Evidence-based Practice

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

Inspections reveal need to overhaul bronchoscope reprocessing methods

Extensive research by Cori L. Ofstead, MSPH, and her colleagues at Ofstead & Associates (St Paul, Minnesota) has raised concerns about insufficient reprocessing of gastrointestinal endoscopes and ureteroscopes—even when recommended practices are followed—and their new study makes a compelling case for more stringent reprocessing of bronchoscopes as well. In their…

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By: Judith M. Mathias, MA, RN
August 23, 2019
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Experts give hospital rating systems low grades

Editor's Note In this study, experts graded the four major publicly reported hospital quality rating systems on their strengths and weaknesses−most received a C and the highest was a B. The grades were: US News & World Report−B Medicare & Medicaid Services’ Star Ratings−C Leapfrog−C- Healthgrades−D+. The researchers found that…

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By: Judy Mathias
August 15, 2019
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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Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations.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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