OR Manager - November 2018 - 32

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At a Glance
Covered table cuts bioburden
A significant decrease in bacterial bioburden
on the instrument table was
found when the table was covered during
static periods of nonuse and dynamic
periods of active OR use in this
study.
Bacterial contamination of the instrument
table was evaluated by settle
plates in static and dynamic ORs, and
airborne particulate and bacterial contaminants
were sampled throughout the
room. The table was covered with sterile
impervious paper covers or sterile
plastic covers, or it had no covers.
Covering the table during static and
dynamic OR conditions significantly decreased
the bacterial load, regardless
of type of cover. Instrument table covers
should be considered during periods
of nonuse and active surgery to
decrease bacterial bioburden near the
instruments, the researchers conclude.
-Markel T A, Gormley T, Greeley
D, et al. Am J Infect Control.
2018;46(10),1127-1133.
Joint Commission: 'Top 5' most
challenging requirements
The Joint Commission released the
" Top 5 " requirements identified most
frequently as " not compliant " during
accreditation surveys and reviews in the
first half of 2018. The Top 5 most challenging
for Hospital Accreditation are:
* LS.02.01.35 The hospital provides
and maintains systems for extinguishing
fires (88%).
* EC.02.05.01 The hospital manages
risks associated with its utility systems
(80%).
* IC.02.02.01 The hospital reduces
the risk of infections associated with
medical equipment, devices, and
supplies (74%).
* EC.02.06.01 The hospital establishes
and maintains a safe, functional
environment (73%).
* LS.02.01.30 The hospital provides
and maintains building features to
protect individuals from the hazards
of fire and smoke (72%).
-https://www.jointcommission.org/
issues/article.aspx?Article=aEkhaxIHVb
4Ze3F9WzMtU6elaOKUxIcYh4C%2bAM
I5U3w%3d.
More readmissions at for-profit
hospitals
Patients who receive care in for-profit
hospitals are more likely to be readmitted
than patients in nonprofit public
hospitals, this study finds.
Data from 14,307 hospital reports
from the national Hospital Readmission
Reduction Program for six major diseases,
including coronary artery bypass
grafting and total hip and knee surgeries,
showed a statistically significant difference
in readmission rates based on
type. In each category, for-profit hospitals
had the highest mean and median
readmission ratios.
More studies are needed to understand
the effect of provider ownership
on patient outcomes, the authors say.
-Mittal M, Wang C-H E, Goben A H,
et al. PLOS One. Published online September
18, 2018.
Effect of Medicaid expansion on
utilization rates
The Affordable Care Act's (ACA's) Medicaid
expansion had no effect on the utilization
rates of regionalized surgery at
high-volume hospitals (HVHs) overall or
on disparities in vulnerable populations,
this study finds.
In this analysis of 166,558 adults
at 468 hospitals who had one of four
surgical procedures in three expansion
(KY, MD, NJ) and two nonexpansion
states (NC, FL), ACA's expansion was
not associated with increased rates of
surgery at HVHs, and disparities in use
of surgical procedures at HVHs among
ethnic/racial minorities and low-income
populations were unchanged.
Early findings highlight the limitations
in ACA's expansion in reducing disparities
in surgical care, the researchers
conclude.
-McDermott J, Zeymo A, Chan K, et al. J
Am Coll Surg. Published online
September 13, 2018.
32
OR Manager | November 2018
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OR Manager - November 2018

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