Patient safety in the operating room and documentary quality related to infection and hospitalization

Objective: To describe the documentary quality of two records related to patient safety in the operating room and to identify differences between information related to infection and hospitalization. Methods: Comparative study based on two cross sections, conducted with 3,033 patients who had been hospitalized for more than 24 hours in an Orthopedics and Traumatology Center. Sociodemographic and clinical data, as well as information provided in forms were compared. Postoperative infection was identified as an adverse event. Results: There was a significant correlation between hospitalization days and the total number of diagnoses collected (Pearson=0.328; p<0.001). When diagnoses and infections were grouped together, a significant value was found between closed fractures and infection (p=0.001). Conclusion: Differences in the degree of completion were observed between the two records. There were no differences between adverse events.

Percepción de los profesionales de enfermería y auxiliares de enfermería sobre cultura de seguridad del paciente en el área quirúrgica

Objetivos: Evaluar las percepciones, opiniones y conductas que tienen enfermeros y auxiliares de enfermería sobre seguridad del paciente en el servicio quirúrgico de un hospital público del Sistema Nacional de Salud español. Describir fortalezas y debilidades/oportunidades de mejora según criterios de la Agency for Healthcare Research and Quality y conocer el número de incidentes de seguridad notificados. Método: Estudio observacional, transversal, llevado a cabo utilizando la versión española del cuestionario Hospital Survey on Patient Safety Culture. La muestra estuvo constituida por profesionales de enfermería que aceptaron participar en el estudio voluntariamente y cumplían los criterios de selección. Se realizó un análisis descriptivo e inferencial en función de la naturaleza de las variables y las condiciones de aplicación de los test estadísticos. Significación p < 0,05. Resultados: Respondieron 74 profesionales de enfermería (63,2%). No se encontró ninguna fortaleza en el servicio quirúrgico, y las áreas principales que necesitan mejora corresponden a «Dotación de personal» (64,0%) y «Apoyo de la gerencia del hospital en materia de seguridad del paciente» (52,9%). El 52,3% (n = 65) califica el grado de seguridad del paciente entre 7 y 8,99 (en una escala de 10); el 79,7% (n = 72) no notificó ningún incidente durante el último año. La varianza total explicada por el modelo de regresión fue 0,56 para «Frecuencia de eventos notificados» y 0,26 para «Percepción de seguridad». Conclusiones: Percepción más positiva sobre cultura de seguridad del paciente a nivel de unidad/servicio. Las debilidades identificadas pueden servir para diseñar actividades concretas de intervención para mejorar la cultura de seguridad del paciente en otros servicios quirúrgicos del entorno.

Seguridad quirúrgica y cumplimentación del registro de información intraquirúrgica en España: Un análisis comparativo de dos instrumentos de registro

El objetivo del presente estudio es describir y comparar los porcentajes de no cumplimentación de dos instrumentos de registro: hoja circulante (HC) y lista de verificación quirúrgica (LVQ), en un mismo entorno quirúrgico para una muestra de pacientes de características similares. Metodología: Estudio descriptivo realizado sobre registros intraquirúrgicos de 3024 pacientes de Cirugía de Ortopedia y Traumatología. 1732 pacientes intervenidos en 2009 con modelo de hoja circulante, cumplimentada al finalizar la intervención y 1292 en 2010 intervenidos con modelo de registro lista de verificación quirúrgica (checklist) cumplimentado durante la intervención en tres tiempos. Se han calculado características descriptivas (media, desviación típica, mínimo y máximo) del porcentaje de no cumplimentación global en ambos registros y el porcentaje de no cumplimentación (intervalo de confianza al 95%) de cada ítem de los registros estudiados. Resultados: Se observa mayor porcentaje de cumplimentación global y, en general, también individual, en la hoja circulante que en la lista de verificación quirúrgica. Conclusiones: El registro intraquirúrgico que mayor porcentaje de cumplimentación ha tenido de manera global ha sido la hoja de circulante y se evidencia la necesidad de implantar estrategias para mejorar el grado de cumplimentación de la LVQ por su relación con la seguridad de pacientes.

Open-access operating algorithms for commercial videokeratographer and improvement of corneal sampling

We present an algorithm to process images of reflected Placido rings captured by a commercial videokeratoscope. Raw data are obtained with no Cartesian-to-polar-coordinate conversion, thus avoiding interpolation and associated numerical artifacts. The method provides a characteristic equation for the device and is able to process around 6 times more corneal data than the commercial software. Our proposal allows complete control over the whole process from the capture of corneal images until the computation of curvature radii.

Topologically protected quantum transport in locally exfoliated bismuth at room temperature

We report electrical conductance measurements of Bi nanocontacts created by repeated tip-surface indentation using a scanning tunneling microscope at temperatures of 4 and 300 K. As a function of the elongation of the nanocontact, we measure robust, tens of nanometers long plateaus of conductance G0=2e2/h at room temperature. This observation can be accounted for by the mechanical exfoliation of a Bi(111) bilayer, a predicted quantum spin Hall (QSH) insulator, in the retracing process following a tip-surface contact. The formation of the bilayer is further supported by the additional observation of conductance steps below G0 before breakup at both temperatures. Our finding provides the first experimental evidence of the possibility of mechanical exfoliation of Bi bilayers, the existence of the QSH phase in a two-dimensional crystal, and, most importantly, the observation of the QSH phase at room temperature.

Gas Storage Scale-up at Room Temperature on High Density Carbon Materials

In relation to the current interest on gas storage demand for environmental applications (e.g., gas transportation, and carbon dioxide capture) and for energy purposes (e.g., methane and hydrogen), high pressure adsorption (physisorption) on highly porous sorbents has become an attractive option. Considering that for high pressure adsorption, the sorbent requires both, high porosity and high density, the present paper investigates gas storage enhancement on selected carbon adsorbents, both on a gravimetric and on a volumetric basis. Results on carbon dioxide, methane, and hydrogen adsorption at room temperature (i.e., supercritical and subcritical gases) are reported. From the obtained results, the importance of both parameters (porosity and density) of the adsorbents is confirmed. Hence, the densest of the different carbon materials used is selected to study a scale-up gas storage system, with a 2.5 l cylinder tank containing 2.64 kg of adsorbent. The scale-up results are in agreement with the laboratory scale ones and highlight the importance of the adsorbent density for volumetric storage performances, reaching, at 20 bar and at RT, 376 g l-1, 104 g l-1, and 2.4 g l-1 for CO2, CH4,and H2, respectively.

Single wall carbon nanotubes loaded with Pd and NiPd nanoparticles for H2 sensing at room temperature

Pd and bimetallic Ni50Pd50 nanoparticles protected by polyvinylpyrrolidone (PVP) have been synthesized by the reduction-by-solvent method and deposited on single wall carbon nanotubes (SWCNTs) to be tested as H2 sensors. The SWCNTs were deposited by drop casting from different suspensions. The Pd nanoparticles-based sensors show a very reproducible performance with good sensitivity and very low response times (few seconds) for different H2 concentrations, ranging from 0.2% to 5% vol. H2 in air at atmospheric pressure. The influence of the metal nanoparticle composition, the quality of SWCNTs suspension and the metal loading have been studied, observing that all these parameters play an important role in the H2 sensor performance. Evidence for water formation during the H2 detection on Pd nanoparticles has been found, and its repercussion on the behaviour of the assembled sensors is discussed. The sensor preparation procedure detailed in this work has proven to be simple and reproducible to prepare cost-effective and highly efficient H2 sensors that perform very well under real application conditions.

Magnetic nanoparticles supported oxime palladacycle as a highly efficient and separable catalyst for room temperature Suzuki–Miyaura coupling reaction in aqueous media

A novel magnetic nanoparticle-supported oxime palladacycle catalyst was successfully prepared and characterized. The magnetically recoverable catalyst was evaluated in the room temperature Suzuki–Miyaura cross-coupling reaction of aryl iodides and bromides in aqueous media. The catalyst was shown to be highly active under phosphine-free and low Pd loading (0.3 mol%) conditions. The catalyst could be easily separated from the reaction mixture using an external magnet and reused for six consecutive runs without significant loss of activity.

The effect of electricity tariffs over the operating costs of the Spanish wastewater treatments plants

Given the complex structure of electricity tariffs and their steady growth in Spanish, we've studied its effect over the operating costs of the wastewater treatment plants (WWTP), concluding that in the last three years the revisions of electricity rates have meant increases in electricity costs of 64.5% in the rate 3.1.A and 79.1% in the rate 6.1. This has caused the cost of electricity, which was the most important, has increased from a 44% of total operating costs in the year 2009, to more than a 56% in the year 2012.