Many patients didn't want to take home the soft slipper socks we gave them to wear during their stay with us, so we'd end up throwing them in the trash. Our staff got together to explore ways to recycle these items. We came up with a great solution when we asked the local homeless shelter if they'd like to distribute the slippers to the folks that come for help. They were thrilled with the idea. We now ask patients to donate their slippers instead of taking them home. We collect the pairs in the PACU and a staff member delivers them to the local shelter, where they're washed and folded for distribution to their clients. We're happy to provide warm slippers to the homeless and at the same time keep our planet a bit greener.

Louise DeChesser, RN, CNOR, MS
Administrator
West Hartford Surgery Center
West Hartford, Conn.
[email protected]

A Safer Way to Archive Drug Records
About 3 years ago, a very active endoscopy center had the misfortune of having its narcotic/controlled drug records doused in the sink area of a procedure room, where they'd been storing well over a month's worth of records all together. To avoid such a catastrophe at your facility, keep completed controlled drug records on file in the nursing leadership office, and only current records in a procedure room or pre-op/PACU area. This also applies to other records of receipt such as your DEA 222 forms. Maintaining controlled drug records in a controlled way is good business practice.

Sheldon S. Sones, RPh, FASCP
Pharmacy Consultant
Sheldon S. Sones & Associates
Newington, Conn.
[email protected]

Customize Your Masks for Capnography
When using capnography during monitored anesthesia care with a face mask, you need to attach a sampling tube in order to send the patient's expired air to the capnography machine. Some anesthesia providers slide the sampling tube under the mask or cut off the tip of an angiocath and attach it to the entrainment hole in the mask. It's simpler and cheaper to use a small-bore T-port extension set with 3mm tubing and an injection port that can be inserted directly into the hold of the mask. Although designed for vascular access procedures, the disposable T-port helps maintain the seal of the mask against the patient's face and stays firmly in place.

Patrick Linton, MD
Assistant Professor of Anesthesiology
NYU Langone Medical Center
New York, N.Y.
[email protected]

Play the Price Guessing Game
Here's a good way to drive home how expensive surgical care really is. At your next open house, invite members of the community, politicians, the local press and even your staff to guess the price of equipment, instruments and supplies. Expect that most everyone will under-price every item. The game will be a real wake-up call for those who learn for the first time exactly how much a pack of sutures or a piece of tubing that we use every day actually costs.

Bonnie Brady, RN
Administrator
Specialty Surgical Center
Sparta, N.J.
[email protected]

Go Green With Eco-Friendly Couriers
If you use a courier service like we do, why not see if a company in your area makes deliveries with as little environmental impact as possible? My facility works with Dallas-based Go Green Couriers (www.gogreencouriers.com), a company that shuttles patient records to our billing service in hybrid or emission-free vehicles, which they say save 17 to 30 tons of carbon emissions each year. When making deliveries in downtown Dallas, the couriers ride bikes. The company's reps work from remote offices to avoid the environmental expense of operating a physical office space. They also use a paperless online billing and ordering system. The green courier service is comparably priced to other couriers, so helping the environment isn't costing us extra.

Debbie Hay, RN, BSN, CASC
President
Texas Institute for Surgery
Dallas, Texas
[email protected]

For Eye Instruments, Rinse Properly and Eliminate Enzymatics
Rather than risk allowing the residue of enzymatic cleaner to burrow into a crevice in the stainless steel of an instrument, we've eliminated enzymatic cleaners altogether. Not only is there evidence that endotoxins form if enzymatic detergent isn't properly rinsed from instruments, but also sterilization doesn't eliminate these endotoxins. Before we sterilize, we manually clean our ophthalmic instruments by vigorously flushing cannulas with deionized water and scrubbing each instrument individually in its entirety with a softened toothbrush. Not knowing whether an ophthalmic instrument is properly rinsed of enzymatic cleaner (with possible endotoxin formation) is a risk we're not willing to take.

Blaney Newton, RN, BS
Director of Nurses
Surgery Center of Northpoint
Dallas, Texas
[email protected]