Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques

Purpose. Wide variability persists in the preparation and storage of common anesthetic medications despite the recognition of anesthesia workspace standardization as a national quality improvement priority. Syringe contamination and medication swaps continue to pose significant hazards to patient sa...

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Main Authors: Dustin R. Long, Allison Doney, Devan L. Bartels, Crystal E. Tan, Puneet K. Sayal, Thomas A. Anderson, Aalok V. Agarwala
Format: Article
Language:English
Published: Wiley 2019-01-01
Series:Anesthesiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2019/2673781
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author Dustin R. Long
Allison Doney
Devan L. Bartels
Crystal E. Tan
Puneet K. Sayal
Thomas A. Anderson
Aalok V. Agarwala
author_facet Dustin R. Long
Allison Doney
Devan L. Bartels
Crystal E. Tan
Puneet K. Sayal
Thomas A. Anderson
Aalok V. Agarwala
author_sort Dustin R. Long
collection DOAJ
description Purpose. Wide variability persists in the preparation and storage of common anesthetic medications despite the recognition of anesthesia workspace standardization as a national quality improvement priority. Syringe contamination and medication swaps continue to pose significant hazards to patient safety. Methods. We assessed differences in practice related to the availability of commonly prepared anesthetic medications. Using baseline provider surveys (n = 87) and anesthesia workspace audits (n = 80), we designed a custom syringe organization device using 3D printing techniques to serve as a cognitive aid and organizational tool. We iteratively tested and then deployed this device in all 60 operating rooms at a single institution, and then, repeated postintervention surveys (n = 79) and workspace audits (n = 75) one year after introduction. Results. Implementation was associated with significant improvements in provider-reported medication availability during coverage and handoff situations (43.7% versus 76.2% reporting 95% confidence preintervention versus postintervention, p<0.001). This was substantiated by audits of the anesthesia workspace which demonstrated reduced variability in the location (p<0.001) and availability (p<0.001) of key medications. Provider confidence in the cleanliness of syringes was also improved (p=0.01). A high degree of acceptance and compliance with the intervention was reported, with 80.4% of syringes observed to be stored in the device one year after implementation and approximately 95% of respondents reporting positive measures of usability and convenience. Conclusion. Use of a simple organizational device for syringes in the anesthesia workspace has numerous safety benefits. 3D printing offers improvements in adaptability and affordability compared with prior approaches.
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spelling doaj-art-25068bb32c2a4b8fbf99d3b909db61c62025-08-20T03:54:52ZengWileyAnesthesiology Research and Practice1687-69621687-69702019-01-01201910.1155/2019/26737812673781Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing TechniquesDustin R. Long0Allison Doney1Devan L. Bartels2Crystal E. Tan3Puneet K. Sayal4Thomas A. Anderson5Aalok V. Agarwala6Department of Anesthesiology & Pain Medicine, University of Washington, 1959 NE Pacific Street, Box 356540, Seattle, WA 98195-6540, USADepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USADepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USADepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USAInternational Spine, Pain and Performance Center, Washington, DC, USADepartment of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Palo Alto, CA, USADepartment of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, USAPurpose. Wide variability persists in the preparation and storage of common anesthetic medications despite the recognition of anesthesia workspace standardization as a national quality improvement priority. Syringe contamination and medication swaps continue to pose significant hazards to patient safety. Methods. We assessed differences in practice related to the availability of commonly prepared anesthetic medications. Using baseline provider surveys (n = 87) and anesthesia workspace audits (n = 80), we designed a custom syringe organization device using 3D printing techniques to serve as a cognitive aid and organizational tool. We iteratively tested and then deployed this device in all 60 operating rooms at a single institution, and then, repeated postintervention surveys (n = 79) and workspace audits (n = 75) one year after introduction. Results. Implementation was associated with significant improvements in provider-reported medication availability during coverage and handoff situations (43.7% versus 76.2% reporting 95% confidence preintervention versus postintervention, p<0.001). This was substantiated by audits of the anesthesia workspace which demonstrated reduced variability in the location (p<0.001) and availability (p<0.001) of key medications. Provider confidence in the cleanliness of syringes was also improved (p=0.01). A high degree of acceptance and compliance with the intervention was reported, with 80.4% of syringes observed to be stored in the device one year after implementation and approximately 95% of respondents reporting positive measures of usability and convenience. Conclusion. Use of a simple organizational device for syringes in the anesthesia workspace has numerous safety benefits. 3D printing offers improvements in adaptability and affordability compared with prior approaches.http://dx.doi.org/10.1155/2019/2673781
spellingShingle Dustin R. Long
Allison Doney
Devan L. Bartels
Crystal E. Tan
Puneet K. Sayal
Thomas A. Anderson
Aalok V. Agarwala
Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques
Anesthesiology Research and Practice
title Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques
title_full Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques
title_fullStr Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques
title_full_unstemmed Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques
title_short Anesthesia Workspace Cleanliness and Safety: Implementation of a Novel Syringe Bracket Using 3D Printing Techniques
title_sort anesthesia workspace cleanliness and safety implementation of a novel syringe bracket using 3d printing techniques
url http://dx.doi.org/10.1155/2019/2673781
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