All ORs have protocols for cleaning between cases and at the end of the day’s schedule. But constant vigilance is needed to make sure cleaning is thorough and carried out consistently. Though an OR may look clean, studies have shown there’s room for improvement. For example, only 25% of OR…

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Productivity monitoring and management are near the top of the priority list for every perioperative nursing director. With 50% to 80% of a hospital’s costs in labor, staffing dollars are a big target for cost management. Some experts say hospitals and health systems will face budget cuts of 20% to…

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This month’s article on preop testing research had a familiar ring (page 20). Researchers at the University of Texas Medical Branch (UTMB) in Galveston have found much more testing is being done than seems to be needed. They’re documenting the patterns. Seems not much has changed. These new studies join…

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Surgical checklists have gained traction in recent years as studies have shown that they improve patient safety. Using surgical crisis checklists might be the next logical step, judging by a recent simulation study. OR staff missed just 6% of life-saving steps when using crisis checklists, but when staff relied on…

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A protocol using color-coded zones has yielded a more thorough, efficient cleaning process for one 17-room OR. The OR leaders knew they had to step up cleaning as part of an effort to reduce surgical site infection (SSI) rates and to accomplish between-case cleaning more systematically. The answer: Divide each…

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Manual cleaning is performed by humans, and thus will always be imperfect. Could technology lend a hand? Some hospitals and a few ORs are adopting an extra disinfection step—employing robot-like machines that can disinfect an entire room. The machines are meant to augment—not replace—manual cleaning. These technologies have some compelling…

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Ten elements of safer surgery. The third in a series, this article focuses on presurgical evaluation.   Making sure patients have the appropriate preoperative preparation, including testing, is necessary not only for patients’ safe care but also for a smooth process on the day of surgery. Advocate Health Care, a…

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What preoperative tests does your facility require for a healthy 40-year-old having a knee arthroscopy? What about a healthy 82-year-old having an elective procedure? Do these patients need testing at all? A good deal of testing is performed without clinical indications, studies have found. Researchers at the University of Texas…

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A float position that combines the duties of a surgical technologist (ST) and a central service (CS) technician creates closer ties between the OR and CS departments and improved morale in CS for a 400-bed community hospital. “These have been independent workforces, but they are highly related,” says Brian Whorley,…

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I have heard the following statement from OR personnel: “We use rigid sterilization containers and run a 270-275ºF (132-135ºC) prevacuum steam sterilization process in our OR. So we no longer use IUSS.” Is that an IUSS cycle? IUSS, or immediate-use steam sterilization, was formerly known as flash sterilization. This article…

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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,…

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