Preventing surgical infections is what perioperative nursing is all about. From the moment they don a scrub suit and cap, they engage in well-practiced steps to protect patients from harmful micro-organisms. Surgical site infections (SSIs) are a well-known cause of suffering and death. An estimated 500,000 SSIs occur each year.…
A new study in the New England Journal of Medicine finds that treating patients who are Staphylococcus aureus nasal carriers with mupirocin nasal ointment and chlorhexidine gluconate soap for 5 days reduces hospital-associated postoperative S aureus infection by 60%. "This well-designed, well-executed study contributes more to our knowledge that screening…
If you were to give patient safety a grade on progress over the past 5 or 10 years, what would it be? OR leaders and their colleagues have participated in an array of initiatives since the Institute of Medicine published its well-known 1999 report, To Err is Human. They include…
The state of Michigan, which used a 5-step checklist to virtually eliminate central-line bloodstream infections in ICUs, has been able to keep the number near zero for 3 years. Peter Pronovost, MD, PhD, a patient safety expert at Johns Hopkins University School of Medicine who developed the checklist, says the…
Why do we so often see the statement, "use in accordance with manufacturer's instructions" in sterilization and disinfection standards and guidelines? That advice is in recommendations from the Association for the Advancement of Medical Instrumentation (AAMI), the Association of periOperative Registered Nurses (AORN), and the Centers for Disease Control and…
Missing instruments and supplies can be one of the OR's biggest frustrations. Chasing down instruments or retrieving items during a case wastes time, irritates surgeons, and prolongs the patient's time under anesthesia. At Exempla Good Samaritan Medical Center in Lafayette, Colorado, chronic problems had eaten away at morale. "We wanted…
A guest column on regulatory standards. In mid-December, the Centers for Medicare and Medicaid Services (CMS) issued an 18-page Survey and Certification memorandum that clarifies and adds new requirements and interpretive guidelines for anesthesia services in Medicare-certified hospitals. Given the Joint Commission's requirement to mirror CMS regulation, we should anticipate…
When surveyors from the Centers for Medicare and Medicaid Services (CMS) arrived at Robinwood Surgery Center in Hagerstown, Maryland, at 2 pm one day last summer, the leaders were ready. "The surveyors were very thorough. You won't pass this if you don't operate as a quality facility and follow all…