UTIs reduced by focusing on catheter use in the OR
Editor's Note Surgical teams at Northwesterm Memorial Hospital in Chicago are decreasing the rate of urinary tract infections by focusing on the use of catheters before and immediately after surgical procedures. A process improvement program reduced the number of UTIs associated with catheters placed in patients in the OR from…
Nurses key to Kaiser Permanente quality
Editor's Note New research from the University of Pennsylvania School of Nursing shows patient and nurse outcomes in Kaiser Permanente hospitals were significantly better than other hospitals. Differences in nursing explained a significant proportion of Kaiser’s outcomes advantages. The researchers found that Kaiser hospitals have significantly better nurse work environments,…
Researchers develop world's most sensitive test for superbugs
Editor's Note A diagnostic tool developed by researchers at McMaster University, Hamilton, Ontario, can detect the smallest traces of compounds that signal the presence of an infectious disease, such as C difficile, MRSA, hepatitis C, and other superbugs. The test has the best sensitivity ever reported for a detection system.…
Surgical patients warmed with forced air still experience hypothermia
Even in patients actively warmed with forced air during surgery, hypothermia is routine during the first hour of anesthesia, a new study finds. Intraoperative core hypothermia causes complications such as coagulopathy, surgical site infections, and possibly myocardial complications. It also decreases drug metabolism, prolongs recovery, and causes thermal discomfort. Warming…
Study sheds new light on natural history of RSIs
Most retained surgical items (RSIs) involve team/system errors and more than two safety omissions or variances, which supports the need for institutional emphasis on team training, finds a study led by S. Peter Stawicki, MD, Ohio State University College of Medicine, Columbus. Though RSIs feature prominently among surgical “never events,”…
Robotic surgery complications underreported
Robotic surgery has been widely adopted by hospitals during the past decade, but its safety is still unclear because of a haphazard system for reporting complications, Johns Hopkins researchers say. A new study led by Martin Makary, MD, finds that of 1 million robotic procedures performed since 2000, only 245…
Curbing OR traffic: Finding ways to minimize the flow of personnel
A traffic cop? Stop signs? Flashing lights? Is there a way to curb the number of people passing in and out of ORs during cases? The number during a lengthy major surgery can reach a dozen or more, with door openings every minute or two. Door openings affect the OR’s…
BMP use up sharply, but outcomes not improved
Use of bone morphogenic protein (BMP) has risen sharply in the past decade, adding costs without evidence of better outcomes, according to a study in the February 2012 issue of Spine. BMP use rose rapidly, from 5.5% of lumbar fusions in 2003 to nearly a third (28.1%) of procedures in…
Nurse-led protocol reduces catheter use, urinary infections
A nurse-driven urinary catheter-removal protocol helped reduce catheter use by 32% and catheter-associated urinary tract infections (CAUTIs) by 45% per 1,000 patient days over 18 months at one hospital. The finding was different in the hospital's ICUs, however, which report data to the National Healthcare Safety Network (NHSN). In the…
Time to do away with 12-hour shifts?
Evidence indicates extended work hours are a hazard to patients as well as to nurses. Now two nursing professors who have studied nurses' working conditions call for alternatives to 12-hour shifts and urge the profession to rethink their extensive use. "Nurses often prefer working a bunch of 12-hour shifts and…
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