Adverse events occur in the best of ORs, but, of course, the goal is to prevent them whenever possible. One strategy used in surgical services at Saint Luke’s Hospital in Kansas City, Missouri, is to turn staff into “legal eagles” who go beyond reporting adverse events after they occur to…

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The number of nurse practitioners is expected to double by 2025, and the need for surgical first assistants is growing as residents’ work hours are reduced and surgeon assistants are eliminated to cut costs. This situation offers a great opportunity for advanced practice perioperative nurses. A double certification of nurse…

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Hospital safety scores released by the Leapfrog Group on April 29 show a 6.3% average improvement since 2012. Performance at almost a third of hospitals has improved at least 10% since 2012, but some hospitals’ scores have dropped. And with medical errors tied to more than 400,000 deaths per year…

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“Each year, diagnostic errors result in the deaths of an estimated 44,000 to 80,000 patients, and many thousands die because of teamwork and communication errors affecting their care or because they do not receive necessary evidence-based interventions,” according to an article published online last year in JAMA. No one would…

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The steam sterilization process is complex and includes a number of important steps: decontamination, preparation and packaging, sterilization, quality control, sterile storage, and product distribution. The effectiveness of this process cannot be determined by inspection or testing of each product, and because sterility assurance is a probability function, it must…

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Working for a small facility after spending many years at a large one can present a host of leadership challenges, but meeting those challenges with process changes and improved efficiencies can be highly satisfying. After serving more than 23 years at the Cedar Crest campus of Lehigh Valley Health Network…

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A mobile, web-based rounding tool is allowing the perioperative leadership team at Vail Valley Medical Center (VVMC) in Vail, Colorado, to collect, analyze, and report on information gathered from surgeons, staff, and patients to improve quality of care and move toward high reliability. Software designed by MyRounding Solutions in Littleton,…

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Efforts to increase patient safety have been successful in some areas, but less so in others—notably, postoperative outcomes—according to a recent study. Researchers who analyzed Medicare Patient Safety Monitoring System data for the period 2005 through 2011 found declines in adverse event rates for patients hospitalized because of acute myocardial…

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Obstructive sleep apnea is a major clinical and economic challenge in the postoperative period, affecting up to one-fourth of patients undergoing elective surgical procedures. The prevalence among orthopedic patients having joint arthroplasty may be especially high because obesity is a widespread comorbidity in this patient population. Obesity is 1 of…

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Surgical checklist compliance among 4 Canadian hospitals was around 60% in a large, retrospective study of acute care operations performed in 2010 and 2011. Although Alberta Health Services in Calgary, Alberta, Canada, had mandated checklist use starting in 2009, limitations such as instructional misuse, lack of perceived benefit, and lack…

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