A Kentucky congressman is urging surgical facilities to contact their members of Congress and request that they sign his letter demanding changes to CMS's guidelines on the use and disposal of single-use drug vials.

At present, the guideline dictates that vials labeled as single use must be discarded after their contents are administered to1 patient, even though these vials are often only available in large doses and could otherwise be used to treat multiple patients.

U.S. Rep. Ed Whitfield, a Republican from Kentucky, is asking fellow representatives to join him in a letter to Secretary of Health and Human Services Kathleen Sebelius that explains how this requirement has forced physicians and healthcare facilities to waste unused portions in a time of short supply among many critical drugs. Many surgical facilities have had difficulty securing propofol, fentanyl and midazolam, for example.

The letter to Secretary Sebelius points out that "there is no evidence that transmission of bloodborne pathogens during healthcare procedures continues to occur because of the use of single-dose vials in multiple patients when appropriate sterile procedures are used."

Mark McGraw

State and federal inspection reports of New Jersey's ASCs are now available online, giving patients an opportunity to make more informed choices about where they undergo surgery.

Patients can search the New Jersey Department of Health and Human Services' website for inspection reports of specific facilities and can compare reports of facilities across regions of the state. The reports, which date back 3 years, outline which facilities meet national and state standards related to infection control, medication management, maintaining patients' rights and equipment sterility, among other factors.

New Jersey's 260 licensed or certified ASCs are routinely inspected by state surveyors every 3 years and by federal regulators every 4 years, according to the DHSS. Last month, Gov. Chris Christie pocket vetoed a bill that would have held single-OR surgical facilities to the same licensing standards as hospitals and multi-room ASCs.

Facilities found non-compliant with state or federal standards must file corrective action reports within 10 days of being cited. These reports, which can also be accessed on the DHSS website, detail the steps centers have taken to raise their level of care back to acceptable standards.

Surgical providers support the information's posting, but are watching the move closely. According to Jeffrey Shanton, who chairs the New Jersey Association of Ambulatory Surgery Centers' advocacy and legislative affairs committee, the organization is committed to transparency for all of the state's facilities and healthcare providers.

"We are in the process of reviewing the information on the DHSS website, as well as the manner in which it is presented," he says. "We need to be certain that the website is accurate, fair and most importantly, that the public understands what they are looking at so this very valuable source of information can be utilized to it's full potential."

Daniel Cook

While it's not always practical, or even possible, to eliminate opioids from your post-op pain management regiment, reducing their use in favor of non-narcotic alternatives can put more efficient post-anesthesia care, including rapid recovery and discharge, within your reach.

For "Can We Eliminate Narcotics?", an article which appears in the January issue of Outpatient Surgery Magazine, we asked a panel of anesthesia experts for their answers to that question. They told us about regional anesthesia techniques, continuous infusion pumps and non-opioid IV analgesics that sidestep common post-op complications and send patients home comfortable and satisfied.

"The origins of pain are multi-factorial," says Laura Clark, MD, a professor of anesthesia at the University of Louisville in Kentucky. "We should treat it multi-factorially."

David Bernard

Research indicates that up to 60% of pre-op lab tests (urine, liver function, coagulation, EKG or chest x-rays, for example) are unnecessary - meaning they're not indicated by clinical practice guidelines - and that up to 90% of patients receive at least 1 unnecessary pre-op test. Tell us in this week's InstaPoll if some of the lab tests your facility orders are unnecessary.

Nearly 6 out of 10 (59%) of last week's 577 respondents predicted that Mitt Romney will be the Republican presidential candidate this fall. The results: