Editor's Note The Joint Commission has issued a new R3 Report to help accredited hospitals better understand and comply with its new and revised pain management standards, which are effective January 1, 2018. This R3 Report provides in-depth rationale, references, and evidence used in the development of the new and…

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Editor's Note The initial event associated with exposure to prescription opioids is often thought to be an injury or surgical procedure, but this study finds that opioid use rarely starts with surgical procedures. Of 117,118 patients with sustained prescription opioid use who were analyzed, just 800 (0.7%) received their initial…

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Editor's Note Inspired by aviation and medical best practices for handling crises, researchers have developed a Stress-APGAR protocol to help managers anticipate burnout in employees, according to the April 26 Harvard Business Review. The Stress-APGAR acronym includes five key areas: Appearance: How does the employee look−overly tired, changes in weight,…

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Editor's Note Physicians and nurses involved in a patient safety incident experience significant negative outcomes, this study finds. Of 5,788 nurses and physicians analyzed, 9% had been involved in an incident during the prior 6 months. Involvement in a patient safety incident was linked to: a greater risk of burnout…

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Editor's Note As part of the drive to reduce opioid use, rotator-cuff repairs are becoming a testing ground for alternative approaches to pain management, the May 23 Wall Street Journal reports. Because rotator-cuff surgery is one of the most painful procedures to recover from, physicians hope that if alternative painkilling…

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Editor's Note Denver's Swedish Medical Center is asking some 2,900 surgical patients to get tested for HIV, hepatitis B, and hepatitis C after finding that an OR employee may have stolen narcotics, the February 3 Denver Post reports. Surgical technologist, 28-year-old Rocky Allen worked in the OR from August 17,…

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It's every OR manager's nightmare—a drug diversion that hits the local news. That nightmare came true for 2 Colorado facilities—Rose Medical Center in Denver and Audubon Surgery Center in Colorado Springs— this year when scrub tech Kristen Diane Parker was accused of not only stealing fentanyl, but also of transmitting…

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Somebody's going to get hurt." It took that statement for one OR director to get administration and the medical staff to take action when an anesthesiologist was abusing cocaine. "They had been tiptoeing around it," she says. Ultimately, the physician was caught in the act. That was more than 20…

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The second of two articles. To outside observers, Mary Jones, RN, lived a charmed life: She was married to a bank owner, had 3 lovely children, and lived in a beautiful home overlooking a park. Colleagues in the OR where she worked enjoyed working with her. But Mary was hiding…

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The first of two articles. Cecil King, RN, MS, CNOR, is a perioperative advanced practice nurse at Sinai Hospital in Baltimore. King is an outgoing, knowledgeable nurse. He's a mover and shaker in the perioperative world: active in AORN, speaking at national meetings, and writing articles for nursing journals. He's…

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