Let's hope this is simply a matter of lawyers trolling for medical malpractice lawsuits and not a sign of things to come, but a Chicago personal injury law firm is urging patients to "talk to a medical malpractice attorney if you think you might have been sent home too early after a procedure."

Check out their pitch to "patients who are rushed home after surgery and suffer further injury as a result." Later on in the press release: "If your healthcare provider puts you in danger by caving in to insurer pressures and sending you home too soon, you may be entitled to monetary compensation."

Statements such as this make you think that the law firm doesn't quite understand that fast - and safe - discharge is one of the pillars of same-day surgery.

We asked ASC Association President David Shapiro, MD, to weigh in. "This only serves to encourage the public to consider every episode of their health care as an opportunity to sue their providers. ...The motivations ascribed by in the lawyer's advertisement are as disingenuous as they are dishonest; and serve, in my opinion, as more of a clarion call for liability reform than as an inducement to seek legal representation."

Dan O'Connor

Hyperglycemia and obesity increase the risk of surgical site infections, according to a pair of studies published in the July issue of the Journal of Bone and Joint Surgery.

The first study reviewed case data from nearly 800 patients, aged 18 years or older, who underwent orthopedic trauma surgery to repair isolated injuries, including open fractures. SSIs developed in 13 of the 294 patients who had more than 1 glucose value greater than or equal to 200mg/dL, but in only 8 of the 496 patients without more than such 1 glucose value, according to the study's authors.

They concluded that hyperglycemia was an independent risk factor for SSIs in orthopedic trauma patients without a history of diabetes at 30 days post-op, and note that nearly one-third of patients admitted to the hospital without a history of diabetes have hyperglycemia.

Authors of the second study discovered 52 post-op joint infections occurred in the year following the approximately 7,000 hip and knee replacement surgeries they analyzed, with infection rates jumping from less than 0.5% in patients with normal BMIs to more than 4.5% in morbidly obese patients. Diabetes more than doubled post-op joint infection risks independent of obesity, according to the study.

The researchers say identifying and treating hyperglycemic patients before surgery and identifying patients with undiagnosed diabetes would result in better surgical outcomes by avoiding infection-related infections. They also suggest weighing the ultimate benefits of joint replacement surgery against the increased risk of SSI in these high-risk patient groups, especially the morbidly obese.

Daniel Cook

The surgical setting regularly tops the federal government's annual list of hazardous workplaces. Just because your facility has never experienced an on-the-job injury, though, doesn't mean you're immune from them. Getting in a safety mindset now can save you and your employees a lot of trouble later. A panel of risk management experts discuss ways to become and stay compliant with safety regulations and safer practices, which stands to benefit everyone. "The reporting of injuries is inconvenient and time-consuming," says one expert, "but prevention is easy."

David Bernard

A new study shows that hospital-employed nurses suffer depression at twice the rate of the national population. Tell us in this week's InstaPoll if you think your nurses suffer from depression. Check back next week to see the final results.

Last week we asked about your return rate for patient satisfaction surveys. Nearly half (49%) of our 392 respondents reported a 20% to 40% response. The results: