Make Your Regional Anesthesia Safer

A new study suggests that a single prophylactic dose of antibiotics may significantly reduce the incidence of both peripheral and epidural catheter infections.

In a study involving more than 40,000 patients who'd received continuous regional anesthesia, researchers found that the infection rates among those not given antibiotics were 2.4% for peripheral catheters and 5.2% for epidural catheters versus 1.1% and 3.1%, respectively, for those who were.

However, since "widespread uncritical use of antibiotics … remains a major problem," the authors advise practitioners to consider the risks and benefits of this infection prevention strategy before putting it to widespread use.

They further note that while "the risk of catheter-related infections was reduced by single-dose antibiotic prophylaxis in all subgroups," patients with prolonged catheter use (4 to 14 days) and patients with BMIs of 25 or greater are known to be at greater risk of infection, "suggesting that single-dose antibiotic prophylaxis might be especially useful in these populations."

Jim Burger

Surgical Studies Biased Against Women

Clinical research focuses more on men than women, even though the sexes suffer different post-op complications and have different rates of hospital readmission, according to a report appearing in JAMA Surgery, which calls for a more balanced approach to gathering the data used to develop evidence-based surgical care.

The report's analysis of 1,300 peer-reviewed journal articles published between January 2011 and December 2012 shows female patients accounted for approximately 50% of the more than 115 million patients involved in the studies, but only 38% of the trials broke down data according to the outcomes of men and women, 33% analyzed data based on sex and 23% discussed sex-based results.

A sex bias in clinical research could jeopardize the surgical care of female patients by leading to the development of drug therapies and surgical devices that are better suited for men, say the study's authors. It might also cause caregivers to abandon drug therapies that could be beneficial to women if studies show the therapy is ineffective overall. Conversely, a gender bias in clinical research could result in the development of drug therapies that are more likely to increase the risk of adverse reactions in women.

The authors of an accompanying commentary say researchers and study reviewers should require that clinical trials include considerations of sex — as well as age, ethnic background and socioeconomic status — in order to produce results that promote precise surgical care and quality of care for both men and women.

Daniel Cook

Have You Made Your OR Excellence Plans?

Good news if you've to pull the trigger on attending Outpatient Surgery Magazine's OR Excellence conference: The deadline for receiving the $100 early registration discount has been extended until Labor Day, Sept. 5.

Of course, what's to consider? The interactive educational sessions with a wide range of knowledgeable speakers and the unique networking opportunities with professional peers and manufacturers' representatives over wine tastings and tropical drinks, all taking place at the Hyatt Regency Coconut Point Resort in Bonita Springs, Fla., might make it the easiest decision on your to-do list.

"We know the summer is a busy time for our readers and attendees, so we want to give them a couple more weeks to take advantage of this discount offer," says ORX Conference Director Stephen Archibald. "The resort is about 80% full, so we highly encourage those interested in attending to register soon."

Meet the winners. When the conference kicks off on Oct. 12, Jill Moscato, RN, MSN, OR manager at Advocate Sherman Hospital, in Elgin, Ill., will be enjoying the resort's Presidential Suite for her stay, compliments of Outpatient Surgery's "Do ORX in Style" contest, in which she was the grand prize winner.

Second-prize winner Cheryl Weisbrod, MSN, BC, nurse administrator at the Mayo Clinic in Rochester, Minn., won a free suite upgrade. Three runners-up won $100 spa gift certificates: Kristina Marquez, MPH, BSN, BA, RN, of Buffalo Surgery Center in Amherst, N.Y.; Karen Neal of Integris Southwest Medical Center in Oklahoma City, Okla.; and Jodie White, BSN, CNOR, of Germantown Surgery Center in Germantown, Tenn.

Stephen Archibald

InstaPoll: When's the Latest You'll Start a Case?

Are more of your surgeons starting cases late in the afternoon — so late that you're discharging patients past 8 p.m. or 9 p.m.? Tell us in this week's InstaPoll when's the latest you'll let a case start in your facility.

It's not uncommon for outpatient surgical facilities to treat ASA III patients, according to the 224 respondents who answered last week's poll. The results:

What percentage of your patients are ASA III?

  • 0% 7%
  • about 10% 17%
  • 10% to 20% 18%
  • 20% to 30% 29%
  • more than 50% 29%

Dan O'Connor

News & Notes

  • FDA: Don't use this AER to reprocess duodenoscopes The FDA has re-emphasized its warning against reprocessing duodenoscopes in Custom Ultrasonics' System 83 Plus automated endoscope reprocessors. The equipment was recalled for that purpose earlier this year, and while they are still validated for use on other types of endoscopes, facilities that use duodenoscopes should seek alternative methods of reprocessing the complex devices.
  • Follow-up care by phone? It might be more time- and resource-effective for some patients who undergo laparoscopic cholecystectomies, inguinal hernia repairs and other low-risk general surgeries to receive a follow-up phone call from their surgeons instead of an in-person examination, according to a study published online by the Journal of the American College of Surgeons. A telephone-based post-op clinic at a Veterans Affairs hospital saw similar outcomes to in-person consultations while triaging the need for the checkups. It also spared patients from traveling long distances for short visits, and freed physicians and the facility to deliver care to more patients.
  • Infection prevention infographic "It Takes a Team" to prevent healthcare-associated infections in the ambulatory setting, says the Agency for Healthcare Research & Quality. In its new infographic, it aims to teach your team (as well as your patients and their families) the best practices for battling bacteria.