Re: "Scrubbed and Stoned" (August, page 40). I thoroughly enjoyed this article, but missing from the story was any mention of the anesthesia provider leaving a filled syringe accessible to addicts such as Ms. Parker. It must have been like being a kid in the candy store for her. In an elective surgical setting, it might be more prudent for the anesthesia provider to lock away the syringes in the anesthesia cart, carry the syringe with him or preferably draw up the medications immediately before use. It's the chain of custody process that helps prevent these events.

Michael Kenney, MBA, RN
Manager of Surgical Services
St. Joseph's Hospital
West Bend, Wis.
[email protected]

Bleach Is Bleach — Or Is It?
You can use bleach to disinfect blood spills, but what is generally not known is that there are no less than 6 types of oxidizing bleaches: sodium hypochlorite (also known as chlorine bleach), hydrogen peroxide, sodium perborate, sodium percarbonate, sodium peroxide and potassium permanganate — each of which functions in a totally different manner.

In terms of being an effective disinfectant — one that kills or destroys nearly all disease-producing organisms with the exception of spores — none have the proven record of sodium hypochlorite. Until a replacement becomes available that is proven to be its equal in effectiveness, sodium hypochlorite should be an integral part of any disinfection process.

Nathan L. Belkin, PhD
Largo, Fla.
[email protected]

Teaching Our Young
Re: "Do you let nursing students do rotations/training at your facility?" (Instapoll, June 11). I was shocked and disappointed that 43% of the respondents to your online poll feel that the operating room is no place for nursing students to be. I am still shaking my head! How is one to learn about the OR? What a wonderful opportunity to introduce young, eager, interested, potential OR nurses to a field of nursing that has been all but forgotten about in many nursing school programs. If we do not take that step, who will? Who will we employ in the OR when the baby boomers retire?

Sue Kunz, BS, RN, CPSN
Clinic of Cosmetic Surgery
Milwaukee, Wis.
[email protected]

Zantac Is an Antihistamine
Re: "Take This Medication Safety Quiz" (July, page 70). The sound-alike for antihistamines included Zyrtec and Zantac. While the correct answer was identified as Zyrtec, it should be noted that Zantac, too, is an antihistamine. H-2 blockers are frequently not recognized as such, and in fact, H-2 blockers are an important drug in the treatment of anaphylaxis as an antihistamine.

Michael Reines, MD
Fountain Valley Regional Hospital
Newport Beach, Calif.
[email protected]

For the Record
The photos accompanying August's Infection Prevention column, "Clearing 4 Instrument Processing Hurdles," show improper reprocessing practice. The photos (left) show technicians decontaminating instruments with their arms exposed, which is in violation of OSHA standards, notes Nancy Chobin, RN, AAS, ACSP, CSPDM. "All skin must be covered, including the arms, during decontamination," she says. "The technicians should be wearing impervious gowns with full-length sleeves." We regret the error. "Thinking of Buying...Electronic Health Records Software" (July, page 60) should have included the following product listing:

NextGen Healthcare Information Systems
NextGen EHR
(215) 657-7010
www.nextgen.com
Pricing: Available through purchase of software licenses or through a monthly subscription-based service.
FYI: The NextGen EHR's pre-built clinical templates and workflow for over 25 specialties ensure complete, accurate documentation stored in a standard format. Disease management templates capture discrete data at the point of care to meet clinical reporting guidelines for pay-for-performance programs. And integration with the NextGen product suite enables consistent, real-time clinical and administrative workflow among providers, hospitals and patients.

OSM Now Printed on Recycled Paper
Beginning with last month's issue, Outpatient Surgery Magazine and its supplements are published using 30% post-consumer waste with partially recycled paper that is certified by the Forest Stewardship Council. Using recycled paper reduces pressure to harvest trees for papermaking and requires less water, compared to paper made from virgin wood. Post-consumer recycled paper also diverts waste from landfills. FSC certification ensures that the virgin trees used to make the paper come from well-managed forests and that the pulp providers, mills and printers meet the international organization's standards.

No More Free
Post-op Eye Surgery Kits
Say farewell to the free post-op eye surgery kits that you give cataract patients on their way out the door. Revisions to the Pharmaceutical Research and Manufacturers of America (PhRMA) Code on Interactions with Healthcare Professionals, which took effect on Jan. 1, prohibit drug companies from giving healthcare providers non-educational items such as pens, notepads and post-op eye kits. As a result, you must either purchase or make your own kits, which might include inexpensive sunglasses and other items.

• At Commonwealth Eye Surgery in Lexington, Ky., Surgicenter Director Karen W. Chiles, RN, BSN, found a supplier for small plastic bags with the center's name printed on them, at 16 cents each. Staff assembles the kits with the eye shield that comes in the procedure pack and 1 ?2-inch tape, which costs 38 cents per roll. Patients receive the kit for free.
• St. Luke's Cataract and Laser Institute in Tarpon Springs, Fla., spends $3 assembling a cataract post-op kit that patients get for free. "We didn't want to nickel-and-dime our patients," says Administrator Brad Houser, MBA.
• The Oregon Eye Surgery Center charges patients $10 for a kit, says Administrator Ginny Pecora, RN.

— Kent Steinriede