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…
Researchers develop world's most sensitive test for superbugs
Editor's Note A diagnostic tool developed by researchers at McMaster University, Hamilton, Ontario, can detect the smallest traces of compounds that signal the presence of an infectious disease, such as C difficile, MRSA, hepatitis C, and other superbugs. The test has the best sensitivity ever reported for a detection system.…
The Effect of Adding Functional Classification to ASA Status for Predicting 30-Day Mortality
Our Take In this study, functional capacity to perform activities of daily living was an independent predictor of postoperative mortality within each ASA class, indicating that it should be incorporated into routine preoperative evaluations. The likelihood for mortality was significantly lower for patients who were functionally independent than for those…
OR staff reap rewards of paperless patient tracking system
Clearing a patient for surgery is no easy feat, and a completely paper-based workflow can be very inefficient. Switching to a paperless tracking system has cut labor and costs in the preanesthesia screening services (PASS) department at Sinai Hospital, LifeBridge Health, Baltimore, and nurse leaders there hope to integrate the…
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