Concerted efforts to reduce readmissions have paid off at Inova Fairfax Hospital in Falls Church, Virginia. Among its bragging rights since launching an initiative last year: decreased length of stay for colorectal surgery patients and a downward trend in readmissions. To learn how they did it, OR Manager spoke with…

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Even in patients actively warmed with forced air during surgery, hypothermia is routine during the first hour of anesthesia, a new study finds. Intraoperative core hypothermia causes complications such as coagulopathy, surgical site infections, and possibly myocardial complications. It also decreases drug metabolism, prolongs recovery, and causes thermal discomfort. Warming…

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Over the past decade, the number of quality measurement programs has grown exponentially as hospitals respond to public and government demands for greater accountability and improved patient care. During this time, quality programs have been focused largely on how to do quality, how to measure it, how to improve it,…

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Serious barriers—including resistance from nursing leaders—are keeping nurses from adopting evidence-based practices that could improve nursing outcomes, finds a survey of more than 1,000 RNs. Leader and manager resistance was ranked among the top barriers along with politics and organizational cultures. Asked what would help, respondents named education, access to…

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Preop “nurse navigators” aided by an electronic tool are helping a Pennsylvania health system create a more standardized, user-friendly preoperative process for preparing patients for surgery. A cornerstone of the process is evidence-based guidelines for preop evaluation developed by a 50-person task force. “We wanted to optimize our approach so…

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Editor's note AUGUST 2011 OR leaders are striving to make evidence-based decisions about new technology. OR Manager, Inc., and ECRI Institute have joined in a collaboration to bring quarterly supplements with summaries of the Institute's Emerging Technology Evidence Reports to OR Manager readers. ECRI Institute is an independent nonprofit organization…

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Every OR has policies and procedures for environmental cleaning. But how do you know surfaces are truly free of pathogens that could transmit infection? The stakes are high. Environmental contamination plays a role in the spread of methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), and Clostridium difficile, among others. Evidence…

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New clinical evidence can take a long time to find its way into practice. How to accelerate that process is the subject of a new project by the Institute for Healthcare Improvement (IHI). Project JOINTS, rolled out in 5 states in April 2011, focuses on accelerating adoption of evidence-based practices…

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Robotic surgical procedures *Includes cardiothoracic, general, and other urologic and gynecologic procedures. Source: ECRI Institute, 2008. Mention robotics in OR circles, and you're likely to spark a debate. Is robotic surgery an innovative technique with wide application or mainly a marketing ploy to attract patients? Or does the truth lie…

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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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