Modeling Phase I Postanesthesia Care Unit Patient Transport Times Among Multiple Destinations.

Background: Although the importance of transporter availability to the operating room and phase I postanesthesia care unit workflow has been known since Marcon et al Anesth & Analg 2003, no detailed data have been published about patient transport times. Nearly all facilities know the times of postanesthesia care unit (PACU) discharges, but transport time through when the transporter returns consumes porter resources.

Methods: Epic's Rover was implemented to track all PACU transports, 22,846 from July 2022 through April 2024.

The Probability Distribution of Times to Awakening From Sevoflurane Anesthesia, Among a Homogeneous Group of Cases With the Same Age-Adjusted Minimum Alveolar Concentration Fraction.

Background: Human studies of awakening from general anesthesia inform understanding of neural mechanisms underlying recovery of consciousness. Probability distributions of times for emergence from anesthesia provide mechanistic information on whether putative biological models are generalizable. Previously reported distributions involved nonhomogenous groups, unsuitable for scientific comparisons.

Most Weekday Discharge Times at Acute Care Hospitals in the State of Florida Occurred After 3 PM in 2022, Unchanged from Before the COVID-19 Pandemic.

When the hospital census is near-capacity, either from insufficient physical beds or nurse staffing, discharge delays can result in postanesthesia care unit (PACU) congestion that backs up the operating rooms. Hospital administrators often promote increasing morning discharges as mitigation. Before the COVID-19 pandemic, most hospitalized Florida patients were discharged after 3 PM, without change from 2010 through 2018.

Incorrectly Charted Operating Rooms, With Resulting Overlapping Times, Corrected Using Meta-Data From Monitors Transmitting Pulse Oximetry Measurements.

Recorded operating rooms (ORs) in electronic health records can differ from the actual anesthetizing locations. A retrospective cohort of cases revealed a 40% (846/2123) room location error rate in the obstetrical (OB) suite compared to 0.03% (18/56,044) in 3 large surgical suites.

Taylor Series Approximation for Accurate Generalized Confidence Intervals of Ratios of Log-Normal Standard Deviations for Meta-Analysis Using Means and Standard Deviations in Time Scale.

With contemporary anesthetic drugs, the efficacy of general anesthesia is assured. Health-economic and clinical objectives are related to reductions in the variability in dosing, variability in recovery, etc. Consequently, meta-analyses for anesthesiology research would benefit from quantification of ratios of standard deviations of log-normally distributed variables (e.

Economic impact of prolonged tracheal extubation times on operating room time overall and for subgroups of surgeons: a historical cohort study.

Background: Prolonged tracheal extubation time is defined as an interval ≥ 15 min from the end of surgery to extubation. An earlier study showed that prolonged extubations had a mean 12.4 min longer time from the end of surgery to operating room (OR) exit.

The Value of Auditing the Frequency of Inhalational Anesthetics With a Combination of Very Low Bispectral Index and High Fraction of the Age-Adjusted Minimum Alveolar Concentration.

Background: Previously, a depth of anesthesia bispectral index (BIS™) <45 was considered lowand found to have no clinical benefit. A BIS <35 was considered very low and was not only without evident clinical benefit but also associated with a greater risk of postoperative delirium. We considered the association between BIS and the anesthetic dose of inhalational agents, quantified using the minimum alveolar concentration (MAC) fraction, which was the patient's end-tidal inhalational agent concentration divided by the agent's altitude- and age-adjusted minimum alveolar percentage concentration.

Literature search for healthcare management decision-making on how to increase productivity by performing more surgical cases in the same staffed time.

This report shows an example of using literature search for healthcare management decision making, specifically, how anesthesiologists can enhance operating room (OR) productivity. A search was conducted using Scopus to gather relevant research on increasing surgical case numbers. References and citations were then examined.

Importance of Ultraviolet-C (UV-C) Emitter Configuration for the Attenuation of Staphylococcus aureus and Candida auris Pathogens.

Background: The relative importance of different ultraviolet-C (UV-C) emitter configurations on the attenuation of vegetative bacterial and fungal pathogens has not been assessed. We hypothesized that emitter configuration would impact the efficacy of UV-C attenuation of and ( pathogens.

Methods: American Type Culture Collection (ATCC) (ATCC 6538) and (ATCC MYA-5001 carriers (ReadyNowTM Test Carriers, Stratix Labs Corporation, Saint Paul, MN) were mounted on an aluminum stand along with three calibrated radiometers (International Light Technologies model ILT1270, Peabody, MA).

Importance of Ultraviolet-C (UV-C) Emitter Configuration for Clostridioides difficile Attenuation.

Background: The impact of ultraviolet-C (UV-C) emitter configuration on pathogen attenuation has not been assessed. We hypothesized that emitter configuration would impact UV-C efficacy for () attenuation.

Methods:  carriers (ReadyNow Test Carriers, Stratix Labs Corporation, Saint Paul, MN) inoculated with > 10 American Type Culture Collection (ATCC) 43593 (according to American Society for Testing and Materials (ASTM) 3135 standards) were obtained, and the following experiments were conducted from April to August of 2023.

Frequently Touched Sites in the Intensive Care Unit Environment Returning 100 Colony-Forming Units per Surface Area Sampled Are Associated With Increased Risk of Major Bacterial Pathogen Detection.

Background: A threshold for surface hygiene has not been defined for the healthcare arena. We aimed to identify the magnitude of bacterial contamination of frequently touched sites in the intensive care unit (ICU) environment that could be used to guide quality improvement initiatives.

Methods: Nineteen patients in a mixed ICU environment (providing care for medical and surgical patients) were followed from admission for 72 hours in 2010.

Since the COVID-19 pandemic, approximately 90% of elective anesthetics have been ambulatory: A retrospective analysis of statewide data in Florida from 2010 through 2022.

Background: When the vast majority (e.g., ≈90%) of a specialty's elective (scheduled) care is ambulatory (i.

Surface Cleaning with a Microfiber Cloth and Water followed by Ultraviolet-C Light Exposure Achieves Non-Inferior Disinfection of a Pathogenic Staphylococcus aureus Strain versus Use of Germicidal Wipes.

Background: We hypothesized that ultraviolet-C (UV-C) irradiation (Surfacide, Waukesha, WI) following use of microfiber cloths (Sanny Shop LLC, Longmont, CO) soaked in water would be noninferior to surface disinfection wipes containing a quaternary ammonium compound and alcohol (PDI Healthcare, Woodcliff Lake, NJ) for the pathogenic () sequence type 5 (ST5).

Methods: This was a randomized laboratory study of disinfection approaches for  ST5. A total of 270 polycarbonate slides loaded with ST5 were prepared for the standard surface disinfection group (N=18) and water-soaked microfiber cloths and UV-C treatment group (N=144), along with positive and negative microbiological controls.

Inhalational Agent Dosing Behaviors of Anesthesia Practitioners Cause Variability in End-Tidal Concentrations at the End of Surgery and Prolonged Times to Tracheal Extubation.

Introduction: Prolonged times to tracheal extubation are intervals from the end of surgery to extubation ≥15 minutes. We examined why there are associations with the end-tidal inhalational agent concentration as a proportion of the age‑adjusted minimum alveolar concentration (MAC fraction) at the end of surgery.

Methods: The retrospective cohort study used 11.

Few Anesthesia-Related Adverse Events in a Retrospective Cohort Study of Patients With Unanticipated Intensive Care Unit Admission After Ambulatory Procedures.

We evaluated whether a hospital-based anesthesia department can validly use automated intensive care unit (ICU) admission data after elective ambulatory procedures to assess the quality of anesthetic care. Among 13,656 patients, 25 (0.2%) had an unplanned hospital length of stay >1 night and ICU admission.

Anesthesia Practitioners' Goals for Sevoflurane Minimum Alveolar Concentration at the End of Surgery and the Incidence of Prolonged Extubations: A Prospective and Observational Study.

Background: Prolonged times to tracheal extubation (≥15 minutes from dressing on the patient) are consequential based on their clinical and economic effect. We evaluated the variability among anesthesia practitioners in their goals for the age-adjusted end-tidal minimum alveolar concentration of sevoflurane (MAC) at surgery end and achievement of their goals.

Methods: We prospectively studied a cohort of 56 adult patients undergoing general anesthesia with sevoflurane as the sole anesthetic agent, scheduled operating room time of at least 3 hours, and non-prone positioning.

Incremental Societal Costs of Perioperative Complications Following Adult Elective Inpatient Major Therapeutic Surgery in the State of Florida: A Seven-Year Retrospective Epidemiological Analysis.

Introduction There is an expanding role for anesthesiologists in the preoperative optimization and postoperative management of patients, often in the context of a so-called perioperative surgical home. Such efforts typically include enhanced recovery after surgery (ERAS) protocols and often an anesthesiologist-led team for perioperative management. Studies of the cost-effectiveness of such approaches have generally been conducted at single institutions, with most patients cared for by small numbers of surgeons.