A 65-year-old man with heart disease schedules a knee arthroscopy with his orthopedic surgeon. Thirty miles away, a note pops up to notify the hospital’s presurgical clinic of the impending surgery. A nurse practitioner pulls up the patient’s electronic health record (EHR), where she reviews the patient’s history. Comparing the…
Preop “nurse navigators” aided by an electronic tool are helping a Pennsylvania health system create a more standardized, user-friendly preoperative process for preparing patients for surgery. A cornerstone of the process is evidence-based guidelines for preop evaluation developed by a 50-person task force. “We wanted to optimize our approach so…
Four years ago, Duke Health’s Preop Screening Unit was facing challenges. The unit had a full schedule, some appointments were double-booked, and some patients had long wait times. There was no system for separating healthy patients from complex ones. Meanwhile, surgery centers were asking the unit to provide screening for…
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)…
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…
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…
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…
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…