Perioperative Practice

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December 2017
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Study: Restrictive vs liberal blood transfusion outcomes in cardiac surgery patients

Editor's Note A restrictive blood transfusion strategy (HGB <7.5 g/dL) was equivalent to a liberal strategy (HGB <9.5 g/dL in the OR or ICU and HGB<8.5 g/dL in the non-ICU ward) with regard to mortality and major disability in cardiac surgery patients who had a moderate-to-high risk of death, this…

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By: Judy Mathias
November 16, 2017
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Greater vigilance needed to combat ureteroscope contamination

A new study by Ofstead & Associates (St Paul, Minnesota) is the latest to raise concerns about infections associated with endoscopic procedures. The study, which focused on ureteroscopes, found that the techniques used to clean and sterilize or high-level disinfect flexible ureteroscopes are not sufficient and leave behind contamination including…

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By: Judith M. Mathias, MA, RN
November 15, 2017
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Latest steam sterilization standard available from AAMI

The Association for the Advancement of Medical Instrumentation (AAMI) in September released the newest version of the ANSI/AAMI ST 79 Comprehensive Guide to Steam Sterilization and Sterility Assurance in Healthcare Facilities. This document, last updated in 2013, has been under a major review for changes in the format presentation and…

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By: Susan Klacik, BS, CRCST, CHL, CIS, ACE, FCS
November 15, 2017
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Landmark study may affect stroke treatment guidelines

Editor's Note Guidelines for stroke treatment currently recommend clot removal within 6 hours of onset. However, a new study led by researchers from Emory University School of Medicine, Atlanta, finds that clot removal up to 24 hours leads to significantly reduced disability. This international multi-center study randomly assigned 206 stroke…

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By: Judy Mathias
November 13, 2017
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Nurse-run telephone triage service for after-hour calls by neurosurgery patients

Editor's Note Clinical Advice Service (CAS), a nurse-run telephone triage service for after-hour calls, developed at the Stanford University School of Medicine, provides well-coordinated care to neurosurgery patients while reducing physician workload, this study finds. Between July 2016 and June 2017, CAS nurses received 1,021 after-hours calls from neurosurgery patients.…

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By: Judy Mathias
November 10, 2017
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Implementing Evidence Based Practice

Evidence-based practice has emerged as one of the most important health care movements of the 21st century. But the challenge for many nurses is converting the theory of evidence-based practice into action and incorporating it into a daily routine. In Implementing Evidence-Based Practice for Nurses: Real-Life Success Stories, real clinicians,…

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Joint Commission updates Patient Blood Management standards

Editor's Note The Joint Commission on November 8 announced the update of its Patient Blood Management standards to align with AABB standards. Among the changes: educational requirements for those who order and/or transfuse blood defined guidelines on transfusion orders procedures for emergent/urgent patients, including massive blood loss intraoperative methods for…

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By: Judy Mathias
November 10, 2017
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Preop cognitive screening predicts postop complications in older total joint patients

Editor's Note Poor preoperative cognition, as assessed by preoperative Mini-Cog screening, is prevalent among older total joint patients and predictive of adverse outcomes, including postoperative delirium, longer hospital stay, and greater likelihood of discharge to a place other than home, this study finds. Of 211 patients 65 years of age…

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By: Judy Mathias
November 7, 2017
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Joint Commission updates emergency management requirements

Editor's Note The Joint Commission on November 3 updated its emergency management requirements for hospital, ambulatory, home health, and hospice settings, effective November 15. The updated standards will assist healthcare organizations in more effectively planning for disasters and coordinate with federal, state, tribal, regional, and local emergency preparedness systems. The…

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By: Judy Mathias
November 6, 2017
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Surveillance is safe for noncancerous, high-risk breast lesions

Editor's Note High-risk, noncancerous flat epithelial atypia (FEA) breast lesions can be treated with close observation rather than surgical removal in most cases, this study finds. The analysis of 208 patients diagnosed with FEA over a 9-year period found that after mammography, biopsy, and surgical excision, five lesions (2.4%) were…

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By: Judy Mathias
November 1, 2017
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Improving readability of discharge instructions linked to fewer follow-up phone calls

  Editor's Note Making discharge instructions easier to read resulted in fewer phone calls from traumatic injury patients after discharge, finds this study presented October 25 at the American College of Surgeons Clinical Congress 2017 in San Diego. A total of 1,006 patients were included in the study, 493 in…

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By: Judy Mathias
October 31, 2017
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Back to Basics: Nurses Take Charge of Their Practice - On-Demand Webinar

Date: Thursday, May 8Time: 2:00 p.m. – 3:00 p.m. ET CEs: 1 Contact Hour The Institute of Medicine has urged nurses to take charge of their practice.  Yet day to day observations of nursing staff might reveal poor professional behavior.  How do you change the culture at a large university…

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