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Digital Issues

Join Us at OR Excellence

Got some space in your schedule next week? There's still time to join us at OR Excellence, our annual education and networking conference, held this year at the Marriott Rivercenter in San Antonio, Texas, from Oct. 14 to 16.

From same-day joints and business boosters, and from patient safety to professional education, there will be a lot to talk about during interactive presentations and at our popular exhibit hall wine tasting and martini madness events.

Mark your calendars for next year's ORX at the Hyatt Regency Coconut Point in Bonita Springs, Fla., Oct. 12-14, 2016. For more information, visit the OR Excellence website or call (888) YOUR ORX.

David Bernard

Joint Commission Highlights Patient Fall Dangers

The Joint Commission has received 465 reports of patient falls since 2009, with nearly two-thirds (63%) of them resulting in death, according to a new Sentinel Event Alert.

The alert additionally notes that the average cost for a fall resulting in injury is about $14,000. The commission's recommendations for patient safety include:

  • improving staff awareness of the need to prevent falls,
  • establishing a fall-prevention team,
  • using a standardized, validated tool to identify risk factors,
  • developing and implementing interventions specific to the patient population,
  • standardizing effective practices, and
  • conducting post-fall analyses.

Hospitals have had some success in reducing falls over the years, says the alert, "but significant, sustained reduction has proven elusive." As such, it says, falls resulting in serious injury, or even death, are consistently among the top 10 incidents reported to the Joint Commission's Sentinel Event database.

Jim Burger

Joint Replacement Surgery Safe for Obese Patients

Obese and overweight patients who undergo joint replacement surgery are no more likely to face complications and are less likely to need blood transfusions than normal-weight patients, a new study finds.

The study out of Henry Ford Hospital in Detroit found no correlation between heavier patients and such post-surgical complications as blood clots and heart attacks. Researchers also found that excess weight did not prolong surgical times, but that heavier patients did face an increased risk of infection.

The researchers studied 2,399 patients and grouped them by BMI. During hip replacement procedures, about 35% of the normal BMI patients needed a blood transfusion, while only about 22% of the obese group required one. In knee replacement surgery, the blood transfusion rate was around 17% for the normal BMI group compared to just 11% in the obese group.

"The results were surprising to us. It goes against the normal thought process," says Craig Silverton, DO, a Henry Ford joint replacement surgeon and the study's lead author. "It's hard to explain but one theory could be that heavier patients have larger blood volume than patients of normal weight."

Additionally, the study looked at post-op complications and found that the rates were similar among the different BMI groups, though the obese group did have a higher infection risk. The study's authors add that these results contradict what others have found in the past, and note that more research is needed.

Kendal Gapinski

InstaPoll: Are Telehealth Post-op Visits a Good Idea?

After low-complexity surgeries, is conducting post-op visits via teleconferencing technology a good idea? Tell us in this week's InstaPoll.

Last week we asked if forced-air warming devices can lead to surgical site infections, as a flood of recent patient lawsuits contend. The 279 respondents were perfectly puzzled: one-third said yes, blowers can send airborne pathogens into the incision and cause a deep joint infection, one-third said it was a bunch of hot air and one-third didn't know. The results:

Can forced-air patient warmers cause surgical site infections?

  • yes 34%
  • no 33%
  • unsure 33%

Dan O'Connor

News & Notes

  • Lawmakers seek ASC updates The Ambulatory Surgical Center Quality and Access Act of 2015, introduced last month by a bipartisan team of U.S. senators, seeks parity and transparency for the nation's ASCs. It would require CMS's annual ASC fee schedule update to equal that given to hospital outpatient departments, and would require the agency to publish comparisons of quality reporting measures, reimbursements and co-pays at ASCs and HOPDs.
  • Hip implant component recalled An unexpectedly high number of post-op fractures linked to a modular neck used in total hip replacement surgery have led the manufacturer, MicroPort Orthopedics, to recall all lots of its PROFEMUR Neck Varus/Valgus CoCr 8 Degree, part number PHAC 1254. The devices were manufactured and distributed in the U.S. between June 2009 and July 2015.
  • Layer of protection for implants French researchers have developed a microscopically thin film embedded with biocompatible agents and built on a silver coating that, when covering titanium implants, provides an antimicrobial, antifungal, anti-inflammatory effect against the threat of surgical site infections.