Capnography—is it the standard of care for patients having moderate sedation? Should capnographic monitoring be added for procedures performed under moderate sedation in areas like the preop holding area, GI endoscopy unit, and cath lab? The issue is generating discussion following an update in the American Society of Anesthesiologists (ASA)…

Read More

Perioperative nurses’ roles have expanded to the point where it is difficult for them to be experts in all areas, especially the reprocessing of complex medical devices. And with reimbursement pressures, OR clinicians need to focus on patient care and physician satisfaction. So I challenge each operating room to recognize…

Read More

The impact of health care reform on ambulatory surgery centers (ASC)—like that on health care in general—is still uncertain. But plenty of other factors are at work that are likely to play a role in shaping the industry’s future. While the dramatic growth of the 1990s has largely abated, a…

Read More

Cataract surgery, almost exclusively outpatient, can have a serious complication if instruments retain a chemical residue after cleaning. It is known as TASS, for toxic anterior segment syndrome. Ophthalmologists say it is rare, but there are no consistent data to indicate when, where, and how often TASS occurs. The Food…

Read More

In a new alert, the Joint Commission adds its voice to calls to curb fatigue from extended work days and work hours. The alert highlights evidence linking fatigue to adverse events and outlines actions organizations can take to mitigate fatigue, especially among nurses and physicians. The commission says the alert…

Read More

Hospitals have aggressive cost reduction goals coupled with more quality incentives. “In the past, we would hear of goals in the millions of dollars,” says Lani Berman, MPH, MBA, senior vice president, performance services for VHA Inc. Today, she says goals are often in the hundreds of millions, especially for…

Read More

An agreement with orthopedic and spine surgeons to share savings has enabled a large medical center to make major strides on its implant costs. It’s also provided eye-opening opportunities to improve patient care. Under the agreement, termed gainsharing, a hospital and physicians enter into a formal contract to share savings…

Read More

Negotiating with orthopedic vendors can be frustrating as OR leaders strive to balance competing agendas among companies, surgeons, and the hospital. Kimberley Murray, MS, RN, CNOR, administrator for the orthopedic and spine service line at St. Joseph’s Hospital (SJH) in Syracuse, New York, reduced frustration by adopting a program that…

Read More