Preoperative Care

Latest Issue of OR Manager
October 2017

Preadmission frailty predicts adverse outcomes in geriatric trauma patients

Editor's Note In this study, preadmission clinical frailty independently predicted adverse discharge destination (ie, death or discharge to a long-term, chronic or acute care facility) in geriatric trauma patients. The analysis of 266 trauma patients 65 years and older using the Clinical Frailty Scale (CFS) and the laboratory Frailty Index…

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By: Judy Mathias
September 11, 2017
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STOP-Bang screening associated with risk of postop complications in OSA patients

Editor's Note This meta-analysis found that patients at higher risk for obstructive sleep apnea (OSA), as determined by preoperative STOP-Bang screening, had a higher risk of postoperative adverse events and longer length of hospital stay, compared with lower risk-OSA patients. The analysis included 10 studies with 23,609 patients (7,877 high-risk…

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By: Judy Mathias
August 28, 2017
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Orthopedic PSH a prime model for value-based care—Part 2

Organizations that have adopted the perioperative surgical home (PSH) model of patient care have reaped the benefits of improved outcomes and a healthier bottom line. In particular, the PSH has a proven track record for colorectal surgery and orthopedic surgery. In part 1 of this two-part series (OR Manager, August…

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By: Cynthia Saver, MS, RN
August 22, 2017
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Outcomes in patients diagnosed with OSA during preop screening vs previously diagnosed

Editor's Note In this study, patients diagnosed on the day of surgery as moderate to high risk for obstructive sleep apnea (OSA) had similar rates of adverse respiratory events (ie, perioperative hypoxemia and difficult airway management) as patients who had been diagnosed with OSA previously. However, those diagnosed with OSA…

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By: Judy Mathias
August 14, 2017
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Cognitive assessment helps predict survival in frail surgical patients

Editor's Note Adding cognitive assessment to frailty assessment predicted poor postoperative outcomes and survival in frail patients better than either measurement alone, this study finds. The study included 330 patients having major surgery who were assessed with a four-level composite frailty scoring system, which was created by combining the Fried…

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By: Judy Mathias
August 10, 2017
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The Perioperative Patient Journey: From Pre- to Postoperative Care in the ASC

After this session you’ll be able to: 1. Describe the three primary advantages of calling your patients preoperatively. 2. Explain how to successfully manage the flow of the patients through the preoperative area. 3. Discuss how to best prepare patients and their families for discharge. Why this is important: Take…

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Preop elderly assessment tool identifies postop complication risks

Editor's Note Screening elderly patients preoperatively using the Vulnerable Elders Surgical Pathways and Outcomes Assessment (VESPA) tool helped identify patients at higher risk of postoperative complications in this study. A total of 736 patients 70 years of age or older were assessed in a preoperative clinic from July 9, 2008,…

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By: Judy Mathias
August 4, 2017
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Effect of postop hyperglycemia, preop hemoglobin on outcomes in diabetic patients

Editor's Note Early postoperative hyperglycemia was linked to increased readmissions after gastrointestinal surgery in insulin-dependent diabetic patients, but elevated preoperative hemoglobinA1c was not, this study finds. Higher preoperative hemoglobinA1c levels were associated with increased postoperative glucose level checks and insulin use as well as lower rates of postoperative complications. Though…

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By: Judy Mathias
August 2, 2017
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'Strong for Surgery' program reduces preop smoking rates

Editor's Note A new study finds a big drop in smoking rates when surgeons get involved in helping patients quit before surgery through the "Strong for Surgery" program. The study was presented July 23 at the 2017 American College of Surgeons (ACS) Quality and Safety Conference. Strong for Surgery is…

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By: Judy Mathias
August 1, 2017
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Colorectal ERAS improves outcomes, reduces costs

Editor's Note An Enhanced Recovery after Surgery (ERAS) program for colorectal surgery patients shortened hospital length of stay by more than half, reduced complications by more than one-third, and cut costs by some $11,000 per procedure, finds a study presented July 23 at the American College of Surgeons 2017 Quality…

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By: Judy Mathias
July 31, 2017
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Orthopedic PSH a prime model for value-based care—Part 1

Uncertainties pepper the healthcare landscape, but the shift to value-based care is expected to continue, even though momentum may slow under the current administration. That means perioperative services leaders must continue to explore new care delivery options such as the perioperative surgical home (sidebar, p 17). “The demand for value…

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By: Cynthia Saver, MS, RN
July 13, 2017
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It Starts with You: Compassionate Connected Care

After this session you’ll be able to: 1. Describe how cross-domain analytics, including patient experience, nurse experience, and NDNQI data, have influenced strategies to reduce patient and caregiver suffering. 2. Discuss the importance of returning to the “why” of perioperative leadership. 3. Demonstrate how to implement Compassionate Connected Care™ themes…

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