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Wound Class Questions

I would appreciate help on how wound vacuum-assisted closure is being classified as to wound class in the OR. I can see the index op as anything but clean (I), but what about subsequent replacement procedures (sometimes up to 4-5 times)? I've seen th...


CRNAs vs Anesthesiologists in ASCs

We are a 1-OR ophthalmology ASC. We currently use only anesthesiologists, who bill the patients directly for their services. We would like to switch to a CRNA only for our anesthesia provider. We would bill the patient and pay the CRNA directly. I'm ...


PACU Staffing Question

As a small, 1-OR ASC, we would like to know how other small centers staff their PACUs. We use only IV sedation/MAC anesthesia, and never general, so technically all our patients are Phase II. According to the ASPAN standards I read, it looks like one...


What's Our Fair Market Value?

Our small GI ASC has 3 owners, each 64 to 68 years old. We do 3,400 cases a year of GI endoscopies only. What would be the fair market value to sell shares within the 3 physician partner-owners? One of the partners is doing more cases and wishes to p...


Surgical attire guidelines

Are your facilities following AORN's guidelines for surgical attire? Specifically the rule that personal clothing should be completely covered by the surgical attire? Our surgeon wears a shirt under his scrubs, with sleeves and a collar that extend o...


Compression Device Use

We have recently been having ongoing discussions regarding the use of sequential compression devices for venous thromboembolism prophylaxis among our general anesthetic patients. We have come across the Caprini risk assessment, but that doesn't reall...


NPO Rules

We are an ophthalmic speciality ASC providing MAC with Versed and Fentanyl. Our patients are instructed to be NPO after midnight. We recently had a patient who ingested 2 graham crackers with a sip of water 6 hours prior to surgery. Does anyone have ...


Positioning a Patient's Head

How do you secure a patient's head to the headrest for cataract surgery? Tape is commonly used, but what about the issue of sticky tape residue? Many ASCs have been cited by the Joint Commission or CMS for tape residue on stretchers, IV poles, etc. W...


Cell Phone Photos in the OR

We seem to have a rash of surgeons lately who want to take photos of patients' surgeries. For example, a picture of a colon, an augementation after mastectomy, a very large goiter, etc. Our policy states that we can only take pictures with the OR cam...


Artificial Nails

Are the nurses providing patient care in the pre-op area allowed to wear artificial fingernails?...


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