Secondary Analysis of Electronic Health Records

Health Informatics; Ethics; Data Mining and Knowledge Discovery; Statistics for Life Sciences, Medicine, Health Science

The Covert Life of Hospital Architecture

The Covert Life of Hospital Architecture addresses hospital architecture as a set of interlocked, overlapping spatial and social conditions. It identifies ways that planned-for and latent functions of hospital spaces work jointly to produce desired outcomes such as greater patient safety, increased scope for care provider communication and more intelligible corridors. By advancing space syntax theory and methods, the volume brings together emerging research on hospital environments. Opening with a description of hospital architecture that emphasizes everyday relations, the sequence of chapters takes an unusually comprehensive view that pairs spaces and occupants in hospitals: the patient room and its intervisibility with adjacent spaces, care teams and on-ward support for, and the intelligibility of public circulation spaces for visitors. The final chapter moves outside the hospital to describe the current healthcare crisis of the global pandemic as it reveals how healthcare institutions must evolve to be adaptable in entirely new ways. Reflective essays by practicing designers follow each chapter, bringing perspectives from professional practice into the discussion. The Covert Life of Hospital Architecture makes the case that latent dimensions of space as experienced have a surprisingly strong link to measurable outcomes, providing new insights into how to better design hospitals through principles that have been tested empirically. It will become a reference for healthcare planners, designers, architects and administrators, as well as for readers from sociology, psychology and other areas of the social sciences

The Covert Life of Hospital Architecture

The Covert Life of Hospital Architecture addresses hospital architecture as a set of interlocked, overlapping spatial and social conditions. It identifies ways that planned-for and latent functions of hospital spaces work jointly to produce desired outcomes such as greater patient safety, increased scope for care provider communication and more intelligible corridors. By advancing space syntax theory and methods, the volume brings together emerging research on hospital environments. Opening with a description of hospital architecture that emphasizes everyday relations, the sequence of chapters takes an unusually comprehensive view that pairs spaces and occupants in hospitals: the patient room and its intervisibility with adjacent spaces, care teams and on-ward support for their work and the intelligibility of public circulation spaces for visitors. The final chapter moves outside the hospital to describe the current healthcare crisis of the global pandemic as it reveals how healthcare institutions must evolve to be adaptable in entirely new ways. Reflective essays by practicing designers follow each chapter, bringing perspectives from professional practice into the discussion. The Covert Life of Hospital Architecture makes the case that latent dimensions of space as experienced have a surprisingly strong link to measurable outcomes, providing new insights into how to better design hospitals through principles that have been tested empirically. It will become a reference for healthcare planners, designers, architects and administrators, as well as for readers from sociology, psychology and other areas of the social sciences

Responsible AI and Analytics for an Ethical and Inclusive Digitized Society

publishedVersio

Separator fluid volume requirements in multi-infusion settings

INTRODUCTION. Intravenous (IV) therapy is a widely used method for the administration of medication in hospitals worldwide. ICU and surgical patients in particular often require multiple IV catheters due to incompatibility of certain drugs and the high complexity of medical therapy. This increases discomfort by painful invasive procedures, the risk of infections and costs of medication and disposable considerably. When different drugs are administered through the same lumen, it is common ICU practice to flush with a neutral fluid between the administration of two incompatible drugs in order to optimally use infusion lumens. An important constraint for delivering multiple incompatible drugs is the volume of separator fluid that is sufficient to safely separate them. OBJECTIVES. In this pilot study we investigated whether the choice of separator fluid, solvent, or administration rate affects the separator volume required in a typical ICU infusion setting. METHODS. A standard ICU IV line (2m, 2ml, 1mm internal diameter) was filled with methylene blue (40 mg/l) solution and flushed using an infusion pump with separator fluid. Independent variables were solvent for methylene blue (NaCl 0.9% vs. glucose 5%), separator fluid (NaCl 0.9% vs. glucose 5%), and administration rate (50, 100, or 200 ml/h). Samples were collected using a fraction collector until <2% of the original drug concentration remained and were analyzed using spectrophotometry. RESULTS. We did not find a significant effect of administration rate on separator fluid volume. However, NaCl/G5% (solvent/separator fluid) required significantly less separator fluid than NaCl/NaCl (3.6 ± 0.1 ml vs. 3.9 ± 0.1 ml, p <0.05). Also, G5%/G5% required significantly less separator fluid than NaCl/NaCl (3.6 ± 0.1 ml vs. 3.9 ± 0.1 ml, p <0.05). The significant decrease in required flushing volume might be due to differences in the viscosity of the solutions. However, mean differences were small and were most likely caused by human interactions with the fluid collection setup. The average required flushing volume is 3.7 ml. CONCLUSIONS. The choice of separator fluid, solvent or administration rate had no impact on the required flushing volume in the experiment. Future research should take IV line length, diameter, volume and also drug solution volumes into account in order to provide a full account of variables affecting the required separator fluid volume