Overseeing construction or renovation of an OR suite requires skill, humor, and a large dose of patience. Few nurses feel ready to helm these massive projects, and even experienced nurses seek ways to do it better. "It's like having a child," says Renae Battié, RN, MN, CNOR, director of intraoperative…

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A regular column on sterilization and infection control issues. Asterilizer may be functioning properly, but if all the steps leading up to actual sterilization have not been carried out properly, the processed item may not be sterile. One of those steps is packaging. The wrong package or packaging done incorrectly…

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Changes in reimbursement are bringing nurse-sensitive quality measures to the fore. Medicare will no longer pay for complications like retained foreign bodies and pressure ulcers. And Medicare's administrator has proposed to Congress that part of DRG payments be based on meeting quality measures. That means nurses could be the new…

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Will your preoperative process need to accommodate screening for MRSA? More hospitals are looking at whether to test presurgical patients for methicillin-resistant Staphylococcus aureus, at least for certain procedures, such as those with implants. Evidence shows that patients colonized with MRSA are more likely to develop an infection than those…

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Narance, right, reviews the inventory list for a reorganized set with employee Eric Johnson. Amajor orthopedic case can take 30 instrument trays, some weighing as much as 40 pounds. A Bookwalter retractor alone is over 25 pounds. Hysterectomy sets can top 30 pounds. Day after day, OR and central service…

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Urinary tract infections (UTIs) are the most common hospital-acquired infection, accounting for 40% of such cases. But most hospitals don't have a consistent strategy for preventing catheter-related UTIs. And most aren't taking basic steps that keep UTIs at bay, a new study finds. Use of urinary catheters is common. One…

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After 5 years of planning, Saint Joseph Mercy Hospital in Ann Arbor, Michigan, opened its 18 new ORs in November 2006. A year later, physicians, staff, and the project team are happy with the outcome—a sign of success in the planning and design process. The new ORs and postanesthesia care…

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In the future, patient safety is likely to be as much a part of education for the surgical team as dissection, suturing, and aseptic technique. Simulation labs are one way OR teams will learn to communicate more effectively and prevent errors. Simulation is playing an increasing role in the education…

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Ambulatory surgery centers (ASCs) have a new set of 5 standard measures to use in quality reporting and benchmarking. The measures, endorsed by the National Quality Forum (NQF), were developed by ASC experts. The measures include: 4 patient outcome measures: —patient burn —patient fall in the ASC —wrong site, side,…

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As president and CEO of MedSynergies, Inc, Irving, Texas, John R. Thomas knows insurance benefits. After all, his company offers management and billing solutions to health care providers and facilities. So when Thomas opened an envelope to find his insurance company had sent him a higher-than-expected bill for spinal surgery…

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Aetna informed physicians in December that it will no longer pay for monitored anesthesia care (MAC) for routine GI endoscopy as of April 1. Aetna joins others, including WellPoint, Inc, the nation's largest health insurer, that no longer cover anesthesia monitoring for these procedures. MAC can add $300 to $1,500…

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HCA, the hospital corporation based in Nashville, Tennessee, with 170 hospitals, is taking an aggressive stance on methicillin-resistant Staphylococcus aureus with its "ABCs" for MRSA control. The effort is led by HCA's chief medical officer, Jonathan B. Perlin, MD, PhD, MSHA, FACP. The ABCs include: Active surveillance cultures Barrier precautions…

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