Features
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Quality of Care Research |
www.uwanesthesiology.org/qi |
University of Washington anesthesiologists and certified nurse anesthetists continually evaluate the quality of the care they deliver. Each hospital has its own program for the objective study of their anesthetic practice.
These studies frequently focus on the adherence of our medical care to guidelines and standards formulated by state, national and international organizations.
In order to facilitate such internal review at hospitals, research projects conducted to improve the quality of services provided by the hospitals in Washington State are generally protected from legal discovery. The details and exceptions for this protection are listed in two Revised Codes of Washington State: RCW 4.24.250 and RCW 70.41.200(3).
CQI Programs by Hospital
Children's Medical Center
Provides comprehensive education in the management of infants and children.
CQI chair: Sally Rampersad, MD
206-987-2518, anesthesia@seattlechildrens.org
VA Puget Sound Health Care System
A wide range of surgical procedures is performed, including cardiac surgery.
Harborview Medical Center
Regional trauma and burn center for the Pacific Northwest
CQI chair: Edward Pavlin, MD
University of Washington Medical Center
Tertiary health-care facility for the Pacific Northwest
CQI chair: Dr. Christopher Lee, MD
CQI coordinator: Karen Mc Elhinney, RN
206-598-0683, mcelhinn@u.washington.edu
Dr. Lee has posted articles related to topics discussed at the monthly CQI meeting at UWMC on his website.
UWMC Anesthesia presents periodic "CQI Alerts" about issues relevant to clinical staff. These alerts are distributed to clinical anesthesiology faculty, residents, fellows and CRNA's.
Downloadable as PDF's
- 2008 January 2008
- OB bleeding emergencies | final verification of OB epidural placement | No midazolam pre-delivery | Wait for obstetrician before inducing GA | Obstetrics patients are at higher risk of aspiration | No MAC for uterine relaxation | GA for herpes and Cesarean section
- 2007 December
- Avoiding injecting propofol or etomidate in same arm as BP cuff | Throat pack safety | Assess GERD carefully preop | Administer vancomycin slowly | Aprotinin withdrawn from UWMC pharmacy
- 2007 September
- MAOI and anesthesia | Difficult intubation| Postop management of esophagectomy patients| CVP safety
- 2007 July
- Perioperative Glucose Control: A progress report from the UWMC's pilot study | What cases are included in the study? | Who gets an hourly glucose check? | Who writes postop diabetes orders? | What should I know about Lispro? | Pilot study results so far.
- 2007 May
- Phenylephrine is now prepared in 200mcg/cc | Filter all blood products | Scopolamine Patch Placement | Jet Ventilator Troubleshooting | Use Soft Bite Blocks when Jaw Clenching is common | New protocols for Bivalirudin and coping with critical incidents
- 2007 Jan-Mar
- Patient placement prior to CT scan | Blood volume for a thoracic epidural blood patch | Using H1 and H2 receptor antagonists | Pain management for chronic pain patients | Get 2 pieces of ID | Central line / spine and MRI protocols
- 2006 December
- CVP / PA catheter issues | Don't open supplies prematurely | Muscle cramps and succinylcholine | Tag broken equipment
- 2006 October
- Patients undergoing chemotherapy | TEE for possible intraop MI | When to sign for and thaw blood | Moving patients via Hovermatt | Documenting reversal: make it a habit | Anaphylaxis can persist postop
- 2006 August
- Stuck epidural catheters | Secure loose epidural catheters | Apheresis platelets in one standard dose | Managing an LMA | Prevent breathing circuit dead space | Toradol (Ketorolac) use
- 2006 July
- Intraoperative care for Roosevelt & Pavilion Patients | Documenting care outside of the OR | Always monitor temperature intraoperatively | Epidural hematomas need immediate action | When to bill for a blood patch
- 2006 June
- Getting and verifying UWMC blood products
- 2006 May
- Oral Midazolam in Main OR Pharmacy, not Pavilion Pharmacy | Get 2 pieces of ID | Keep bite blocks from slipping away | Reduce Pyxis errors | Responding to patients' postop concerns
- 2006 March
- Documenting neuromuscular blockade | Noting the block site | Administering cephalosporins | Epidural choice for pain management after abdominal surgeries
- 2006 February
- Special consent to anesthesia / sedation
- 2006 January
- Documenting poor dentition | Considering case cancellation? Call Medicine Consult Service | Promptly check IVs that don't drip | Reposition the head during long cases | Tape nasal tubes downwards, not up
- 2005 December
- Pain management for chronic pain patients | Flip patients supine to treat a cardiac arrest | Label your medications | Stent thrombosis and PCI | AICD's are allow for Pavilion patients | Nursing can give some preop meds
- 2005 September
- Preferred blood values for general anesthesia | INR and nasotracheal intubation | Double-check blood orders! They may change! | Aprotinin and liver transplants: Consult surgeons
- 2005 August
- RFA grounding pad burn prevention | Difficult intubation? Tell staff and patient | UWMC Anesthesia protocols | Clinical schedules for UWAMC
- 2005 July
- Check your specimen labels | Rocuronium for defasciculation | Operating room fire | Patient's blood antigens at Puget Sound Blood Center
- 2005 June
- Reporting allergies | Riding elevator: Use Cascade and get key | I need 2 pieces of ID | Read label text, not label colors
- 2005 May
- Transduce your center lines when you can | Atropine for CPR: 1 mg to start | Test patient reaction to Tiseel VH Fibrin Sealant
- 2005 March
- Avoid epinephrine in blocking doses for regional blocks | Checking jaw dislocations | Drugs and lines | Guidelines for epidurals | Clinical / staffing problems
- 2005 February
- Label your labs | Get dental and neuro consults ASAP! | Facial bruising and abrasions shock patients | Include difficult intubation letters in the medical chart | OR ventilators can be set to ICU ventilator pressure settings
- 2004 Autumn
- Overloading on normal saline | Notify patients and future doctors of difficult airways | Careful of those lower incisors! | Asystole? Get a TEE! | Visit your patient the night before surgery | Pre-incision "time out" | Useful web resources
- 2003 Autumn
- Medical exchange trays | Patient ID bands | Swan placement | New NIF monitors | Lab specimens | Anesthesiology protocols | Patient privacy | Did you know...
- 2003 Summer
- Protect the eye | Difficult airway | Monitor blockade | Use bite blocks | Central lines | DNAR status | Communicate | Team present?
- 2003 Spring
- Insulin dosing | Surgeon presence | Drager training | Report problem | Difficult intubation? Tell staff and patient
- 2002 Spring
- Using recuronium at the UWMC | Proper disposal of sharps and bloody garbage | CQI Reporting
- 2002 Winter
- Holding area | Pharmacy | Operating room | Special requests from the PACU Nurses | Code 199 | Epidurals | Progress notes
- 2001 Autumn
- Patient safety reminders | JCAHO Results | Transfusion service notes | PACU | BIS monitoring
- 2001 Summer
- Documentation | Antacids | Paging an attending | Face mask blow by O2 over ETT | Assuring the right patient is in the room | Verification prior to transfusing blood products | Pre-surgery clinic | Customer service | Prevention of patient falls | Remifentanyl / sevoflurane
- 2001 Spring
- Neuromuscular blockade function | Assessing change via the CQI program | When is recovery deemed adequate? | Consult the experts | Assessing the patient | Transfusion | Epidural catheter placements
- 2000 Summer
- Epidural anesthesia study follow-up | Protecting the eye during anesthesia | Extuation in the PACU - What needs a CQ "Y"? | Currently active CQI projects | CQI Meetings
- 2000 Spring
- Drug error prevention | Currently activy CQI projects | Nerve injuries | CQI Meetings
- 2000 June
- OB Sedation in General | Cesarean sections | Fire in the OR | Actions to take for fire prevention | Actions to take if there is a fire in the airway | Difficult intubations | Airway problems | Implantable defibrillators | IV infiltrations | Dental damage
- 1999
- Pacemakers
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