Compounding pharmacies have long been valued for their ability to tailor prescription drugs for specific patients. More recently, they have helped conserve scarce drugs by redistributing them from larger to smaller single-use vials. For an ambulatory surgery center (ASC) that is not associated with a hospital and therefore has no…

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Though retained surgical items (RSIs) cases are rare, they do happen, and they take a heavy toll throughout the system in terms of steep fines, malpractice claims, and compromised patient safety. Estimates of RSIs range from 1 in 1,000 to 1 in 7,000 procedures. And a 2003 study by the…

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Hospitalizations involving a lost sponge or instrument cost more than $60,000 on average, and related malpractice suits can cost hospitals between $100,000 and $200,000 per case, according to a March 8 USA Today article on retained surgical items (RSIs). “For many hospitals, lost sponges and other surgical items aren’t considered…

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Noise in the OR, whether it is the sound of loud equipment, talkative team members, or music, is a patient and surgical safety factor that can affect the processing of auditory information by surgeons and other members of the OR team, finds a study. The study is the first to…

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During a procedure in the OR, a medication is retrieved from the automated supply station and introduced onto the sterile field. The sterile field is then, unknowingly and unintentionally, contaminated by an unsterile medication. This example could happen in any operating room setting. In this case, the circulating nurse spoke…

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The circulating nurse was cleaning up after surgery in an ambulatory surgery center (ASC) when she noticed the internal chemical indicator (a Class 5 integrating indicator) had not reached its appropriate endpoint response, which is a pass. That meant an unprocessed instrument tray had been used on the patient. Her…

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The number of elderly people in the US is on the rise, and so is the number of older patients having surgery. However, while advances in technology and techniques may make surgery more feasible for those age 65 and older, ensuring successful outcomes for this cohort is challenging. Specific guidelines…

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Sixth in a series on ten elements of safer surgery.   Could you and your team find 30 minutes a day to prepare for the next day’s surgical schedule? The effort can be worthwhile. A Chicago-area hospital has found that a half-hour daily huddle not only heads off delays and…

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AORN leaders’ efforts over the past few years have led to evidence-rated recommendations for some of the 2013 Perioperative Standards and Recommended Practices (RPs), representing “landmark progress in the evolution of recommended practices,” according to Ramona Conner, MSN, RN, CNOR, manager of the standards and recommended practices. Conner introduced speakers…

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Anyone undergoing surgery is at heightened risk of falling, especially during recovery from sedation, and for the most vulnerable patients, a fall can be disabling or even deadly. Falls are among the adverse events monitored by the Centers for Medicare and Medicaid Services and state surveyors. The science of assessing…

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