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Outpatient Surgery Magazine readers, we want to know: What is the one product in your ORs that you absolutely refuse to give up? From mops and mats to cord covers, we've got the favorites that no operating room should be without.
1. Direct-to-drain fluid management systems
Direct-to-drain fluid management systems improve fluid capture efficiencies, enable faster room clean-up, eliminate exposure to infectious material, and spare your staff from hauling canisters filled with that material around your ORs.
Jody Delahunty, RN, CNOR, administrator at Kearney, Neb.-based Heartland Surgery Center relies on Stryker Medical's Neptune 2 Fluid Management System as an irrigation solution for arthroscopy and endoscopy. The system can be used for 1 case and then docked at a docking station, where the system cleans itself internally, she says, adding that the direct-to-drain system frees staff from filling up suction canisters, carrying them to the decontamination room and then having to dump them.
"In the past, our staff was spending several minutes after each case just dumping fluid down the hopper," she says. "The Neptune system probably saves us 10 minutes between each case."
Bemis Health Care
Quick-Drain
Dornoch Medical Systems
Transposal Fluid Carts
Hologic
The Aquilex Fluid Control System\
MD Technologies
Environ-mate Suction-Drain System
Smith & Nephew
Access 15 Fluid Management System
Stryker Medical
Neptune 2 Waste Management System
2. Patient transfer
Moving patients — from an OR table to a stretcher, from a stretcher to a bed — shouldn't be grueling for you or the patient. Devices like the AliMed AliSlide Half Shifter "provide for easy and safe transfer," says Ann Roberts, RN, clinical nurse manager at St. Louis Women's Surgery Center in Ballwin, Mo. Patients can be transferred upright or lying down on the 0.08" thick polyethylene boards, which include 6 built-in hand holes (1 on each end and 2 on each side) that aid in positioning, says Ms. Roberts, adding that the holes also provide a cut-out for easy hanging when the boards aren't in use.
AliMed
AliSlide Half Shifter
Biodex Medical Systems
Easy Mover
Hill-Rom Services
Advanta 2 Med-Surg Bed
Novum Medical Products
Transfer Stretcher
The Stretcher Pad Co.
Superior Comfort Patient Transfer Pad
3. Patient warming
Warming patients isn't only critical to preventing intraoperative hypothermia and post-op complications, but also to calming patients' nerves and quickening recovery times. Christy Marshall, RN, BSN, CNOR, unit manager at Lexington, Ky.-based Saint Joseph East, a division of KentuckyOne Health, uses the popular Bair Paws forced-air warmer. She estimates the cost of laundering blankets at her facility at about $1.65 per 5-lb. blanket. "We used to go through 3 or 4 gowns with each patient. So we've gone to using just 1 sheet with the Bair Paws," says Ms. Marshall. "It saves us money on laundering heavy hospital blankets. Plus, once the patient puts it on, they're warm and cozy, and can use the different settings to adjust their temperature themselves."
Augustine Temperature Management
Hot Dog Underbody Warming Mattress
CSZ Medical
Gelli-Roll Warming/Cooling Gel Pad
Encompass Medical
Thermoflect Patient Care Products
Kimberly-Clark Health Care
Patient Warming Thermal Pads
Ecolab-Microtek Medical
ChillBuster
Arizant Healthcare, a 3M company
Bair Paws
Stryker Medical
Thermacare Patient Warming System
4. All-in-one cutting/sealing electrosurgery
Monopolar and bipolar electrosurgery units let surgeons dissect much more tissue than they could with a scalpel, while cauterizing and sealing the tissue to prevent bleeding. Covidien's LigaSure tissue fusion technology with the ForceTriad Energy Platform is an example of an "all-in-one" electrosurgery device that combines monopolar and bipolar electrosurgery units to safely and accurately cut and seal vessels.
Bovie Medical Corporation
Aaron product line of electrosurgery generators and accessories
Covidien
ForceTriad LigaSure Tissue Fusion Devices
Microline Surgical
MiSeal Reposable Thermal Ligating System
5. Quick turnaround mops
To keep floors dry in between cases, the Wooster (Ohio) Ambulatory Surgery Center uses a simple, lightweight, 5-foot-long microfiber mop on its OR floors. It's been a boon to both turnover times and patient safety in the past year, says Victoria Caillet, RN, CNOR, RNFA, the center's administrator.
A more heavy-duty mop is still necessary to use at the end of the day (and after arthroscopic cases or when the floor has gross contamination), but the Rubbermaid, "Swiffer-style" mop can be used in between every case for a quick clean of OR floors.
Cygnus Medical Products
Operating Room Set-Up Kit with Fiber-Free Mop System
Micro-Scientific
Micro-Kleen Microfiber Systems for OR Floors
Rubbermaid
Rubbermaid Hygen Microfiber Cleaning System
6. Cord covers
Loose cords and cables on your floors are accidents waiting to happen. Using adhesive tape to secure cords to the floor leaves behind sticky residue, and can go unnoticed by OR staff members as they move around the OR. Cardinal Health's Trip-No-More Cord Alert Devices have addressed both of those problems at the Plastic Surgical Center of Rapid City (S.D.). It's simple: Peel the back from the bright-orange colored strips, straighten your cords and place the strips over them. In addition to securing the cords, the brightly colored strips also alert staff where the cords are located.
AMC Advantage Medical Cables and Electronics
Advantage Medical Cables
Ansell Sandel Medical Solutions
Trip-No-More Cord Alert
Cardinal Health
Trip-No-More Cord Alert Devices
GFMS
Cable Jacketz
7. Smoke evacuators
Removing dangerous smoke doesn't have to be difficult or interfere with surgical procedures. Smoke evacuators like Stryker Medical's Neptune 2 Waste Management System make eliminating exposure to smoke that much easier. The closed, self-contained unit quickly (and quietly) removes smoke through a ULPA filter with an "Auto-Mode" that keeps the smoke evacuation system operating at low speeds when no smoke is present, cutting down on noise in the room. However, the filter automatically detects smoke as soon as its generated, and increases power to capture smoke plumes, says Donna Gunneson, RN, AD, assistant nurse manager at Wichita, Kan.-based Wesley Medical Center. "The Neptune suction device greatly lessens the chance of employee exposure [to surgical smoke], and never loses suction power," she says.
Blue Endo
Safe-plume Laparoscopic Smoke Evacuation System
Bovie Medical Corporation
Smoke Shark
Buffalo Filter
PlumeSafe Smoke Evacuation Systems
CooperSurgical
SeeClear Laparoscopic Smoke Evacuation Systems
DeRoyal Medical Products
Crystal Vision Smoke Evacuation Machine
Stryker Medical
Neptune 2 Waste Management System
Surgimedics
Purevac Turbo Smoke Evacuation System
8. Floor mats
Floor mats save staff and surgeons' feet, legs and backs, soaking up fluid from the floor and providing traction to keep your OR team on their feet. New Pig Grippy Surgical Absorbent Mats are made with absorbent, 8-layer pads that retain up to 3,000cc of fluid, says JoAnne Kelch, RN, materials manager at Northern Virginia Surgery Center in Fairfax, Va. The disposable, 31" x 40" perforated mats lie flat on the floor — no more bunched-up blankets — and include special "Grippy" backing that, when placed on a dry floor, makes the mats virtually unmovable, says Ms. Kelch. "These mats are absorbent, and they don't slide or move once you've positioned them around the OR table," she says.
Flagship Surgical
The Surgical Mat and The Mini Mat
LDI Environmental and Safety Solutions
EnviroSorb Surgical Floor Pads
New Pig
New Pig Grippy Surgical Absorbent Mats
9. Rapid read-out biologicals
In the "old days," Interim LSU Public Hospital used biological read-out devices to monitor the effectiveness of its steam sterilization process for surgical instruments, reading them after 24 and 48 hours to check for growth, says Rudolph Gonzales, RN, MSN, CNOR, CRCST, CHL, manager at the New Orleans, La.-based facility. "If we had an issue, we had to recall the load," he says. 3M's Attest Biological Monitoring System now provides results after an hour to see if an instrument passes the gravity test, and can identify problems with biological loads after just 3 hours.
"We don't have to wait 24 hours to determine we had a problem with a biological run," says Mr. Gonzales. "Today we know our biologicals pass before we release instrumentation, and we know we're sending a good instrument set to our ORs every day."
3M
Attest Biological Monitoring System
10. Lumen cleaners
Using lumen-cleaning devices for rinsing phacoemulsification and I/A handpieces, cannulas and other surgical instruments can help your OR staff say goodbye to manually flushing handpieces forever.
The QuickRinse System from American Optisurgical, for example, automatically flushes handpieces with 120cc of irrigant (per the manufacturer's recommendation) from pre-prepared bottles and purges the instruments with air before resterilization, and does it all in about 1 minute, says JoAnne Looker, RN, CNOR, clinical director at Winchester (Va.) Eye Surgery Center, which has employed the system for about 5 years.
"In this day and age, efficiency is what it's all about. And now I know that once a handpiece is hooked up to the system, it's getting the recommended amount of irrigant before we resterilize it," she says. "The scrub nurse can hook handpieces up to the unit, then go deal with other instruments, wipe the back table down, arrange instruments to be resterilized, get the autoclave ready and so on. They have time to do that now, because they're not pulling up distilled water. This system lets them do the other things they have to do before the next case."
American Optisurgical
QuickRinse Automated Instrument Cleaning System
Medisafe
Endoscopic Equipment Cleaning Brushes
Minntech Corporation
Scope Buddy Endoscope Flushing Aid
New Wave Surgical Corporation
D-H.E.L.P. Defogging Heated Endoscopic Lens Protector System
17 Interesting New Products and Services You Might Have Missed
Would any of these ideas work in your facility?
Over the course of a year, Outpatient Surgery team members tour 12 different surgical exhibit halls, receive hundreds of new product announcements and have contact with thousands of vendors, so we see and hear about plenty of interesting new ideas in the process. Here are a few that caught our eye in 2011-2012 … apologies to anyone we missed!
There's an app for that
The Apple iPad debuted to great fanfare in 2010, and surgical applications followed very quickly. Here are a few:
- Centralized OR controls, via an app from orthopedics giant Arthrex. The app lets you control your Arthrex imaging system, including the HD camera, LED lighting and the image-management system, right from the iPad. A separate app just for surgeons lets them review, edit, annotate and tag stills and video recordings. They can also create and transmit images, videos and post-op reports to patients.
- Biomedical service. Phaco machine won't prime? Implant set not working properly? Use your iPad to solve the problem with an app from SpotOn Surgical. Just hit the smart dial and you'll be in a video conference with the field rep, clinical specialist or support desk. Show the tech your problem with the camera built in to the iPad, and get advice about how to fix it.
- Ultrasound. Mobisante and Interson make PC tablet-based ultrasound systems. Now an iPad version may be in the works from ultrasound giant Sonosite. A patent filed by the company in 2012 shows an iPad case that connects the iPad directly to an ultrasound wand, presumably using the iPad as the monitor and the controller.
- Surgical guidance for plastic surgery. Irvine, Calif., plastic surgeon Donald Altman, MD, snaps photos of surgical markings on patients in the upright position before surgery, then e-mails those photos to his iPad, which he takes into the OR for reference.
New products for safety
Your MIS, ophthalmology and radiology teams may find it easier to prevent medication errors, count sponges correctly and avoid sharps injuries in low-light situations with the M.I.S Sunshine Sterile Task Light from RMAC Surgical. The low-cost sterile device can provide task lighting in dimly lit ORs for up to 12 hours.
For a high-tech approach to improving medication safety, check out the SLS Safe Label System from Codonics. Hold the drug ampule under the bar-code reader and the system audibly identifies the drug and prints out an ASA-compliant color label as you draw up the medication into the syringe. Apply the label and you're done. Before administering the drug, you can scan the syringe just to make sure it contains what you think it contains. The system connects with medical records systems.
New products for anesthesia
When the airway becomes obstructed in conscious-sedation patients, LMA's Jaw Elevation Device, or JED, may provide an answer. The JED slips under the patient's neck, elevating the jaw and rotating the head backward, opening the airway so that your anesthesia pro won't have to hold the jaw open.
You may be able to prevent post-op nausea and vomiting much more economically and without injection with Quease/EASE, a drug-free post-op treatment. Patients simply open the inhaler pack and inhale the aromas of peppermint, spearmint, ginger and lavender oils. A study done in a Maine hospital showed that the therapy relieved nausea in ?two-thirds of patients. Sample kits are available for trial; the inhalers costs less than $5 each.
Post-op pain relief without opioids may be possible with Exparel, a liposomal version of bupivicaine that lasts three days rather than four hours. In clinical trials, Exparel reduced pain by 30% all through the 72-hour period, and cut opioid consumption almost in half. You infiltrate Exparel at the close of surgery just as you would local anesthetic.
?Another possibility for cutting opioid use: Sprix, a nasal spray that contains the anti-inflammatory drug ketorolac. In 2 studies, patients who used Sprix required 36% less morphine and 26% less morphine over a 48-hour post-op period as compared with patients receiving placebo.
It's estimated that every failed attempt to start an IV costs your facility about $32 in direct costs and loss of efficiency. It also increases the risk of a catheter-born infection. Improve your success rate with a vein-viewing device like the AV300 from AccuVein or the VeinViewer from Christie Medical. You just point the device at the skin and click to display the veins underneath. It comes in both hand-held and hands-free models.
New ideas in infection control
In many types of gastrointestinal, spine, OB, urologic and podiatric surgeries, the best practices for infection control call for cefazolin 2g, delivered perioperatively via IV. Complying with that protocol may be a lot more convenient with B. Braun's Duplex 2g Cefazolin. The Duplex system uses a 2-compartment plastic container that stores pre-measured drug and diluent doses. You just squeeze and shake and you're ready to go.
How do you remove shorn hair after using surgical clippers? The ClipVac System from Surgical Site Solutions offers one answer. It's a small portable vacuum that connects to your clippers. As you clip the hair, the ClipVac sucks it up, trapping it in a disposable filter that you throw away after each use. No need to tape off the skin.
Your OR equipment should be a lot cleaner and look and work a lot better after a visit from EquipSystems. The company removes all dirt, dried fluids, tape, stickers and residue from equipment, disinfects all hard surfaces to 3 log units, makes simple repairs of wheels, casters, rubber tips and the like, and provides all documentation needed for reporting to accrediting agencies. The workers visit at night so as not to disrupt your daily routine.
New products for efficiency
You can permanently match instrument sets to their trays with Farbtek's Instrument IDentification System. Farbtek imprints small colored dots, lines or shapes on instrument sets and trays — or completely coats them in a permanent color anodyzing process — so that it's easy to see which go together. The imprints have been shown to last through at least 4,000 autoclave cycles. Bar coding is also available.
You may be able to cut nursing hours with Simple Admit, a web-based pre-admission questionnaire that asks patients history questions and collects and organizes the answers into your EMR for you. The system can preset your ?patients' rights, ownership disclosures and other policies, and do follow-up as well.
An Amazon.com for the surgical industry? That's the goal of s4, a web-based purchasing system sponsored by Surgical Care Affiliates, which owns and operates more than 145 surgery centers and hospitals across the U.S. The company says you can ?save up to 20% on purchases.
Laparoscopic surgery may be more efficient with Aesculap's new Caiman laparoscopic instruments. The Caiman features an articulating jaw for maneuvering through tight spaces, and the jaw is 50mm long, meaning that surgeons can cut and seal more tissue at a bite than with other radiofrequency-powered devices.
Get better control over who enters your facility with Vendormate, an online service that tracks and screens reps and contractors. The web-based system credentials vendors and contractors to make sure they're who they say they are, and tracks who is in your facility and why. Vendormate ensures that reps pass a background check, that their immunizations are up to date and that they're trained to be in an OR.
New products in lighting
Everybody's talking about LEDs, but is plasma the next big thing? The plasma lamp in BFW's Chromalume Turbo headlight lasts 10,000 hours, meaning that if you used it for 8 straight hours every workday for 4 years it would still have 6 months of light left! Amazing brightness is also possible: Turn it all the way up to 220,000 lux and outshine a 300-watt xenon lamp.
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