Home Issues OR Manager [August, 2011]

A call to self-care, reflection, and renewal

"When was the last time you relived a favorite bedtime routine from your past? Do you remember the special feeling and aroma of a warm bath, clean pajamas, and freshly laundered sheets with a relaxing bedtime story and a cup of warm milk or bedtime tea?" This is one tip…

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By: OR Manager
August 20, 2011
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A new perspective on OR time-out

Sometimes it's all in a word. Struggling for compliance with the pause before surgery, a Michigan hospital tried changing the terminology, and that has made all the difference. Instead of "time-out," the new term is "patient safety briefing." Once the change was made, "we saw immediately that the focus changed,"…

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By: Pat Patterson
August 1, 2011
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What are your ASC's security gaps?

Laptops are stolen from a physician's office in a break-in, compromising data for hundreds of patients. An employee loses a personal hard drive that contains patient data. A radiologist joins a new outpatient facility and contacts patients from his previous employer, using information he downloaded before he left. Is your…

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By: OR Manager
August 1, 2011
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What's new in endoscopy guidelines?

Flexible endoscope reprocessing continues to be a major focus in infection prevention. All of the known cases of pathogen transmission during GI endoscopy have been traced to breaches in accepted cleaning and disinfection guidelines or other infection prevention practices. A revised Multisociety Guideline on Reprocessing Flexible GI Endoscopes, released in…

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By: Pat Patterson
August 1, 2011
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Time to tone it down: Strategies for managing noise, distractions

"Our society has become a lot louder, and we tolerate a lot more noise," says Verna Gibbs, MD, director of NoThing Left Behind and professor of clinical surgery, University of California, San Francisco. That includes the OR, where phones, overhead pages, alarms, suction, ventilation equipment, medical devices such as drills,…

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By: Cynthia Saver, MS, RN
August 1, 2011
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Simple cotton swab lowers postop SSIs

Gently probing a wound with a dry cotton swab after surgery for a perforated appendix dramatically reduced infections in a study. Only 3% of patients who had the daily probing got surgical site infections (SSIs) compared with 19% in the control group who did not. Though the exact mechanism isn't…

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By: OR Manager
August 1, 2011
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Rapid methicillin-resistant Staphylococcus aureus (MRSA) screening in infection control programs

Editor's note AUGUST 2011 OR leaders are striving to make evidence-based decisions about new technology. OR Manager, Inc., and ECRI Institute have joined in a collaboration to bring quarterly supplements with summaries of the Institute's Emerging Technology Evidence Reports to OR Manager readers. ECRI Institute is an independent nonprofit organization…

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By: OR Manager
August 1, 2011
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Quandary: What to do for vaginal prep

It's a question ORs have faced for several years—what do you use for the vaginal prep when the patient is allergic to povidone iodine? After Techni-Care (PCMX, or chloroxylenol) stopped being made in 2009, clinicians were left without a skin prep indicated for use in the genital area for iodineallergic…

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By: Pat Patterson
August 1, 2011
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Pinpointing risks of wrong surgery

Do you know where your OR's process is at most risk for an error that could lead to wrong-site surgery? A South Carolina health system identified its improvement opportunities and came up with solutions as part of a national project with the Joint Commission Center for Transforming Healthcare (CTH). Five…

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By: Or Manager
August 1, 2011
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More complications in obese patients after elective breast surgery

Obese patients are nearly 12 times more likely to have postoperative complications after elective breast procedures than nonobese patients, finds a study published online ahead of print in Plastic and Reconstructive Surgery. Overall, 18.3% of obese patients suffered complications compared to 2.2% of nonobese patients in a review of insurance…

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By: OR Manager
August 1, 2011
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Is postop nausea and vomiting hereditary?

Researchers from Penn State College of Medicine have singled out a genetic variation in patients who have postoperative nausea and vomiting (PONV). In the study, the researchers pooled DNA samples from 122 patients with severe PONV. Findings identified 41 genetic targets (called single nucleotide polymorphisms, or SNPs) in these patients…

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By: OR Manager
August 1, 2011
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Hardwiring the right-site process

For the past four years, Rhode Island Hospital (RIH) in Providence has reviewed its processes for preventing wrongsite surgery from top to bottom. The hospital has been under the microscope after several widely publicized incidents dating back to 2007. The hospital has been fined by the state and successfully passed…

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By: Pat Patterson
August 1, 2011
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Editorial

We all think we are good at multitasking—but we're really not. A good way to enhance decision-making is to sleep on it. Exercise boosts brain power and could stave off Alzheimer's. These are a few of 12 "brain rules" laid out by writer John Medina in his fascinating book of…

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By: Pat Patterson
August 1, 2011
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Devil in details: Identifying defects that could lead to a wrong surgery

The devil really is in the details. That's a key message from a national project to prevent wrong-site surgery. Five hospitals and three surgery centers have worked with the Joint Commission's Center for Transforming Healthcare (CTH) to measure defects in their own processes and come up with targeted ways to…

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By: OR Manager
August 1, 2011
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CMS proposes to increase quality reporting

The Centers for Medicare and Medicaid Services (CMS) proposes new quality measures, including a new quality reporting program for ambulatory surgery centers (ASCs), in its proposed 2012 outpatient rule issued July 1, 2011. The rule applies to hospital outpatient departments and ASCs. Comments are accepted until August 30. A final…

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By: OR Manager
August 1, 2011
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A critical eye on Infuse use studies

A leading spine journal is casting a critical eye on industry-supported research that has led to widespread use of Medtronic's controversial bone growth product Infuse. The June 2011 issue of Spine Journal carries a strongly worded editorial about the trial designs, reporting bias, and peer review shortfalls that the authors…

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By: OR Manager
August 1, 2011
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Anesthesiologists release infection control document

Updated infection control practices from the American Society of Anesthesiologists draw on data and national guidelines to inform anesthesia providers of practices shown to alter the incident of health care-associated infections. The recommendations also focus on prevention of occupational transmission of infection in anesthesiologists. The document has not been reviewed…

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By: OR Manager
August 1, 2011
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