When did the health care crisis get to be a crisis? Was it last year with the capital crunch and reimbursement cutbacks? Was it the evolution of managed care and corporate medicine? Does it go back to when Medicare was established? What would Florence Nightingale say about the health care…
The Hospital for Special Surgery (HSS) in New York City has one of the highest volumes of total joint replacements in the world. It also has one of the lowest surgical site infection (SSI) rates. The hospital, which performs about 8,000 joint replacements a year, was recently commended by the…
Under the Joint Commission’s National Patient Safety Goal 07.05.01 on preventing surgical site infections (SSIs), organizations are required to measure their SSI rates. They also need to provide process and outcome measures, such as SSI rates, to key stakeholders; for example, surgeons and senior administrators. Perioperative nurses play an important…
Strong evidence from a new 6-hospital study could lead many ORs to change their traditional practice for surgical skin preparation. In the first prospective, randomized study to compare the effect of 2 skin prep agents on the incidence of surgical site infections (SSIs) after clean-contaminated surgery, a chlorhexidine (CHG)-alcohol product…
New data from Minnesota hospitals offers more insight into preventing pressure ulcers during long surgical procedures. Data collected through the state’s adverse event reporting system in 2009 found 13% of the 122 Stage 3, Stage 4, and unstageable pressure ulcers reported were related to long surgical procedures. Attention to this…
Preoperative baths or showers to prevent surgical infections have played to mixed reviews. Enthusiasm was dampened after a systematic Cochrane review in 2006, updated in 2009, examined 7 trials and found no clear evidence of a benefit for bathing or showering with chlorhexidine gluconate (CHG) over a placebo. Preop bathing…
With tighter budgets and long lists of technology requests, organizations need a fair and systematic way to set priorities. At Virginia Mason Medical Center (VMMC) in Seattle, where Lean manufacturing principles are part of the culture, it was natural to apply Lean to the review of new surgical supplies and…
Every morning when the central service (CS) staff arrived for work, they were greeted by a jumble of unprocessed sets left from the previous day. There were service problems with the OR, and morale was low. "When the first shift came in, there was a never-ending pile of sets. They…