 |
November 2009 |
NIOSH
NIOSH creates Respirator Trusted-Source Information Page
The National Institution for Occupational Safety and Health (NIOSH) created the Respirator Trusted-Source Information Page to help verify which respirators are approved by NIOSH, how to get them and how to use them.
The new Web page simplifies the process of identifying respirators, explains various NIOSH classifications for respirators and how to identify them. Though the page is still in development, it currently divides all information into three sections: Section 1 is NIOSH-Approved Respirators – What are they, How can they be identified, Where can I get them?; Section 2 is Use of NIOSH Respirators; and Section 3 is Ancillary Respirator Information.
BUSINESS
DARK Daily lists 10 largest health systems
The US Veterans Affairs Dept. (VA) is the largest of the top-10 health systems in the country, according to DARK Daily, a clinical laboratory and anatomic pathology group management publication.
DARK Daily published its list of the 10 largest health providers Nov. 13. With an annual revenue of $40.7 billion in 2008, the VA system was well ahead of the next largest health provider, HCA, Inc., which brought in $28.4 billion. Other health systems on the list included Ascension Health, Community Health Systems and NY Presbyterian Healthcare System. The cumulative revenue of the top-10 health systems in 2008 was $137,858.3 billion.
Read the full list online.
MRSA
New MRSA strain possibly more lethal than others
A new methicillin-resistant Staphylococcus aureus (MRSA) strain called USA600 could be more lethal once it enters the bloodstream than other strains, according to a HealthLeaders Media report.
The USA600 strain was discussed at the Infectious Disease Society of America’s annual meeting in Philadelphia, based on preliminary findings. The small sample of patient found to be infected with the USA600 MRSA strain at the Henry Ford Hospital in Detroit were at an average age of 64, however, and the reports are still considered preliminary.
PATIENT SAFETY
RI hospital fined for repeat wrong site surgeries
Following its fifth wrong site surgery in two years, Rhode Island’s largest hospital has been fined $150,000 and is ordered to install video cameras in all of its operating rooms. The latest incident of wrong site surgery at Rhode Island Hospital occurred last month to a patient who was to have surgery on two fingers. Instead, the surgeon performed both operations on the same finger.
The Associated Press reported that the surgical team marked the wrist, rather than each finger, and the surgeon did not mark the site himself. The team did not take a timeout before the second surgery. When they discovered the error, they checked with the patient's family to see if they should perform the surgery on the correct finger. When they did the surgery on the correct finger, they also did not do a timeout. The Rhode Island State Health Department has also ordered a clinical employee who is not part of the surgical team to observe all surgeries at the hospital for at least one year.
AORN is in the process of updating its Correct Site Surgery Tool Kit to help perioperative professionals meet The Joint Commission's 2010 National Patient Safety Goal on Universal Protocol. Stay tuned to AORN news to access the tool kit when it is released.
PATIENT SAFETY
ASA releases new recommendations for safe use of propofol
New recommendations for safe use of propofol were recently passed during the American Society of Anesthesiologists (ASA) annual meeting, according to a report from Medscape Medical News. The recommendations focus on safety monitoring when the drug is administered, particularly during endoscopic procedures, and suggest monitoring for exhaled carbon dioxide and careful attention to airway management, particularly during procedures performed in the prone position where ventilator monitoring, airway maintenance and resuscitation can be especially difficult.
Earlier this year the society’s board of directors also recommended the Drug Enforcement Agency label propofol as a controlled substance in an effort to reduce abuse of the drug. These recommendation build on the society’s previous position that propofol should be used in a medical setting by professionals trained in the provision of general anesthesia, with proper supervision by a physician trained in anesthesia and qualified to provide resuscitation should too much drug be given.
Meanwhile, the ASA has been in contact with the FDA to share its concern about the simultaneous supply problems that are occurring with propofol and thiopental in some parts of the country. According to the FDA, its Drug Shortage Program is continuing to monitor the propofol and thiopental supply situation and is working with manufacturers to ensure that adequate product remains available. To learn more visit www.asahq.org.
REGULATORY
CMS issues a final rule for 2010 payment polices and rates for outpatient departments and ASCs
The Centers for Medicare & Medicaid Services (CMS) has issued a final rule updating payment policies and rates for hospital outpatient departments and ambulatory surgical centers in calendar year 2010.
Among other provisions, payment rates under the outpatient prospective payment system will increase 2.1%, with hospitals projected to receive a total of $32.2 billion for outpatient services in 2010. CMS does not add any new quality measures for 2011 reporting purposes, but finalizes a data validation process for 2011. The final rule also includes changes to the physician supervision of outpatient therapeutic and diagnostic services. Starting in 2010, certain non-physician practitioners may directly supervise hospital outpatient therapeutic services that they are able to personally perform within their state’s scope of practice and hospital-granted privileges.
Read the final rule here.
WORKPLACE SAFETY
Toxic chemicals found in nurses, other healthcare professionals
Chemicals known to be toxic and present in products common to the healthcare setting have been found in the bodies of nurses and doctors, according to a new report Hazardous Chemicals in Health Care. Released by Physicians for Social Responsibility in partnership with the American Nurses Association (ANA) and Health Care Without Harm, the report found that all 20 study participants had toxic chemicals associated with health care in their bodies. Each participant had at least 24 individual chemicals present that are all associated with chronic illness and physical disorders.
The project tested for 62 distinct chemicals in six categories: bisphenol A, mercury, perflourinated compounds, phthalates, polybrominated diphenyl ethers, and triclosan. The chemicals tested in the investigation are used in common healthcare products, including baby bottles, hand sanitizer, medical gauges, industrial paints, IV bags and tubes and stain-resistant clothing.
“Simply put, we are being ‘polluted’ by exposure to chemicals used in health care. This study demonstrates the urgent need to find safer alternatives to toxic chemicals whenever possible; to demand adequate information on the health effects of chemicals; and to require manufacturers to fully disclose the potential risks of their products and their components, for the safety of both health care professionals and the communities we serve,” added ANA President Rebecca M. Patton, MSN, RN, CNOR.
QUALITY
Patients safer at top-rated hospitals
Patients at highly rated hospitals have a 52% lower chance of dying compared with the U.S. hospital average, according to TheTwelfth Annual HealthGrades Hospital Quality in America Study. The study looks at trends in mortality and complication rates and also provides the foundation for HealthGrades’ quality ratings of procedures and diagnoses at each individual hospital.
Study findings are based on HealthGrades' ratings of each of the nation’s 5,000 nonfederal hospitals in nearly 30 procedures and diagnoses. Each hospital receives a 1-, 3-, or 5-star rating for each procedure or diagnosis, reflecting the mortality or complication rates at that hospital. The study also found that approximately 57% (127,488) of the potentially preventable deaths were associated with four diagnoses: sepsis (44,622); pneumonia (29,251); heart failure (26,374) and respiratory failure (27,241). Also, across all orthopedic procedures in which complications were studied, there was a 79.69% lower chance of experiencing one or more in-hospital complications in a 5-star rated hospital compared to a 1-star rated hospital.
Learn more about the study.
RESEARCH
Prostatectomy: Minimally invasive vs open surgery
Despite shorter hospital stays, and decreased surgical complications, minimally invasive radical prostatectomy (MIRP) may result in an increased rate of certain complications, including incontinence and erectile dysfunction, according to a study in the October 14 issue of JAMA, a theme issue on surgical care.
Read the study and find more articles in this theme issue on surgical care in JAMA.
CORRECTION
An incorrect URL was listed in a news brief on page 4 of the October issue of AORN Connections. In a story announcing the American Nurses Association’s new Web site addressing safe patient handling, the correct URL for this Web site is www.anasafepatienthandling.org.
Read more news.