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Military-civilian partnership creates first fully integrated trauma system

Editor's Note The American College of Surgeons on May 23 announced that a partnership between the Military Health System and civilian trauma institutions is underway to create the first fully integrated military-civilian trauma system. The system will train military surgeons before deployment, help surgeons retain skills while deployed, and bring…

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By: Judy Mathias
May 24, 2018
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New formulation of bupivacaine does not reduce opioid use after TKA

Editor's Note Contrary to what some studies are suggesting, use of the local anesthetic liposomal bupivacaine as part of a multimodal approach to postoperative pain did not reduce in-hospital opioid use or opioid-related complications after total knee arthroplasty (TKA) in this study. Researchers analyzed data on 88,830 TKAs performed with…

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By: Judy Mathias
May 21, 2018
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Statewide safety program sharply reduces colorectal SSIs

Editor's Note A Hawaii statewide collaborative for surgical patient safety successfully reduced colorectal surgical site infections (SSIs) and improved patient safety culture, finds this study. Between January 2013 and June 2015, Hawaii’s 15 hospitals implemented the Agency for Healthcare Research and Quality’s (AHRQ’s) Comprehensive Unit-based Safety Program (CUSP) in addition…

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By: Judy Mathias
May 18, 2018
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Surgical Council facilitates service line moves between hospitals

To improve healthcare delivery and eliminate duplication, hospitals are banding together into systems in which specialties such as labor and delivery and smaller surgical cases are performed at satellite hospitals, and larger, more complex procedures are done at the main campus. This is the approach taken at the Cleveland Clinic,…

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By: Judith M. Mathias, MA, RN
May 18, 2018
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Opioid prescriptions drop after orthopedic team changes protocol

Can hospital leaders and surgeons partner to reduce opioid use while maintaining high patient satisfaction scores? Leaders at OSS Orthopaedic Hospital in York, Pennsylvania, answer that question with a yes. Meghan McNelly, PharmD, MHA, FACHE, who was director of pharmacy at OSS when the opioid-reduction project started, says that from…

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By: Cynthia Saver, MS, RN
May 18, 2018
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Homeless veterans at increased risk of postop readmission

Editor's Note For veterans having surgical procedures performed in the VA healthcare system, homelessness is an important risk factor for unplanned readmission, finds this study. Analyzing 232,373 surgical procedures performed on 199,879 patients, researchers found that 5,068 of the procedures were performed on homeless patients. The rate of readmission within…

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By: Judy Mathias
May 16, 2018
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Preop walking test helps predict postop cognitive dysfunction

Editor's Note A simple 6-minute walking test before cardiac surgery helped predict the risk for cognitive issues after surgery, in this study from Japan. A 6-minute walk distance (6MWD) test was performed preoperatively on 181 patients who had nonemergency cardiac surgery. After surgery, 51 patients had postoperative cognitive dysfunction (POCD).…

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By: Judy Mathias
May 14, 2018
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Effect of ambient OR temperature on patient temperature

Editor's Note Ambient intraoperative OR temperature had a negligible effect on core temperature when patients were warmed with forced air in this study. The effect was larger when patients were passively insulated, but the magnitude remained small. A total of 292 adult patients were randomized to ambient temperatures 19º, 21º,…

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By: Judy Mathias
May 11, 2018
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Opioid abuse, dependence increases postop readmissions

Editor's Note Opioid abuse or dependence after major surgical procedures was associated with increased readmission rates and healthcare utilization. Of 16,016,842 patients in the National Readmission Database analyzed, 94,903 (0.6%) had diagnoses of opioid abuse or dependence. Comparing patients with and without opioid abuse or dependence, researchers found that patients…

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By: Judy Mathias
May 9, 2018
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FDA sends letter to healthcare providers on neurovascular stents

Editor's Note The Food and Drug Administration (FDA) on May 8 sent a letter to healthcare providers that included recommendations on the use of neurovascular stents for stent-assisted coiling in the treatment of unruptured brain aneurysms. The FDA has received reports associated with these devices that suggest events of peri-procedural…

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By: Judy Mathias
May 9, 2018
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