Chlorhexidine better than triclosan for skin prep
Editor's Note Chlorhexidine is the best antiseptic for skin prep when a prolonged effect is needed, such as when implanting medical devices or performing surgical procedures, this study finds. Of 135 healthy volunteers tested, at 24 hours: unscrubbed control bacterial counts were 288 CFU/cm2 scrubbed control counts were 96 CFU/cm2…
Henry Ford drops out of total joint bundled-payment program
Editor's Note Henry Ford Health System (Detroit, Michigan) is one of dozens of organizations that have dropped out of Medicare’s bundled payment model program in the past 3 years, the November 29 Modern Healthcare reports. In 2013, three of Henry Ford Health System hospitals participated in the first phase of…
Impact of discontinuity in nursing care
Editor's Note Discontinuity in nursing care in hospitals was high and negatively impacted patient clinical conditions in this study. Discontinuity in care declined from nearly 100% in the first 24 hours, to 70% at 36 hours, and to 50% by the 10th day after admission. Each instance of discontinuity lead…
Effectiveness of SAS in predicting emergency surgery outcomes
Editor's Note The Surgical Apgar Score (SAS) was found to be significantly predictive but weakly discriminative for major complications and death after emergency high-risk abdominal surgery in this study. The risk of major complications, death, and ICU admission increased significantly with decreasing SAS (P < .001). The score’s c-statistics were…
CDC updates guidelines on CHG dressings
Editor's Note The Centers for Disease Control and Prevention (CDC) is accepting comments on the draft update to its recommendations for the use of chlorhexidine (CHG)-impregnated dressings to prevent intravascular catheter-related infections. The draft addresses new and updated strategies and is based on a review of the evidence since 2010…
Residents’ perceptions of patient safety linked to duty hour violations
Editor's Note Surgical residents who perceived negative effects of The Accreditation Council for Graduate Medical Education’s duty hour policies on patient safety were more likely to violate duty hour policies, this study finds. Of 4,554 residents in 184 programs analyzed: 25.3% felt the current duty hour policies negatively affected patient…
Risk Analysis Index measures frailty in surgical patients
Editor's Note In this study, a Risk Analysis Index was found to measure frailty in surgical patients with predictive ability equal to other frailty tools, with an additional advantage of rapid, real-time, preoperative assessment feasible for guiding surgical decision making. The Index measures frailty prospectively using a questionnaire or retrospectively…
FDA: Class I recall of SentreHeart’s FindrWIRZ Guidewire System
Editor's Note The Food and Drug Administration (FDA) on November 22 categorized the recall by SentreHeart (Redwood City, California) of its FindrWIRZ Guidewire System as Class I, the most serious. The recall was initiated because the PTFE coating may separate from the packaging and potentially cause serious injuries to patients. The…
Study: Nursing skill mix linked to mortality, quality
Editor's Note This study led by Linda H. Aiken, PhD, University of Pennsylvania School of Nursing, Philadelphia, finds that employment of more nurse assistants relative to the number of professional nurses in hospitals is associated with higher mortality and lower quality of care. Every 10-point increase in the percentage of…
Factors associated with postop readmission to nonindex hospital
Editor's Note Patients who were readmitted to a nonindex hospital after having emergency general surgery were significantly more likely to have had their index surgery at a large, teaching, safety-net hospital, this study from Brigham and Women’s Hospital, Boston, finds. Readmission to a nonindex hospital was independently associated with mortality…