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…

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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…

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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…

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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…

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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…

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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…

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Purchasing managers are used to walking a tightrope between tough bargaining with suppliers and respect for the product preferences of physicians. Eventually, purchasing professionals, as well as physicians, realize these goals need not be inconsistent. The best value often is in the best product. At many ambulatory surgery centers (ASC),…

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Pilot survey: ASC infection control lapses Infection control category Facilities with lapses* Examples of lapses Hand hygiene, use of gloves 12/62 (19%) 4 facilities had providers who failed to perform hand hygiene after contact with blood, body fluids, or nonintact skin. Injection and medication safety 19/67 (28%) 18 facilities used…

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