OR Manager - November 2018 - 15

Patient safety
Continued from page 13
Expanding to other care units
Because of the encouraging results,
the project has been expanded to include
more postsurgical units in the
hospital along with unit-specific posters.
For example, the floors that receive
primarily gynecological surgery patients
will receive education focused on
the lithotomy position and associated
complications. They also are discussing
making the surveys more specific for
each unit.
In addition, the results of the survey
were presented at a hospital-wide
Nursing Grand Rounds as well as to
the hospital's Dermal Defense Team,
which includes four nurses. The Dermal
Defense Team does skin assessments
on patients monthly and documents any
skin breakdowns.
At the Nursing Grand Rounds, the
attendees' knowledge of the information
that was presented was measured
before and after the presentation with
automated pre- and post-presentation
surveys, says Nicole Washington, RN,
OR staff nurse.
Susan Rubin, RN, OR staff nurse,
notes that the presentation to the Dermal
Defense Team was met with a lot
of enthusiasm. " Even though their primary
focus is skin integrity, they told us
we provided them with information they
didn't know, and really welcomed the
information we provided them, " Rubin
says.
In the future, Rose says they hope
to measure not only nurses' knowledge
but also improvement in patient outcomes
once this program has been
implemented on all the postsurgical
care units.
Hyonchu Kim, RN, OR staff nurse,
and Courtney Sparango, RN, OR staff
nurse, the other members of the
bridge, noted how proud they are to
have been a part of this team and
what they have accomplished for the
patients and the nurses on the care
units.
All six nurses in the bridge group
continue to work in the OR and have
been there for a year. ✥
-Judith M. Mathias, MA, RN
References
AORN. Guideline for positioning the
patient. Guidelines for Perioperative
Practice 2018. 673-743.
Kim H, Orsini C O, Washington N, et
al. Improving post-op care by educating
floor nurses on intra-op positioning.
Poster. AORN Global Surgical
Conference & Expo. 2018.
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this questi on when tackling a tough issue.
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OR Manager | November 2018 15
11/29/17 11:45 AM
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
Ambulatory
Surgery Centers
IN THIS ISSUE
The monthly publication for OR decision makers
P
Peer review inspires high
performance from providers 26
Education
OR Manager 2017 Index 29
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
IN THIS ISSUE
The monthly publication for OR decision makers
29
I
Process improvement
Coming in
December
Get ready for the
2018 OR Business
Management Conference,
January 30-February 2
in San Antonio!
Success stories
Efficiency efforts improve
staff satisfaction with
turnover time
Ambulatory
Surgery Centers
ASC leaders like their jobs despite
stagnant salaries 25
CMS proposes delay for mandatory
implementation of OAS
CAHPS Survey
29
n 2016, after 10 years of research
and validation, Cassendra Munro's
Pressure Ulcer Risk Assessment
PACU patient flow improves with
CRNA assistance
17
Salary/Career Survey
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 inpaD
21
CMUNRO
SCALE created to facilitate
risk assessment for pressure injuries
tient unit nurse for continuation of care.
With validation of the scale ongoOR
leaders report strong job satisfaction
but weak compensation
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
Human resources
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
ing 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.
hadn't
Continued on page 10
Continued on page 6
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
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
Externships help suss out
nurses best suited to the OR 13
Leadership
ambulatory surgery centers (ASCs).
" We've seen improved patient
Skill plus will equals successful
OR leadership succession 17
M
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
Remote video auditing: A path to
compliance and safety
OR Manager Conference
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
Celebrating three decades of OR leader
education, networking
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
ore than 1,350 perioperative
nurse leaders from across the
US and other countries gatheasy
view of staff and physicians.
" We can look at every case every
ered 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
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
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.
Continue
Continued on page 7
page 8
OCTOBER
2017
Volume 33
Number 10
" 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
Volume 33
Number 11
NOVEMBER
2017
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OR Manager - November 2018

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