Editor's Note Very low pressure irrigation with saline is an acceptable, low-cost alternative for irrigating open fractures, this study finds. Managing open fractures requires wound irrigation and debridement, but the effectiveness of various pressures and solutions remains controversial. Researchers investigated the effects of castile soap versus normal saline irrigation delivered…

Read More

Editor's Note Though recent studies using large databases have concluded that neuraxial compared with general anesthesia is associated with a decreased incidence of SSIs in total joint patients, this 11-year retrospective, controlled study found no difference. The use of peripheral nerve blocks also was not found to influence the incidence…

Read More

Editor's Note The Joint Commission reviewed 9,119 sentinel events from 1995 through the second quarter of 2015. They included: 1,162—wrong-patient, wrong-site, wrong-procedure 1,037—unintended retention of a foreign body 1,013—delay in treatment 884—op/postop complication 228—medical-equipment related 182—infection-related event 130—fire 109—anesthesia-related event.  

Read More

Editor's Note Nearly one-quarter of more than 600 wrong-site surgery events reported to the Pennsylvania Patient Safety Authority (PPSA) since 2004 have involved wrong-site anesthesia blocks. Based on these findings, PPSA has developed evidence-based practices for preventing wrong-site surgery and wrong-site anesthesia blocks that complement the Joint Commission’s Universal Protocol.…

Read More

Editor's Note Medtronic has agreed to buy RF Surgical Systems for $235 million. The technology embeds radio frequency tags in surgical sponges, towels, and other products to help track and prevent them from being retained in the patient after surgical procedures.   Medtronic agreed to pay $235 million to buy…

Read More

Studies have estimated the incidence of retained surgical items (RSIs) as one in 5,500 to one in 6,975 cases. In October 2013, The Joint Commission issued a Sentinel Event Alert on RSIs, and periodic reports in the media have raised the public’s awareness of this persistent problem. Effective policies, reliable…

Read More

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…

Read More

Use of the World Health Organization’s surgical safety checklist has reduced surgical complications and mortality, but a narrow escape after a checklist failure at an Italian hospital suggests that more vigilant efforts are needed to avoid errors. In August 2012, an 81-year-old patient with vascular dementia was brought to the…

Read More

Fifth in a series on ten elements of safer surgery.   This marks the fifth year since the worldwide roll-out of the World Health Organization (WHO) Surgical Safety Checklist. In some hospitals, the checklist has taken root and become a way of life. In others, acceptance is slower. For others,…

Read More

Since the early days of aviation, pilots have used checklists before, during, and after each flight. Cooks follow recipes. Builders don’t build without team meetings and signoffs at every step. Health care professionals, however, only recently began to adopt checklists. Often, the excuse has been that medicine is an art,…

Read More