Perioperative Practice

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May 2019
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Off-label use of simethicone, lubricants, and tissue glue contributes to endoscope reprocessing failures

Editor's Note The off-label use of defoaming agents, lubricants, and tissue glue is common, and these insoluable substances are not removed during reprocessing, this study finds. Of 69 fully reprocessed endoscopes examined in four hospitals, microbial cultures were positive for 50% or more. The researchers, led by Cori Ofstead, MSPH,…

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By: Judy Mathias
April 23, 2019
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FDA considering additional regulatory actions to reduce duodenoscope risks

Editor's Note The Food & Drug Administration on April 16 announced it is considering additional regulatory actions, including consulting with federal health experts for guidance, to reduce the risks of contamination and infections associated with duodenoscopes. The FDA is also working with manufacturers of disposable duodenoscopes that would make reprocessing…

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By: Judy Mathias
April 23, 2019
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Preop functional status predicts total hip outcomes

Editor's Note Compared with preoperative independent functional status, preoperative dependent functional status was independently associated with worse outcomes after primary total hip arthroplasty in this study. Of 43,179 patients analyzed, those who were less able to care for themselves: were 2 to 3 times more likely to have surgical complications…

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By: Judy Mathias
April 23, 2019
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How will artificial intelligence impact surgical patient care? Part 1

Artificial intelligence (AI) may be coming to your OR sooner than you think. AI is already being used to identify areas needing quality improvement by analyzing surgical workflow, communication patterns, and errors that went unnoticed during a procedure. OR leaders need to understand AI and participate in its development and…

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By: Cynthia Saver, MS, RN
April 22, 2019
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Imagining the unimaginable: Preparing for mass casualty

The Centers for Medicare & Medicaid Services (CMS) and the Joint Commission require healthcare facilities to have policies and protocols in place for emergency situations and to hold regular practice drills. With natural disasters like hurricanes, floods, or fires, often there is at least some warning—some amount of time to…

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By: Elizabeth Wood
April 22, 2019
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Conference keynote puts compassion at the heart of patient care

Compassion fatigue can come into play at any stage of nurses’ careers. Nursing is growing at a faster rate than other occupations, but it carries a high risk for burnout. Loss of job satisfaction, job-related distress, or perhaps exposure to too many traumatic events can threaten the ability of staff…

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By: Elizabeth Wood
April 22, 2019
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Expect the unexpected: How we recovered operations after Hurricane Harvey

Whatever your facility’s disaster management plan, it needs continual refinement to account for the differences between imagined and real scenarios. Hurricane Harvey, which hit Houston hard on Saturday, August 26, 2017, is a case in point. The storm brought more than 60 inches of rain within a couple of days,…

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By: Elizabeth Wood
April 22, 2019
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Cross-training staff solves competency and engagement puzzle

High labor costs, surgeon dissatisfaction, high staff turnover, and low staff competency are problems that dog many OR leaders at some point in their careers. When managers at the Stanford University Medical Center Main OR in Stanford, California, found themselves facing all of these problems at once, they knew something…

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By: Judith M. Mathias, MA, RN
April 22, 2019
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'Coming clean' in the SPD requires collaboration and competency--Part 2

Contaminated surgical instruments pose a danger to patients and to an organization’s bottom line. In Part 1 of this two-part series, we discussed prevention strategies (OR Manager, April 2019, 14-15, 19). In Part 2, the focus is on investigating potential contamination, along with design considerations.   Detective work Despite best…

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By: Cynthia Saver, MS, RN
April 22, 2019
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FDA continues efforts to assess duodenoscope contamination risk

Editor's Note The Food & Drug Administration (FDA) on April 12 announced that it is taking steps to implement additional regulatory actions, including consulting with federal health experts, on how to reduce the risks of contamination and infections linked to duodenoscopes. The agency is also collaborating with manufacturers of disposable…

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By: Judy Mathias
April 18, 2019
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