Crew resource management in the OR takes another step forward with the World Health Organization's (WHO) launch of Safe Surgery Saves Lives, which puts a new checklist, the surgical safety checklist (SSC), at the center of patient safety. Preliminary results from 8 pilot sites worldwide indicate the checklist nearly doubled…

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Revised infection control guidelines for GI endoscopy have been issued by the Society of Gastroenterology Nurses and Associates (SGNA) and the American Society for Gastrointestinal Endoscopy (ASGE). Both SGNA and ASGE point out that failure to adhere to established reprocessing guidelines accounts for most if not all of reported cases…

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In the middle of the night, a patient arrives with a leaking abdominal aortic aneurysm, and the surgeon wants to insert an endograft. Or a patient arrives with a major pelvic fracture. Another patient needs an image-guided craniotomy. Who will answer the call? In an ideal world, specialized teams for…

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Radio frequency identification systems (RFID) have the potential to cause critical patient equipment to malfunction, Dutch researchers report in the June 25 JAMA The researchers tested 2 types of RFID systems in a nonclinical setting with 41 medical devices such as external pacemakers, ventilators, infusion pumps, and anesthesia devices. There…

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Third article in a series on performance management. This article continues to build on the first 2 articles in this series, published in the June and July issues. The first article gave an overview of the performance management process. The second article covered the job description, initial competencies, orientation, and…

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Medicare plans to step up quality reporting in 2009 for hospital outpatient departments. Ambulatory surgery centers (ASCs) would get a reprieve for 2009, as they did for 2008. A draft rule issued July 3 by the Centers for Medicare and Medicaid Services (CMS) proposes 2009 updates for the outpatient prospective…

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The Joint Commission has overhauled its standards, intending to make them easier to understand and use. The revised standards were posted online July 1 for hospitals, critical access hospitals, ambulatory care, office-based surgery, and home care. The standards are effective Jan 1, 2009, for these programs. No new standards have…

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The Joint Commission has revised the Universal Protocol for surgical site verification for the first time since its launch in 2004. The revised protocol, effective Jan 1, 2009, follows the same format as Joint Commission standards, with a rationale and elements of performance. The changes were announced June 17 with…

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Organizations that haven't already adopted evidence-based practices to prevent infections will need to do so to meet Joint Commission National Patient Safety Goals in 2009. For surgery, that includes appropriate administration of antibiotics and eliminating preoperative shaving. As part of the 2009 goals announced June 17, facilities will have to…

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The community turned out to help sandbag at Mercy Medical Center in Cedar Rapids, Iowa. As Mercy Medical Center's OR nurses were readying their patients for their 7:30 am cases on June 12, the Cedar River, some 10 blocks away, was edging dangerously close to the top of its banks.…

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Just run it up before the case." "Flash it." "Put it in the flash sterilizer." These are all phrases you hear in the OR. It has become increasingly clear to me that there is confusion about the words flash, flash sterilization, flash cycle, and flash sterilizer. There is general agreement…

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Many nurses at ambulatory surgery centers managed by Addison, Texas-based United Surgical Partners International (USPI) are sporting a new badge. It says, "We Care," followed by a promise to speak up if they see an error or potential error in treatment. It is a promise to patients and physicians. It…

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If certain proposed rules regarding Medicare conditions for coverage (CFC) take effect, ambulatory surgery centers (ASCs) will face more complex—and some say unfair—regulatory criteria. The Centers for Medicare and Medicaid Services (CMS) plans to release final rules later this year, to take effect in January 2009. Until then, ASCs should…

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