Psychiatric disorder linked to morbidity after fast-track total joints
Editor's Note In this study, patients with psychiatric disorders (PsDs) requiring psychopharmacological treatments had an increase in postoperative morbidity after fast-track total hip and total knee arthroplasties, regardless of treatment type and preoperative comorbidities. Among PsD patients: Pain, postoperative anemia, and pulmonary complications were the most frequent causes of length…
Study: Perioperative mortality 2010 to 2014
Editor's Note This analysis of data from the National Anesthesia Clinical Outcomes Registry found several factors independently associated with increased perioperative mortality (within 48 hours of anesthesia induction): Increasing American Society of Anesthesiologists physical status Emergency case status Cases beginning between 4:00 pm and 6:59 am Patient age less than…
Door openings affect OR pressure during joint arthroplasty
Editor's Note This study from Johns Hopkins Bayview Medical Center, Baltimore, found a significant relationship between OR door openings and room pressure. The OR door was opened, on average, once every 2.5 minutes of surgery. For 77 of 191 knee and hip arthroplasties, the doors were open long enough for…
Specific care bundles successfully cut surgical site infection rates
Three new studies on reducing surgical site infections (SSIs) were reported at the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) conference in July. Researchers at three different institutions identified several process changes that, once implemented, brought down SSI rates. Each study used different methodology, but all…
Editorial
Earlier this year, we published two articles about the emerging perioperative surgical home (PSH) model of care, and the topic was included in a panel session on innovative programs at this year’s OR Manager Conference. The basic concept of the PSH is to provide integrated patient-centered care from the time…
Vanderbilt's anesthesia QI program reduces adverse postoperative events
The anesthesia quality improvement program at Vanderbilt University Medical Center in Nashville can claim a variety of successes, notably less postoperative hypo- and hyper-glycemia and fewer wound infections. When anesthesia providers noticed they weren’t monitoring blood glucose in patients with diabetes as frequently as their own goals specified, they put…
Joint Commission recognizes this year’s top performing hospitals
Editor's Note The Joint Commission on November 17 released its annual report on America’s Hospitals: Improving Quality and Safety, which summarizes data on 49 accountability measures reported by more than 3,300 accredited hospitals. For the first time, acute care hospitals were required to meet program criteria in six sets—an increase…
FDA: Class I recall of G5 Ventilators by Hamilton
Editor's Note The Food and Drug Administration on November 13 identified the recall of Hamilton G5 Ventilators V2.00 and V2.31 as Class I, the most serious. The ventilator may stop working, without sounding an alarm, when the oxygen enrichment key is pressed to attach the mask to the patient. If…
FDA orders recall of all Custom Ultrasonics automated endoscope reprocessors
Editor's Note The Food and Drug Administration (FDA) on November 13 ordered Custom Ultrasonics (Ivyland, Pennsylvania) to recall all of its automated endoscope reprocessors from healthcare facilities because of federal law violations and a consent decree entered with the company in 2007. The violations could result in an increased risk…
Ultrasound-guided vs angiography-guided coronary stent implantation
Editor's Note In patients requiring long coronary stents, the use of intravascular ultrasound (IVUS)-guided vs angiography-guided drug-eluting stent implantation resulted in a significantly lower rate (2.9% absolute reduction, 48% relative reduction) of major adverse cardiac events at 1 year, finds this study. These differences were mainly driven by the reduction…
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