Surgeons reduce opioid prescriptions using new multipronged strategy
Editor's Note A system-wide, multipronged pain management and opioid reduction program significantly reduced postoperative opioid discharge prescriptions written for more than 5 days, this study finds. Surgeon education, monitoring, and incentives lead to a shift from longer-term to shorter-term prescriptions for patients after surgery, reducing postoperative opioid prescriptions of more…
Use of frailty screening tool to predict poor postop outcomes
Editor's Note The Risk Analysis Index (RAI) frailty screening tool, which was previously validated in the VA health system, can be efficiently implemented in multispecialty, multihospital healthcare systems to predict adverse postoperative outcomes, including mortality, readmission, and extended hospital stays, this study finds. From July 1 to December 31, 2016,…
Improved work environments linked to lower nurse burnout, higher patient satisfaction
Editor's Note This study from Linda Aiken, PhD, and colleagues at the University of Pennsylvania, Philadelphia, found that high levels of nurse burnout are associated with lower patient satisfaction. In this analysis of nurse burnout and patient satisfaction in 463 hospitals in four states, 50% of the hospitals where burnout…
Preop cancer-related malnutrition depends on cancer type
Editor's Note Common definitions of malnutrition do not apply to all cancers, and the best approach for surgeons to identify malnourished cancer patients preoperatively is specifically related to the type of cancer the patient has, this study finds. Of 205,840 major cancer surgical procedures for six different cancers analyzed: 16%…
Back to basics: How collaboration can improve PACU patient flow
Healthcare technology can be a great thing, but nurses at Abington—Jefferson Health, in Abington, Pennsylvania, have discovered that sometimes stepping back from it is the best way to make progress. Going low-tech was the key that unlocked patient flow gridlock that had plagued the postanesthesia care unit (PACU). Before 2017,…
Using project management principles to hardwire ERAS protocols
Implementation of Enhanced Recovery After Surgery (ERAS) at Virginia Commonwealth University (VCU) Health System in Richmond has been achieved through project and change management tools that transform the current state to the desired future state. To hardwire ERAS protocols in the OR as well as the ambulatory and acute care…
How prepared is your ASC to handle a surgical emergency?
Surgical errors and emergencies can happen at any time, at any facility. For ambulatory surgery centers (ASCs), a major challenge is finding official guidance on the topic. For the most part, it’s up to the individual facility to craft its own policies, competencies, and drills for OR emergencies. “The Association…
Use of internationally educated nurses in US hospitals
Editor's Note US hospitals with more internationally trained nurses have more stable, educated, nursing workforces, and collaboration among healthcare professionals is not hindered, this study finds. Researchers analyzed 2013 survey data from the National Database of Nursing Quality Indicators that included responses from 24,045 nurses (2,156 were trained outside the…
Using smartphones to capture patient differences in postop physical recovery
Editor's Note Metrics derived from smartphone accelerometer data can capture differences in postoperative physical recovery in surgical patients, this study finds. In this analysis of 62 patients, smartphone accelerometer data showed decreases in daily exertional activity in 17 who experienced a postoperative event (eg, complication, reoperation) up to 6 weeks…
Joint Commission: Texas hospital earns first Primary Heart Attack Center certification
Editor's Note The Joint Commission announced February 19 that the Texas Health Harris Methodist Hospital in Fort Worth has been awarded the first Primary Heart Attack Center (PHAC) certification by the Joint Commission and American Heart Association. The certification standardizes and improves coordinated systems of care for identification, assessment, monitoring,…
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