scholarly journals Surfactant Stock Optimization for Cost Minimization in Neonatal Intensive Care Units

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Müfide Narli ◽  
Ali Kokangül
Keyword(s):  
Mathematical Model ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Cost Minimization ◽  
Control Policy ◽  
Real Data ◽  
Weight Changes ◽  
Purchase Order ◽  
Vital Functions ◽  
Inventory Control Policy

Surfactant deficiency in newborns is a result of a respiratory insufficiency condition, which is a major cause of illness and death. In terms of maintaining vital functions that require emergency intervention, it is crucial that surfactant is available for treatment upon request. The unknown times between patient arrivals and the patients’ stochastic weight changes in the hospital cause difficulties in determining the surfactant doses needed. The surfactant dose treatment for patients must be calculated according to the patient’s weight. In this study, a mathematical model that minimizes the purchase, order, holding, and waste costs of the surfactant has been developed while finding the optimum vial by considering random variables such as the time between a patient’s arrival and weight changes. With cost and demand affecting each other, the model uses a continuous inventory control policy, including calculating how much each preparation and vial should be used for, the reorder point, and the optimum order quantity. Also, the validity of the optimum values obtained with the mathematical model of a 66-bed neonatal intensive care unit in a hospital was tested with real data.

scholarly journals Optimized Procedure to Schedule Physicians in an Intensive Care Unit: A Case Study

Mathematics ◽  
2020 ◽  
Vol 8 (11) ◽  
pp. 1976
Author(s):  
Lotfi Hidri ◽  
Achraf Gazdar ◽  
Mohammed M. Mabkhot
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Minimization ◽  
Optimal Schedule ◽  
Real Life ◽  
Real Data ◽  
Experimental Tests ◽  
Operating Costs ◽  
Healthcare Personnel ◽  
Total Cost

Hospitals are facing an important financial pressure due to the increasing of the operating costs. Indeed, the growth for the hospitals’ services demand causes a rising in the number of required qualified personnel. Enlarging the personnel number increases dramatically the fixed total cost. Based on some studies, 50% of operating costs in US hospitals are allocated to healthcare personnel. Therefore, reducing these types of costs without damaging the service quality becomes a priority and an obligation. In this context, several studies focused on minimizing the total cost by producing optimal or near optimal schedules for nurses and physicians. In this paper, a real-life physicians scheduling problem with cost minimization is addressed. This problem is encountered in an Intensive Care Unit (ICU) where the current schedule is manually produced. The manual schedule is generating a highly unbalanced load within physicians in addition to a high cost overtime. The manual schedule preparation is a time consuming procedure. The main objective of this work is to propose a procedure that systematically produces an optimal schedule. This optimal schedule minimizes the total overtime within a short time and should satisfies the faced constraints. The studied problem is mathematically formulated as an integer linear program. The constraints are real, hard, and some of them are non-classical ones (compared to the existing literature). The obtained mathematical model is solved using a state-of-the-art software. Experimental tests on real data have shown the performance of the proposed procedure. Indeed, the new optimal schedules reduce the total overtime by up to 69%. In addition, a more balanced workload for physicians is obtained and several physician preferences are now satisfied.

Noise control engineering on neonatal incubators

2021 ◽  
Vol 263 (3) ◽  
pp. 3217-3217
Author(s):  
Christian Adams ◽  
Regine Stutz ◽  
Elisabeth Kaiser ◽  
Michelle Bous ◽  
Sybelle Goedicke-Firtz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Oxygen Supply ◽  
Acoustic Measurements ◽  
Future Design ◽  
Sound Exposure ◽  
Vital Functions ◽  
System Components

Neonatal incubators provide suitable environmental conditions for premature newborns and allow for medical treatment such as medication and monitoring of vital functions such as blood pressure. The incubator includes several system components such as a control system, an oxygen supply, a scale or flaps and drawers for patient care and storage of medical material, respectively. These system components generate noise such as monitoring alarms, noise of the oxygen supply, or noise due to opening and closing of flaps during medical treatments. The noise leads to a significantly increased sound exposure inside the incubator. Increased sound exposure is known to cause distress and to increase the risk of acute or chronic diseases in the preterm neonate. This paper presents acoustic measurements on an incubator in a neonatal intensive care unit. Several vibration and acoustic measurements are performed inside the incubator as well as in the surrounding environment in order to characterize typical acoustic scenes from everyday life on the neonatal intensive care unit. Based on the measurement results, the scenes are categorized in terms of sound exposure. This forms the basis for a future design for acoustics of the incubator.

Outbreak of Nosocomial Sepsis and Pneumonia in a Newborn Intensive Care Unit by Multiresistant Extended-Spectrum β-Lactamase-ProducingKlebsiella pneumoniaeHigh Impact on Mortality

2001 ◽  
Vol 22 (11) ◽  
pp. 725-728 ◽  
Author(s):  
Gerardo Martínez-Aguilar ◽  
Celia M. Alpuche-Aranda ◽  
Carmen Anaya ◽  
Dolores Alcantar-Curiel ◽  
Catalina Gayosso ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Control Policy ◽  
Case Control ◽  
Nosocomial Sepsis ◽  
Newborn Intensive Care Unit ◽  
Newborn Intensive Care ◽  
Control Study

AbstractWe describe a case-control study of a small outbreak of nosocomial sepsis and pneumonia with high mortality due to clonal dissemination of a multiresistantKlebsiella pneumoniaein the neonatal intensive care unit of a Mexican institution. Our study helped to change nosocomial infection control policy in this hospital.

Outbreak of Nosocomial Sepsis and Pneumonia in a Newborn Intensive Care Unit by Multiresistant Extended-Spectrum β-Lactamase-Producing Klebsiella pneumoniae High Impact on Mortality

2001 ◽  
Vol 22 (11) ◽  
pp. 725-728 ◽  
Author(s):  
Gerardo Martínez-Aguilar ◽  
Celia M. Alpuche-Aranda ◽  
Carmen Anaya ◽  
Dolores Alcantar-Curiel ◽  
Catalina Gayosso ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Neonatal Intensive Care ◽  
Case Control Study ◽  
Control Policy ◽  
Nosocomial Sepsis ◽  
Newborn Intensive Care Unit ◽  
Newborn Intensive Care ◽  
Control Study

AbstractWe describe a case-control study of a small outbreak of nosocomial sepsis and pneumonia with high mortality due to clonal dissemination of a multiresistantKlebsiella pneumoniaein the neonatal intensive care unit of a Mexican institution. Our study helped to change nosocomial infection control policy in this hospital.

scholarly journals Multidrug-resistant Acinetobacter septicemia in neonates: A study from a teaching hospital of Northern India

2019 ◽  
Vol 11 (01) ◽  
pp. 023-028 ◽  
Author(s):  
Asifa Nazir
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Control Policy ◽  
Antibiotic Use ◽  
Multidrug Resistant ◽  
Acinetobacter Species ◽  
Mortality And Morbidity ◽  
Acinetobacter Sp ◽  
Acinetobacter Infection

Abstract BACKGROUND: Acinetobacter species are typical nosocomial pathogens causing infections and high mortality, almost exclusively in compromised hospitalized patients. Acinetobacter sp. are intrinsically less susceptible to antibiotics and have propensity to acquire resistance. Multidrug-resistant (MDR) Acinetobacter sp. blood infection in the neonatal intensive care unit patients create a great problem in hospital settings. AIMS: A prospective data analysis was performed over a one year period of all neonates admitted with sepsis who developed Acinetobacter infection and their antibiotic susceptibility pattern was carried out. MATERIALS AND METHODS: Blood samples of infected neonates were collected aseptically and cases of Acinetobacter septicemia were identified. Speciation of Acinetobacter species was done. Various risk factors were identified and their drug-sensitivity test was performed. RESULTS: The incidence of neonatal septicemia due to Acinetobacter species was 13.7% (49/357). Predominant species isolated was Acinetobacter baumannii (98%). The major symptoms were lethargy and poor feeding. The major signs were tachypnea, intercostal retraction, and respiratory distress. The major fetal risk factors were low birth weight and prematurity. High degree of resistance was observed to the various antibiotics used. Majority of the isolates (95.9%) were MDR while 93.68% were resistant to carbapenems as well as extensively drug resistant. However, all the strains were sensitive to colistin. CONCLUSION: MDR Acinetobacter septicemia in neonatal patients is becoming alarmingly frequent and is associated with significant mortality and morbidity. Therefore, rational antibiotic use is mandatory along with an effective infection control policy in neonatal intensive care areas of each hospital to control Acinetobacter infection and improve outcome.

The Psychosocial Aspects of Feeding in the Neonatal Intensive Care Unit and Beyond

2019 ◽  
Vol 4 (6) ◽  
pp. 1507-1515
Author(s):  
Lauren L. Madhoun ◽  
Robert Dempster
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Hospital Discharge ◽  
Neonatal Intensive Care ◽  
Oral Feeding ◽  
Medical Attention ◽  
Primary Role ◽  
Speech Language Pathologists ◽  
The Family

Purpose Feeding challenges are common for infants in the neonatal intensive care unit (NICU). While sufficient oral feeding is typically a goal during NICU admission, this can be a long and complicated process for both the infant and the family. Many of the stressors related to feeding persist long after hospital discharge, which results in the parents taking the primary role of navigating the infant's course to ensure continued feeding success. This is in addition to dealing with the psychological impact of having a child requiring increased medical attention and the need to continue to fulfill the demands at home. In this clinical focus article, we examine 3 main areas that impact psychosocial stress among parents with infants in the NICU and following discharge: parenting, feeding, and supports. Implications for speech-language pathologists working with these infants and their families are discussed. A case example is also included to describe the treatment course of an infant and her parents in the NICU and after graduation to demonstrate these points further. Conclusion Speech-language pathologists working with infants in the NICU and following hospital discharge must realize the family context and psychosocial considerations that impact feeding progression. Understanding these factors may improve parental engagement to more effectively tailor treatment approaches to meet the needs of the child and family.

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