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August 2012 See the full issue

Lateral violence: Tools managers can use to help shift the culture

An orientee comes to you in tears saying a couple of tenured nurses have snapped at her or huffed impatiently when she asked a question. Several other staff have met with you individually about conflict and hurtful comments they say are happening on one of the specialty teams. You already…

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By: OR Manager
August 1, 2012
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Raising the bar for safety in the handling of surgical specimens

Is this specimen fresh or frozen? Is it routine, or does it require a lung protocol? Does it go to the frozen section lab or the microbiology department? Proper labeling and handling of surgical specimens are critical to reduce the risk of misdiagnosis and the need for repeat surgery. Decreasing…

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By: OR Manager
August 1, 2012
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Editorial

NSQIP—you see those initials more and more in studies on surgical quality. NSQIP stands for the National Surgical Quality Improvement Program from the American College of Surgeons (ACS). NSQIP is gathering momentum, with 475 hospitals enrolled. Benefits are credible data for improving surgical outcomes and the buy-in from surgeons. By…

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By: OR Manager
August 1, 2012
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FDA proposes a UDI system for medical devices

The US Food and Drug Administration (FDA) released its long awaited proposed rule for a unique device identification (UDI) system on July 3, 2012. Comments will be accepted for 120 days after the proposed rule is published in the Federal Register, which was expected in early July. The rule would…

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By: OR Manager
August 1, 2012
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Reducing variation in total knee replacements

A new study in the journal Health Affairs of total knee replacement (TKR) confirms that wide variations in care exist among hospitals based on factors such as geographic location. The High Value Healthcare Collaborative found significant variations in TKR among the 5 participating health care systems. Among these were length…

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By: OR Manager
August 1, 2012
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Tying anesthesia salaries to on-time starts, turnovers

Better data coupled with an at-risk salary model for anesthesiologists have helped one academic medical center to improve its performance for on-time starts and turnover time between cases. The hospital’s surgical volume was growing, and it had to make the most of its OR time. Yet a lot of the…

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By: OR Manager
August 1, 2012
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Key OR design, construction changes proposed

Key changes are being proposed in the OR design and construction guidelines that are used by the Joint Commission, federal agencies, and 42 states. OR leaders may wish to offer comments. Comments are accepted until November 22, 2012, on the draft 2014 Guidelines for Design and Construction of Health Care…

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By: OR Manager
August 1, 2012
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Lumens and endoscopes: Meeting cleaning basics

Narrow-lumened instruments and endoscopes are one of your biggest reprocessing challenges. They have the highest risk of being improperly processed, notes Michelle J. Alfa, PhD, FCCM, a researcher in health care-associated infections. If the lumens and channels of endoscopes are not cleaned properly, high-level disinfection or sterilization may not be…

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By: OR Manager
August 1, 2012
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Sleep apnea: Identifying patients at risk in the ASC

With obesity increasing across the country, it is not surprising that obstructive sleep apnea (OSA) also is on the rise. For ambulatory surgery centers (ASCs), obesity offers a major—but not the only—clue that a patient may have, or be at risk for, OSA. A common health risk of obesity, OSA…

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By: OR Manager
August 1, 2012
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August At a Glance

Regional anesthesia better for hip fracture Regional anesthesia was linked with a significant reduction in major pulmonary complications and death after hip fracture surgery in a study. Of patients having hip fracture surgery in 126 New York State hospitals, those who had regional rather than general anesthesia had 29% lower…

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By: OR Manager
August 1, 2012
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New TJC tool for hand-offs

The Joint Commission Center for Transforming Healthcare announced its new Hand-off Communications Targeted Solutions Tool in June 2012. The tool will assist organizations with the process of passing patient care information from one caregiver to another to prevent miscommunication. Organizations piloting the tool reduced readmissions by 50% and reduced by…

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By: OR Manager
August 1, 2012
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1 in 5 hospital RNs is depressed

The rate of depression in hospital–employed nurses, at 18%, is twice the rate of the general population, finds a study. Body mass index, job satisfaction, number of health problems, mental well-being, and health-related productivity were significantly related to depression in the survey of 1,171 RNs. Advanced practice nurses and nurse…

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By: OR Manager
August 1, 2012
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Huge cost for total hip, knee surgical infection

  Readmission of patients who develop surgical site infections (SSIs) after total knee and hip replacement is common, adding more than $65 million to health care costs annually, in a new study. “We found that the impact of these infections is not only significant and profound in the immediate diagnosis…

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By: OR Manager
August 1, 2012
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