Feasibility of preop cognitive stratification of older surgical patients
Editor's Note Preoperative cognitive screening is feasible in most older elective surgical patients, and results show a substantial prevalence of probable cognitive impairment in this population, this study finds. Because preexisting cognitive impairment is emerging as a predictor of poor postoperative outcomes in seniors, researchers examined whether preoperative cognitive screening…
Mobility predicts postop outcomes in older patients
Editor's Note A quick, reliable, and cost-effective mobility assessment tool helped to identify older patients at risk for adverse postoperative outcomes in this study. Mobility was assessed with 10 animated video clips of activities. Patients were asked to watch each clip and respond to a series of questions about their…
Total joint patients benefit from preop one-on-one education sessions
Editor's Note Total joint patients benefited from preoperative one-on-one educations sessions provided by a physical therapist and access to a custom web portal, in this study presented February 20 at the annual meeting of the American Physical Therapy Association. Researchers from the Hospital for Special Surgery, New York City, followed…
Rates of lab tests before low-risk surgical procedures
Editor's Note Depending on which hospital a patient goes to for a low-risk surgical procedure, he or she may be 2.4 times more or less likely to be sent for preoperative blood work, this study finds. Researchers found that overall, unnecessary preoperative lab tests (eg, complete blood count, blood clotting…
Preanesthesia testing area well positioned to prepare patients for surgery
Is your preanesthesia testing area providing measurable value, and is it positioned to drive surgery toward a new paradigm of care? As government payers shift toward value-based care with the required bundled payment for total joints starting in 800 hospitals and 75 markets (as part of the Comprehensive Care for…
Calming words as effective as preop medication to relax patients
Editor's Note A few calming words from an anesthesiologist are as effective as medication in relaxing patients before anesthesia and surgery, finds research presented at the Anesthesiology 2015 annual meeting. Researchers compared conversational hypnosis (ie, talking quietly and positively and focusing the patient’s attention on something other than the upcoming…
Study questions use of two common preop tests
Editor's Note A significant percentage of two common preoperative tests—prothrombin time (PT) and activated partial thromboplastin time (aPTT)—are unnecessary, this study finds. PT was ordered unnecessarily in 94.3% of patients and aPPT in 99.9% of patients. PT evaluates the patient’s blood clotting ability, and aPPT determines if heparin therapy is…
Standardized approach for preop chlorhexidine showers reduces SSIs
Editor's Note A standardized process of dose, duration, and timing for preoperative showers with 4% chlorhexidine gluconate maximizes the benefit of the shower as an effective risk reduction strategy for surgical site infections, finds this study. The process includes: 118 mL of aqueous 4% chlorhexidine gluconate per shower a minimum…
Effect of professional guidelines on preop testing
Editor's Note The release of 2002 guidelines on preoperative testing by the American Society of Anesthesiologists, American College of Cardiology, and American Heart Association was associated with a reduction in routine ECG testing but not of x-rays, hematocrit, urinalysis, or cardiac stress testing, in this study. Because routine preoperative testing…
Integrate systems to sustain gains from process change
Many organizations have reaped the benefits of adopting Lean concepts, such as greater workflow efficiency, staff engagement, and cost savings. After initial improvements are made, however, it can be hard to sustain the process changes over time. That was the case at Nemours A. I. duPont Hospital for Children in…
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