Enhanced Recovery After Surgery (ERAS®) is a comprehensive, multifaceted, and multidisciplinary approach to the care of the surgical patient. ERAS bundles evidence-based elements to facilitate a faster recovery with fewer complications.1 Spanning the continuum of perioperative care, ERAS elements include: • patient engagement and education • preoperative optimization of nutrition…

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A patient’s condition can change in the blink of an eye. Are you prepared to respond? And what happens if the patient dies? This is the focus of an annual seminar at Houston Methodist Hospital that was developed to increase the comfort level of perioperative nurses caring for a patient…

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Editor's Note Though recent guidelines mandating additional barrier attire for all scrubbed and unscrubbed OR personnel from the Agency for Healthcare Research and Quality (AHRQ) and Joint Commission, which include bouffant caps covering all hair and long-sleeved surgical attire covering all exposed skin, this study finds that this mandate does…

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Editor's Note Overlapping, nonconcurrent surgery was not associated with an increase in serious unanticipated events in this study. Of 61,525 surgical procedures performed over 1 year at a large academic medical center, a total of 8,391 patients had any overlap (beginning or end) and were matched on 11 variables. Compared…

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Editor's Note This study found a very large variability in the use of postoperative opioids in different countries. The study sample included 129,379 opioid-naïve patients in the US, 84,653 in Canada, and 9,802 in Sweden. More than 70% of surgical patients in the US (76.2%) and Canada (78.6%) filled opioid prescriptions…

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Editor's Note In this study, changing the responsibility for ICU patient transports to the OR from the anesthesia to the ICU services did not change turnover times, but it resulted in more on-time starts and high compliance with preoperative checklist documentation. The crude proportion of on-time starts increased from 32.6%…

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Editor's Note Senior surgical residents can safely supervise junior residents performing appendectomies, and training programs should encourage faculty to let senior residents manage operative appendicitis as independently as possible as well as supervise junior residents intraoperatively, this study finds. In this review of 928 appendectomies performed at the University of…

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Editor's Note The Joint Commission on August 28 announced the publication of an R3 Report on two new standards designed to improve the quality and safety of perinatal care in accredited hospitals. The standards, which will take effect July 1, 2020, require organizations to examine their processes and procedures for…

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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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Poor communication has been the root cause of many sentinel events over the years, and there has been growing recognition of how the work environment and culture influence patient outcomes. In a 2018 Sentinel Event Alert, the Joint Commission stressed the need to develop a “reporting culture”—to make it safe…

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