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Priya Shah, Nitish Mehta, Carol Lee; Analyzing and Reducing the Rates of Perioperative Corneal Abrasions. Invest. Ophthalmol. Vis. Sci. 2017;58(8):4802.
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Patient safety is a number one priority at NYU Langone Medical Center. The Department of Ophthalmology has noticed an increased number of consultations for post-operative ophthalmic complications since the start of 2016 as compared to previous years. Our goal is to analyze the types and causes of these complications and to work with the Department of Anesthesia in order to improve the overall patient care experience at NYU.
To quantity this, the Department performed a retrospective chart review of all consultations performed by the ophthalmology service in the post-anesthesia care units at Tisch Hospital from January 1, 2016 to April 1, 2016. Search criteria was 'consultation orders placed by any service' and 'all consultations written by ophthalmology' and the results were sorted by location. Individual consultations of suspect were then reviewed manually.
Twelve post-operative ophthalmic complications were noted: nine corneal abrasions, and three nonspecific ocular irritations. Primary services included orthopedics (3), neurosurgery (4), and OB/GYN (2). Each case had a unique attending anesthesiologist and unique resident or CRNA. Minor ophthalmic pathology is generally self-limited and requires little intervention; however, it is a huge detriment to the patent experience. Reviewing prior experience, the department generally receives 3-4 calls for such conditions a quarter. Thus, this represented a large spike in occurrence of corneal abrasions.
The Department of Ophthalmology presented this information as well as an overview of eye protection in the peri-operative arena at the Anesthesia Clinical Conference on October 26, 2016, in effort to reduce the number of these complications. Upon discussion with the Department of Anesthesia, an action plan consisting of four practice changes was determined. Our action plan consists of 1) horizontal eye taping with lubricant, as opposed to vertical taping, 2) placing pulse oximetry on the 4th or 5th digit, 3) rechecking the eyes every 2 hours, and 4) taping eyes in MAC/regional block cases, which was previously not being done.To assess the success of this intervention, the department will track the number of calls received for this condition for the next four months. We anticipate working with the Department of Anesthesia to improve the patient care experience at New York University Medical Center.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
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