It’s common for physicians to order 2 units of blood. But with growing awareness of the hazards of transfusions, hospitals are adopting stricter measures to manage their blood supplies, including developing guidelines for transfusions and making sure physicians are compliant. Over the past 5 years, research has shown that transfusions…

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A surgical site infection (SSI) prevention “bundle” is helping OR teams at Maine Medical Center (MMC) in Portland to further a strategic goal of preventing SSIs. Known as Operation Zero, or “Op-Z,” the initiative is led by the chief of surgery, Brad Cushing, MD, with inspiration from a family whose…

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Are you following recommended practices when processing implants? Both the Association for the Advancement of Medical Instrumentation (AAMI) and the Association of Perioperative Nurses (AORN) state that a load containing an implant should be quarantined until the results of the biological indicator (BI) testing are available. The rationale is to…

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Patients are getting heavier, and outpatients are no exception. The Centers for Disease Control and Prevention (CDC) classifies nearly one-third of Americans as obese. Meanwhile, the number of procedures deemed suitable for ambulatory surgery centers (ASCs) is increasing. That is not a problem if patients are properly screened, experts agree,…

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Starting now, in January 2012, ambulatory surgery centers (ASC) and hospital outpatient departments need to be using a safe surgery checklist and keep using it through all of the calendar year. That’s one quality measure in Medicare’s new ASC quality reporting program set forth in the 2012 outpatient payment rule…

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Do you know where your OR's process is at most risk for an error that could lead to wrong-site surgery? A South Carolina health system identified its improvement opportunities and came up with solutions as part of a national project with the Joint Commission Center for Transforming Healthcare (CTH). Five…

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The anesthesiologist switches the patient from the ventilator to the cardiopulmonary bypass machine but forgets to resume ventilation after the patient is removed from bypass. The possible results? Longer surgery time, permanent brain damage, or even death. This isn't an uncommon error. A simple "smart system" would give a warning…

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If you were to give patient safety a grade on progress over the past 5 or 10 years, what would it be? OR leaders and their colleagues have participated in an array of initiatives since the Institute of Medicine published its well-known 1999 report, To Err is Human. They include…

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New recommendations for preventing surgical fires seek to change a long-standing practice—open delivery of 100% oxygen to the face during head, face, neck, or upper-chest surgery. The new advice from the Anesthesia Patient Safety Foundation (APSF) and ECRI Institute includes: Use only air for open delivery on the face for…

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Everything from washers to cars comes with a warranty, so why not health care? Geisinger Health System in Danville, Pennsylvania, introduced health care warranties with an innovative program called ProvenCare. Under the 90-day warranty, one cost covers the surgery and 90 days of follow-up treatment. Geisinger absorbs any additional costs…

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