Evidence-based Practice

Latest Issue of OR Manager
June 2019
Home Periop Nursing > Perioperative Practice > Evidence-based Practice

Association of TAVR for bicuspid vs tricuspid aortic stenosis with mortality, stroke

Editor's Note In this study, patients who had transcatheter aortic valve replacement (TAVR) for bicuspid compared with tricuspid aortic stenosis had no significant difference in mortality, but they had a 30-day increased risk of stroke. In this cohort of 2,691 matched pairs of patients having TAVR for bicuspid vs tricuspid…

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By: Judy Mathias
June 12, 2019
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OR leaders see benefits of briefer NPO period

Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations. In 1999, the American Society of Anesthesiologists (ASA) revised their fasting guidelines to clear liquids up to 2 hours before surgery and…

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By: Judith M. Mathias, MA, RN
May 17, 2019
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Performance on patient safety measures linked to hospital financial performance

Editor's Note Hospitals that perform better on measures to prevent postoperative complications also have better performance on measures of profitability, this study finds. Improved patient safety performance was associated with higher net patient revenue for five of seven Surgical Care Improvement Project (SCIP) measures, including starting and stopping preventive antibiotics…

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By: Judy Mathias
May 16, 2019
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Adherence to ERAS protocols associated with fewer postop complications

Editor's Note An increased in adherence to Enhanced Recovery after Surgery (ERAS) protocols was associated with a decrease in postoperative complications in this study. Of 2,084 patients analyzed, 566 had moderate to severe postoperative complications. The number of patients with moderate to severe complications was lower in the ERAS group…

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By: Judy Mathias
May 13, 2019
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Increased duration of surgical antimicrobial prophylaxis linked to adverse events

Editor's Note In this multi-center study, longer durations of surgical prophylaxis did not result in further reductions in surgical site infections (SSIs) but were associated with increasing adverse events. Of 79,058 surgical patients in the VA healthcare system, SSI was not associated with duration of prophylaxis, but odds of acute…

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By: Judy Mathias
April 25, 2019
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Association of AORN’s OR attire policy with SSIs, costs

Editor's Note Implementation of AORN’s 2015 guidelines for OR attire, which also were adopted by the Centers for Medicare and Medicaid Services, has not decreased surgical site infections (SSIs) and has increased healthcare costs, this study finds. For the study, data were collected on general, cardiac, neuro-, orthopaedic, and gynecologic…

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By: Judy Mathias
January 8, 2019
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Spillover effect of postop opioid prescribing

Editor's Note After opioid prescribing recommendations were implemented for a single surgical procedure, laparoscopic gall bladder removal, opioid prescribing decreased for four other surgical procedures in this study. The analysis involved 1,158 patients, 558 who had surgery before the opioid recommendations were implemented and 600 after implementation. Opioid prescription size…

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By: Judy Mathias
July 30, 2018
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Military-civilian partnership creates first fully integrated trauma system

Editor's Note The American College of Surgeons on May 23 announced that a partnership between the Military Health System and civilian trauma institutions is underway to create the first fully integrated military-civilian trauma system. The system will train military surgeons before deployment, help surgeons retain skills while deployed, and bring…

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By: Judy Mathias
May 24, 2018
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Effect of ambient OR temperature on patient temperature

Editor's Note Ambient intraoperative OR temperature had a negligible effect on core temperature when patients were warmed with forced air in this study. The effect was larger when patients were passively insulated, but the magnitude remained small. A total of 292 adult patients were randomized to ambient temperatures 19º, 21º,…

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By: Judy Mathias
May 11, 2018
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First US study on nurses’ evidence-based practice competencies finds major deficits

Editor's Note The results of this study indicate that US nurses do not believe they are meeting evidence-based practice competencies. In this survey of 2,344 nurses from 19 hospitals or healthcare systems, the nurses overall reported they were not yet competent in meeting any of the 24 evidence-based practice competencies.…

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By: Judy Mathias
May 4, 2018
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