Editor's Note In this study from Israel, researchers found that surgical scrubs worn outside the OR were contaminated with a low bacterial load and only a small number of pathogenic bacteria. For the study, specimens were collected at the entrance to the OR from surgical scrubs worn by 133 surgeons.…

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Editor's Note In this study from Washington University School of Medicine, St Louis, a first case on-time starts (FCOTS) improvement initiative was linked to a higher frequency of FCOTS, which was independently associated with last case on-time ends (LCOTE) and decreased OR overtime costs. Of 12,073 cases (6,095 pre- vs…

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Editor's Note In this study, researchers at the Massachusetts General Hospital, designed, implemented, and assessed the effect of the first surgery-specific peer support program in the US. The program uses five steps: creation of a conceptual framework choice of peer supporters training of peer supporters multifaceted identification of major adverse…

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Malignant hyperthermia (MH) is a rare but life-threatening surgical complication that seems to turn the effects of general anesthesia upside down. Instead of relaxing, muscles become rigid, releasing large amounts of acid and potassium into the blood. Instead of a normal slowing of breathing, respirations quicken, and end-tidal CO2 rises.…

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Projections for healthcare industry trends in 2020 started to proliferate near the end of 2019 as attention turned to the new year. Reflecting on the Institute of Medicine’s (IOM) landmark 1999 report, “To Err Is Human: Building a Safer Health System,” some healthcare leaders said the report has raised awareness…

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A care transition poses a danger point for patients—failing to “hand off” needed information from one clinician to another can lead to significant morbidity and mortality. The Joint Commission was so concerned about handoffs that in 2017 it issued a sentinel event alert on the topic. “Handoffs are a safety…

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In 2017, the Joint Commission issued a Sentinel Alert Event on the problem of inadequate handoff communication, focusing attention on this vital aspect of care. (See related story, p 22.) Clinicians and leaders agree that handoffs are important, but implementing them effectively can be challenging, particularly in the fast-paced perioperative…

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Enhanced Recovery After Surgery The implementation of Enhanced Recovery After Surgery (ERAS) is based on the concept of organizing care around the patient, addressing medical condition needs to optimize readiness for surgery and reducing the likelihood of postoperative complications. Efficacy is measured by how well we perform according to these…

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Editor's Note In this study from New York University Rory Meyers College of Nursing, nurses were found to sleep nearly an hour and a half less before work days than before days off, affecting patient care and safety. Using data from two surveys of 1,568 nurses collected in 2015 and…

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Editor's Note In this analysis of measurements (ie, staff’s caring, workplace engagement, and work empowerment) assessed before and after implementation of an interprofessional shared governance model, only work empowerment scores of staff working in relationship-based care professional practice models were sustainable and increased progressively and significantly over time. Work engagement…

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