Editor's Note In this advisory, the Pennsylvania Patient Safety Authority reviews retained surgical item (RSI) events in Pennsylvania hospitals and RSI guidelines from various organizations. Analysis of events reported to the Pennsylvania Patient Safety Authority from 2014 to 2015 reveals 112 RSIs that met the definitions of the National Quality…

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Editor's Note The Joint Commission’s Targeted Solutions Tool (TST) for Hand-off Communications provides a framework for what the communication process between hospitals and skilled nursing facilities should be to reduce potential patient readmissions, the Joint Commission said in a March 15 news release. “The TST helps organizations: Facilitate examination of…

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Editor's Note Bariatric surgery performed before hip or knee replacement can reduce in-hospital and 90-day postoperative complications, finds this study presented March 14 at the American Academy of Orthopedic Surgeons annual meeting in San Diego. Compared with morbidly obese patients who did not have bariatric surgery before joint replacement, those…

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Editor's Note There were about 3.1 million fewer hospital-acquired conditions (HACs) between 2010 and 2015, according to a newly released report from the Agency for healthcare Research and Quality (AHRQ). Most of the decline was because of a: 42% reduction in adverse drug events 23% drop in pressure ulcers 15%…

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Editor's Note The Food and Drug Administration (FDA) on March 14 categorized the recall by Medtronic (Minneapolis) of its SynchroMed II and SynchroMed EL implantable drug infusion pumps as Class I, the most serious. The pumps are being recalled because a software problem may cause unintended delivery of drugs during…

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Editor's Note Lumbar spinal fusion performed within 3 months after lumbar epidural steroid injections was associated with a statistically significant increase in postoperative infections in this study. The association was not found when surgery was performed more than 3 months after steroid injections. Of 88,540 patients analyzed, infection rates were:…

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Editor's Note The use of inpatient rehabilitation compared with a monitored home-based program did not improve mobility at 26 weeks after total knee surgery, this study finds. In the study, 81 patients received 10 days of hospital inpatient rehabilitation followed by an 8-week home-based program, and 87 patients received only…

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Editor's Note The ECRI Institute on March 13 released its 2017 Top 10 Patient Safety Concerns for Healthcare Organizations. This year’s list includes: Information management in electronic health records Unrecognized patient deterioration Implementation and use of clinical decision support Test result reporting and follow-up Antimicrobial stewardship Patient identification Opioid administration…

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Editor's Note The Coalition for Quality in Geriatric Surgery (CQGS) developed high-quality, valid standards to improve surgical care in the older adult, this study finds. A total of 306 of 308 standards developed were rated as valid to improve quality of geriatric surgery, 290 were rated as feasible, and 18…

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Editor's Note The Food and Drug Administration (FDA) on March 8 issued a Safety Alert about the use of balloon angioplasty devices to perform an experimental procedure, called transvascular autonomic modulation (TVAM). TVAM consists of threading a catheter into a patient’s venous system, such as the jugular vein, where a…

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