Performance improvement system and postoperative corneal injuries: Incidence and risk factors

David P. Martin, Toby N. Weingarten, Paul W. Gunn, Kunmoo Lee, Michael A. Mahr, Darrell R. Schroeder, Juraj Sprung

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

BACKGROUND: The authors' department conducted a performance improvement initiative aimed to reduce the rate of perioperative corneal injuries. This study reports the effects of the initiative and examines the risk factors for corneal injury. METHOD: The rate of corneal injuries during nonophthalmologic procedures under anesthesia was compared between the two time periods: preinitiative baseline (August 1, 2005-December 31, 2005) and initiative period (January 1, 2006-April 30, 2007). To examine the risk factors for corneal injury, a nested case-control study with a 2:1 matched-set design was separately performed and included cases between January 1, 2006 and July 31, 2008. RESULTS: During the baseline period, the corneal injury rate was 1.51 per 1,000, and it decreased to 0.79 per 1,000 during the performance initiative (P = 0.008). Independent risk factors were longer anesthetics (odds ratio = 1.2, 95% confidence interval (CI) 1.1-1.3 per 30 min), lower American Society of Anesthesiologists physical status (odds ratio 0.5, 95% CI 0.3-0.8 for American Society of Anesthesiologists physical status 3-4 vs. 1-2), and student nurse anesthetist as a primary anesthesia provider (odds ratio 2.6, 95% CI 1.3-5.0). CONCLUSION: Corneal injury rate in our institution was significantly reduced and remains at low levels long after initiation of perioperative eye care improvement initiative. The higher rate of corneal injuries among student nurse anesthetists highlights the importance of standardizing education and supervision among all anesthesia providers. We believe that our model of performance improvement initiative can be used to improve other perioperative outcomes.

Original languageEnglish (US)
Pages (from-to)320-326
Number of pages7
JournalAnesthesiology
Volume111
Issue number2
DOIs
StatePublished - Aug 2009

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Incidence
Nurse Anesthetists
Anesthesia
Odds Ratio
Confidence Intervals
Students
Perioperative Care
Corneal Injuries
Anesthetics
Case-Control Studies
Education

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Martin, D. P., Weingarten, T. N., Gunn, P. W., Lee, K., Mahr, M. A., Schroeder, D. R., & Sprung, J. (2009). Performance improvement system and postoperative corneal injuries: Incidence and risk factors. Anesthesiology, 111(2), 320-326. https://doi.org/10.1097/ALN.0b013e3181ae63f0

Performance improvement system and postoperative corneal injuries : Incidence and risk factors. / Martin, David P.; Weingarten, Toby N.; Gunn, Paul W.; Lee, Kunmoo; Mahr, Michael A.; Schroeder, Darrell R.; Sprung, Juraj.

In: Anesthesiology, Vol. 111, No. 2, 08.2009, p. 320-326.

Research output: Contribution to journalArticle

Martin, DP, Weingarten, TN, Gunn, PW, Lee, K, Mahr, MA, Schroeder, DR & Sprung, J 2009, 'Performance improvement system and postoperative corneal injuries: Incidence and risk factors', Anesthesiology, vol. 111, no. 2, pp. 320-326. https://doi.org/10.1097/ALN.0b013e3181ae63f0
Martin, David P. ; Weingarten, Toby N. ; Gunn, Paul W. ; Lee, Kunmoo ; Mahr, Michael A. ; Schroeder, Darrell R. ; Sprung, Juraj. / Performance improvement system and postoperative corneal injuries : Incidence and risk factors. In: Anesthesiology. 2009 ; Vol. 111, No. 2. pp. 320-326.
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