OR Manager - June 2020 - 15

COVID-19
After the masks are processed, staff
take them off the clotheslines and put
them in new white paper bags with
each employee's information on it. The
masks are then taken back to each of
the units. The next day, staff pick up
their reprocessed masks. They mark
them with an indelible marker each time
the masks are worn. After the fourth
time, they are discarded.
" In the beginning, we thought we
would need about 20 people each day
to reprocess masks, but now we have
it down to 4 per shift as the volume is
less than expected, " says Woolley.
They continue to reuse N95 masks
because, although 3M said their N95
masks used for construction and other
non-healthcare jobs were the same
quality as the masks used in the hospital,
they haven't yet been approved at
the hospital for patient care use.
Woolley says the hospital is considering
moving away from this process
and using Bioquell hydrogen peroxide
vapor because masks can be reprocessed
up to 20 times, and more
masks can be run each cycle in a prebuilt
room. This process also requires
less labor.
As of the middle of April, all hospital
staff are given isolation masks each
day, which they must wear in patient
care areas. The isolation masks do not
have to be worn in administrative areas,
but all staff must wear cloth masks or
face coverings everywhere in the facility.
Woolley says all hospital staff must
be checked in every morning. They do
a REDCap survey, have their temperatures
taken, are given a sticker that
indicates they passed the screening,
and then they are issued a new isolation
mask.
The REDCap survey is done to collect
data for research and to track
whether staff have any signs or symptoms
of the coronavirus.
Face shields are worn over the
isolation masks any time staff are
doing direct patient care. OR staff
www.ormanager.com
and PACU staff wear regular surgical
masks and face shields for COVID19-negative
patients.
The face shields are plastic and
cleaned between each patient use. At
the end of each shift, they are placed
in a dirty utility room to go through a
Bioquell hydrogen peroxide vapor cleaning
cycle. PAPR hoods also are collected
and reprocessed using Biquell.
Though they have not had any shortage
of ventilators, Woolley says, Colorado's
governor asked them to take
inventory of all their ventilators and anesthesia
machines at the beginning of
the pandemic.
" We had to submit that inventory
to the state, which then could have
taken our ventilators and anesthesia
machines if they were needed elsewhere,
but they haven't needed to do
that, " says Woolley. " We have gone
through our surge, and they haven't
been needed. " ✥
-Judith M. Mathias, MA, RN
References
American College of Surgeons. COVID19
guidelines for triage of pediatric
patients. Published online March
24, 2020. https://www.facs.org/
covid-19/clinical-guidance/electivecase/pediatric-surgery.
Centers
for Disease Control and Prevention.
Coronavirus Disease 2019
in Children-United States, February
12-April 2, 2020. Morbidity and
Mortality Weekly Report (MMWR).
2020:69(14);422-426.
Lowe J J, Paladino K D, Farke J D, et
al. N95 filtering facepiece respirator
ultraviolet germicidal irradiation
(UVGI) process for decontamination
and reuse. Updated 4-10-20.
https://www.nebraskamed.com/
sites/default/files/documents/
covid-19/n-95-decon-process.pdf.
Yeo C, Kaushal S, Yeo D. Enteric involvement
of coronaviruses: Is fecaloral
transmission of SARS-CoV-2 possible?
The Lancet Gastroenterology &
Hepatology. 2020:5(4);335-337.
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31460 ORM Article Ad_1/3.indd 1
OR Manager | June 2020
11/29/17 11:45 AM
15
DECEMBER
2017
Volume 33
Number 12
IN THIS ISSUE
The monthly publication for OR decision makers
Patient safety
OR Business Management
Conference
San Antonio to host 2018
OR Business Management
Conference
Leadership
Just culture creates a safe,
positive environment
Sterilization & infection
prevention
Latest steam sterilization
standard available
from AAMI
20
ECRI Institute Perspectives
Violence in healthcare
facilities-Know your risks 22
18
7
Greater vigilance needed to combat
ureteroscope contamination
A
new study by Ofstead & Associates
(St Paul, Minnesota) is the
latest to raise concerns about
infections associated with endoscopic
procedures.
The study, which focused on ureteroscopes,
found that the techniques
used to clean and sterilize or highlevel
disinfect flexible ureteroscopes
are not sufficient and leave behind
contamination including debris, residue,
and bacteria.
Process improvement
Remote video auditing: A path to
compliance and safety
Ambulatory
Surgery Centers
Peer review inspires high
performance from providers 26
OR Manager 2017 Index
29
P
erioperative services leaders
seeking to improve safety
and efficiency without sacrificing
quality may want to turn to remote
video auditing (RVA), which is being
successfully used in hospital ORs and
ambulatory surgery centers (ASCs).
" We've seen improved patient
safety, efficiency, and cleaning processes, "
says Sheldon Newman, MD,
executive vice chairman of the department
of anesthesiology at Long Island
Jewish Medical Center/Northwell in
New Hyde Park, New York. " That's a
win-win all the way around. "
Northwell has been using RVA from
Arrowsight, Inc, Mount Kisco, New York,
since 2010, first to improve handwashing
adherence in the ICU and later for
surgical safety monitoring in the OR.
With RVA, offsite auditors watch
time-stamped video feeds from ORs
and assess whether specific metrics
are met. Aggregate real-time feedback
is transmitted to the OR via monitors in
easy view of staff and physicians.
" We can look at every case every
day instead of having someone just
spot check compliance with safety measures, "
Dr Newman says.
That feedback has paid off. Dr NewContinued
on page 13
Continued on page 6
" Our study provides evidence that
contaminated ureteroscopes are
being used, with unknown implications
for patients, " lead researcher
Cori L. Ofstead, MSPH, told OR Manager.
Ofstead, an epidemiologist, has
published numerous studies on endoscope
reprocessing and contamination.
This study adds ureteroscopes
to the list of devices that threaten
patient safety.
Continue
Continued on page 8
page 8
NOVEMBER
2017
Volume 33
Number 11
IN THIS ISSUE
The monthly publication for OR decision makers
Education
Externships help suss out
nurses best suited to the OR 13
Leadership
Skill plus will equals successful
OR leadership succession 17
Success stories
Improved communication tools
put PACU visitors at ease
21
Ambulatory Surgery Centers
Track ASC metrics to produce
a healthy bottom line
Walk the talk: Words matter
when it comes to patient
safety
Patient safety
25
29
CMUNRO SCALE created to facilitate
risk assessment for pressure injuries
I
Coming in
December
Get ready for the
2018 OR Business
Management Conference,
January 30-February 2
in San Antonio!
n 2016, after 10 years of research
and validation, Cassendra Munro's
Pressure Ulcer Risk Assessment
Scale for Perioperative Patients (Munro
Scale) was made available for use
in the perioperative setting and was
added to the AORN Prevention of Pressure
Ulcers Tool Kit.
The Munro Scale assesses a patient's
risk level for each phase of
surgery: preoperative, intraoperative,
and postoperative. Each phase of the
assessment results in a risk score of
low, medium, or high, with a cumulative
score at the end. That score is documented
and communicated to the inpatient
unit nurse for continuation of care.
With validation of the scale ongoing
and while waiting for the scale to
be integrated into existing electronic
health records (EHRs), OR managers
are using the scale to educate staff on
risk factors for pressure injuries, but
they haven't implemented it yet, Cassendra
Munro, MSN, RN, CNOR, told
OR Manager. The only EHR in which the
scale has been integrated is AORN's
Syntegrity, notes Munro, who is Magnet
and professional practice manager,
Providence Health and Services, Santa
Monica, California.
Continued on page 10
Continued on page 6
OCTOBER
2017
Volume 33
Number 10
IN THIS ISSUE
The monthly publication for OR decision makers
Salary/Career Survey
Process improvement
PACU patient flow improves with
CRNA assistance
Success stories
Efficiency efforts improve
staff satisfaction with
turnover time
Ambulatory
Surgery Centers
ASC leaders like their jobs despite
stagnant salaries
CMS proposes delay for mandatory
implementation of OAS
CAHPS Survey
25
Human resources
29
Successful onboarding of surgeons
makes good business sense
P
Coming in November
Highlights of the 2017
OR Manager Conference
erioperative staff complete a
thorough orientation to ease
their transition into a new job,
but what about surgeons? How are they
onboarded into a new OR? This isn't an
academic question-effective onboarding
is key to the success, including financial
success, of the OR.
" To have someone walk through the
door ready to do surgery but not have
what they need affects staff morale,
patient care, scheduling, surgeon satisfaction,
overall operations, and revenue, "
says Jon Brickman, MS, CRCST,
director of perioperative operations for
University of Chicago Medicine (UCM) in
Chicago. UCM developed an onboarding
program that has helped integrate new
surgeons into the team and launch expanded
service lines.
Unfortunately, a negative first experience
happens too often, says Michael
Goldfarb, MD, FACS, a general surgeon
in private practice in Long Branch, New
Jersey, and chair of the Surgeon Workforce
Subcommittee of the American
College of Surgeons (ACS) Governors
Surgical Care Delivery Workgroup. " I've
seen what a terrible job many systems
do with onboarding. "
Dr Goldfarb collaborated with the
Continued on page 12
Continued on page 6
21
17
OR leaders report strong job satisfaction
but weak compensation
D
espite continued challenges
ranging from declining reimbursements
to finding qualified
staff, most OR leaders (71%) are
satisfied with their jobs, according to
the 2017 annual OR Manager Salary/
Career Survey. However, they are less
inclined to view some parts of that job
favorably.
Slightly more than half (55%) are
satisfied with their total compensation,
perhaps partly because 71% of them
hadn't
received a raise in the past
12 months. When raises did come,
they averaged a modest 3.07%, compared
with 3.38% last year and 3.4%
in 2015, but consistent with predicted
nationwide raises of only 3% for 2017.
These financial effects come at a time
when OR leaders are seeing their scope
widen. This year, they reported overseeing
an average of 117.27 employees,
up significantly from 95.4 last year and
Continue
page 8
Continued on page 7
Celebrating three decades of OR leader
education, networking
M
ore than 1,350 perioperative
nurse leaders from across the
US and other countries gathered
in Orlando, Florida, October 2-4 for
the 30th annual OR Manager Conference.
The celebration of this milestone
anniversary coincided with the inaugural
postanesthesia care unit (PACU) Manager
Summit, which brought together
more than 250 leaders.
Many participants attended both
events, soaking up sun and a wealth
of new knowledge from conference sessions,
posters, and the largest-ever exhibit
hall with nearly 200 booths.
The interactive hybrid OR exhibit
enabled OR leaders to examine technology
options up close and discuss
their needs with manufacturers. Hybrid
OR Steering Committee members
provided programs designed for both
" newbies " and those with hybrid OR
experience.
Continued
Continued on page 7
page 8
OR Manager Conference
https://www.facs.org/ https://www.nebraskamed.com/ http://www.ormanager.com http://www.ormanager.com
OR Manager - June 2020

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