Safety/Quality

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Increased duration of surgical antimicrobial prophylaxis linked to adverse events

Editor's Note In this multi-center study, longer durations of surgical prophylaxis did not result in further reductions in surgical site infections (SSIs) but were associated with increasing adverse events. Of 79,058 surgical patients in the VA healthcare system, SSI was not associated with duration of prophylaxis, but odds of acute…

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By: Judy Mathias
April 25, 2019
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FDA considering additional regulatory actions to reduce duodenoscope risks

Editor's Note The Food & Drug Administration on April 16 announced it is considering additional regulatory actions, including consulting with federal health experts for guidance, to reduce the risks of contamination and infections associated with duodenoscopes. The FDA is also working with manufacturers of disposable duodenoscopes that would make reprocessing…

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By: Judy Mathias
April 23, 2019
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How will artificial intelligence impact surgical patient care? Part 1

Artificial intelligence (AI) may be coming to your OR sooner than you think. AI is already being used to identify areas needing quality improvement by analyzing surgical workflow, communication patterns, and errors that went unnoticed during a procedure. OR leaders need to understand AI and participate in its development and…

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By: Cynthia Saver, MS, RN
April 22, 2019
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Imagining the unimaginable: Preparing for mass casualty

The Centers for Medicare & Medicaid Services (CMS) and the Joint Commission require healthcare facilities to have policies and protocols in place for emergency situations and to hold regular practice drills. With natural disasters like hurricanes, floods, or fires, often there is at least some warning—some amount of time to…

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By: Elizabeth Wood
April 22, 2019
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AI detects prostate cancer as well as experienced radiologists

Editor's Note A new artificial intelligence (AI) system developed by researchers at the UCLA David Geffen School of Medicine improved the ability to diagnose prostate cancer in this study. The system, called “FocalNet,” helps identify and predict the aggressiveness of the disease by evaluating MRI scans. Results showed that FocalNet…

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By: Judy Mathias
April 17, 2019
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Editorial

Attendees at the annual OR Manager Conference have enjoyed the opportunity to ask experienced OR leaders questions about difficult managerial and clinical issues. The popularity of these “Ask Me Anything” sessions reflects the hunger for knowledge about how things are handled in ORs around the country, and they will be…

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By: Elizabeth Wood
March 15, 2019
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'Coming clean' in the SPD requires collaboration and competency—Part 1

Contaminated surgical instruments made ECRI Institute’s 2019 annual top 10 list of health technology hazards, coming in at number five: “Mishandling flexible endoscopes after disinfection can lead to patient infections.” Number two on the list in 2018 was “Endoscope reprocessing failures continue to expose patients to infection risk.” It’s not…

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By: Cynthia Saver, MS, RN
March 15, 2019
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Prioritizing patient safety unites and empowers OR team—Part 2

Several never events at The Medical Center of Aurora (TMCA) in Aurora, Colorado, over a 1-year period prompted leaders there to launch patient safety first (PSF) initiatives. Part 1 of this series discussed how these initiatives were identified and implemented, and the importance of evidence-based communication tools (OR Manager, March…

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By: Iris Llewellyn
March 15, 2019
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Protective garments get makeover in new cleaning protocol

Surgical site infections are multifactorial, and perioperative leaders often struggle with how to reduce or eliminate them. In 2013, after an unexplained increase in surgical site infections (SSIs) among patients undergoing total hip arthroplasty at our facility, we began to investigate the cause. A fairly robust ERAS (enhanced recovery after…

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By: Rhonda L. Anders
March 15, 2019
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Joint Commission moves THKR performance measures

Editor's Note The Joint Commission on March 6 announced that it is moving the inpatient and outpatient Total Hip and Total Knee Replacement (THKR) implementation guides from the performance measure webpage to the 2019 Specifications Manual for Joint Commission National Quality Measures. The Manual was published in February. The move will…

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By: Judy Mathias
March 11, 2019
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