Hudson Valley Hospitals Increase OR Safety
Monday August 10, 2009
Print This- Select Text Size:
Comments
“Our goal is to never have an event, and we’re trying to maintain that,” says Mary Ellen Rauner, RN, MA, chief nursing officer and vice president of patient care services at Newton (N.Y.) Memorial Hospital.
advertisement
“Our goal is to never have an event, and we’re trying to maintain that,” says Mary Ellen Rauner, RN, MA, chief nursing officer and vice president of patient care services at Newton (N.Y.) Memorial Hospital.
The Centers for Medicare & Medicaid Services stopped reimbursement for care related to items left in after surgery and certain surgery-associated infections last October.
Although Medicare’s cuts pertaining to hospital-acquired errors may have convinced some hospitals to step up their safety processes, many facilities began their journeys long before reimbursement changed. The CMS decision served to reinforce the importance of following the safety measures already implemented, says Rochelle Greenberg, RN, BSN, MPA, director of surgical services at Phelps Memorial Hospital Center in Sleepy Hollow, N.Y.
“If the care is substandard as clearly defined, we shouldn’t be paid for it,” adds Margo McGilvrey, RN, BSN, MBA, chief nursing officer at HealthAlliance of the Hudson Valley, which consists of The Kingston Hospital and Benedictine Hospital in Kingston, N.Y. However, she says hospital leaders remain cognizant about CMS policies. “I’m not going to say we are blind to the reimbursement issues, but too often people get hung up on what the regulatory bodies say rather than the simple focus of doing what’s best for the patient.”
Surgeons must see their patients at Newton Memorial in the pre-op area and mark the surgical site before entering the operating room.
“Initially, it was a little bit of a struggle, but now they are used to it,” Rauner says.
Phelps Memorial nurses complete a checklist in the holding area. They use the SBAR (Situation-Background-Assessment-Recommendation) communication technique, with double identifiers, for all handoffs. Lorrie Presby, RN, BA, CNOR, a nurse educator in the OR at Phelps Memorial, credits multiple verifications with preventing near-misses in the OR.
HealthAlliance’s Kingston and Benedictine Hospitals unfailingly conduct time-outs, McGilvrey says, and nurses feel empowered to stop a procedure. They have caught a couple of near misses.
“It takes a few more seconds on the front end, but you end up with a safer environment,” McGilvrey says.
At Phelps Memorial, nurses check in the electronic medical record that the appropriate antibiotics were given. Surgeons must confer with a radiologist who has viewed the patient’s films before proceeding with a nephrectomy, craniotomy, carotid endarterectomy, or other procedures.
Newton Memorial developed standard order sets with suggested prophylactic antibiotics for various procedures, as recommended by the Surgical Care Improvement Project (SCIP) and approved by the medical executive committee, which the surgeon can simply check off. Multiple committees and the board of directors review compliance. The hospital also follows SCIP standards for venous thromboembolism prophylaxis and monitoring patient temperatures.
To ensure zero mistakes with specimens, Newton scrub and circulating nurses, transport personnel, and the laboratory receiving person verify the specimen and patient name.
Debra Anscombe Wood, RN, is a freelance writer. To comment, e-mail editorNJ@nursingspectrum.com.
Reader Comments
Login
Be the first to comment!