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…
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…
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…
Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations.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…
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…
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…
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…
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…
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…
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…