Association of Pre-Operative Full-Body Surgical Preparation with Reduced Incidence of Surgical Site Infection at a Large, Urban Safety-Net Medical Center

2021 ◽  
Author(s):  
Rachel E. Sargent ◽  
Jace Jacobsen ◽  
Kari Cole ◽  
Robert Olson ◽  
Dolores M. Gibbs ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Medical Center ◽  
Safety Net ◽  
Site Infection ◽  
Urban Safety ◽  
Surgical Preparation ◽  
Full Body

scholarly journals Independent risk factors for surgical site infection after cesarean delivery in a rural tertiary care medical center

2016 ◽  
Vol 31 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Manuel C. Vallejo ◽  
Ahmed F. Attaallah ◽  
Robert E. Shapiro ◽  
Osama M. Elzamzamy ◽  
Michael G. Mueller ◽  
...  
Keyword(s):  
Risk Factors ◽  
Surgical Site Infection ◽  
Cesarean Delivery ◽  
Medical Center ◽  
Tertiary Care ◽  
Site Infection ◽  
Tertiary Care Medical Center ◽  
Independent Risk Factors

Validation of semiautomated surgical site infection surveillance using electronic screening algorithms in 38 surgery categories

2018 ◽  
Vol 39 (8) ◽  
pp. 931-935 ◽  
Author(s):  
Sun Young Cho ◽  
Doo Ryeon Chung ◽  
Jong Rim Choi ◽  
Doo Mi Kim ◽  
Si-Ho Kim ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Surveillance System ◽  
Chart Review ◽  
Medical Center ◽  
Tertiary Care ◽  
Microbial Culture ◽  
Site Infection ◽  
Electronic Screening ◽  
Sensitivity Specificity ◽  
Infection Preventionists

ObjectiveTo verify the validity of a semiautomated surgical site infection (SSI) surveillance system using electronic screening algorithms in 38 categories of surgery.DesignA cohort study for validation of semiautomated SSI surveillance system using screening algorithms.SettingA 1,989-bed tertiary-care referral center in Seoul, Republic of Korea.MethodsA dataset of 40,516 surgical procedures in 38 categories stored in the conventional SSI surveillance registry at the Samsung Medical Center between January 2013 and December 2014 was used as the reference standard. In the semiautomated surveillance system, electronic screening algorithms flagged cases meeting at least 1 of 3 criteria: antibiotic prescription, microbial culture, and infectious disease consultation. Flagged cases were audited by infection preventionists. Analyses of sensitivity, specificity, and positive predictive value (PPV) were conducted for the semiautomated surveillance system, and its effect on reducing the workload for chart review was evaluated.ResultsA total of 575 SSI events (1·42%) were identified by conventional SSI surveillance. The sensitivity of the semiautomated SSI surveillance was 96·7%, and the PPV of the screening algorithms alone was 4·1%. Semiautomated SSI surveillance reduced the chart review workload of the infection preventionists from 1,283 to 482 person hours per year (a 62·4% decrease).ConclusionsCompared to conventional surveillance, semiautomated surveillance using electronic screening algorithms followed by chart review of selected cases can provide high-validity surveillance results and can significantly reduce the workload of infection preventionists.

scholarly journals 3532 Vitamin D assay utilization and outcomes in pregnant women in an urban safety net medical center: a retrospective cohort study

2019 ◽  
Vol 3 (s1) ◽  
pp. 30-30
Author(s):  
Grace Hyojung Yoon ◽  
Michael Holick ◽  
Arash Hossein
Keyword(s):  
Vitamin D ◽  
Pregnant Women ◽  
Low Income ◽  
Medical Center ◽  
Safety Net ◽  
Vitamin D Supplementation ◽  
Vitamin D Levels ◽  
Urban Safety ◽  
Study Population ◽  
Boston Medical

OBJECTIVES/SPECIFIC AIMS: The goals of this retrospective cohort study is threefold: 1) to assess how many pregnant women at Boston Medical Center from 2012 to 2017 have had their vitamin D status checked prior to and during pregnancy, 2) determine associations between vitamin D levels, birth outcomes and demographics and 3) assess how many of those found to have lower than satisfactory vitamin D levels (<30ng/mL) received interventions, including receiving vitamin D supplementation and/or being referred to an appropriate specialist such as an endocrinologist or a nutritionist. METHODS/STUDY POPULATION: Our study population is mothers over age 18 who received care at Boston Medical Center during their pregnancy from 2012 to 2017. Our primary outcomes are vitamin D utilization rates and associations between vitamin D levels with clinical outcomes during pregnancy and at birth. Secondary outcomes are demographic predictors of mothers who receive vitamin D testing and those who have complications associated with low vitamin D. We will conduct multiple linear regressions to check for associations between vitamin D levels, birth outcomes and demographic variables. We will adjust vitamin D levels with maternal BMI. De-identified clinical data was gathered from Boston University Medical Center’s (BUMC) Clinical Data Warehouse. This retrospective study was approved with a HIPAA waiver by the BUMC Institutional Data Warehouse. All statistical analysis was completed using SAS version 9.4 and was primarily done by the student PI and reviewed by Dr. Hossein, the co-investigator who is trained as a statistician and geneticist. The team also utilized Boston University’s Biostatistics, Epidemiology & Research Design (BERD) team to check the feasibility of the statistical methods. RESULTS/ANTICIPATED RESULTS: We anticipate that our descriptive demographic data will reflect the medical center’s predominantly black/Hispanic and low-income profile. Based on previous literature, we expect low vitamin D levels to have positive associations with gestational diabetes, pre-eclampsia, and preterm birth. Analyses are currently actively in progress and we expect to have results before the ACTS conference date in March, 2019. DISCUSSION/SIGNIFICANCE OF IMPACT: Vitamin D is an essential part of the human body system. It is well documented in current literature that vitamin D is correlated with bone health, mental health and maternal health. Moreover, there is evidence that maternal vitamin D supplementation prevents vitamin D deficiency in newborns. Previous literature suggests that low vitamin D may be associated with gestational diabetes, pre-eclampsia, and pre-term births. Boston Medical Center is Massachusetts’ largest urban medical center and acts as its only safety-net hospital, serving predominantly low-income and socially marginalized patient populations. There is limited existing research on assessment of maternal vitamin D in urban hospital settings. Pregnant women rarely receive vitamin D screenings as part of their prenatal checkups as current national and regional guidelines do not require pregnant women to be screened for vitamin D deficiency or insufficiency. The results will demonstrate the potential effects vitamin D supplementation, or lack thereof, in expectant mothers living in urban, safety net communities. We hope to inform prenatal care practices and attitudes of vitamin D supplementation in maternal health with the results of our study.

Implementation of Surgical Unit-Based Safety Program at a Safety-Net Hospital: Impact on Surgical Site Infection Rates

2016 ◽  
Vol 223 (4) ◽  
pp. e20
Author(s):  
Bryan C. Morse ◽  
Clarence E. Clark ◽  
Roland P. Matthews ◽  
Nicholas S. Fogelson ◽  
Mary A. Cole ◽  
...  
Keyword(s):  
Surgical Site Infection ◽  
Safety Net ◽  
Site Infection ◽  
Infection Rates ◽  
Safety Program ◽  
Safety Net Hospital ◽  
Surgical Unit

Factors Affecting Compliance With Myringotomy Tube Follow-up Care

2022 ◽  
pp. 000348942110722
Author(s):  
Helen H. Soh ◽  
Katherine R. Keefe ◽  
Madhav Sambhu ◽  
Tithi D. Baul ◽  
Dillon B. Karst ◽  
...  
Keyword(s):  
Medical Center ◽  
Private Insurance ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Safety Net ◽  
Tube Placement ◽  
Factors Affecting ◽  
Urban Safety

Objective: Myringotomy and tube insertion is a commonly practiced procedure within pediatric otolaryngology. Though relatively safe, follow-up appointments are critical in preventing further complications and monitoring for improvement. This study sought to evaluate the factors associated with compliance of post-myringotomy follow-up visits in an urban safety-net tertiary care setting. Methods: This study is a retrospective chart review conducted in outpatient otolaryngology clinic at an urban, safety-net, tertiary-care, academic medical center. All patients from ages 0 to 18 who received myringotomy and tube placement between February 3, 2012, to May 30, 2018 at the aforementioned clinic were included. Results: A total of 806 patients had myringotomy tubes placed during this period; 190 patients were excluded due to no visits being scheduled within 1 and 6 month visit windows post-operatively, leaving 616 patients included for analysis. Of 616 patients, 574 patients were seen for the 1-month visit, (42 patients did not have follow-up visits within the 1-month window), and 356 patients were examined for the 6-month visit (260 patients did not schedule follow-up visits within the 6-month window). For the 1-month follow-up visits post-procedure, only race/ethnicity type “Other” was associated with lower no-show rates (OR = 0.330, 95% CI: 0.093-0.968). With the 6-month follow-up visits, having private insurance (OR = 0.446, 95% CI: 0.229-0.867) and not having a 1-month visit scheduled (OR = 0.404, 95% CI: 0.174-0.937) predicted lower no-show rates. Conclusion: No meaningful factors studied were significantly associated with compliance of short-term, 1-month visits post-myringotomy. Compliance of longer-term, 6-month post-operative visits was associated with insurance type and previous visit status.

Lean methods to improve operating room elective first case on-time starts in a large, urban, safety net medical center

2018 ◽  
Vol 216 (2) ◽  
pp. 194-201 ◽  
Author(s):  
Charles Coffey ◽  
Edward S. Cho ◽  
Eric Wei ◽  
Allison Luu ◽  
Maria Ho ◽  
...  
Keyword(s):  
Operating Room ◽  
Medical Center ◽  
Safety Net ◽  
First Case ◽  
Urban Safety ◽  
Improve Operating Room ◽  
Lean Methods ◽  
Improve Operating
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