Say goodbye to skin injuries in surgical patients
Hospital-acquired pressure injuries (HAPIs) fall under the care management serious event category, and the literature suggests the incidence of a pressure injury following surgery or a procedure may contribute to more than half of all hospital-related skin injuries. Furthermore, the Centers for Medicare & Medicaid Services (CMS) has defined numerous…
Superior patient-centered care crucial for complex outpatient procedures
About 2 years ago I was diagnosed with prostate cancer. As I researched the treatment alternatives, I became very concerned about the complications associated with traditional surgical prostatectomy or radiation. Then I learned that I might be eligible for an outpatient procedure: high-intensity focused ultrasound (HIFU). Although HIFU is relatively…
Music reduces anxiety before regional anesthesia
Editor's Note Music is a viable alternative to IV midazolam in reducing anxiety before a preoperative peripheral nerve block, this study finds. A total of 157 adult patients were randomly assigned to one of two options 3 minutes before peripheral nerve block−either an injection of 1-2 mg of midazolam or…
Preop opioid, benzodiazepine use linked to postop mortality, opioid consumption
Editor's Note Use of opioids and benzodiazepines 6 months before surgery was associated with increased short- and long-term mortality and an increased rate of persistent postoperative opioid consumption, this study finds. In this analysis of 41,170 noncardiac surgical cases in 27,787 patients in Iceland, preoperative prescriptions for opioids only were…
AHRQ opens enrollment for hospitals to implement enhanced recovery pathways
Editor's Note The American College of Surgeons on June 6 called for interested hospitals to join a new cohort of the Agency for Healthcare Research and Quality (AHRQ) Safety Program for Improving Surgical Care and Recovery (ISCR). In the program, presented in collaboration with the Johns Hopkins Medicine Armstrong Institute…
OR leaders see benefits of briefer NPO period
Though long fasting before a surgical procedure is tied to increased patient risks, the outdated guideline of NPO after midnight continues to be practiced by many healthcare organizations. In 1999, the American Society of Anesthesiologists (ASA) revised their fasting guidelines to clear liquids up to 2 hours before surgery and…
Adherence to ERAS protocols associated with fewer postop complications
Editor's Note An increased in adherence to Enhanced Recovery after Surgery (ERAS) protocols was associated with a decrease in postoperative complications in this study. Of 2,084 patients analyzed, 566 had moderate to severe postoperative complications. The number of patients with moderate to severe complications was lower in the ERAS group…
Patient, surgeon outcomes reporting app helps predict success of ventral hernia repair
Editor's Note Researchers have developed an online app that patients and surgeons can use to guide preoperative planning and provide predictive data for how a patient’s ventral hernia repair will turn out. The basis of the app is a tool named the “Outcomes Reporting App for CLinical and Patient Engagement”…
Intervention to reduce low-value preop tests before cataract surgery
Editor's Note Reducing low-value testing before cataract surgery was associated with cost savings for financially capitated healthcare systems, but it was also associated with losses for fee-for-service healthcare systems, which could be a barrier to eliminating low-value care, this study finds. Of 1,054 patients (469 intervention, 585 controls) included in…
Preop functional status predicts total hip outcomes
Editor's Note Compared with preoperative independent functional status, preoperative dependent functional status was independently associated with worse outcomes after primary total hip arthroplasty in this study. Of 43,179 patients analyzed, those who were less able to care for themselves: were 2 to 3 times more likely to have surgical complications…
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