4 research outputs found
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Quality assurance implementation plan for spent nuclear fuel characterization
A plan was prepared to implement the Quality Assurance requirements of the Office of Civilian Radioactive Waste Management RW-0333P to the Spent Nuclear Fuel Characterization activities. The plan was based on an evaluation of the current characterization activities against the RW-0333P requirements
Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications
BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients.
OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs.
DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification.
PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries.
MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes.
RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (VT) size was 500 ml, or 7 to 9 ml kg1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P < 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P < 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure.
CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high VT and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome
Epidemiology, practice of ventilation and outcome for patients at increased risk of postoperative pulmonary complications: LAS VEGAS - An observational study in 29 countries
BACKGROUND Limited information exists about the epidemiology and outcome of surgical patients at increased risk of postoperative pulmonary complications (PPCs), and how intraoperative ventilation was managed in these patients. OBJECTIVES To determine the incidence of surgical patients at increased risk of PPCs, and to compare the intraoperative ventilation management and postoperative outcomes with patients at low risk of PPCs. DESIGN This was a prospective international 1-week observational study using the ‘Assess Respiratory Risk in Surgical Patients in Catalonia risk score’ (ARISCAT score) for PPC for risk stratification. PATIENTS AND SETTING Adult patients requiring intraoperative ventilation during general anaesthesia for surgery in 146 hospitals across 29 countries. MAIN OUTCOME MEASURES The primary outcome was the incidence of patients at increased risk of PPCs based on the ARISCAT score. Secondary outcomes included intraoperative ventilatory management and clinical outcomes. RESULTS A total of 9864 patients fulfilled the inclusion criteria. The incidence of patients at increased risk was 28.4%. The most frequently chosen tidal volume (V T) size was 500 ml, or 7 to 9 ml kg−1 predicted body weight, slightly lower in patients at increased risk of PPCs. Levels of positive end-expiratory pressure (PEEP) were slightly higher in patients at increased risk of PPCs, with 14.3% receiving more than 5 cmH2O PEEP compared with 7.6% in patients at low risk of PPCs (P ˂ 0.001). Patients with a predicted preoperative increased risk of PPCs developed PPCs more frequently: 19 versus 7%, relative risk (RR) 3.16 (95% confidence interval 2.76 to 3.61), P ˂ 0.001) and had longer hospital stays. The only ventilatory factor associated with the occurrence of PPCs was the peak pressure. CONCLUSION The incidence of patients with a predicted increased risk of PPCs is high. A large proportion of patients receive high V T and low PEEP levels. PPCs occur frequently in patients at increased risk, with worse clinical outcome.</p
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Quality Assurance Program Plan (QAPP) Waste Management Project
The Waste Management Project (WMP) is committed to excellence in our work and to delivering quality products and services to our customers, protecting our employees and the public and to being good stewards of the environment. We will continually strive to understand customer requirements, perform services, and activities that meet or exceed customer expectations, and be cost-effective in our performance. The WMP maintains an environment that fosters continuous improvement in our processes, performance, safety and quality. The achievement of quality will require the total commitment of all WMP employees to our ethic that Quality, Health and Safety, and Regulatory Compliance must come before profits. The successful implementation of this policy and ethic requires a formal, documented management quality system to ensure quality standards are established and achieved in all activities. The following principles are the foundation of our quality system. Senior management will take full ownership of the quality system and will create an environment that ensures quality objectives are met, standards are clearly established, and performance is measured and evaluated. Line management will be responsible for quality system implementation. Each organization will adhere to all quality system requirements that apply to their function. Every employee will be responsible for their work quality, to work safely and for complying with the policies, procedures and instructions applicable to their activities. Quality will be addressed and verified during all phases of our work scope from proposal development through closeout including contracts or projects. Continuous quality improvement will be an ongoing process. Our quality ethic and these quality principles constantly guide our actions. We will meet our own quality expectations and exceed those of our customers with vigilance, commitment, teamwork, and persistence