the cleanliness of equipment, medical procedures, and the level of microorganisms in the immediate and surrounding environments. Another major factor to consider is the quality of the air in the operating room (OR). The aim of this paper is review different ventilation systems in order to evaluate the of infection control (IC). This review consists of a literature review and observations in OR.

The objective is to assist design engineers in developing more efficient ventilation systems, and to help stakeholders in choosing the ?best? system for the particular type of surgery they need to perform. The practical result will be that security aspects of IC will be strengthened, which should lead to lower PIR.Melhado, M.A.; Hensen, J.L.M.; Loomans, M.

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Id_original

207896

URL original

http://hospitecnia.com/?p=207896

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instalaciones

Thermal comfort, uniformity, and ventilation effectiveness in patient rooms: performance assessment using ventilation indices

info@anyma.io — Fri, 23 Jan 2009 00:00:00 +0000

Thermal comfort, uniformity, and ventilation effectiveness in patient rooms: performance assessment using ventilation indices Vie, 23/01/2009 - 00:00

Páginas: 14 págs.Abstract:

This paper describes a study of the performance of a ventilation system in a typical patient room using CFD modeling and calculations of various ventilation indices. The results show that the use of basboard heating is necessary in extreme weather conditions. In particular, good occupant conditions are virtually impossible to achieve without baseboard heating. Further, in general weather conditions, a ventilation rate of 4 ACH provides adequate conditions, though an increase to 5 or 6 ACH is optimum.Memarzadeh, Farhad; Manning, Andy

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Id_original

207895

URL original

http://hospitecnia.com/?p=207895

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HVAC

Isolation room ventilation design case studies

info@anyma.io — Fri, 23 Jan 2009 00:00:00 +0000

Isolation room ventilation design case studies Vie, 23/01/2009 - 00:00

IAQ, 2004:1-16Autores:

Duncan A. Phillips, Ph.D., P.Eng.
Associate Member ASHRAE

Ray J. Sinclair, Ph.D.
Glenn D. Schuyler, P.Eng.
Member ASHRAE

Abstract:

This paper discusses the design of ventilation systems for negatively and positively pressurized patient isolation rooms. The paper focuses on how to quantify and achieve target levels of protection for either the patient (positively pressurized rooms) or health care workers and other hospital occupants (negatively pressurized rooms). Attention is paid to the influence of ceiling supply diffuser selection. Thermal comfort issues are also discussed, and an alternative to ?age-of-air? techniques using age-of-contaminant calculations is recommended for use in patient isolation room design. Practical considerations are illustrated through the presentation of two case studies.

The first case study of a TB isolation room includes a CFD model analysis of different air distribution systems including an assessment of ventilation effectiveness and patient thermal comfort. This work includes simulation of a cough from a patient toward a health care worker and throughout the isolation
suite. The second case study of a positive pressure isolation room assesses the throw of supply air around a patient bed in terms of providing protection for the patient while maintaining comfortable conditions.Phillips, Duncan A.; Sinclair, Ray J.; Schuyler, Glenn D.

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Id_original

207892

URL original

http://hospitecnia.com/?p=207892

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HVAC

Modifiable risk factors associated with deep sternal site infection after coronary artery bypass grafting

info@anyma.io — Fri, 23 Jan 2009 00:00:00 +0000

Modifiable risk factors associated with deep sternal site infection after coronary artery bypass grafting Vie, 23/01/2009 - 00:00

The Journal of Thoracic and Cardiovascular Surgery, 2000;119(1):108-14Autores:

William E. Trick, MD
Jerome I. Tokars, MD
Kevin C. Jones, DO
William R. Jarvis, MD
Hospital Infections Program, Centers for Disease Control and Prevention
Atlanta, Ga

William E. Scheckler, MD
Mel L. Reppen, RN
Ellen M. Smith, RN
Saint Marys Hospital Medical Center
Madison, Wis

Abstract:

Objective: Our objective was to identify risk factors for deep sternal site
infection after coronary artery bypass grafting at a community hospital.

Methods: We compared the prevalence of deep sternal site infection among patients having coronary artery bypass grafting during the study (January 1995?March 1998) and pre-study (January 1992?December 1994) periods. We compared any patient having a deep sternal site infection after coronary artery bypass graft surgery during the study period (case-patients) with randomly selected patients who had coronary artery bypass graft surgery but no deep sternal site infection during the same period (control-patients).

Results: Deep sternal site infections were significantly more common during the study than during the pre-study period (30/1796 [1.7%] vs 9/1232 [0.7%]; P = .04). Among 30 casepatients, 29 (97%) returned to the operating room for sternal debridement or rewiring, and 2 (7%) died. In multivariable analyses, cefuroxime receipt 2 hours or more before incision (odds ratio = 5.0), diabetes mellitus with a preoperative blood glucose level of 200 mg/dL or more (odds ratio = 10.2), and staple use for skin closure (odds ratio = 4.0) were independent risk factors for deep sternal site infection. Staple use was a risk factor only for patients with a normal body mass index.

Conclusions: Appropriate timing of antimicrobial prophylaxis, control of preoperative blood glucose levels, and avoidance of staple use in patients with a normal body mass index should prevent deep sternal site infection after
coronary artery bypass graft operations.Trick, William E. ... [et al.]

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Id_original

207698

URL original

http://hospitecnia.com/?p=207698

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Enhanced Identification of Postoperative Infections among Inpatients

info@anyma.io — Mon, 17 Nov 2008 00:00:00 +0000

Enhanced Identification of Postoperative Infections among Inpatients Lun, 17/11/2008 - 00:00

Emerging Infectious Diseases, november 2004;10(11):1924-30Autores:

Deborah S. Yokoe, Gary A. Noskin, Susan M. Cunningham, Gianna Zuccotti, Theresa Plaskett, Victoria J. Fraser, Margaret A. Olsen, Jerome I. Tokars, Steven Solomon, Trish M. Perl, Sara E. Cosgrove, Richard S. Tilson, Maurice Greenbaum, David C. Hooper, Kenneth E. Sands, John Tully, Loreen A. Herwaldt, Daniel J. Diekema, Edward S. Wong, Michael Climo, and Richard Platt

Abstract:

We evaluated antimicrobial exposure, discharge diagnoses, or both to identify surgical site infections (SSI). This retrospective cohort study in 13 hospitals involved weighted, random samples of records from 8,739 coronary artery bypass graft (CABG) procedures, 7,399 cesarean deliveries, and 6,175 breast procedures. We compared routine surveillance to detection through inpatient antimicrobial exposure (>9 days for CABG, >2 days for cesareans, and
>6 days for breast procedures), discharge diagnoses, or both. Together, all methods identified SSI after 7.4% of CABG, 5.0% of cesareans, and 2.0% of breast procedures. Antimicrobial exposure had the highest sensitivity, 88%?91%, compared with routine surveillance, 38%?64%. Diagnosis codes improved sensitivity of detection of antimicrobial exposure after cesareans. Record review confirmed SSI after 31% to 38% of procedures that met antimicrobial
surveillance criteria. Sufficient antimicrobial exposure days, together with diagnosis codes for cesareans, identified more postoperative SSI than routine surveillance methods. This screening method was efficient, readily standardized, and suitable for most hospitals.Yokoe, Deborah S. ... [et al.]

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Id_original

217753

URL original

http://hospitecnia.com/?p=217753

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The Attributable Mortality and Costs of Primary Nosocomial Bloodstream Infections in the Intensive Care Unit

info@anyma.io — Mon, 17 Nov 2008 00:00:00 +0000

The Attributable Mortality and Costs of Primary Nosocomial Bloodstream Infections in the Intensive Care Unit Lun, 17/11/2008 - 00:00

AM J RESPIR CRIT CARE MED, 1999;160:976?981Autores:

Bruno DiGiovine, Carol Chenoweth, Charles Watts, and Millicent Higgins
Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit; Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine and Division of Infectious Diseases, University of Michigan
Medical School, Ann Arbor; and University of Michigan School of Public Health, Ann Arbor, Michigan

Abstract.

Primary nosocomial bloodstream infection (BSI) is a common occurrence in the intensive care unit (ICU) and is associated with a crude mortality of 31.5 to 82.4%. However, an accurate estimate of the attributable mortality has been limited because of confounding by severity of illness. We undertook this study to assess the attributable mortality and costs associated with an episode of BSI. Infected patients were defined as those who had an episode of BSI during the study period. Uninfected control subjects were matched to the infected patients based upon a number of factors, including predicted mortality on the day prior to infection. The main outcome measures were crude ICU mortality,
length of stay, and costs. We found no difference in the crude mortality for the infected and the uninfected patients (35.3 and 30.9%, respectively, p=0.51). However, among survivors, the patients with nosocomial bloodstream infections did have excess length of stay (mean, 10 d; median, 5 d; p=0.007) and increased direct costs (mean difference, $34,508; p=0.008). After matching for severity of illness, we could not detect an association between primary nosocomial bloodstream infections and increased ICU mortality. We did find that primary nosocomial bloodstream infections increased ICU length of stay and costs.Di Giovine, Bruno ... [et al.]

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Artículos

Bibliografias

Id_original

217443

URL original

http://hospitecnia.com/?p=217443

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UCI

Thermal Comfort, Uniformity, and Ventilation Effectiveness in Patient Rooms: Performance Assessment Using Ventilation Indices

info@anyma.io — Tue, 01 Jan 2008 00:00:00 +0000

Thermal Comfort, Uniformity, and Ventilation Effectiveness in Patient Rooms: Performance Assessment Using Ventilation Indices Mar, 01/01/2008 - 00:00

MN-00-11-3, ASHRAE Transactions SymposiaAbstract:

This paper describes a study of the performance of a ventilation system in a typical patient room using CFD modeling and calculations of various ventilation indices. The results show that the use of basboard heating is necessary in extreme weather conditions. In particular, good occupant conditions are virtually impossible to achieve without baseboard heating. Further, in general weather conditions, a ventilation rate of 4 ACH provides adequate conditions, though an increase to 5 or 6 ACH is optimum.Memarzadeh, F.; Andy Manning, P.E.

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Inglés

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ASHRAE Transactions Symposia

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