Editor's Note Increased adherence to an Enhanced Recovery After Surgery (ERAS) protocol after total hip arthroplasty (THA) and total knee arthroplasty (TKA) was associated with a decrease in postoperative complications in this study from Spain. However, only a few interventions were linked to decreased complications In this analysis of 6,146…

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At Virginia Commonwealth University (VCU) Health System in Richmond, implementation of Enhanced Recovery After Surgery (ERAS) incorporates principles of Lean thinking, a management methodology that emphasizes “…maximize[ing] customer value while minimizing waste. Simply, lean means creating more value for customers with fewer resources,” according to the Lean Enterprise Institute.1 Several…

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Editor's Note In this study, specialty certification was associated with greater professional identity in ICU nurses and higher perceptions of knowledge of and value in evidence-based practices, whereas education level was not. Of 268 respondents from six hospitals and 12 adult ICUs in an integrated health system, 71% had a…

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Editor's Note Higher levels of nursing education and more certified nurses improved the number of patient falls in this study. Using data from the National Database of Nursing Quality Indicators from 2010 to 2016 from medical centers in Central and Southern Illinois, researchers found that with every 1-unit increase in…

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Editor's Note In this study, competency ratings increased significantly from 1 to 5 months and from 5 to 11 months in a nurse residency program. Preceptors, nurse educators, and/or unit managers rated new nurse residents using The Appraisal of Nursing Practice, an observational rating based on Quality and Safety in…

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Extensive research by Cori L. Ofstead, MSPH, and her colleagues at Ofstead & Associates (St Paul, Minnesota) has raised concerns about insufficient reprocessing of gastrointestinal endoscopes and ureteroscopes—even when recommended practices are followed—and their new study makes a compelling case for more stringent reprocessing of bronchoscopes as well. In their…

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Editor's Note In this study, experts graded the four major publicly reported hospital quality rating systems on their strengths and weaknesses−most received a C and the highest was a B. The grades were: US News & World Report−B Medicare & Medicaid Services’ Star Ratings−C Leapfrog−C- Healthgrades−D+. The researchers found that…

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Editor's Note In this study, patients who had transcatheter aortic valve replacement (TAVR) for bicuspid compared with tricuspid aortic stenosis had no significant difference in mortality, but they had a 30-day increased risk of stroke. In this cohort of 2,691 matched pairs of patients having TAVR for bicuspid vs tricuspid…

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Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations. In 1999, the American Society of Anesthesiologists (ASA) revised their fasting guidelines to clear liquids up to 2 hours before surgery and…

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Editor's Note Hospitals that perform better on measures to prevent postoperative complications also have better performance on measures of profitability, this study finds. Improved patient safety performance was associated with higher net patient revenue for five of seven Surgical Care Improvement Project (SCIP) measures, including starting and stopping preventive antibiotics…

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