Evidence-based Practice

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March 2020
Home Periop Nursing > Perioperative Practice > Evidence-based Practice

Using project management principles to hardwire ERAS protocols

Implementation of Enhanced Recovery After Surgery (ERAS) at Virginia Commonwealth University (VCU) Health System in Richmond has been achieved through project and change management tools that transform the current state to the desired future state. To hardwire ERAS protocols in the OR as well as the ambulatory and acute care…

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By: OR Manager
February 21, 2020
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Association between ERAS and postop complications after total hips and knees

Editor's Note Increased adherence to an Enhanced Recovery After Surgery (ERAS) protocol after total hip arthroplasty (THA) and total knee arthroplasty (TKA) was associated with a decrease in postoperative complications in this study from Spain. However, only a few interventions were linked to decreased complications In this analysis of 6,146…

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By: Judy Mathias
February 13, 2020
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Develop standard work for successful ERAS implementation

At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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By: OR Manager
January 13, 2020
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Study supports value of nurses with specialty certifications

Editor's Note In this study, specialty certification was associated with greater professional identity in ICU nurses and higher perceptions of knowledge of and value in evidence-based practices, whereas education level was not. Of 268 respondents from six hospitals and 12 adult ICUs in an integrated health system, 71% had a…

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By: Judy Mathias
January 9, 2020
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Relationship between patient falls and levels of nursing education, certification

Editor's Note Higher levels of nursing education and more certified nurses improved the number of patient falls in this study. Using data from the National Database of Nursing Quality Indicators from 2010 to 2016 from medical centers in Central and Southern Illinois, researchers found that with every 1-unit increase in…

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By: Judy Mathias
January 9, 2020
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Study: Changes in new nurses’ competencies over 1 year in a nurse residency program

Editor's Note In this study, competency ratings increased significantly from 1 to 5 months and from 5 to 11 months in a nurse residency program. Preceptors, nurse educators, and/or unit managers rated new nurse residents using The Appraisal of Nursing Practice, an observational rating based on Quality and Safety in…

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By: Judy Mathias
October 2, 2019
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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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