OR Today - November 2016

SPOTLIGHT ON

DAVID FITZGERALD PAGE 54

CONTINUING EDUCATION

TEACHING NURSES PAGE 32

TAKE GOOD CARE NURSES • SURGICAL TECHS • NURSE MANAGERS

OR TODAY LIVE!

RECAP PAGE 10

NOVEMBER 2016

www.ortoday.com

READ OUR CORPORATE PROFILE ON PAGES 42-45

Copyright ©2013 Ruhof Corporation 033115 AD-008

KEEP CALM AND BE SURE with the

GUARDIAN Disposable Valve Set Color coded for easy identification Disposable, one-time use to prevent cross contamination Eliminates the need for reprocessing reusable valves Set containing one each of air/water, suction, and biopsy valves For use in OlympusÂŽ 140/160/180/240/260 Series Endoscopes

For More Information Contact Ruhof at 1-800- 537-8463 www.ruhof.com 071516 AD-27

Redefining Pressure Ulcer Prevention DabirAIR® Overlays use low-profile, alternating micropressure nodes to provide periodic off-loading and tissue perfusion while minimizing skin shear. This clinically effective system can be used in virtually any healthcare environment where pressure injuries are a concern.

• Alternating Tissue Off-loading With Reduced Skin Sheer

• Low-Profile Design

2 mm Deflated – 25 mm Inflated

• Ideal for Procedures Over 3 Hours

(888) 559-3641

YOUR SOURCE FOR HOSPITAL-GRADE REPLACEMENT CORDS Interpower® is your source for North American hospital-grade replacement cords, power cords, and cord sets. Made in Iowa, we have no minimum order requirements which means you can order just what you need—whether it’s 1, 5, 100, or more!

Custom labeling is available. Mark your cords with labels that contain your specific information. Interpower offers a number of different labeling options which can be customized to your specifications. If you have specialized requirements for a replacement cord set, we can do custom orders.

Identify a certain location—such as Operating Room 1, ER 2, or OR 3. With your cords specially labeled, hopefully they will stay in the correct location. And if you need to replace one, you only have to order one! Order only the exact number that you need.

All Interpower manufactured cords are 100% electrically tested for safety. We offer a variety of options with an extensive range of clear, black, and gray North American hospital-grade plugs on power cords, cord sets, and replacement cords.

Contact our Customer Service Representatives who can answer questions about pricing availability and technical aspects, such as application and/or approvals, help in obtaining required documentation, and assist you in designing specialty products.

• Made in Iowa • No minimum order requirements • Same day shipments available for in-stock products

• 1-week U.S. manufacturing lead-time on non-stock Interpower products • Over 4 million parts in stock • Free technical support

QUICK PICK REPLACEMENT OPTIONS P/N 86610400 Rating: 10A/125VAC

P/N 86610810 Conductor Size: 3 x 18AWG

Length: 3.05m/10.0ft

Rating: 10A/125VAC

P/N 86611610 Conductor Size: 3 x 18AWG

Length: 3.05m/10.0ft

Rating: 15A/125VAC

Conductor Size: 3 x 14AWG

Length: 3.05m/10.0ft 011

®

Order Online! www.interpower.com

®

INTERPOWER | P.O. Box 115 | 100 Interpower Ave | Oskaloosa, IA 52577 | Toll-Free Phone: (800) 662-2290 | Toll-Free Fax: (800) 645-5360 | info@interpower.com Business Hours: 7 a.m.–6 p.m. Central Time | ORDER A FREE CATALOG TODAY! E-mail catalog@interpower.com or call toll-free.

Patient lives demand quality monitoring equipment.

You can trust the Certified Experts at Pacific Medical to deliver precision, accuracy and attentiveness when servicing your equipment.

Check out our website or give us a call today to find out more about our special offers on monitoring equipment, cables, repair and much more.

REPAIR

PURCHASE

ONE SOLUTION FOR ALL YOUR PATIENT MONITORING NEEDS

EXCHANGE

ONE SOLUTION FOR ALL YOUR PATIENT MONITORING NEEDS

PARTS & ACCESSORIES

ONE SOLUTION FOR ALL YOUR PATIENT MONITORING NEEDS

pacificmedicalsupply.com ONE SOLUTION FOR ALL YOUR PATIENT MONITORING NEEDS

800.449.5328

#PACMEDLLC

CONTENTS

features

CORPORATE PROFILE: IMP IMP’s patient positioning solutions did not spring solely from IMP’s imagination.

The company developed its positioning solutions by listening to stakeholders – everyone who voiced a need – to help make patient outcomes safer and more successful.

46

OR TODAY | November 2016

42

TRAINING THE NEXT WAVE When you consider the high degree of complexity involved in becoming a competent perioperative nurse, it’s surprising how little specialized OR training is included in standard nursing program curricula.

This makes OR nurse training one of the biggest challenges facing the industry today.

54

SPOTLIGHT ON: DAVID FITZGERALD David Fitzgerald is a trailblazer and a “start-up nurse” in Arizona. Find out how challenges motivate him and how that has created an exciting and satisfying career.

OR Today (Vol. 16, Issue #9) November 2016 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to OR Today at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

For subscription information visit www.ortoday.com. The information and opinions expressed in the articles and advertisements herein are those of the writer and/or advertiser, and not necessarily those of the publisher. Reproduction in whole or in part without written permission is prohibited. © 2016

WWW.ORTODAY.COM

November 2016 | OR TODAY

7

CONTENTS

departments

PUBLISHER

John M. Krieg | john@mdpublishing.com

VICE PRESIDENT

Kristin Leavoy | kristin@mdpublishing.com

26

EDITOR

John Wallace | jwallace@mdpublishing.com

10

ART DEPARTMENT Jonathan Riley Jessica Laurain Kara Pelley

ACCOUNT EXECUTIVES

Warren Kaufman | warren@mdpublishing.com Jayme McKelvey | jayme@mdpublishing.com

16

Chandin Kinkade | chandin@mdpublishing.com

ACCOUNTING

68

Kim Callahan

WEB SERVICES Taylor Martin Adam Pickney Cindy Galindo

INDUSTRY INSIGHTS 10 12 15 20

OR Today Live! Recap AAAHC Update News & Notes ASCA Update

CIRCULATION Lisa Cover Laura Mullen

IN THE OR 22 25 26 32

Suite Talk Market Analysis Product Showroom CE Article MD PUBLISHING | OR TODAY MAGAZINE 18 Eastbrook Bend, Peachtree City, GA 30269 800.906.3373 | Fax: 770.632.9090 Email: info@mdpublishing.com www.mdpublishing.com

OUT OF THE OR 60 Health 62 Fitness 66 Nutrition 68 Recipe 70 Pinboard 76 Index

8

OR TODAY | November 2016

SURGICAL CONFERENCE

Chicago, IL | August 28-30 | www.ortodaylive.com

SAVE THE DATE

for the 2017 conference to be held August 27-29 in Washington, D.C. ortodaylive.com

PROUD SUPPORTERS OF

WWW.ORTODAY.COM

IGNITE YOUR TRAINING

Where New and Experienced Perioperative Nurses Go To Take Their Practice to the Next Level

April 1-5, 2017 | Boston, MA CUSTOMIZE YOUR LEARNING WITH TAILORED EDUCATION TRACKS Ambulatory Clinical Educator Evidence-Based Practice/Research Global Infection Control/Prevention Leadership/Management Professional Development Quality Indicators

EARLY BIRD PRICING WWW.ORTODAY.COM

REGISTER BY JANUARY 31 TO SAVE www.aorn.org/SurgicalExpo November 2016 | OR TODAY

9

INDUSTRY IN THE OR INSIGHTS OR TODAY LIVE!

STAFF REPORT

SURGICAL CONFERENCE

EDUCATION, EXHIBITS AND GOOD EATS HIGHLIGHT 2016 EVENT

T

he OR Today Live! Surgical Conference continues to deliver quality experiences for perioperative leaders from around the nation.

The 2016 OR Today Live! Surgical Conference provided a unique conference experience for attendees which included an excellent opportunity for quality exhibit hall interactions with industryleading vendors, top-notch educational materials eligible for CE contact hours, a powerful and inspirational keynote address and entertaining networking events.

One highlight of the 2016 conference was the partnership with the Competency & Credentialing Institute (CCI) that included the pre-conference workshop “Fundamentals of OR Management” and other educational opportunities.

“OR Today Live strives to present a conference with quality education because we know the importance

10

OR TODAY | November 2016

of earning CE contact hours for our attendees,” explains Kristin Leavoy, vice president of MD Publishing, the parent company of OR Today Live. “But we also want to balance the curriculum with an opportunity for attendees to relax and enjoy themselves. It’s more often than not that the networking events allow the attendees to let down their guard and really get to know each other and the struggles they face on a day-to-day basis.”

The ’80s Karaoke Party sponsored

by AIV was such an event. The evening provided a fun, relaxed atmosphere for quality interactions. Attendees and exhibitors alike were able to let loose as they enjoyed delicious food and belted out some ’80s classics.

OR Today Live once again succeeded in bringing together perioperative leaders in an ideal environment for fostering solutions for the prevailing challenges, regulations and culture changes facing the surgical suite and the professionals called on to manage the decisions and patient care within the OR.

“I think this is one of the best conferences I have attended. It was intimate, small, well run. I like that you partnered with CCI. I thought the content was professional, and kept me engaged. I hope you keep it small to not ruin the atmosphere of the up close and personal relationship you gained with the presenters,” says Megan B., a director of surgical services.

“Excellent, excellent excellent! Well worth the money and time spent! Great experience from the time I registered until the time I left … great price, great learning, great networking, great activities and, lets not forget, great food,” says Rebecca S., a perioperative educator. “I know this was only your seconnd year to do this conference. I loved the small, intimate feeling and personal attention.

I know you will grow larger each year as word gets out, but please continue to provide the same excellence in learning sessions and personal, hands-on attention during the conference. You have a great organizing staff!”

WWW.ORTODAY.COM

OR TODAY LIVE!

Q&A: KEYNOTE SPEAKER EXPANDS ON WORKPLACE BULLIES

Q:

The keynote address at the 2016 OR Today Live! Surgical Conference addressed a topic on the minds of many perioperative professionals. “Bringing Shadow Behavior Into the Light: Understanding and addressing bullying behavior,” presented by Phyllis Quinlan, Ph.D., RN-BC, President, MFW Consultants, fostered a greater understanding of why bullying occurs, explained the subtle distinctions between incivility and bullying behavior, and discussed the collaboration needed between leadership, labor and human resources to create a zero tolerance for bullying culture.

Quinlan shared more in a recent Q&A.

Q:

Do you believe that workplace bullying and incivility are the same?

QUINLAN: No. Workplace incivility can

best be defined as low-intensity unpleasant behavior that is rude, impolite, or inconsiderate. While the target can feel insulted or angry; an actual desire or intent to harm the other person is ambiguous. Anyone has the potential to behave inappropriately toward a coworker given the right circumstances coupled with a lack of selfmanagement.

Workplace bullying, however, is ongoing offensive, abusive, intimidating or insulting behavior or actions directed at a person(s), causing the target to feel threatened, abused, humiliated or vulnerable. The person experiencing prolonged bullying can feel a range of psychological and physiological symptoms. The research supports that those who bully are very aware of their behavior and its effect on others; even though they may deny that there is intent. Fortunately, there is a very small percentage of the workforce that is capable of such sustained disregard for another individual.

Q:

Since these behaviors are very different, should the management be different as well?

QUINLAN: Yes, they should and I want to be

clear as to why. The two keys here are insight WWW.ORTODAY.COM

Why is managing bullying behavior in nursing so challenging?

QUINLAN: This is a complex issue, but

PHYLLIS QUINLAN, PH.D., RN-BC, PRESIDENT, MFW CONSULTANTS

and sustainability. The person who behaves in an uncivil manner has the ability to selfreflect on that indiscretion, feel remorse or regret and make the active choice to work on their self-management skills and achieve personal growth. A bully does not have this ability.

It is vital that we understand and accept that a nurse bully is a narcissist with a license. A narcissist lacks the capacity for empathy. The ability to reflect empathically on the consequence that one’s poor behavior has on another is vital for driving the desire to change.

Bullies (narcissists) are incapable of this.

An uncivil staff member can gain insight though coaching and training. Positive, sustained changes in behavior can be noted within six to twelve weeks of working a clear emotional intelligence improvement action plan. A narcissist typically reacts in one of two ways to someone attempting to hold them accountable. They may escalate their behavior and retaliate or they will tell you what you want to hear and vow to reform. However, they cannot sustain any improvement because they lack a connection with the need to improve.

one reason is that nurses are professional caregivers. Nursing leaders have a good deal of difficulty coming to terms with the fact that a bully/narcissist cannot be fixed. It is not a part of our caregiver DNA to “give-up” on someone. We talk ourselves into believing that if we just try a little harder that this individual will have an epiphany and the problem will be resolved.

The bully/narcissist is hoping that you will react exactly in this manner. They are experts at taking your wonderful qualities of empathy, patience and the need to heal and use them against you to achieve their goal of never being held accountable to sustained improvement. Essentially, we need to get out of our own way in order to take charge of this situation. Nurse leaders must try to accept that once someone shows you their true colors, you need to resist repainting them.

The only performance improvement plan for a bully/narcissist is a collaborative effort put forth by administration, human resources and the nurse leader that is time sensitive and rich with mandatory training.

The documentation should discuss the need for improvement to be demonstrated within three to six months then sustained for six months as well.

Most bully/narcissists will not be able to withstand this type of scrutiny and may decide to move on. The others may stay, but will find it very challenging to sustain the improvement. Should termination be the only option left, you can have the peace of mind that a sincere effort was made on your part; and 12 months’ worth of documentation to support your action.

SAVE THE DATE for the 2017 conference to be held August 27-29 in Washington, D.C. More information can be found at ortodaylive.com along with a Call for Presenters application for those interested in presenting at next year’s conference.

November 2016 | OR TODAY

11

INDUSTRY IN THE OR INSIGHTS AAAHC UPDATE

BY JACK EGNATINSKY, MD

ADDING NEW PROCEDURES FACTORS TO CONSIDER

I

t seems that every week we read about a new procedure being done in ASCs. This is good news because evidence points to the quality and safety of the ASC environment. Femtosecond laser cataract extraction, total knee and/or hip replacements and ultrasound guided blocks are some recent examples. For 2016, CMS finalized the addition of 17 codes to the ASC-payable list.

Providers may be eager for the opportunity to perform new procedures in your facility, but there are many things to think through before taking the leap. Of course you know that your governing body must approve (and document approval) for new procedures. But before asking for a change to the approved procedure list, use AAAHC Accreditation Standards as a framework for considering the implications.

PRIVILEGING Before your surgeons, proceduralists, or anesthesiologists can begin performing a new procedure in your center you must grant them privileges. Start by reviewing what your medical staff by-laws say about adding new privileges.

• What education, training, and experience do you require?

• How will you evaluate current competence?

• What documentation will you look for?

• What time frame is applied to the new privileges?

OPERATIONAL FACTORS – PERSONNEL, EQUIPMENT, AND COSTS • Are you subject to Certificate of Need (CON) constraints?

• Will new or additional staff training be required to accommodate these new procedures? How will that training be delivered?

• Is there anything that should be added to your pre-op evaluation?

12

OR TODAY | November 2016

• Will the new procedure(s) add extra time to your OR and recovery room scheduling?

• Will these new procedures require you to purchase or lease new equipment?

How long will it take you to get the new equipment?

• How will you clean, disinfect and or sterilize the new equipment?

• Are there significant costs for “disposable,” one-time use devices needed in conjunction with the newly purchased equipment?

• Are there implications for your physical environment, e.g. new construction required?

• Do you need a special power source, e.g. 240 volts, to be added to your operating room to accommodate the new equipment?

• Do you have to make changes to your existing space?

• Do you have policies in place for obtaining blood or blood products or “recycling” blood lost by the patient?

• Do you need to send the patient home with special dressings or devices that qualify as durable medical equipment (DME)? Who will apply the dressings and who will educate the patient and/or family member on how to maintain these or change them if necessary? If there are devices, who will educate the patient on device use and will there be follow-up provided on device maintenance?

• Will in-home nursing care follow-up be

required? Will the surgeon be arranging this or are you expected to do this?

• Do you know how to code for the procedure(s)? Will your third-party payers cover these procedures in your center?

• Will you have to adjust your charges?

AND DON’T FORGET: • Have you met notification requirements from your accrediting organization prior to the implementation of new services?

This is not an all-inclusive list of questions to answer before you add new procedures but, at a minimum, these are topics you should be able to answer. If you have not considered these kinds of likely-to-arise issues before you add the procedures, you may be forced to deal with economic and/or medical-legal questions arising later.

Be progressive – but be cautious.

ABOUT THE AUTHOR Jack Egnatinsky, MD, has been a surveyor for AAAHC since 1996, and currently serves as the AAAHC Medical Director. Egnatinsky is an anesthesiologist who lives in Christiansted, U.S Virgin Islands. He is Board Certified by the American Board of Anesthesiology and a Fellow of the American College of Anesthesiologists.

WWW.ORTODAY.COM

{

AAAHC ACCREDITATION

}

It’s validation of how well you deliver care.

We send physicians, nurses, administrators – professionals whose opinion you can respect.

Their mission is to help your organization be the best it can be.

• We are the leader in ambulatory accreditation.

Improving health care quality through accreditation

Contact us to learn more 847-853-6060 • info@aaahc.org • www.aaahc.org

• Our Standards are nationally-recognized.

• Our surveys are consultative not just a checklist.

WWW.ORTODAY.COM

November 2016 | OR TODAY

13

KEEP COOL OR WARM UP WITH VESTS FROM HEALTHMARK

There are few better ways to beat the heat within the SPD or Operating Room than our Single-Use Cooling Vest. When used with our reusable Phase Change Packs, the Single Use Vest is designed to keep your body at a comfortable temperature while on your feet for extended periods of time. When you’re wearing Cool Aids under your PPE you’ll feel more comfortable because the light-weight, durable fabric is designed for the active individual.

Fight frigid temperatures with our reusable heated vest that emits comfortable levels of warmth for the wearer's torso to keep cozy in all ambient conditions. Fashioned with a soft-shell barrier eece fabric, the Heating Vest features zippered front pockets with adjustable elastic cord at the bottom and zipper closure provides comfort and mobility. The Heating Vest comes equipped with a controller that has three temperature settings for selecting the desired amount of heat, removable heating elements for easy cleaning and a LI-Ion battery that pairs with a charger.

HMARK.COM | 800.521.6224

INDUSTRY INSIGHTS NEWS & NOTES

SEALED AIR’S DIVERSEY CARE MAKES TRICLOSAN-FREE COMMITMENT Sealed Air’s Diversey Care division has announced that it will remove triclosan from all of its hand care products globally within the next 12 months. Recently, the Food and Drug Administration (FDA) issued a final rule that over-the-counter consumer antiseptic wash products containing triclosan can no longer be marketed in the U.S. “Our hand care products protect people across the globe,” said Dr. Ilham Kadri, president, Diversey Care. “We are dedicated to providing the safest and most effective hand care products available and are proud to lead the industry in making triclosan removal a global commitment.”

For over 20 years, Diversey Care has offered customers hand care products with and without triclosan, as authorities in many countries still approve of its use. However, through innovation, Diversey Care is now able to remove triclosan as an active ingredient from its hand care products, while improving overall performance and gentleness to the skin. This transition will also widen the range of hand hygiene options for customers• FOR MORE INFORMATION about Diversey Care’s hand hygiene solutions, visit https:// sealedair.com/diversey-care/hand-hygiene.

EXPERTS DISCUSS BENEFITS OF PICO At a recent meeting hosted by Smith & Nephew in Paris, over 160 European experts in plastic and onco-plastic surgery met to discuss new data and share the latest evidenced-based best practice around the use of PICO, a novel single use negative pressure wound therapy (NPWT), in the prevention of incisional complications following breast surgery.

Incisional complications and delayed healing are not uncommon following breast surgery and can cause avoidable hospital readmissions or increased lengths of stay, which has implications for the health care system and patient outcomes. Delayed healing is a particular issue in post mastectomy reconstruction where the risk of a surgical complication has WWW.ORTODAY.COM

been found to be four times higher than in non-oncology breast surgery, and where any delay to adjunctive treatment such as radiotherapy is to be avoided.

With regards to breast reduction surgery, other key issues were raised with regards to wound care and post operative issues including scar quality. A multicenter-study involving 200 bilateral breast reduction patients was presented to delegates, which showed significantly fewer wound healing complications for PICO compared to standard care (p=0.004), and a 38 percent relative reduction in surgical dehiscence by day 21 (a surgical complication in which the wound ruptures along the surgical suture line) from 52 patients (26.4 percent) to 32 patients (16.2

percent) (p<0.001). The study also evaluated the scar quality at 42 and 90 days post surgery. PICO showed significantly better scar quality at each time point (p<0.001).

Clinical complications including surgical site infections following breast surgery were also identified as significantly higher amongst patients with a high BMI, impacting on both clinical and aesthetic outcomes, but also on the hospital’s resources due to re-admissions and further surgery or post-operative care.

The Plastic Surgery Expert Meeting hosted by Smith & Nephew is one of a series of six meetings happening during 2016, including the use of NPWT across specialties such as orthopedic and obstetrics and gynecology. • November 2016 | OR TODAY

15

INDUSTRY INSIGHTS NEWS & NOTES

MINDRAY INTRODUCES OPTIMIZER SUITE FOR A7 ANESTHESIA WORKSTATION Mindray has formally introduced the expanded Optimizer suite of functionality for the A7 Anesthesia Workstation to the North American market at the American Association of Nurse Anesthetists (AANA) Annual Congress in Washington, D.C. The Optimizer suite, standard on the A7, supports real time monitoring of anesthetic agent use during the OR procedure, assists in minimizing agent waste, and provides end-of-case consumption calculations. The user interface is integrated into the A7’s standard 15-inch touchscreen display for ease of access and use.

This suite of capabilities on the A7 can assist the staff in potentially reducing anesthetic agent usage and waste. It can also help protect the environment from harmful emissions. The new features can also help to improve clinical workflow to positively affect process efficiencies and can support cost-reduction initiatives in the operating room (OR).

In addition to the A7, Mindray featured its new Passport Series monitors, including the Passport 17m designed to meet the requirements of the high acuity OR. The Passport 17m supports the T1 Transport Monitor/Module, which provides the ability to monitor the patient continuously from pre-op through the post-op environments, minimizing patient cables changes and speeding workflow while helping to ensure continuous monitoring.

Mindray’s leadership in point-of-care ultrasound highlighted the TE7 Touch-Enabled Ultrasound System with live scanning during the meetings. Unlike many POC systems, the TE7 cuts the clutter with no keyboard, supporting rapid assessment, needle placement with iNeedle optimized visualization, and pain management with intuitive gestures. •

MASIMO ANNOUNCES CE MARKING FOR RAS-45 SENSOR Masimo has announced the CE Marking of RAS-45, a single-use adult and pediatric acoustic respiration sensor for rainbow Acoustic Monitoring (RAM) of respiration rate (RRa).

Continuous monitoring of respiration rate is especially important for post-surgical patients receiving patientcontrolled analgesia for pain management. The Anesthesia Patient Safety Foundation (APSF) and The Joint Commission recommend continuous oxygenation and ventilation monitoring for all patients receiving opioidbased pain medications. RAM noninvasively and continuously measures respiration rate using an innovative adhesive sensor with an integrated acoustic transducer, such as Masimo’s RAS-125c and now RAS-45, that is applied to the patient’s neck. Using acoustic signal processing that leverages Masimo’s Signal Extraction Technology (SET), the respiratory signal is separated and processed to display continuous acoustic respiration rate (RRa). RRa has been shown to be accurate, easy-touse, and reliable, and to enhance patient compliance.

RRa may facilitate earlier detection of respiratory compromise and patient distress, offering a breakthrough in patient safety for post-surgical patients and for procedures requiring conscious sedation.

16

OR TODAY | November 2016

RAS-45 is designed to facilitate placement on and improve attachment to the neck, but with a smaller adhesive profile than the RAS-125c. It is flexible and uses a transparent adhesive. Like the RAS-125c, it operates with Masimo MX technology boards to measure RRa and display the acoustic respiration waveform. RAS-45 maintains the same performance parameters, range, and accuracy specifications as RAS-125c. Both sensors are for patients who weigh more than 10 kg. • WWW.ORTODAY.COM

NEWS & NOTES

GOJO INTRODUCES ANTIMICROBIAL FOAM HANDWASH GOJO Industries, a producer and marketer of skin health and hygiene solutions, has announced the introduction of its latest formulation, PROVON Antimicrobial Foam Handwash with 2% Chlorhexidine Gluconate (CHG).

This new formulation, which exceeds the FDA Healthcare Personnel Handwash requirements, is gentle on hands making it mild enough for everyday use. This non-irritating, hypoallergenic, dermatologist-tested formulation maintains the skin’s natural moisture barrier. It also is fragrance and dye free, leaves hands feeling clean and soft, rinses quickly

with no sticky residue and is compatible with latex gloves.

“This CHG formulation delivers strong germ kill as well as an unexpected mildness not usually associated with CHG handwashes and surgical scrubs,” said Jeff Hall, healthcare business vice president and general manager, GOJO. “We know hand hygiene plays a critical role in protecting patient safety and reducing germ transmission, but practicing good hand hygiene can be difficult on your hands when you are not using the right products.” •

CIANNA MEDICAL RECEIVES ADDITIONAL FDA CLEARANCE Cianna Medical Inc. has announced that the company has received an additional FDA 510(k) clearance for the SAVI SCOUT radar localization system, allowing the reflector to be placed at the lumpectomy site up to 30 days prior to surgical removal. SCOUT, the first medical device to use radar in human tissue, is a tool for localizing and directing the removal of non-palpable breast lesions.

“The new clearance enabling reflector placement up to 30 days before surgery provides us even more flexibility with scheduling,” said Charles Cox, M.D. “As an early adopter and ongoing user of SCOUT, I’ve found the technology to be highly intuitive, easy to implement and a significant improvement over wire localization in terms of patient experience. Importantly, use of SCOUT also supports greater efficiency in the hospital with less wait time for both patients and physicians.”

Peer-reviewed data recently published in the July issue of “Annals of Surgical Oncology” demonstrated 100 percent surgical success, with significantly lower repeat surgery rates than those reported when using wire localization. In all cases where localization was performed, targeted lesions and reflectors were successfully removed without any observed reflector migration. In another key study finding, researchers concluded that the SCOUT reflector could be reliably detected up to 5 cm from the handpiece.

WWW.ORTODAY.COM

The study also demonstrated high clinician and patient satisfaction with SCOUT. Overall, physicians reported favorably on patient comfort, patient anxiety and overall patient experience and a majority of physicians (85 percent) reported workflow improvement with SCOUT compared with wire localization.

The study also received the 2016 Scientific Impact Award at the Society of Breast Surgeons (ASBrS) Annual Meeting, recognition given annually to the clinical research presentation that is considered to have the greatest scientific impact on breast cancer care, as judged by surgeon attendees. •

November 2016 | OR TODAY

17

INDUSTRY INSIGHTS NEWS & NOTES

HEALTHMARK OFFERS CLEAN LABEL Healthmark Industries has announced the addition of the Clean Label to its labeling line. Manufactured to convey key information to health care professionals, the clean label is intended to conceal and cover the bio symbol on SST systems when transporting clean medical instruments.

The Clean Label provides effective communication among health care professionals in various departments. The label is

a 4x4 inch design with a removable adhesive backing that has a green colored background and “CLEAN” in white text. •

DT RESEARCH UNVEILS NEW LINE OF MEDICAL-CART COMPUTERS DT Research has announced the DT590 series of All-in-One Medical-Cart Computers, integrating small and inexpensive hot-swappable batteries to facilitate mobility for health care applications. The design of the DT Research Medical-Cart Computers addresses long-standing challenges with Computers on Wheels (COWs) and Workstations on Wheels (WOWs) by providing a cordless, lightweight, and anti-microbial computer system that operates continuously with batteries that can be dynamically changed.

The DT590 series can make data access efficient, optimize staff workflow, and minimize the total cost of ownership.

“Doctors, nurses and health care professionals at hospitals, medical clinics, laboratories and retirement communities have been plagued by significant computer design deficiencies while trying to enter

18

OR TODAY | November 2016

and access patient data at the point-of-care, which has been a gating factor for many care facilities to fully embrace Electronic Medical Records (EMR) systems,” said Daw Tsai, Sc.D., president of DT Research. “We studied the issues with COWs and WOWs – all were related to unreliable, heavy, and expensive power supplies. Our focus for the DT590 series was to address the power supply issues, while also improving upon key medical computer functionality.”

The DT590 series features a 19-inch, 22-inch or 24-inch display with a high performance Intel 5th Generation Core i7, i3, or Celeron processor in a compact, mountable package. It boasts a three-bay hot-swappable battery system for zero downtime work environments to increase mobility over traditional workstations and decrease costs and maintenance associated with

COWs. Designed to sustain at least one working shift without adding charged batteries, DT Research Medical-Cart Computers use inexpensive Lithium-ion batteries to combine for 250W capacity for up to 16 hours of runtime. With battery power and wireless connectivity, this computing solution is ideal for health professionals to manage patient information, dispense medication and work collaboratively.•

WWW.ORTODAY.COM

®

E

CLEARVUE CLEAR VUE VIDEO LARYNGOSCOPE

®

®

NEWS & NOTES

ALBAHEALTH INTRODUCES PATIENT SAFETY FOOTWEAR VIDEO LARYNGOSCOPE FOR BARIATRIC PATIENTS Albahealth, a Division of Encompass Group LLC, now offers patient safety footwear for bariatric patients The Infinium ClearVue® within the Confetti Treads line.

Video Laryngoscopes are: The Confetti Treads bariatric offering provides ® The Infinium ClearVue multiple sizes for a range of bariatric patients, with COMPACT AND ERGONOMIC The Infinium ClearVue® Video Laryngoscopes are: the largest being 5 X-Large. n Lightweight - unit is less than 350g.

Video Laryngoscopes are: “The 5XL sock offering features a flexible profile to n Vacuum Packed Disposable Blades COMPACT AND ERGONOMIC easily accommodate either a short/wide or long foot, n Lightweight - unit is less than 350g.

Quick installation and removal of blades COMPACT nAND ERGONOMIC ® and a stretchnwelt design made to accommodate larger n Quick n Lightweight Camera Button for Recording - unitShot is less than 350g.

Vacuum Packed Disposable Blades ankles and calves without creating restriction on the n Vacuum Packed Disposable Blades n Quick installation and removal of blades LOW COST PER PATIENT patient’s limb, said Jennifer Woody, Senior Marketing n Quick installation and removal of blades n Quick Shot Camera Button for Recording n Reusable blades can be used up to Manager, Encompass Group.CHANGES NEEDED PROOF APPROVED n Quick Shot1000 Camera Button for Recording times.

LOW COST PER PATIENT “The uniquely designed stretch welt helps keep the n LowPATIENT cost disposable blades n Reusable blades can be used up to LOW COST PER sock in position and up on the limb, while providing CLIENT SIGN–OFF: 1000 times. n ReusableDURABLE blades can be used up to maximum patient comfort,” Woody said. n Low cost disposable blades 1000 times. n 2 years warranty Available standard and risk-management styles, ARE CORRECT PLEASEinCONFIRM THAT THE FOLLOWING n Low cost disposable blades n Screen all Confetti Treads feature top of the line slip-resiscreated with the Encompass belief that better is reinforced withcare anti-® DURABLE LOGO PHONE NUMBER WEBSITE starts ADDRESS shatter protection tance and 360-degree withDURABLE safety andSPELLING comfort in mind.GRAMMAR We’re pleased n 2 years protection warranty with a unique, and n the Light weight long lastingfor this patented all-around tread profile. with antito offer these health care industry n 2socks n Screen years to warranty is reinforced rechargeable li-ion battery “The Confettishatter Treads bariatric sock offering was growing segment inVIDEO patient care,” Woody said. • protection n Screen is reinforced with antiLARYNGOSCOPE

CLEARVUE

PROOF SHEET

DEO LARYNGOSCOPE

CLEARVUE

n

WIDTH 7”

Light weight long lasting rechargeable li-ion battery

HIGH-DEFINITION n 3.5 inch display n Anti-Fog Lens n 2.0 Mega Pixel Camera with Video and Photo n 4 GB Memory

n

CLEARVUE

®

VIDEO LARYNGOSCOPE ® The TheInfinium InfiniumClearVue ClearVue® Video Video Laryngoscopes Laryngoscopes are: are:

n n

n 2.0 Mega Pixel Camera with HIGH-DEFINITION COMPACT AND ERGONOMIC Video and Photo n 3.5 inch display n Lightweight - unit is less than 350g. n 4 GB Memory n Anti-Fog Lens n Vacuum Packed Disposable Blades n 2.0 Mega Pixel Camera with n Quick installation and removal of blades Video and Photo n Quick Shot Camera Button for Recording n 4 GB Memory LOW COST PER PATIENT n Reusable blades can be used up to 1000 times. n Low cost disposable blades

DURABLE n 2 years warranty The Infinium ClearVue® n Screen is reinforced with antishatter protection Video Laryngoscopes n Light weight long lasting COMPACT AND ERGONOMIC rechargeable li-ion battery n

are:

Lightweight - unit is less than 350g.

n Vacuum Packed Disposable Blades HIGH-DEFINITION n Quick installation and removal of blades n 3.5 inch display n Quick Shot Camera Button for Recording n Anti-Fog Lens n 2.0 Mega Pixel LOWCamera COST PER PATIENT with Video andnPhoto Reusable blades used up 12151 62nd St N can #5 be • Largo FLto33773 • USA 1000 times. n 4 GB Memory 866-918-8434 • www.infiniummedical.com n

Low cost disposable blades

DURABLE

12151 62nd St N #5 • Largo FL 33773 • USA n 2 years warranty 866-918-8434 • www.infiniummedical.com n n

Screen is reinforced with antishatter protection November Light weight long lasting 2016 | OR TODAY 19 rechargeable li-ion battery

Th V

CO n L n V n Q n Q

LO n R 1 n L

HEIGHT 4.5”

COMPACT AND ERGONOMIC COMPACT AND ERGONOMIC n Lightweight - unit is less than 350g. n Lightweight - unit is less than 350g. n Vacuum Packed Disposable Blades n Vacuum Packed Disposable Blades n Quick installation and removal of blades n Quick installation and removal of blades n Quick Shot Camera Button for Recording n Quick Shot Camera Button for Recording LOW COST PER PATIENT LOW COST PER PATIENT n Reusable blades can be used up to n Reusable blades can be used up to 1000 times.

1000 times. n Low cost disposable blades n Low cost disposable blades DURABLE DURABLE n 2 years warranty n 2 years warranty n Screen is reinforced with antin Screen is reinforced with antishatter protection 12151 62nd St N #5 • Largo FL 33773 • USA shatter protection n Light weight long lasting n Light weight long 866-918-8434 • www.infiniummedical.com lasting rechargeable li-ion battery rechargeable li-ion battery HIGH-DEFINITION HIGH-DEFINITION n 3.5 inch display WWW.ORTODAY.COM n 3.5 inch display n Anti-Fog Lens n Anti-Fog Lens

shatter protection HIGH-DEFINITION

® The Infinium ClearVue Light weight 3.5long inchlasting display rechargeable li-ion battery Video Laryngoscopes Anti-Fog Lensare:

DU n 2 n S s n L r

HI n 3 n A n 2 V n 4

INDUSTRY INSIGHTS ASCA UPDATE

BY WILLIAM PRENTICE

COMING SOON FOR ASCS W

hile late December and early January may be more traditional times for making projections about the new year, as I was reading some of the articles scheduled for the November/December issue of ASCA’s ASC Focus magazine, I realized that many of them cover important developments that are likely to have a significant impact on ASCs in 2017 and beyond.

Some of the topics discussed there include: • Bundled payments – the move away from fee-for-service payments and toward bundles and value-based payments is news that can’t be ignored. ASCs that want to stay ahead of the curve will stay on top of critical developments in this area.

• Spine surgery in ASCs – the successful outcomes, low incidence of complications and cost savings associated with the growing number of spine surgeries being performed in ASCs are important developments for patients and providers alike. As more of these procedures continue to move into the ASC setting, we can expect many others to follow, including more total joint surgeries, more gynecologic procedures and maybe even some advanced neurosurgery.

• Cybersecurity and social media – protecting data from hackers and ransomware attacks is a growing concern for health care providers of all kinds and a testament to the ever-expanding role that increasingly sophisticated e-communication tools are playing in patient care. Going forward, ASCs will need to manage these tools effectively to protect their 20 OR TODAY | November 2016

patients and facilities. At the same time, they need to keep an eye on any new developments in electronic health record systems for ASCs. • Medicare’s new physician payment system – Beginning January 1, 2017, the Medicare Access and CHIP Reauthorization Act of 2015 changes how and how much physicians will be paid for services furnished to Medicare beneficiaries and how physicians will interact with the program. While these changes won’t affect facility fees in ASCs, they will affect the physicians who work there and need to be a concern for all ASC management teams.

• The growing need for individual ASC involvement in grassroots advocacy – in the November/ December issue of ASC Focus magazine, ASC political and advocacy counsel John McManus reviews some of the ways ASCA’s advocacy efforts have already changed the operating landscape for ASCs and some of the challenges that lie ahead. He also outlines steps ASCs need to take now to ensure their future success. As you read his message, I encourage you to keep in mind that ASCA’s annual meeting next year, ASCA 2017, is

May 3-6, in Washington, D.C., and will include many opportunities for attendees to learn more about ASC advocacy and get involved in enlisting congressional support for their ASC. ASCA reserves full access to ASC Focus magazine for ASCA members only, but for a limited time everyone can read about some of the changes affecting ASCs that we can expect to hear more about in 2017. On October 17, we began offering everyone 30 days of unlimited access to read the November/December issue online at www.ascfocus.com.

When the 30-day period ends, only ASCA members will be able to access magazine content.

While we consider all of the new developments that are on the horizon for ASCs in 2017, we cannot lose sight of some old favorites like the increasingly complex regulatory environment ASCs face, new developments in Medicare’s ASC quality reporting requirements, new codes introduced to ICD-10 and the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) that we expect to become mandatory for ASCs soon.

To get what you need to stay on top, check in with ASCA every day. Attend ASCA 2017 and ASCA’s three Winter Seminars, January 12-14, in San Antonio, Texas, this year; access ASCA’s online training series and webinars; participate in ASCA Benchmarking and ASCA’s Salary and Benefits Survey; and visit ASCA’s Career Center. If you do not already hold your Certified AdminWWW.ORTODAY.COM

ASCA UPDATE

With almost 30 years of experience, Bulb Direct is your source for medical and

FREE CATAL OG!

scientific bulbs. Specializing in replacement bulbs for your microscopes, operating lights, optical, diagnostic and other medical devices. We pride

istrator Surgery Center (CASC) credential, you should also consider taking that exam this year.

You can learn more about that program at www. aboutcasc.org.

When we enter the new year, ASCA will be standing ready to keep you connected, informed and involved. Make sure that your ASC is an ASCA member in 2017 so that as you navigate all of these changes, and the challenges they will bring, you don’t have to stand alone.

ourselves in providing exceptional customer service, great prices, and brand name quality, such as GE, Phillips, etc.

Contact us for your Bulb Direct Catalog! sales@bulbdirect.com 800-772-5267

Visit us online at Bulbdirect.com

WILLIAM PRENTICE is the chief executive officer of the Ambulatory Surgery Center Association.

Infusion Pump Support and Power Relocation Devices PowerMATE® Special Purpose Relocatable Power Taps AIV Gives You Confidence

• CMS Waiver Compliant • UL-1363A Recognized • Locking IV Pole Mount • 15 & 20 Amp Models

Everything we manufacture and repair at AIV is done to ISO-13485 standards.

Infusion Pump Sales & Support • Flat Rate Repairs • AIV Certified Refurbished Pumps • Replacement Parts

888.656.0755 • aivsales@aiv-inc.com • www.aiv-inc.com

The manufacturers listed are the holders of their respective names and/or trademarks, and are not to be taken as an endorsement or affiliation with AIV, Inc.

616C

WWW.ORTODAY.COM

November 2016 | OR TODAY

21

IN THE OR SUITE TALK

SUITE TALK

Conversations from the OR Nationâ&#x20AC;&#x2122;s Listserv

Q

MEDITECH 6.8 AND TRACKERS I am curious as we are looking at both UDI Tracker and TrackCore. Is anyone using one of the products with Meditech 6.8?

A: We are not here at Onslow A: No issues on our end. We Memorial Hospital. implemented TTC in 2010 and just upgraded to the A: We are using TrackCore. newest version with a data We implemented it when interface from Meditech to we were using Magic, but TTC. That was a tricky now we are 6.07 interface, but all in all it

Q

went great! I have no issues with TTC and their staff. They have always been good to us!

DISCHARGING WITH A TAXI Is it acceptable to allow a patient who has received general anesthesia to be discharged with a taxi as their means of transportation to home?

A: We only allow if they have a responsible party accompanying them in the taxi.

A: I assume you mean alone in a taxi. If so, then no that would not be acceptable in my opinion. Post general anesthesia discharge A: Only if they have a responsible adult with would require someone to take responsibilthem, in addition to the taxi driver. ity for being with the patient for the first 24hours after same day surgery. Of course A: Not without a responsible adult, according the patient and the designated care to The Joint Commission. It has been a provider can go home in a taxi but the challenge for the last several years for us as patient should not be discharged alone. In doctors want to be able to do it. Get your the past, we usually insured that prior to underwriters to comment on it and a copy surgery. If they showed up alone we would of The Joint Commission regulations to make sure that someone was picking them show the folks who think it is OK. up and going to stay with them. On several occasions we cancelled surgery for this A: Although it is not ideal, we have disreason and if we could not cancel surgery charged patients home in a taxi but require then we admitted them overnight. a surgeon order in writing.

A: No. A: I think that could get you in trouble.

22

OR TODAY | November 2016

WWW.ORTODAY.COM

Q

SUITE TALK

SURGICAL SMOKE What does your facility do to protect patients and staff from surgical smoke?

A: AORN will release “Guideline for Surgical smoke. Other nurses were experiencing Smoke Safety” in January. It will provide flu-like symptoms – stuffy heads, scratchy facilities with evidence on the toxicity of eyes, low energy – and they wanted to avoid surgical smoke and recommendations on how the electro-surgery cases as much as possible. to reduce and eliminate exposure. One gram At AORN, we’re very interested to know what of surgical smoke is equivalent to smoking six your experience is – are the smoke removal unfiltered cigarettes in 15 minutes. If anyone devices being used consistently? Is their use is interested to learn more, you can go to determined by the surgeon, or the facility? www.aorn.org/goclear to sign up for information on how to start a smoke safety program A: It’s not required, but we are just moving to in your facility. smoke removal electrosurgical pencils so any case using electrocautery will also A: When I was working in the OR, and later as remove surgical smoke. Not all surgeons are the clinical manager of several ORs, I had happy, but it’s for staff health as well as for chronic sinus infections which my doctor told patients who are exposed (many of our me was due to some sort of environmental plastic cases are done under MAC without exposure which I thought was the surgical supplemental oxygen).

THESE POSTS ARE FROM OR NATION’S LISTSERV FOR MORE INFORMATION OR TO JOIN THE CONVERSATION, VISIT WWW.THEORNATION.COM.

PROFESSIONAL COMFORT FOR SURGEONS, NURSES & TECHNICIANS

Stop the Hurt While You Work GELPRO MEDICAL ANTI-FATIGUE MATS SIGNIFICANTLY REDUCE PAIN AND FATIGUE WHILE STANDING ®

EXCLUSIVE

DUAL DENSITY™ COMFORT

100% GELPRO GEL ENERGY-RETURN FOAM

TOP SURFACE • Provides necessary friction with surgical booties • Easy-to-clean with hospital grade quaternary cleaners • NFPA 260 & CAL 117 compliant • Anti-microbial & anti-bacterial

NON-SLIP BOTTOM • Certified for high traction by National Floor Safety Institute 1.866.435.6287 MADE IN THE USA WITH IMPORTED TOP FABRIC

GelProMedical.com

Ideal for Operating Rooms, Procedure Areas, Cath Labs, Radiology & Pharmacy WWW.ORTODAY.COM

November 2016 | OR TODAY

23

Patient positioning solutions for MIS & robotic surgery.

PatientGuard™ Robotic Positioning System FEATURING FEATURING

TrenGuard

TM TM

Trendelenburg Trendelenburg Patient Patient Restraint Restraint

. No No shoulder shoulder braces. braces.

Non-structural Non-structural lateral lateral stabilizing stabilizing pillows pillows concontrol body mass shift. trol body mass shift.

. No No patient patient sliding. sliding.

Patented “Speed Bump” bolster is

Patented “Speed Bump” bolster is clinically proven proven to to stop stop patient patient sliding. sliding. clinically

. System System easily easily accommodates accommodates High High BMI BMI papatients up up to to 550 550 lbs. lbs. tients

TM “TrenGuard “TrenGuardTM is is the the ONLY ONLY safe safe restraint restraint for for extreme Trendelenburg without extreme Trendelenburg without a a single single report report of of a a patient patient sliding. sliding.

There has never There has never been been a a report report of of postpostoperative discomfort or patient operative discomfort or patient injury.” injury.”

– – Dan Dan Allen Allen

Visit our our website website for for aa link link to to our our webinar: webinar: Visit “The Trendelenburg Trendelenburg Position Position for for Robotic Robotic “The Surgery.” Earn Earn one one free free contact contact hour! hour!

Surgery.”

TrenGuard™ TrenGuard™ Trendelenburg Trendelenburg Restraint Restraint

ArmGuard™ ArmGuard™ Arm Arm Protector Protector FIND FIND US US ONLINE ONLINE

da-surgical.com da-surgical.com 24

FaceGuard™ FaceGuard™ Face Face Protector/ Protector/ Tray Tray EMAIL EMAIL US US

info@da-surgical.com info@da-surgical.com

OR TODAY | November 2016

PatientGuard™ PatientGuard™ Lateral Lateral Positioner Positioner CALL CALL US US

800.261.9953 800.261.9953 WWW.ORTODAY.COM

TrenGuard™ TrenGuard™ Covered Covered by

by Patent Patent ## 9149406B2, 9149406B2, Other Other Patents Patents Pending Pending Copyright Copyright 2016 2016 D. D. A. A. Surgical Surgical All All Rights Rights Reserved Reserved AD201603271 AD201603271

IN THE OR MARKET ANALYSIS

STAFF REPORT

PATIENT POSITIONER MARKET FUELED BY SURGERY MARKET GROWTH

P

atient positioners are essential tools for surgeons, especially with advancements in robotic surgery and other minimally invasive surgery techniques worldwide.

Patient positioners facilitate surgery and prevent injury by ensuring patients do not move during procedures. They are among the many accessories used during surgery to assist health care professionals and promote positive outcomes. They can also help to reduce patient stays by allowing for minimally invasive surgery that can reduce a patient’s recovery time.

In May 2016, PRNewswire reported continued growth in the surgery market, including the patient positioner segment.

“The growth of the overall market is due to rise in number of hospitals, growing number of ambulatory surgical centers, surge in demand for hybrid operating rooms, growing number of regulations for operating room equipment, and increase in number of geriatric population coupled with high number of surgeries worldwide,” according to PRNewswire. “Globally, the operating room equipment market has been experiencing steady growth and the trend is expected to continue during the forecast period from 2015 to 2023.”

WWW.ORTODAY.COM

“Major drivers of demand and growth of the operating room equipment market include growing number of ambulatory surgical centers, product innovations driven by advances in technology, rising demand for hybrid operating room, and increase in the number of surgeries,” PRNewswire adds. “Apart from this, innovations related to patient handling techniques will propel the operating room equipment market in the next few

“This market is expected to reach $29.15 billion by 2020 from $24.31 billion in 2015, at a CAGR of 3.7 percent,” according to MarketsandMarkets.

“Growing investments, funds, and grants by government bodies worldwide, rising number of hospitals, increasing patient preference for minimally invasive surgeries, growing number of regulatory approvals for operating room equipment, and growing number of geriatric popula-

“ Globally, the operating room equipment market has been experiencing steady growth and the trend is expected to continue during the forecast period from 2015 to 2023.” years. Major restraints of the market include high cost of operating room equipment. However, the report also highlights various opportunities that are expected to boost market growth during the forecast period.”

According to a new market report published by Transparency Market Research “Operating Room Equipment Market - Global Industry Analysis, Size, Share, Growth, Trends, and Forecast 2015-2023,” the global operating room equipment market was valued at $23.9 billion in 2014 and is anticipated to expand at a compound annual growth rate (CAGR) of 6.9 percent from 2015 to 2023 to reach $42.9 billion in 2023.

A report by MarketsandMarkets also predicts growth in the operating room equipment and supplies market.

tion coupled with the increasing number of surgeries globally are some of the factors that are expected to drive the growth of the global operating room equipment and supplies market in the coming years,” MarketsandMarkets adds.

Transparency Market Research expects the minimally invasive surgery market, which includes patient positioners, to more than double from 2013 to 2019.

According to the Transparency Market Research market research report, the minimally invasive surgery market is “exhibiting a robust CAGR of 10.50 percent from 2013 to 2019, the minimally invasive surgery market is anticipated to expand from a value of $25 billion in 2012 to $50.6 billion in 2019.”

November 2016 | OR TODAY

25

IN THE OR PRODUCT SHOWROOM

LONG DOME POSITIONER ACTION PRODUCTS Patient positioning devices used under the knees should run the entire width of the surgical table pad. Most dome positioners are 14-inches long and are used under the knees during supine surgeries. In order for this positioner to cover the entire table many nurses put two positioners together. This solution hangs off of the edge of the table, may slide during surgery and cause pressure sores if skin falls between the cracks. The Action Dome Positioner (40603L) solves this problem, with 20-inches of Akton polymer gel to cover the table end to end. It redistributes the weight across the entire table.

26

OR TODAY | November 2016

WWW.ORTODAY.COM

PRODUCT SHOWROOM

ESTAPE TRENMAX INNOVATIVE MEDICAL PRODUCTS INC. Innovative Medical Products Inc. new Estape TrenMAX is safer and secure positioning system that provides OR staff an alternative to all foam solutions when positioning patients for Trendelenburg surgical procedures. The key component of the TrenMAX system is IMP’s proprietary sticky pad. The Sticky Pad adheres directly to the patient’s torso and fastens securely to the OR table’s side rails to prevent patients from moving or sliding off the OR table.

For maximum, secure fixation of the base pad to the OR table, TrenMAX employs patent-pending TrenMAX clamps that tightly secure the base pad hook-and-loop material straps affixed to the OR table’s siderails.

Besides its unique holding power, TrenMAX provides these benefits: • A system of arm straps that allow access to leads and IVs by anesthesiologists. Designed to meet AORN recommendations, IMP’s arm strap system prevents potential neurological impairment caused by sheet tucking.

WWW.ORTODAY.COM

• TrenMAX does not require the use • Designed for single usage, The of a chest strap, therefore improvSticky Pad is free from potential ing ventilation. Plus, it prevents cross contamination. nerve damage by eliminating pressure on the brachial plexus caused by shoulder-holder devices

November 2016 | OR TODAY

27

IN THE OR PRODUCT SHOWROOM

COMFORT GLIDE DRYPAD MEDLINE Comfort Glide Drypad is the moisture management component in Medline’s Comfort Glide line of patient repositioning products. In the operating room, they are used with Low Air Loss Therapy and in any other area where skin dryness is needed such as the ICU. Comfort Glide Drypad is the moisture management component in Medline’s Comfort Glide line of patient repositioning products.

28

OR TODAY | November 2016

WWW.ORTODAY.COM

PRODUCT SHOWROOM

SAFE-T-SECURE STEEP TREND DISPOSABLE POSITIONER DAVID SCOTT COMPANY David Scott Company distributes Safe-T-Secure, an all-in-one integrated disposable solution for Steep Trendelenburg. Designed by a laparoscopic and robotic surgeon to maximize efficiency and minimize setup time and effort (approximately 1 minute). Safe-T-Secureâ&#x20AC;&#x2122;s single use premium foam and impermeable perineal barrier are designed to eliminate direct patient skin contact decreasing the risk of contamination. Safe-T-Secure also allows for IV tubing and monitor wires to be easily tucked. This design includes the foam, Velcro and sheets necessary to secure the patient to the operating table. Sold in a case of five disposable units, item number DSC-STSNMED1.

WWW.ORTODAY.COM

November 2016 | OR TODAY

29

New & Refurbished Anesthesia Equipment

Refurbished Passport 2

Video Stylet Only $499 each

S/5 Aestiva SPECIAL $9,800

Refurbished Cardiocap/5

Refurbished Mindray Spectrum

New Mindray Passport 8 & 12

Masimo Pronto StimPod Nerve SpHb Spot-Check Stimulator & Locator

Masimo Root w/ EtCO2 & Multigas

Refurbished Fabius GS

Refurbished Aespire 7900

Refurbished S/5 Avance

Regional Biomedical Service In-house Biomedical Repairs New and Refurbished Vaporizers Vaporizer Pole Mounts Gas Fittings and Hoses- All Types Anesthesia Accessories Oxygen Sensors Heine Laryngoscopes Oral Surgery Analgesia Units

New Gomco Aspirators & Suction Equipment

800-448-0814

Paragon Service www.ParagonService.com

SPECIAL Paragon/Penlon $8,900

Fax 734-429-3197

OPERATING ROOM

SAFETY SOLUTIONS

State-of-the-Art Surgical Mats • Safety Products • Fluid Management Solutions Disposable, Economical, Practical

Made in the U.S.A.

THE SURGICAL MAT™ PATENTED

FLUID DIAMOND™ FLOOR ASPIRATOR

PATENTED PENDING

www.flagshipsurgical.com

THE MINI MAT™

THE SUCTIONER™

THE ECOSUCTIONER™

PATENTED

PATENTED

PATENTED

CONTACT US TO TRY OUR PRODUCTS! 888-633-5843 www.flagshipsurgical.com

SAFE CORD™ FLOOR STRIP

@flagshipsurg #ORergonomics

DRI-SAFE™

ABSORBENT PADS

IN THE OR CONTINUING EDUCATION CE595D

32

OR TODAY | November 2016

BY ROSALINDA ALFARO-LEFEVRE, MSN, RN, ANEF

WWW.ORTODAY.COM

CONTINUING EDUCATION CE595D

TEACHING TOMORROW’S NURSES What’s Happening in the Classroom?

“T

he job of the teacher is, as it has always been, to make learning so compelling that people find it more satisfying to learn than to attend to any one of the score of competing possibilities.” – Carol Ann Tomlinson, EdD, professor and chairwoman of educational leadership, foundations and policy at the University of Virginia’s Curry School of Education1

OnCourse Learning guarantees this educational activity is free from bias. The planners and authors have declared no relevant conflicts of interest that relate to this educational activity. See page 39 to learn how to earn CE credit for this module.

The goal of this nursing education continuing educations program is to provide nurses with information about changes in nursing education that influence how today’s students are being prepared for practice. After studying the information presented here, you will be able to: • Describe four teaching strategies that nurse educators use to meet the learning needs of diverse groups of students • Identify trends in healthcare and education that challenge educators to prepare students for changing RN roles • Discuss the rewards and challenges of being a nursing faculty member

Behind every good nurse is an inspirational educator — or perhaps many. As gatekeepers who ensure safe nursing practice, faculty members have a rich history of providing knowledge, teaching essential skills and inspiring students to set high standards for patient care. Today’s faculty faces unparalleled challenges as they prepare students for increasingly complex nursing roles in a rapidly changing world.

This module discusses innovative approaches educators use to meet the challenges of transforming education and preparing nurses who will succeed in this millennium. It also describes forces driving changes in nursing and nursing education, how faculty meet the learning needs of diverse students, and the rewards and challenges of being a nurse educator.

NOT YOUR MOTHER’S PROGRAM

Gone are the days of sitting in threehour lectures trying to stay awake after pulling an all-nighter. Educators today work to promote meaningful, interactive learning by using a variety of strategies. From using technology to designing collaborative learning experiences that focus on “real world” issues, educators aim to ensure that their students remain engaged in learning every step of the way.

TECHNOLOGY IMPACT

Not surprisingly, technology affects what happens in today’s classrooms.

WWW.ORTODAY.COM

Laptops, iPads, smart phones, Webbased videos, webinars and other uses of the Internet are commonplace.2 Many programs use e-learning management systems, such as Blackboard. These systems let faculty members give online examinations and quizzes, use software to identify plagiarized papers, and post resources for reinforcement and enrichment.

Students have easy access to materials and information, such as grades, lecture materials, readings and syllabi. Students also use handheld remote devices, clickers, to let the instructor know immediately how well they understand a lecture. (With clickers, students key in answers to quizzes given during lectures. The instructor has a receiver device through which he or she can see immediately how many students passed the quiz.) In addition, many instructors record lectures so students can listen to them on their iPods or smart phones.

Online discussion boards allow students to post assignments and information for classmates and faculty.

The ability to share information promotes great online discussions and allows constructive peer evaluation. Blogs (online personal journals) facilitate peer support and can document individual reflections on courses for faculty review. Wikis, collaboratively constructed websites that allow content to be added and edited, are used by students to share information and work together on November 2016 | OR TODAY

33

IN THE OR CONTINUING EDUCATION CE595D reports and projects.2 Interactive teaching strategies using computerbased instruction — including computer-assisted instruction, computer simulations, interactive video instruction and tutorials — promote active learning. Technology also affects students’ clinical learning.

Students use smart phones and personal digital assistants to access information about disease processes, evidence-based nursing, and drug and treatment information.

educators to transform learning from traditional teacher-focused delivery of information to student-centered teaching in which students are engaged actively in learning. As part of curriculum development, faculty must select the concepts, competencies and exemplars on which to build courses and base content. Then they must organize the concepts in a way that facilitates learning. This is challenging intellectually, and takes a lot of work and a commitment to making changes.

CREATING LEARNING CULTURES

SIMULATION AND DEBRIEFING

Increasingly, schools today are accountable for creating a learning culture that embraces the motto that “everyone teaches, everyone learns.”

Building learning cultures —school and work environments that encourage learners and employees at all levels to ask questions, share information freely, and create teaching/learning opportunities— is the foundation for developing critical thinking, improving outcomes and keeping patients safe.3 CONCEPT-BASED CURRICULUM

Responding to the call for education reform, many schools of nursing are considering changing to a conceptbased curriculum.4 Concept-based curriculums aim to promote critical thinking and reduce content overload by teaching big ideas that can be transferred from one situation to another. For example, a student in a concept-based curriculum may learn the concepts of oxygenation and inflammation in adult nursing, and then when they get to pediatrics, discuss how these change in children’s bodies.

In the past, content focused on facts.

Concept-based curriculums focus on making sense of those facts. Faculty can’t possibly teach everything, but they can teach the big ideas. Content can change. Concepts stay the same.

Successful implementation of concept-based curriculums requires 34

OR TODAY | November 2016

With the use of high-fidelity human simulators — life-like mannequins that mimic many of the human body’s processes, such as heart rate and blood pressure — the worlds of laboratory and clinical learning merge. Using simulators, students can practice complex assessment skills, and hone their ability to set priorities, make decisions, and take appropriate action when things go wrong. Simulated experiences offer a controlled-learning environment and provide students with immediate feedback, allowing for self-correction and remediation if needed.2,3,5 Students learn from their own mistakes, which is a powerful way to learn, in a safe environment. When well-designed simulated experiences are followed by debriefing on what went well and what could be done better, students learn to manage common clinical issues before they care for real patients.2,3,5 PROBLEM-BASED LEARNING AND FLIPPED CLASSROOMS

Problem-based learning is another educational process that engages students actively. With problem-based learning, the teacher presents a patient scenario to a small group of students and asks the group to decide what information is needed to address the patient’s issues. Group members pair off to conduct an independent inquiry

that they later share with the group.

A faculty member serves as a learning facilitator and guide.6 To increase student engagement, some faculty use a “flipped classroom” (time allotted for lecture and homework is reversed).7 In a flipped classroom, students learn content online before coming to school, and then they do homework in class, with teachers and students discussing and solving questions together. Teacher interaction with students is more personalized, and guidance is used instead of lecturing. While some teachers believe the flipped classroom is more engaging, school’s still out (pardon the pun) on how well it works.

A study that aimed to determine the effects of a flipped classroom found that examination scores were higher for students in flipped classrooms than those in traditional lecture classes.

But students in flipped classrooms indicated lower satisfaction with learning than those in the lecture classes.7 You can find informative YouTube videos on how to flip the classroom by entering “flipped classroom” in to the search field at http://www.youtube.com.

MORE DIVERSE THAN EVER

Classrooms today are full of students who are ethnically diverse. Faculty must know how to reach out to all their students equally. There are also more men in nursing than ever before.

Because of their socialization, some men may have a different, but valid, approach to particular elements of nursing.3 For example, some men have a harder time expressing emotion and may not establish therapeutic relationships with patients in the same way that most female nurses do. Men may be more likely to use humor and less likely to use touch. Based on their female expectations for communication, women may view this way of relating as inattentive and nontherapeutic.3 WWW.ORTODAY.COM

CONTINUING EDUCATION CE595D

You can learn more about issues facing men in nursing and education on the American Assembly for Men in Nursing website. The organization provides a framework for nurses as a group to meet, discuss and influence factors that affect men as nurses.

Faculty members also face the challenge of meeting learning needs of students from different generations.

A generation refers to a group of people who share birth years and have lived through the same significant events. The beliefs, culture and values of each generation are shaped by historical, political and social events that occur during the formative years of its members.6 Although there are individual differences, members of one generation tend to view the world differently than members of other generations. For example, members of the baby boom generation, born between 1946 and 1964, grew up in a time of post-World War II optimism and unparalleled economic growth.

Baby boomers are sometimes described as “living to work,” and work has significant meaning in their lives.

In today’s nursing programs, baby boomers are mature students who may be returning to college or completing a second degree.8 Because baby boomers didn’t grow up with technology, they may prefer to learn through more traditional teaching methods.6 Generation X, born between 1964 and 1981, had different life experiences as children. Generation Xers grew up during a time of rising divorce rates, rapid movement of women into the workforce and a faltering economy.

Many members of this generation were “latchkey” children while both parents worked. As a group, members of Generation X are self-reliant and resourceful, and are sometimes described as “working to live.” In general, they want to learn content in a quick and direct way.8 Most faculty members are baby boomers or WWW.ORTODAY.COM

Generation Xers, and are familiar with the learning styles of students from these generations.

THE NEWEST GENERATION

Meeting the learning needs of nursing’s newest generation, the Millennials (those born after 1981), is a challenge.8 They have characteristics different than those of students of previous generations. Millennials share two key life experiences that affect how they view the world: intensive parental involvement during their formative years and the technology revolution that occurred during their childhood.

Members of this generation have led highly structured lives that were organized and supervised by adults.

As a result, they may need support in balancing the demands of a nursing program. Technology is their native language; they are comfortable with multitasking and switch easily from completing an assignment, listening to their iPods, writing or reading a blog, texting friends and talking on their cell phones.8 As children, they participated in interactive computer activities and are often more comfortable getting information from the Web than from a library. In general, they prefer active and engaging activities, such as simulations and group work, rather than lectures.8 JOIN THE RANKS

Being a nurse educator is unlike any other role. Nursing faculty must prepare students for nursing practice while providing them with knowledge they will need to pass state licensing examinations. Becoming a nursing faculty member requires education, experience and the desire to share knowledge with others. Most nursing programs seek faculty members who are educated at least one level higher than the students they will teach, with most requiring a master’s degree.

In a BSN program, both full- and

part-time faculty must have at least a master of science degree in nursing; a doctoral degree is generally required for appointment to tenure track at most schools of nursing. Many nurse educators take the certified nurse educator examination to verify their qualifications.

WHAT MAKES A GREAT TEACHER?

A study that asked students to name the traits of a great nursing educator showed that the ideal instructor is approachable, a good communicator, professional, supportive, understanding, motivating, receptive to people and ideas, has a sense of humor, and is dedicated to teaching nursing.9 Overall, students described the best faculty members as being those who respected them as people and who were professional role models.

Effective educators are knowledgeable about generational and learning style differences and tailor learning activities accordingly.

They make links between theory and practice, teach simple concepts before complex ones, give constructive feedback and build trusting relationships with students.10 You can find more information on what makes a great nurse educator at the links below.

• 10 qualities of a great nurse educator http://nursinglink.monster. com/education/articles/933710-qualities-of-a-great-nurseeducator • Top 10 qualities of a great nurse educator http://scrubsmag.com/10qualities-of-a-great-nurseeducator/ CHALLENGES AND REWARDS

Nursing faculty members experience their own challenges and rewards.

Factors that influence faculty to teach in a particular nursing program or to November 2016 | OR TODAY

35

IN THE OR CONTINUING EDUCATION CE595D stay in one include the philosophical tenets of the college or university, the organizational culture of the faculty and student diversity. Working in an intellectually stimulating environment, having autonomy, contributing to the profession and having work flexibility are all important benefits for nurse educators.8 To encourage nurses to become nurse educators, the National League for Nursing has developed a list of the top 10 reasons to become a nurse educator.

One researcher found the following important experiential themes among both novice and experienced full-time faculty in a BSN program:11 1. The most rewarding part of the role was the sense among faculty that they were “making a difference in students, the profession and the world.” They described the gratification they felt by being instrumental in students’ success while also feeling that student accomplishments were their successes.

2. The sense of accountability faculty members have to nursing as “gatekeepers of the profession.”

Evaluating who will be ethical, caring nurses is a critical faculty task.

3. The challenges of trying to balance multiple roles. Nursing faculty members are not only responsible for teaching, but are also expected to keep their practice skills current, participate in research and community service, and work with others in curriculum development and committee work. Balancing these roles with a personal life was another part of this theme, as was the need for support and mentoring, especially as new faculty members.

Faculty members’ earning less than their nursing peers in clinical positions and the lack of support for role orientation and growth are often 36

OR TODAY | November 2016

reported as problems. The National League for Nursing (NLN), the American Association of Colleges of Nursing (AACN) and other groups involved in supporting nursing faculty are working to address these issues.

Current and projected faculty shortages threaten nursing education, nursing’s future and ultimately patient care. The 2014 annual AACN report confirmed that growth in U.S. schools of nursing is restrained by a faculty shortage, which is driven by a limited pool of doctoral-prepared nurses and noncompetitive faculty salaries.12 Based on data from 680 schools of nursing with baccalaureate and graduate nursing programs, the nursing faculty vacancy rate in 2013 was 8.3%. The large majority of reported vacancies (86.9%) are for faculty positions requiring or preferring a doctoral degree. To address these issues, the AACN report calls for collaboration, innovation and leadership to address nursing education issues.

SAFEGUARDING THE FUTURE

With a looming nursing shortage, recruiting, compensating and retaining the best nurse educators are vital for the profession’s future.13 There is a particular need for nurses from minority groups to become nurse educators. Seventy-five percent of current nursing faculty members are expected to retire by 2019, creating tremendous opportunities for those who want to become full- or parttime nurse educators.13 Federal and state governments are developing scholarships and loan repayment programs to attract graduate nursing students as faculty members. The NLN website contains excellent information about the nurse educator role and provides information about scholarships and loans. There is the Simulation Innovation Resource Center, where faculty can learn to develop and integrate simulations into

the curriculum, as well as professional development courses for both seasoned and new educators.

The AACN’s Minority Nurse Faculty Scholars Program offers information about financial support for graduate nursing students from minority backgrounds who agree to teach in a nursing program after graduation. You can find other financial aid from the AACN at http://www.aacn.nche.edu/ students/financial-aid.

AT THE CROSSROADS

The goal of providing safe, evidencebased and cost-effective healthcare is driving change in the healthcare industry. Nurses are crucial to this process because they’re the ones on the front line, assessing patients’ health status, monitoring and evaluating responses to treatment, providing direct care and teaching patients to manage complex healthcare problems.

Experts inside and outside healthcare have raised issues that are affecting significantly how nursing care is provided and how future nurses will be educated. The Institute of Medicine (IOM) report “To Err is Human: Building a Safer Healthcare System” was a wake-up call for both healthcare providers and consumers.14 The report estimated that as many as 98,000 Americans die each year of largely preventable medical errors and concluded that the goal of reducing harm to patients will be reached by developing a culture of safety in healthcare organizations and by changing the way healthcare professionals are educated.

The implications of the IOM’s report for nursing education (“Teaching IOM: Implications of the Institute of Medicine Reports for Nursing Education”) reinforce the need for undergraduate and graduate nursing students to be better prepared to develop and implement policies and practices that reduce harm and WWW.ORTODAY.COM

CONTINUING EDUCATION CE595D

improve quality.15 This report outlines several key patient care concerns for which nurses must provide leadership.

Although providing direct physical care is the most visible nursing role, other roles — such as monitoring patient status, helping patients compensate for functional loss, providing emotional support, educating patients and families, and integrating and coordinating care — are equally important to ensure consumers safe, high-quality, costeffective healthcare. Work is in progress to guide curricula to prepare students for future nursing roles.

The AACN documents key competencies for BSNs. These competencies address the need for graduates to be able to use evidencebased practice, ensure patient safety, use clinical reasoning, work as members of an interprofessional team, and have a basic knowledge of genetics and genomics. The NLN posts both competencies for nursing program graduates and nurse educators.

Nurse educators responded to the IOM reports by developing the Quality and Safety Education for Nurses project. The QSEN goal is to prepare future nurses to gain the knowledge, skills and attitudes needed to continually improve the quality and safety of the healthcare system.16 This includes integrating the following competencies into nursing education:16 • Patient-centered care: Recognize that patients or their designees must be the source of control.

Make them full partners in giving compassionate and coordinated care based on respect for their preferences, values and needs • Teamwork and collaboration: Function effectively within nursing and inter­professional teams, fostering open communication, mutual respect, and shared decision making to achieve quality patient care • Evidence-based practice: WWW.ORTODAY.COM

Integrate best current evidence with clinical expertise and patient/ family preferences and values for delivery of optimal healthcare • Quality Improvement: Use data to monitor the outcomes of care processes, and use improvement methods to design and test changes continually to improve the quality and safety of healthcare systems • Safety: Minimize risk of harm to patients and providers through both system effectiveness and individual performance You can find many resources for teaching the QSEN competencies and using various teaching strategies at its website.

RADICAL TRANSFORMATION

The national study “Educating Nurses: A Call for Radical Transformation,” is expected to have a significant impact on nursing education.17 Sponsored by the Carnegie Foundation for the Advancement of Teaching in collaboration with the NLN, AACN and National Student Nurses’ Association, this publication is the first national study of nursing education in 30 years. It examines the strengths and weaknesses of contemporary nursing education, describes the most effective ways of teaching nursing students and calls for major changes in the way future nursing students will be educated.18 The study concluded that nurses are undereducated for the demands of practice and that it’s increasingly difficult for nursing education to keep ahead of rapid changes driven by research and technology. Among the report’s most significant recommendations are to 1) improve the integration of theory with clinical practice; 2) use active learning strategies with a focus on exemplars (i.e., accounts of skilled nursing practice) and case studies to improve clinical reasoning; 3) support

nursing faculty in augmenting their teaching skills; and 4) increase faculty compensation.

The Carnegie report urges educators to provide as many experiences as possible to allow students to practice clinical reasoning and multiple ways of evaluating and responding to patient needs as clinical situations evolve.

Nursing faculty members should see themselves as learning coaches and mentors rather than as providers of content, a role that’s increasingly described as going from “sage on the stage” to “guide on the side.”

Nurse educators have the opportunity to pass on their passion for nursing and desire for great patient care and lifelong learning to all those whose lives they touch. We all can remember a faculty member whose personal qualities continue to influence our practice. Opportunities abound for those who want to help shape nursing education.

EDITOR’S NOTE: Maureen Habel, MA, RN, is the original author of this educational activity, but has not had an opportunity to influence the content of this current version.

Ann Kim, MSN, MPH, RN, CNS, and Nancy Schoofs, PhD, RN, are past authors of this educational activity, but have not had an opportunity to influence the content of this current version.

OnCourse Learning guarantees this educational activity is free from bias.

Rosalinda Alfaro-LeFevre, MSN, RN, ANEF, is president of Teaching Smart/ Learning Easy in Stuart, Fla. (http://www.

AlfaroTeachSmart.com). She’s known nationally and internationally for her books and programs on teaching critical thinking and improving personal and professional performance.

References 1. Tomlinson C. Forward. In: Erickson H. Concept-Based Curriculum and Instruction: Teaching Beyond the Facts. Thousand Oaks, CA: Corwin Press:viii; 2002.

November 2016 | OR TODAY

37

IN THE OR 2. Thompson BW. The connected classroom: using digital technology to promote learning. In: Billings DM, Halstead JA. Teaching in Nursing: A Guide for Faculty. 5th ed. St. Louis, MO: Elsevier-Mosby. In press.

3. Alfaro-LeFevre R. Critical Thinking, Clinical Reasoning and Clinical Judgment: a Practical Approach. 6th ed. Philadelphia, PA: Elsevier-Saunders. In press.

4. Giddens J. Caputi L, Rodgers, B. Mastering Concept-Based Teaching: a Guide for Nurse Educators. St. Louis, MO: ElsevierMosby; 2014.

5. Pauly-O’Neill S. Simulation basics: getting ready for the real

thing. Nurse.com Web site. http://ce.nurse.com/course/ce664/ simulation-basics. Accessed April 22, 2015.

6. McMahon M, Christopher K. Case study method and problem-based learning: utilizing the pedagogical model of progressive complexity in nursing education. Int J Nurs Educ Scholarship. 2011;8:Article 22. doi: 10.2202/1548-923X.2275.

7. Missildine K. Fountain R, Summers L, Gosselin K. Flipping the classroom to improve student performance and satisfaction. J Nurs Educ. 2013;52(10):597-599. doi: 10.3928/01484834-20130919-03.

8. Halfer D, Saver C, Alfaro-LeFevre R. Bridging the generation

CLINICAL VIGNETTE Jenny Garcia completed her BSN program four years ago and is considering a career as a nurse educator. She is seeking information about what the faculty role involves and what resources can help her get started.

1. Which is a basic requirement to teach in an RN program? a. An MSN degree b. A doctoral degree c. A BSN degree d. All of the above

2. In reading about the nursing faculty role, Jenny learns that one of the most important rewards for nurse educators is: a. T he ease of balancing work and personal responsibilities b. The ability to increase their income c. T he opportunity to make a difference in students’ lives d. Having the chance to have a structured orientation and role mentoring

3. Jenny learns that in one study, students said they most value _______ in nursing faculty. a. Years of experience in nursing b. Dedication to teaching nursing c. T he number of research projects the faculty member has done d. Being able to establish mutual trust and being a good role model 4. Jenny is aware that being able to use technology to engage students will become increasingly important. Which resources would be most appropriate for Jenny to investigate? a. Asking her computer-savvy friends to give her some quick lessons b. A ccessing the National League for Nursing and American Association of Colleges of Nursing’s resources designed to support new faculty members c. Enrolling in university technology media classes d. Enrolling in online media programs

4. Correct Answer: B - Although having friends help and participating in further education can be helpful, NLN and AACN resources are the most relevant for faculty members wishing to learn how to apply technology to education.

3. Correct Answer: D - Students want faculty members to establish relationships of mutual trust and serve as role models. Years of experience, dedication and involvement in research are important, but not as important in the teaching role as the ability to establish trust with students and model excellent nursing practice.

2. Correct Answer: C - Being able to make a difference in students’ lives is cited as the most important reward for nurse educators. The need to balance work and personal life is not any different for nursing faculty than for nurses in other roles. Drawbacks to teaching include lower pay than would typically be possible in a clinical setting and the lack of orientation and mentoring.

1. Correct Answer: A - The basic educational preparation for a faculty role is an MSN degree. A doctoral degree is required to teach in graduate nursing programs and to obtain tenure. Experience teaching is helpful but not required.

38

OR TODAY | November 2016

WWW.ORTODAY.COM

HOW TO EARN CONTINUING EDUCATION CREDIT gaps. Nurse.com Web site. http://ce.nurse.com/course/ ce478/bridging-the-generation-gaps/. Accessed April 22, 2015.

9. Wieck K. Faculty for the millennium: changes needed to attract the emerging workforce into nursing. J Nurs Ed. 2003;42(4):151-158.

10. Tagliareni M. Nursing education needs you.

Lippincott’s Nursing Center.com Web site. http:// journals.lww.com/ajnonline/fulltext/2009/01001/ nursing_education_needs_you.3.aspx. Accessed April 22, 2015.

11. Gaza E. The experience of being a full-time nursing faculty member in a baccalaureate nursing education program. J Prof Nurs. 2009;25(4):218-226. doi: 10.1016/j.profnurs.2009.01.006.

12. American Association of Colleges of Nursing.

Building a Framework for the Future (2014 annual report). American Association of Colleges of Nursing Web site. http://www.aacn.nche.edu/aacnpublications/annual-reports/AnnualReport14.pdf.

Accessed April 22, 2015.

13. Malone B. Testimony of the National League for Nursing: FY 2008 appropriations for Title VIII: nursing workforce development programs. Subcommittee on Labor, Health and Human Services, Education and related agencies committee on appropriations. US House of Representatives, March 29, 2007. National League for Nursing Web site. http://www.nln.org/ docs/default-source/advocacy-public-policy/ceo_ testimony.pdf?sfvrsn=2. Accessed April 22, 2015.

14. Kohn L, Corrigan J, Donaldson M, eds. Committee on Quality Healthcare in America, Institute of Medicine. To Err Is Human: Building a Safer Health System. Washington, DC: National Academy Press; 2000. National Academies Press Web site. http://www. iom.edu/Reports/1999/To-Err-is-Human-Building-ASafer-Health-System.aspx. Accessed April 22, 2015.

15. Finkelman A, Kenner C. Teaching IOM: Implications of the Institute of Medicine Reports for Nursing Education. 3rd ed. Silver Springs, MD: American Nurses Association; 2013.

16. Quality and Safety Education for Nurses (QSEN) goal statement. QSEN Web site. http://qsen.org/ about-qsen. Accessed April 21, 2015.

17. Benner P, Sutphen M, Leonard V, Day L. Book highlights from Educating Nurses: A Call for Radical Transformation. The Carnegie Foundation for the Advancement of Teaching Web site. http://www. carnegiefoundation.org/elibrary/educating-nurseshighlights. Accessed April 22, 2015.

18. Schmidt P. Carnegie Foundation calls for ‘radical transformation’ of nursing education. Chronicle of Higher Education Web site. http://chronicle. com/article/Carnegie-Foundation-Calls-for/63443.

Published January 6, 2010. Accessed April 22, 2015.

WWW.ORTODAY.COM

1. Read the Continuing Education article.

2. Go online to ce.nurse.com to take the test for $12.

If you are an Unlimited CE subscriber, you can take this test at no additional charge. You can sign up for an Unlimited CE membership at www.nurse.com/ unlimitedCE for $49.95 per year.

DEADLINE Courses must be completed by 5/15/2017.

3. If the course you have chosen to take includes a clinical vignette, you will be asked to review the vignette and answer 3 or 4 questions. You must answer all questions correctly to proceed. If you answer a question incorrectly, we will provide a clue to the correct answer.

4. Once you successfully complete the short test associated with the clinical vignette (if there is one), proceed to the course posttest. To earn contact hours, you must achieve a score of 75%. You may retake the test as many times as necessary to pass the test.

5. All users must complete the evaluation process to complete course. You will be able to view a certificate on screen and print or save it for your records.

ACCREDITED OnCourse Learning is accredited by the American Nurses Credentialing Center (ANCC), the Accreditation Council for Pharmacy Education (ACPE), and the Accreditation Council for Continuing Medical Education (ACCME), to provide continuing education for the healthcare team.

OnCourse Learning is also accredited by the Florida Board of Nursing, District of Columbia Board of Nursing, and Georgia Board of Nursing (provider # 50-1489).

OnCourse Learning is approved by the California Board of Registered Nursing, provider # CEP16588.

ONLINE Nurse.com/CE You can take this test online or select from the list of courses available.

Prices subject to change.

QUESTIONS Questions or for a complete listing of our courses Phone: 800-866-0919 Email: ce@nurse.com

November 2016 | OR TODAY

39

POWDER-FREE SURGICAL GLOVE SOLUTIONS

POWDER-FREE: OUR TIME IS NOW

DISCOVER OUR NEW

ENCORE® Perry® Style 42® PF • Exceptional value in powder-free category • Delivers the same clinical experience as the time-honoured Original Perry Style 42 • Features our new SMART Pack packaging

Powder-free gloves have long been shown to be much safer for both patients and healthcare workers. Now, recent changes in the marketplace mean FDA compliant powdered surgical gloves will no longer be available, and powder-free (PF) will become standard in all hospital environments.

Ansell is ready to provide the solutions you need with the addition of the ENCORE® Perry ® Style 42® PF to our already broad ENCORE® PF product range.

So why wait?

Let’s move together towards a safer, powder-free world.

For more information visit www.ansell.com/powderfree or contact Customer Service at 1-800-952-9916 ® & ™ are trademarks owned by Ansell Limited or one of its affiliates. © 2016 Ansell Limited. All Rights Reserved.

WWW.ANSELL.COM

CORPORATE PROFILE

IMP emulates original

“GOLD STANDARD”

with each evolution in its patient positioning portfolio

T

he best, most reliable thing of its type in a product or business category is often referred to as the “gold standard.” In August 2003, IMP designed what was to become the company’s “gold standard” in patient positioning for knee surgeries – the De Mayo Knee Positioner®, a solution that allowed for precise control of flexion, extension, tilt and rotation of the knee during surgery.

The IMP positioner generated unprecedented sales and sparked the beginning of a steady evolution in providing the latest in patient positioning technology for knee surgery. This progression has so far produced a variety of products for surgeons and OR staff to choose from within IMP’s family of De Mayo Knee Positioners: the D2, V2™ and V2E™.

D2: The first step in the advancement of the original De Mayo Knee Positioner was mainly in response to personnel in hospital sterile processing departments. Staff members there wanted a positioner that would let them easily remove the carriage from the rail for disassembling and thorough cleaning.

IMP designed the D2 to be used with the positioner’s existing clamping system, as many customers had requested, but with a completely different carriage engineered for easy removal. As an added benefit, the new carriage design provides a better gripping capability by holding the positioner’s boot in place more securely than the original version.

42

OR TODAY | November 2016

(It should be noted that users are not able to install the new D2 carriage on the original De Mayo Knee Positioner [the D], as the D2 base plate has been largely redesigned and is not interchangeable with the D.) V2: The second advancement in IMP’s knee positioner evolution is the V2. This solution was also designed in response to customer feedback. Some surgeons reported that when they pulled up on the patient’s knee during surgery to achieve the necessary distraction, the positioner sometimes had a tendency to lift up off the table, owing to the design of the clamp. To prevent this from happening, IMP redesigned a new clamp and the bar that swings down into a slot on the clamp where it can be firmly tightened and locked into place.

Also, at surgeons’ requests, IMP provides a Varus tilt control slide mechanism for the V2 that locks the positioner’s ball solidly into place, thus stopping a patient’s leg from drifting off to the side of the OR table.

This solution is especially effective in dealing with large patients whose

weight and size can put additional stress on the knee positioning system.

(The V2 is its own complete system and cannot be interchanged with the clamps on the original D or D2 knee positioners.)

V2E: The V2E is the latest step forward in IMP knee surgery technology. The solution is unique for its sterile extension arm that comes off the end of the OR table.

Orthopedic surgeons, especially those performing unicompartmental surgeries, were requesting a positioning solution that would enable them to stand between the legs of the patient and easily see the inside of the patient’s knee. With such a solution, surgeons would no longer have to lean over the OR table when performing unicompartmental procedures. IMP is the first company in the marketplace to make and sell a sterile extension.

IMP’s patented sterile extension arm solution not only allows the surgeon easy access to the inside of the patient’s knee but, through the manufacturing process for connecting the extension WWW.ORTODAY.COM

SPECIAL ADVERTISING SECTION

The D2 comes with a new carriage that improves holding power and is easily removed for cleaning.

Enhancements to De Mayo Knee Positioner® and development of Estape TrenMAX™ attest to Innovative Medical Products’ leadership in patient positioning technology. arm to V2 base plate, the V2E plate and extension have been made significantly lighter, which is a big advantage for OR staff who often have to lift or move heavy surgical equipment. Although engineered lighter, the V2E positioning system has not been compromised in its strength capabilities.

IMP Distractor: IMP’s distractor is a device that has significantly improved the surgical technique in knee surgery. Before IMP developed this solution, OR staff typically had to use manual methods to distract the knee joint. One technique was to have an OR assistant pull up and hold a WWW.ORTODAY.COM

patient’s leg in the hamstring area during the surgical procedure. This is difficult for the assistant and not very effective. That’s when IMP came up with its solution: The De Mayo Universal Distractor®.

The distractor’s advantages are clear: Reducing procedure time for unicompartmental, arthroscopies, ACL and TKA surgeries, it eliminates the need for lamina spreaders, the use of a bone hook or manually pulling on the femur at the thigh throughout the surgical procedure. The IMP device also delivers precise, finite femoral distraction with a completely unobstructed view of the operative site.

Ideally used with any version of the De Mayo Knee Positioner, the IMP distractor is a sterile external device that allows the surgeon to independently control the distracting of the knee joint. The distractor applies finite pressure to separate the joint space by means of a handle on the device that incrementally pumps the required tension.

A PACESETTER IN TRENDELENBURG POSITIONING Not only has IMP striven to emulate its “gold standard” through its evolution of knee surgery positioning solutions, it has also broadened its November November 2016 2016 || OR OR TODAY

43

CORPORATE PROFILE

portfolio in patient positioning for Trendelenburg surgeries.

Like its partnership with Dr. Edward De Mayo to create orthopedic positioning solutions, IMP has worked with the renowned gynecologist and oncologist, Ricardo Estape, M.D., in developing TrenMAX, a new, safer, more secure positioning system that provides OR staff a better alternative to all foam solutions when positioning patients for Trendelenburg surgical procedures.

The key component of the TrenMAX system is IMP’s proprietary sticky pad. The Sticky Pad™ adheres directly to the patient’s torso and fastens securely to the OR table’s siderails to prevent patients from moving or sliding off the OR table. Foam pads, on the other hand, depend on the patient’s anatomy and weight to sink into the material to prevent slippage.

For maximum, secure fixation of the base pad to the OR table, TrenMAX employs patent-pending TrenMAX clamps that tightly secure the base pad hook-and-loop material straps affixed to the OR table’s siderails. IMP’s clamps are a sureholding, back-up mechanism that other positioning systems lack.

“TrenMAX has the highest co-efficient of friction, or the minimalist amount of patient movement, compared to any other Trendelenburg positioning system in the market today,” remarked Dr. Estape.

Besides its unique holding power, TrenMAX provides additional benefits: • A system of arm straps that allow access to leads and IVs by anesthesiologists.

• Designed to meet AORN recommendations, IMP’s arm strap system prevents potential neurological impairment caused by sheet tucking.

• Does not require the use of a chest strap, therefore improving ventilation.

44 OR TODAY | November 2016

The V2E features a unique sterile extension arm that allows surgeons to stand between the patient’s legs for unicompartmental surgeries.

• Prevents nerve damage by eliminating pressure on the brachial plexus caused by shoulder-holder devices.

• Designed for single usage, The Sticky Pad™ is free from potential cross contamination.

INNOVATIONS BUILT ON PARTNERSHIP WITH STAKEHOLDERS IMP’s ground-breaking solutions in knee surgery and in Trendelenburg patient positioning technology did not simply spring whole from IMP’s imagination. Rather, IMP developed its positioning solutions by listening to

stakeholders whether they be surgeons, nurses, hospital staff members, or sales representatives – everyone who voiced a need to help make patient outcomes safer and more successful.

“We constantly listen to what the market is telling us,” notes Earl Cole, IMP vice president. “By responding to customer needs, we continue to produce innovations that aren’t just new for newness sake but are real, practical solutions based on customer feedback. In this way, we remain faithful to the ideals inherent in our original ‘gold standard’ solution produced more than a decade ago.”

WWW.ORTODAY.COM

Secure positioning, easy access, unmatched patient safety.

Introducing...

• • • •

Secure positioning Fast easy access to surgical field Single-use pad prevents cross contamination Prevents nerve damage by eliminating pressure on the brachial plexus Arm Strap Functionality

>

• Allows access for leads and IV’s • Prevents potential neurological impairment from sheet tucking • Meets AORN recommendations

The Sticky Pad™

>

delivers superior holding power without a chest strap, improving ventilation and without shoulder bumps to reduce pressure on the brachial plexus

>

TrenMAX™ Clamps

unique design locks the pad securely to the OR table

The right position for you and for the patient: Estape TrenMAX™ You never compromise patient safety, and neither do we. So we designed the Estape TrenMAXTM Trendelenburg Pad to meet AORN recommendations in “Recommended practices for positioning the patient in the perioperative practice setting.” It prevents tissue injury and ischemia that may be caused by tucking a patient’s arms at his or her side and so much more. In other words, it’s the system you would have designed yourself.

Learn more about the unique features of the Estape TrenMAXTM Trendelenburg Pad at www.impmedical.com or call 800-467-4944 for more information or to speak with a representative.

The operative word in patient positioning. www.impmedical.com TrenMAXTM is a trademark of Innovative Medical Products, Inc. – PATENT APPLIED FOR TrenMAXTM Clamp - PATENT APPLIED FOR The Sticky PadTM is a trademark of Innovative Medical Products, Inc.

AORN is a registered trademark of AORN, Inc. AORN does not endorse any commercial company’s products or services.

All Rights Reserved © 2016 IMP

46 OR TODAY | November 2016

WWW.ORTODAY.COM

WWW.ORTODAY.COM

November 2016 | OR TODAY

47

“The challenge of OR nurse training is significant and growing each year with the number of retiring nurses,” says ChrysMarie Suby, the President and CEO of the Labor Management Institute.

INCREASING COMPLEXITY

Hope L. Johnson, DNP, RN, CNOR, NEA-BC, the Director of Perioperative and Endoscopy Services for the Lehigh Valley Health Network in Allentown, Pennsylvania, puts it this way: “I think anyone in our field would be foolish to say that OR nurse training is anything but challenging.”

“The field is specialized and is not well publicized as an option for nurses during their training,” Johnson adds. “There is an increasing complexity to the field that only seems to gain acuity as years go by.”

Dawn Whiteside MSN, RN, CNOR, RNFA, Nurse Manager, Credentialing and Education Development for the Competency & Credentialing Institute, agrees with Suby and Johnson.

“Today there is an enormous challenge in training perioperative nurses,” says Whiteside. “Most nursing programs offer only one or two days of observation in the perioperative environment.”

For example, a nursing student might follow a patient from the floor throughout the perioperative experience.

“Depending on the type of surgery being observed, students may receive explanations of the perioperative nurse’s role, or they might simply be an observer off to the side of the room,” says Whiteside.

Also, training for perioperative nurses tends to not be specific.

“Each facility determines what its training will look like,” adds

48

OR TODAY | November 2016

“

“The Fundamentals of Perioperative Practice provides a well-defined foundation of perioperative nursing concepts.”

Whiteside. “If the facility is using a formal program like the one from AORN, educators still must develop a curriculum or plan for how the content will be grouped together and delivered.”

According to Susan Root, MSN, RN, CNOR, the Manager of Perioperative Education for the Association of periOperative Registered Nurses (AORN), AORN has developed a special course for integration into existing nursing curriculum to try to address this lack of perioperative exposure.

“The Fundamentals of Perioperative Practice provides a welldefined foundation of perioperative nursing concepts,” says Root. “It gives students basic information about aseptic technique and teamwork that can be translated into clinical experiences.”

Typically, the novice perioperative nurse undergoes an orientation period, Root explains. “This orientation should contain didactic content, opportunities to practice new skills in a sheltered environment, and a clinical preceptorship that encompasses all the specialty areas he or she will be expected to practice in,” she says.

Susan Root, MSN, RN, CNOR, the Manager of Perioperative Education for the Association of periOperative Registered Nurses (AORN),

PERIOP 101: STANDARDIZED TRAINING

In addition, AORN also offers Periop 101, which is a standardized blended training curriculum for OR nurses.

Root says this program, which is built on evidence-based guidelines, is currently being used by more than 2,500 hospitals and ambulatory surgery centers nationwide.

“I think a best practice is any one that involves the AORN Periop 101 course,” says Johnson. “A strong foundation, rooted in providing rationales and recognizing standards and recommended practices, is essential to training a nurse who truly understands the OR at its core.”

Regardless of whether a facility uses a training program they develop inhouse or a standardized program like Periop 101, Root says it’s important to blend the didactic content with skills labs and a clinical preceptorship.

“Many facilities don’t include all three components, each of

WWW.ORTODAY.COM

which is important in its own way,” she says.

“We allow the intern to build upon the foundations taught in Periop 101 through repetition and partner them with the same preceptor when in the initial phases of clinical experience,” says Jeanne Luke, MSN, RN, CNOR, the Director of Perioperative Internship and Clinical Program Development at the Lehigh Valley Health Network.

“This will allow for a consistent learning atmosphere and enables the learner to gain ‘wins’ day to day,” Luke adds.

PRECEPTORS AND MENTORS

According to Suby, OR orientation is usually based on rotations through the functional areas of responsibility within the OR for scrub and circulating positions, from general to specialty surgery.

“Newly hired OR nurses should be paired with preceptors or mentors to help them throughout the training period,” Suby says.

“Preceptor selection is an enormous part of being successful. One big mistake is assuming the person with the most experience is the best preceptor.”

Suby recommends that hospitals develop clearly defined competency and skills check-lists for newly

WWW.ORTODAY.COM

hired OR nurses to work their way through to completion.

“Proctors and managers should meet monthly to review the orientee’s progress toward measurable expectations,” she says. “And unit managers should conduct ‘stay reviews’ at periodic intervals thereafter.”

AORNs position statement on “Orientation of the Registered Nurse to the Perioperative Setting” provides guidelines for an orientation program.

“It should be between six and 12 months long and include both didactic and clinical components,” says Root. “In addition, completion of the program should be measured by successful competency assessment that is both rolespecific and scope-specific.”

THE INSTITUTION’S RESPONSIBILITY

Johnson says that without a strong foundation in perioperative training in academia, “the burden for education and training falls on the institution where the nurse will work. In some institutions, this means on-the-job training while in others, it involves a robust OR/ perioperative internship program.”

The internship program where Johnson works is offered in conjunction with the AORN Periop 101 course. “This allows the nurse to be informed and become knowledgeable about the basic tenets of OR nursing, such as positioning, prepping, aseptic technique, gowning and gloving, etc.,” she says.

Anyone without prior OR experience is put through the OR internship, says Johnson.

“This serves as their orientation,” she says. “Recently we have added team specific orientation to the internship program to decrease

the overall length of training time.”

All of this is then followed up with OR simulation, Johnson adds.

“We are fortunate to have an OR

Dawn Whiteside, MMSN, RN, CNOR, RNFA, Nurse Manager, Credentialing and Education Development for the Competency & Credentialing Institute

“

T oday there is an enormous challenge in training perioperative nurses.

Most nursing programs offer only one or two days of observation in the perioperative environment.”

November 2016 | OR TODAY

49

simulation lab where all of these skills can be practiced.”

The use of simulations is becoming more prevalent in the perioperative specialty.

“Previously, the high-priced simulation labs were reserved for medical training, but the importance of interdisciplinary training has emerged recently,” Root says. “With the advent of more complex training manikins, specialized perioperative scenarios are now possible.”

Perioperative simulation allows students and experienced staff to experience high-risk, low-volume patient scenarios more frequently and develop effective responses to

ensure patient safety, Root says.

“Even the use of low-fidelity simulations can have a significant impact on the quality of perioperative team training,” she adds.

THE ROLE OF HR

“It’s important for HR to understand the workflow of perioperative services and the different aspects of patient care in the OR so they can clearly communicate this with applicants who want to work in the OR,” Luke says.

Luke stresses the importance of making sure perioperative nursing candidates who apply to work in the OR know what they’re getting into.

“Many applicants don’t know what working in the OR entails,” she says. “They think it’s like one of the shows they watch on TV, but quickly learn that it’s not.”

This is where the human resources department enters the picture.

4

MANUFACTURED BY

ANDERSEN S T E R I L I Z E R S

NEXT GENERATION GAS STERILIZATION

DISINFECTION IS NOT ENOUGH © Copyright 2015-2016 Andersen Products, Inc

Introducing EOGas 4, true 10-6 sterilization to halt nosocomial infections of endoscopes and sensitive materials. FDA cleared, damage-free.

The proven reliability of EtO in a tabletop sterilizer using only 17.6g of gas/cycle.

50 OR TODAY | November 2016

CLEARED

www.anpro.com 1-800-523-1276

WWW.ORTODAY.COM

ARE YOUR REUSABLE SUCTION TUBES A PROBLEM? "Surgical instruments that cannot be thoroughly cleaned of debris cannot then be sterilized effectively for patient use"

Extended Length

A variety of suction tips were cleaned and tested with a variety of processes and products to determine best instrument cleaning practices. Results of the project were eye-opening: debris was found where debris should not be"

Difficult Angles Small Lumen

AORN J 96 (August 2012) 152-162. © AORN, Inc, 2012

MAKE THE SWITCH TO CLEAN AND EFFECTIVE SINGLE USE SUCTIONS FROM BOSS INSTRUMENTS Over 100 Patterns of Procedure-Specific Suctions S074-Frazier Suction 12 Fr

Sold Sterile in Convenient Dispenser Box High Quality - Ergonomic Feel

S189-Teardrop Suction 9 Fr

Dissecting & Atraumatic Tips S177-Fine Suction 5 Fr

FREE Evaluation Samples Also available as part of our expansive line of Single Use Instruments:

Kerrison Rongeurs

Myringotomy Kits

104 Sommerfield Drive Gordonsville, VA 22942 USA www.bossinst.com

Aspiration Needles

Toll Free: 800-210-2677 Fax: 540-832-5515 Email: inquiry@bossinst.com

Boss Instruments is the exclusive US distributor of the Single Use Surgical line of products, manufactured by Pelican Feminine Healthcare (www.pelicanfh.co.uk)

WE ONLY MAKE ONE SINK…

TH E B E ST ONE FOR Y OU D E SIG NE D B Y Y OU !

TBJ sinks are designed specifically for the pre-cleaning of surgical instruments and endoscopes. All of our sinks are custom made to order to enable you to design a system around your specific needs. A wide range of optional features and accessories enable you to tailor a design that puts the tools you for efficient, effective and ergonomic pre-cleaning right at your fingertips.

FEATURED PRODUCT Scope Consolidator

TBJ’s Scope consolidator system provides

OPTIONAL FEATURES INCLUDE Integrated Ultrasonic System

Air and water pistols

Hydro-Force rinse

Scope Consolidator

a comprehensive endoscope cleaning system that dramatically improves the speed of endoscope reprocessing Automated scope inflation for leak testing | Precison chemical dosing | Automated channel flushing with pulsating fluid technology for main and auxilary ports | Data management system | Optional bar code scanner | Optional automatic sink bowl filling | Customized around your specific needs – single, double and tripble bowl

Additional Options not shown: Push-button Height Adjustment - Auto sink bowl filling | Heated Sink Bowls | Custom Sink Bowl sizes | DI/RO faucets | Integrated Sonic Irrigator | Etched sink gallon markings | Storage shelves and drawers | Deck mounted Eyewash | Stainless steel peg board storage system

717.261.9700 • sales@tbjinc.com • www.tbjinc.com

Doesn’t Your Work Deserve Antimicrobial Clear Silicone Adhesive Dressing with Chlorhexidine and Silver

Finally, a fully transparent post-op dressing that offers the synergistic antimicrobial protection of Silver and Chlorhexidine with the added skin benefits of a silicone adhesive.*

Request an evaluation sample† surgiclear@covalon.com

covalon.com / 1-877-711-6055 * Covalon Technologies Ltd., Data on file. In vitro effectiveness does not predict clinical performance. † Some conditions apply.

SurgiClear is a trademark of Covalon Technologies Ltd. © 2016 Covalon Technologies Ltd. 1660 Tech Avenue Unit 5 Mississauga, ON, Canada L4W 5S7.

Clinical Specialist for Phoenix Childrenâ&#x20AC;&#x2122;s Cardiovascular Services

54

OR TODAY | November 2016

WWW.ORTODAY.COM

Spotlight On: David Fitzgerald

By Matt Skoufalos

There weren’t many male nurses in

America when David Fitzgerald entered nursing school in 1978, but there were a lot of nurses in his family, including his mother, sister, and aunt. Perhaps that’s why he’s been comfortable as one of the first nurses invited to pioneer cardiac units at several different Arizona hospitals over the past 14 years.

WWW.ORTODAY.COM

November 2016 | OR TODAY

55

Spotlight On: David Fitzgerald

“I’ve got the reputation of a start-up nurse.

I get a lot of satisfaction coming in at Ground Zero.”

In 2002, Fitzgerald and his spouse moved to the West Valley of the Phoenix metropolitan area, as he started working in adult cardiac care at Boswell Memorial Hospital. Shortly thereafter, a phone call from Banner Health presented an opportunity to join the start-up team at a hospital scheduled to be constructed nearby. Fitzgerald was invited to focus especially on guiding plans for the operating room. He spent two years consulting with designers and five years managing the OR after the hospital was built. Then, St. Joseph’s Hospital and Medical Center in Phoenix invited Fitzgerald to help with its start-up cardiothoracic program, and it was time for another change.

“At St. Joe’s, we did adult and pediatric hearts, and had a thoracic program that today is number one in lung transplants,” Fitzgerald said. “I did charge nursing there for a little bit, and then did the whole gamut of surgeries.”

After another five years in the program, the hospital decided to maintain its focus on adult patients exclusively, and Phoenix Children’s Hospital moved to adopt its pediatric program.

Fitzgerald joined a team that con56

OR TODAY | November 2016

sisted of “a single surgeon and a handful of staff,” but because that surgeon was Dr. John Nigro, whom Fitzgerald described as “probably one of the best surgeons on the west coast,” it was an opportunity he couldn’t pass up.

“I knew what the program was and I knew what Dr. Nigro’s vision was for this program,” he said.

“He wanted to be ranked nationally, he wanted our outcomes to be the best it could possibly be, and he wanted an efficient program, because all those things come out in numbers.”

For someone who describes himself as driven to the point of needing a challenge for motivation, there was no other choice.

“This was the obvious progression for me,” Fitzgerald said. “I was at Joe’s doing the lung transplants and pediatric hearts, which were by far the most challenging, and then when they moved this program over, and asked if I would move with the program and start it up. It was a no-brainer [but] it wasn’t easy.”

The cardiovascular services unit at Phoenix Children’s Hospital specializes in complex care for children with congenital heart conditions. The program proceeds according to a grueling schedule, seeing the sickest of patients through surgeries that last eight hours or more. Its goal is to perform 15 transplants a year, and there are 10 children on its latest waiting list. Any time a heart becomes available, one of two standby teams is sent to procure it, 24/7. Fitzgerald described it as difficult work that can attract glory-seekers; however, the folks who last the longest on the job are committed to the integrity of the process and mak-

“ For the first three years, I ran this program with a couple of techs and a handful of nurses.” ing connections with families in need of lots of support.

“I have trained people for a year, and out the door they go because now, on their resume, they can put they’ve done congenital hearts,” Fitzgerald said. “These children and their parents don’t know where to turn. You’re seeing a kid who comes to us with a very sick heart, and the prognosis isn’t very good, and they’re put on a transplant list.”

When Fitzgerald joined the department, it was transitioning from one or two congenital cardiac cases a week to eight to 10 cases a week; today, it’s become a service line for three full-time and one part-time surgeons.

“For the first three years, I ran this program with a couple of techs and a handful of nurses,” he said. “My team works extremely hard. It’s a very skilled profession, and we go on bypass for the betWWW.ORTODAY.COM

“ What I instill in my team is the idea that we’re all one, and we’re only as strong as each other. I’ll look at the cases for the week and pick and choose who’s going to do what.

I’ll team them up so that everybody is at their top level.” ter majority of our cases. It’s very stressful but very rewarding.”

Finding the right nursing staff to support the unit required a nationwide candidate search. As the patient volume kept growing and the staff stayed the same, however, “the obvious thing was to train them ourselves,” Fitzgerald said, adding, “it was a stressful process.”

“These cases are very complex cases,” he said. “What I instill in my WWW.ORTODAY.COM

team is the idea that we’re all one, and we’re only as strong as each other. I’ll look at the cases for the week and pick and choose who’s going to do what. I’ll team them up so that everybody is at their top level.”

Designing that team is a critical part of Fitzgerald’s role at Phoenix Children’s Hospital, but so is elevating their individual skills.

He said he’s provided – and been provided with – a good amount of

educational resources through the years, but what makes him able to do the job he does is working as part of a team.

“There’s no individual that can achieve this goal on his or her own,” he said. “This program is fast-growing, and we are doing hearts with outcomes that are right up there with these other hospitals. Just to be an active part of that is very rewarding.”

November 2016 | OR TODAY

57

Use the Coupon Code STERILIZE to save $15 on Calzuro Orders

Autoclave Your Calzuro & Personalize Scrubs Today!

The Italian Calzuro is ergonomically designed for medical professionals.

The 1.5 â&#x20AC;&#x153; heel reduces fatigue by setting the body anatomically correct.

Protect against contamination by sterilzing the Calzuro in the autoclave, machine wash, or disinfecting with bleach.

CALZURO.COM 800-257-9472

OUT OF THE OR HEALTH

BY HEIDI GODMAN HARVARD HEALTH LETTERS

WHAT TO DO WHEN BLOOD TEST RESULTS ARE NOT QUITE 'NORMAL'

P

icture this: You're reading the results of your recent blood work, and you notice some numbers are teetering on the edge of the normal range. Should you be concerned? s.

"It's tricky, because in some tests, a borderline result makes no difference.

In others, it might indicate an important change in health that we need to follow or act on," says geriatrician Suzanne Salamon, M.D., assistant professor at Harvard Medical School.

ABOUT NORMAL RANGES AND INTERPRETING THE NUMBERS

When you look at a printout of your lab results, you'll find the normal ranges for each blood test next to your personal results. For example, if your routine blood work includes a test for calcium in the blood, your lab may list the normal range for calcium as 8.3 to 9.9 milligrams per deciliter (mg/dL). If your result is a 9.1 mg/dL, right in the middle, you can feel confident that your calcium level is normal.

60 OR TODAY | November 2016

But what if a blood test result is at the very low or high end of normal, or even slightly outside the normal range? Is that a red flag?

"Don't jump to conclusions," warns Salamon. "Blood test results can vary a little bit, depending on the lab. And many people are consistently on one side or the other of the normal range, and for them, that's healthy."

Take, for example, a routine measure of blood urea nitrogen (BUN), a waste product created as your body breaks down the protein in your diet. Excess urea is removed from the blood by the kidneys, so high levels of BUN in the blood can indicate that kidney function is declining. So, what does it mean if your BUN level is at the very high end of the normal range?

"If I see that it's borderline high, I might ignore it," says Salamon. "It's common for BUN to go up if you don't drink enough, and that can happen when someone is fasting before having blood drawn."

Minor fluctuations in test results may also reflect: recent infections, medication side effects, stress, gender, age and inaccurate lab procedures.

Salamon emphasizes the need to look at someone's entire picture of health to interpret a blood test. In our BUN example, a number just above the normal range might actually be a sign of a bleeding ulcer in the stomach or small intestine, not failing kidneys.

"It depends on the person, the symptoms, and the other conditions that are present," she says.

WHEN TO BE CONCERNED

Instead of looking at a one-time test result on the high or low end of normal, Salamon says she looks at trends. "I get concerned if there's a change from what's been normal for WWW.ORTODAY.COM

HEALTH

years, for you. If your test result is always in the high normal range, I'm not concerned. But if it's always been in the low normal range, and today it's high normal, that's different,” Salamon says.

For example, let's say you have your blood sugar (glucose) measured every three years (that's how often the American Diabetes Association recommends routine blood sugar testing for everyone over age 45, if previous test results have been normal). The normal range is between 60 and 100 mg/dL. Levels between 100 and 125 mg/dL are considered "prediabetes" – that is, not quite full-blown diabetes, but approaching it. If your results have usually been 81 or 82 mg/dL, but your latest result is suddenly 98 mg/dL, it's still considered normal, but the change might spark a conversation about your diet. Salamon says she would, for example, ask you questions like "Have you put on weight? Are you eating more carbohydrates and sugary foods?" as a way to start investigating why your blood sugar is suddenly going up.

But some tests don't have any room for fluctuation, such as tests for liver enzymes, called AST (aspartate aminotransferase) and ALT (alanine aminotransferase).

"If these levels were always normal, and now one of them starts to go up one or two points, there might be something wrong with liver function, and I'd want to know why," says Salamon.

WHAT YOU SHOULD DO

Get an annual check-up, and don't skip routine blood work. Even if you feel that you're healthy, it's still a good idea to have a continuous record of standard blood markers so your doctor can look for trends. If you have some results at the high or low end of normal, ask your doctor if you should repeat the test or investigate them further. But remember: "Each test has its own rules, and it takes years to understand how the numbers work together," says Salamon. "Leave the interpretation up to your doctor." .

HEIDI GODMAN is the executive editor of the Harvard Health Letter.

WWW.ORTODAY.COM

NEED PATIENT MONITORING EQUIPMENT? LOOK NO FURTHER. GOPHER MEDICAL has what you need at affordable pricing, backed by our 1-year industry-leading warranty.

Patient/Bedside Monitors Vital Sign Monitors Anesthesia Monitors Gas Monitors

Your trusted source for all your patient monitoring needs

Authorized Distributor

Defibrillators Electrocardiographs (EKG) Repairs by factory-trained biomedical technicians

844-2GOPHER (844-246-7437) sales@gophermedical.com www.gophermedical.com

Exclusive National Distributor

Authorized Distributor

November 2016 | OR TODAY

61

OUT OF THE OR FITNESS

BY EATINGWELL.COM

HOW TO EXERCISE

WITHOUT EVEN KNOWING IT

J

ust to remind you, lifestyle change is a step-by-step kind of thing. No one can do it for you, not even your next president. Sometimes it’s two steps forward, one step back. And that’s OK, because every day you can begin again, eating smarter, moving instead of sitting, mindfully releasing the stress and heebie-jeebies that come from watching the Hillary and Donald show.

In a review that appeared in the International Journal of Obesity, a group of scientists recently suggested that Americans are simply spending too much time talking about how our toxic food environment and our couch potato ways are making us obese. Perhaps there are other reasons that we’re plumping up, they proposed.

Among the alternate obesity theories: We’re not sleeping enough; air pollution messes up our metabolism; we’ve adapted to air conditioning – so we don’t need to regulate our internal temperatures by ramping up our metabolic rates (thus, burning more calories). All that may be true, but that doesn’t change the fact that eating right and

62

OR TODAY | November 2016

exercising are the ways to manage your weight.

To that end, try incorporating some of these excellent ways to exercise without even knowing it.

You may not think of the activities below as exercise – but at the end of the day, all of these strategies burn calories and get your heart rate up.

1

WASH YOUR CAR Burn calories and make your car look beautiful as you wash, dry and get it (and you) buff. Bonus points for waxing it too!

2

.DO YOUR OWN YARD WORK. Tell the teenage kid from down the street that you’ll mow your own

lawn – and pay him to make some iced tea instead. While you’re at it, weed the vegetable garden and toss some new mulch around the perennials out front. You’ll score some exercise and a great-looking yard.

3

REINSTATE THE ‘WATER COOLER’ AT WORK. Everyone needs a periodic work break, but instead of emailing witty quips to your buddy in the next office, walk to the water cooler to dish about the latest episode of your favorite TV show. Sure, it’s not many steps, but they all add up.

4

GET STARTED ON THAT HOME-IMPROVEMENT PROJECT. WWW.ORTODAY.COM

TRIM 3.25”

FITNESS

Unique Immobilizers for Unique Patients The Medi-Kid Co.Inc, is the manufacturer and distributor of pediwraps, the most widely used pediatric arm and leg immobilizer.

TRIM 4.5”

Visit our website for our complete catalog! www.medi-kid.com • Fast & easy to use • Soft cotton fabrics • Machine washable • Kid friendly prints • Adult sizes available • Dryer safe

Painting, hammering, hoisting – it’s all exercise (some of it moderate to vigorous, we’d say). And don’t discount all the walking that you’ll do as you wander around the big home-improvement warehouse looking for that specific hinge (or someone who can help you find it).

5

PUBLICATION

www.medi-kid.com | 888-463-3543

GI

AD SIZE (800) 521-6224 healthmark@hmark.com 1/4 Page Vertical

DOG SIT. MEDICAL DEALER TECHNATION ORTODAY FOR A PUPPY, IDEALLY. BUYERS GUIDE OTHER You won’t be able to sit on the couch NOTES for long – unless you don’t care about MONTH your carpet – or your shoes. Know anyone with a dog? Ask if they’ll be traveling, sans pet.

J F– M A M J J A S O N D You’ll sneak in a week’s worth of exercise Healthmark and our GI products help the and probably earn yourself a nice bottle of DESIGNER: JR JL Endoscopy center manage the reprocessing of wine upon their return. their scopes. We do this through monitoring of cleaning (cleaning verification products), tools EAT to improve cleaning (cleaning products) and AL FRESCO. finally products to organize and track the steps Pack a picnic – one that requires in reprocessing (accessories, including labels). schlepping a big ice-filled cooler across a field or a park. Bring a ball or a Frisbee for after-eating activities, and you’ll start burning your picnic off before you even get home. And choose your friends carefully; the activity-obsessed ones who Reprocessing Cleaning Cleaning love to kick a soccer ball around will help you get Accessories Verification Products off the blanket and move it with them.

www.HealthmarkGI.com

6

EatingWell is a magazine and website devoted to healthy eating as a way of life.

Online at www.eatingwell.com.

WWW.ORTODAY.COM

November 2016 | OR TODAY

63

WIDTH 7”

HEIGHT 4.5”

Protect Your Peepers with Palmero Temple (arm)*

PUBLICATION

Bridge

MEDICAL DEALER

TECHNATION

BUYERS GUIDE

OTHER

ORTODAY

F

Frame AD SIZE HALF PAGE HORIZONTAL

NOTES

Hinge End Piece

Lens

MONTH J

Temple Tip (ear rest)

Nose Pads

Bifocal

Eye safety doesn’t have to make you look uncool.

M

A

M

J

J

A

S

O

N

Kills...

MRSA, HIV, TB, H1N1, hepatitis B, hepatititis C, VRE, RSV, avian

influenza A, adenovirus, herpes simplex 2, coronavirus, influenza A, E.coli, Pseudomonas aeruginosa, salmonella, staphyloccus aures, athelete’s foot fungus, among others.

IN ONE MINUTE or less!

800-344-6424

64 OR TODAY | November 2016

D Don’t gamble with your LIFE!

Gallon

DisCide Ultra is a hospital grade disinfectant that kills major pathogens in ONE MINUTE or less and won’t evaporate until the job is done.

Towelettes 160 count 60 count Quart

4 oz. bottle

Request a free sample http://www.palmerohealth.com/requestSamples Please mention ORTODAY when requesting a sample

WWW.ORTODAY.COM

e Th nal igi r O

Cosgrove® Mitral Valve Retractor System

Surgical Knee Immobilizer/Positioner Sterile Adhesive Organizer Keeps sterile tethered appliances from falling to the floor with 4 hook & loop closures Latex free self adhesive back for attachment to the surgical field Economical - Saves pre-op time Several sizes and configurations - yellow or red iridescent for laser surgery Sterile shelf life 2 years

AWARD WINNER!

FOR ARTHROSCOPIC AND ALL KNEE SURGERY PROCEDURES Secure flexion & extension stabilization Easy hook & loop adjustment Frees surgical practitioner’s hands to retract soft tissue Sterile and disposable for single use Economical solution Call for FREE samples

Call for FREE samples

PROOF SHEET

Mitral Valve Repair or Replacement Surgery

Exceptional Exposure for Right & Left Atrium PROOF APPROVED CHANGES NEEDED

CLIENT SIGN–OFF: PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT LOGO PHONE NUMBER WEBSITE ADDRESS

SPELLING

GRAMMAR

WIDTH 7”

Refurbished Powered Surgical Equipment www.surgicalpower.com

(574) 267-8207 sales@surgicalpower.com

HEIGHT 4.5”

Sales • Repairs • Service Surgical Power Equipment

Drills Saws Accessories Consoles Batteries Attachments WWW.ORTODAY.COM

November 2016 | OR TODAY

65

OUT OF THE OR NUTRITION

BY EATINGWELL.COM

8 WAYS TO SNACK SMARTER E

ating a snack or two between meals can curb hunger so that you don’t inhale the dining room table when you finally sit down to supper. Snacking can also help you get in all the nutrients you need. On the flip side, grazing all day – particularly on foods of little nutritional value – may result in eating too much and packing on extra pounds. The key is taking a smart approach to snacking. Here are some simple strategies to get you started.

1

SLOW DOWN. Take some time to enjoy what you’re eating. If that’s hard to do, try eating unshelled pistachios or other foods that take some effort to uncover, like oranges. The pile of empty shells or peels is a good visual cue to remind you to keep an eye on serving sizes.

2

KEEP CHICKPEAS IN THE PANTRY. They have a meaty texture and a nutty flavor along with plenty of satiating fiber and a little protein – the perfect combination for a filling snack. Toss chickpeas with crunchy veggies and shallots and drizzle with a hint of olive oil and a squeeze of

66

OR TODAY | November 2016

lemon. Just be sure to watch your serving size.

3

TOSS GRAPES IN THE FREEZER FOR AN EASY SNACK. Because they’re sweet and you savor them individually, you’ll get a lot of satisfaction for just a handful of calories.

4

INCLUDE A TREAT EVERY DAY. Believe it or not, giving yourself little treats may be the secret to losing weight – for good. Aiming to be “too good” sets you up to fail. If you like a glass of wine with dinner, make room

for it. Prefer dessert? Skip the drink and go for a low-calorie chocolate treat instead.

5

SNACK (AND MULTITASK) MINDFULLY. Munching mindlessly in front of the TV is a surefire way to eat unnecessary calories – but that doesn’t mean you can’t enjoy a bowl of freshly popped popcorn or your favorite snack. Instead of popping a big bag of microwave popcorn, for example, choose a “mini” 100-calorie bag. And be sure to account for those calories elsewhere in your day.

6

USE SNACKS TO FILL NUTRITIONAL GAPS. Make your snacks count. Choose those that provide calcium and fiber – two nutrients that people often skimp on. Two snacks to try: a cup of yogurt with a half-cup of whole-grain cereal mixed in, or a skim latte plus an apple.

7

BROWN-BAG YOUR SNACK. Skip the vending machine and satisfy the afternoon “munchies” WWW.ORTODAY.COM

NUTRITION

Reducing Infections.

Improving Outcomes.

More than 50% of health care environments are not properly cleaned. Admittance to a hospital room previously occupied by a patient with an infection or with a healthy snack you packed at home. You’ll save money and get a bigger bang for your nutritional buck.

Try an ounce of almonds and an orange, or a handful of pretzels with some hummus. Planning snacks that provide both carbohydrates and protein will help tide you over until dinner.

8

DON’T GET TRIPPED UP BY TRAVEL. However often you travel, prepare in advance so you’ll have healthy snacks to eat en route. For shorter trips, pack a quarter-cup of dried fruit, such as apricots, a handful of almonds and a few whole-wheat crackers as healthier alternatives to the salty snacks you might find at convenience stores or the airport. Sip plenty of water along the way to arrive better hydrated.

EatingWell is a magazine and website devoted to healthy eating as a way of life.

Online at www.eatingwell.com.

WWW.ORTODAY.COM

multidrug-resistant organism results in the new patient having an increased risk of acquiring that pathogen by 39-353%*. Tru-D is the only automated no-touch UV disinfection device that is clinically-validated by a randomized clinical trial to decrease HAIs, not only from patient to patient, but throughout an entire healthcare facility. * Weber, et al, (2016 March). ‘No touch’ technologies for environmental decontamination: focus on ultraviolet devices and hydrogen peroxide systems. Current Opinion on Infectious Diseases. http://journals.lww.com/.

Learn more about how Tru-D provides a safer, cleaner environment at TeamTru-D.com

SEE THE TRU-DIFFERENCE AT TRU-D.COM

(800) 774-5799

November 2016 | OR TODAY

67

OUT OF THE OR RECIPE

BY DIANE ROSSEN WORTHINGTON ENTRÉE

It’s easy to understand why fried rice is such a universal dish. Rice is the common thread, an extremely inexpensive ingredient, along with ingredients indigenous to each country.

This nasi goreng (which literally means “rice fried” in Indonesian) is spicy and full of bright flavors; just the thing to pick you up on a crisp early fall night, since it is hearty and satisfying. In Indonesia, the taste can differ dramatically depending upon the region and the proximity to the ocean. Based on my research and testing, I came up with this adaptation that will perk up any cook’s culinary repertoire.

68

OR TODAY | November 2016

WWW.ORTODAY.COM

RECIPE

INDONESIAN FRIED RICE

OFFERS A LITTLE PICK-ME-UP

N

o one really knows where fried rice originated, but one thing is for sure. Many countries have adopted it as their own dish with variations (e.g., Spanish paella, Thai fried rice, Italian risotto, Indian biryani, French pilaf and Hawaiian fried rice).

For a good result, the rice should be allowed to cool to room temperature before making the dish.

So keep that in mind and plan ahead. If the rice is warm, it will become oily when stir-fried. I consider this a Seriously Simple dish because all of the preparation is done ahead of time.

The cooking will go quickly, so it’s essential to have all of the ingredients prepared and ready. That way the dish takes just a few minutes to put together.

I like to use serrano chilies but any small, hot, flavorful chile like jalapeno or Thai chilies will work well. Avoid Scotch

bonnet or habanero chilies unless you like your food extremely hot and spicy. Finally, roasted peanuts may not be authentic, but their addition as a garnish looks pretty and tastes delicious! Select a cold beer to accompany this comforting dish.

DIRECTIONS: 1. A t least three hours before preparing the dish: In a large saucepan with a lid, heat the water on medium-high heat until boiling. Add the rice and turn down the heat to medium-low, cover and simmer for about 20 minutes or until the rice is cooked and the water is absorbed.

Remove from the heat and transfer the rice to a large cookie sheet or strip of wax paper to cool, separating any clumps of rice. Let cool to room temperature.

2. Heat 2 tablespoons of the oil in a large wok or sauté pan on high heat.

When the oil is hot and almost smoking, add the carrots, mushrooms and red pepper and stir-fry for about 1 minute or until slightly softened. Remove the vegetables to a side bowl and reserve.

3. A dd the shrimp and scallions to the wok and toss every 15 to 20 seconds for 1 to 2 minutes or until the shrimp just turn pink. Remove the shrimp to a side bowl and reserve.

WWW.ORTODAY.COM

4. A dd the remaining 2 tablespoons of oil to the wok. When the oil is very hot and almost smoking, stir-fry the shallots for 1 to 2 minutes or until lightly browned. Add the garlic, ginger and chilies and toss for about 30 seconds or until they are aromatic.

5. A dd the rice and spread the rice all around and halfway up the sides of the pan. Let the rice cook about 10 seconds and then toss to combine and coat the ingredients. Add the paprika, ketchup and soy sauce and toss to blend. Add the reserved vegetables and shrimp and toss again, making sure to evenly distribute the ingredients. Add the bean sprouts and toss once more. Taste for seasoning.

6. T ransfer the ingredients to a large serving bowl or platter and garnish with the cucumber and peanuts.

Serve immediately.

Indonesian-Style Fried Rice (Nasi Goreng with Shrimp) Serves 4 to 6 For the fried rice: 3 cups water 1 1/2 cups long grain rice 1/4 cup peanut oil 3 carrots, peeled and diced 1/2 pound mushrooms, cleaned and diced 1 red pepper, seeded and diced 1 pound shrimp, peeled and deveined, cut into 1-inch pieces 3 scallions, white and light green parts, finely chopped 3 shallots, peeled and thinly sliced 3 garlic cloves, minced 1 tablespoon minced ginger 2 small green or red chilies, seeded and finely chopped 1 teaspoon paprika 2 tablespoons tomato ketchup 2 tablespoons soy sauce 1/4 pound fresh bean sprouts (about 2 cups) For the garnish: 1/4 cup peeled, seeded and diced cucumber 1/2 cup roasted shelled peanuts – Diane Rossen Worthington is an authority on new American cooking. She is the author of 18 cookbooks, including “Seriously Simple Parties,” and a James Beard Award-winning radio show host. You can contact her at www.seriouslysimple.com.

November 2016 | OR TODAY

69

OUT OF THE OR PINBOARD

PINBOARD

The News and Photos That Caught Our Eye This Month

OR TODAY

CONTEST • NOVEMBER • ARE YOU IN THE KNOW?

VOLUNTEERING IS GOOD FOR YOUR HEART If you do volunteer work, whether it’s at a school, soup kitchen or senior center, perhaps you’ve experienced the emotional rewards of donating your time. What you might not realize, however, is that volunteering may offer some added advantages for your heart.

“There’s a growing body of research showing that volunteering is associated with better physical and mental health outcomes,” says Eric S. Kim, a research fellow at the Harvard T.H. Chan School of Public Health. A study he co-authored, published in “Social Science and Medicine” earlier this year, found that volunteers were more likely to use preventive health care services.

70 OR TODAY | November 2016

{

Win Lunch!

THE WINNER GETS A $50 SUBWAY GIFT CARD

For instance, people who volunteered were 47 percent more likely to get cholesterol checks and 30 percent more likely to get flu shots than those who didn’t volunteer. (An annual flu shot appears to lower the risk of heart attack and stroke by about one-third over the following year.)

The participants were part of the Health and Retirement Study, a nationally representative study launched in 1992 that includes more than 7,100 adults over age 50. Earlier research from the same study found that people who volunteered on a regular basis (at least 200 hours a year) were less likely to develop high blood pressure over a four-year period than non-volunteers. Volunteers also had greater increases in psychological well-being and physical activity.

{

Email us a photo of yourself or a colleague reading a copy of OR Today magazine to be entered to win a $50 Subway gift card!

Snap a photo with your phone and email it to Editor@MDPublishing.com to enter. It’s that easy! Good luck!

Friends volunteer ing together to help the commun ity.

You can explore a wide range of volunteer opportunities online at these organizations, which offer many different ways to give back to your community: • Volunteer Match: www. volunteermatch.org • The Corporation for National and Community Service: www.nationalservice.gov • Experience Corps: www.aarp. org/experience-corps – Harvard Health Letters WWW.ORTODAY.COM

PIN BOARD

OR TODAY SEPTEMBER

CONTEST ENTRIES

Brunelle, Christopher

Monica Heyn , MSN, RN, CNOR “I love your magazine!”

LVN

Congratulations to Dianna Taraskewich RN, BSN, CNOR! “Can’t stop reading my OR Today and investing in my knowledge base!”

chez Martin San ing Tech II ss ce ro Sterile P

HEALTHY FALL VEGGIES Many of fall vegetables are great candidates for high-heat oven roasting, which makes them deliciously crisp and brings out their inherent sweetness. And, as if their good taste weren’t enough, there are some compelling health reasons to eat these vegetables too!

Beets You may not love their earthy flavor, but beets are rich in naturally occurring nitrates (as are cabbages and radishes.) Unlike the unhealthy artificial nitrates found in processed meat, these nitrates may be WWW.ORTODAY.COM

beneficial. These compounds may help poor blood flow, which contributes to age-related cognitive decline. Nitrate-rich foods can also help people with hypertension by widening blood vessels and aiding blood flow, according to research.

Cabbage You’re probably already a coleslaw fan, but there are many more ways to enjoy cabbage. It’s loaded with vitamins C and K, fiber and detoxifying sulfur compounds. Red cabbage also boasts anthocyanins, antioxidants thought to keep your heart healthy and brain sharp.

Leeks You may only pick up leeks at the store if you need them for a specific recipe, but consider buying them

Colleen Smith , PCA and Car y Bell, RN “ W e were about the pretty excited kabob recip e .”

more often to use in place of onions.

Just a single leek contains 10 grams of fructans, a type of fiber associated with better gut health.

Turnips Turnips may help decrease risk for certain cancers. Don’t miss out on their tasty greens too. They’re packed with vitamin A, a nutrient important for bone growth, as well as K, which aids in blood clotting.

Winter squash Sure squash requires a little extra time to prepare, but it’s a worthy endeavor.

Winter squash is high in fiber, an excellent source of vitamins A and C, and also provides vitamin B6, folate, vitamin K and potassium.

– EatingWell.com November 2016 | OR TODAY

71

TRIM 4.5”

CONTINUE YOUR EDUCATION

TRIM 4.5”

SAVE THE DATE!

AUGUST 27-29, 2017 • WASHINGTON, D.C.

AT

PROOF APPROVED

PROOF SHEET

CHANGES NEEDED

EDUCATION • NETWORKING KEYNOTE • EXHIBIT HALL • FUN!

CLIENT SIGN–OFF: PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT LOGO PHONE NUMBER WEBSITE ADDRESS

www.ortodaylive.com

SPELLING

GRAMMAR

WIDTH 7”

ON DEALER

TECHNATION

GUIDE

A

ORTODAY

OTHER

M

J

J

WHERE’S BEN C.?

AD SIZE 1/3 Page Square 4.5”x4.5” NOTES

A

S

O

N

D

: JL

DON’T HAVE A BEN C.?

Share a pic of Ben C. on the MedWrench

Facebook page and show us what he has been

up to for a chance to win lunch on MedWrench!

HERE ARE THE RULES: 1. Like our page!

2. Post your photo to our facebook page 3. Write a funny caption

4. Tag @MedWrench and hastag #BenC

www.facebook.com/MedWrench | #BenC 72

OR TODAY | November 2016

WWW.ORTODAY.COM

HEIGHT 4.5”

Visit www.medwrench.com/ BenC to download your own!

JOIN THE CONTEST!

TRIM 3.25”

PT20C

PT20 TRAP

CHECKLIST BOARDS

®

ARE PROVEN TO

REDUCE PREVENTABLE ERRORS

Fine mesh screen captures the smallest specimen GI / ENDOSCOPY – POLYP RETRIEVAL Order PT20 (with plain tube)

• No more straining or fishing!

• No lost or damaged polyps!

OTHER APPLICATIONS

Order PT20C (with blue connector as shown)

TRIM 4.5”

Checklist Boards improve health care outcomes by adherence to standardized processes. Each custom designed board contributes to best practice in:

Process Improvement Trapping/Reducing Errors Standardizing Your Time Out MADE IN THE U.S.A.

Checklist Boards helped three hospitals in Ohio REDUCE RE-ADMISSIONS BY 30% & SAVE $2 MILLION. View sample designs at ChecklistBoards.com!

Get a free trial board to share with your team!

585.586.0152 or email us at info@checklistboards.com

Earn CE Credit Without Traveling

PUBLICATION

MEDICAL DEALER BUYERS GUIDE

TECHNATION

ORTODAY

OTHER

AD SIZE 1/4 Page Vertical NOTES

MONTH J

F

M

A

M

J

J

A

S

O

N

D

DESIGNER: KP

ASCA’s online Regulatory Training Series is a convenient, low-cost way to earn CE credit.

These 24 interactive online courses cover topics that are important to ASC professionals, including three that were added this year: • Hand Hygiene • Latex Allergy • Prevention of Healthcare-Associate Influenza in Ambulatory Care 18 of the courses offer CE credit and the complete series can be ordered easily online for ASCs registering 50 users or less.

Learn more and sign up at ascassociation.org/TrainingSeries.

WWW.ORTODAY.COM

November 2016 | OR TODAY

73

INDEX

ALPHABETICAL AAAHC………………………………………………………… 13 AIV Inc.……………………………………………………………21 Anderson Products Inc.…………………………… 50 Ansell…………………………………………………………… 40 AORN Works………………………………………………… 9 ASCA…………………………………………………………… 73 Belimed Inc.………………………………………………… 61 Boss Instruments, LTD.……………………………… 51 Bulb Direct Holding, LLC.……………………………21 C Change Surgical……………………………………… 41 Checklist Boards Corp.……………………………… 73 Covalon Technologies LTD……………………… 53 D.A. Surgical………………………………………………… 24

Dabir Surfaces……………………………………………… 4 David Scott Company……………………………… 64 Enthermics Medical Systems, Inc.………… IBC Flagship Surgical, LLC……………………………… 31 GelPro…………………………………………………………… 23 Gopher Medical…………………………………………… 61 Healthmark Industries………………………… 14,63 Infinium Medical, Inc.………………………………… 19 Innovative Medical Products, Inc.………………………………… 42-45, BC Interpower Corporation……………………………… 5 Jet Medical Electronics……………………………… 72 MD Technologies………………………………………… 73

Medwrench…………………………………………………… 72 Pacific Medical LLC……………………………………… 6 Palermo Health Care………………………………… 64 Paragon Service………………………………………… 30 Ruhof Corporation………………………………………2-3 SMD Waynne Corp.…………………………………… 58 Surgical Power…………………………………………… 65 TBJ, Inc.………………………………………………………… 52 Tru-D.…………………………………………………………… 67 USOC Medical……………………………………………… 59

ACCREDITATION AAAHC………………………………………………………… 13

GelPro…………………………………………………………… 23 Surgical Power…………………………………………… 65

Innovative Medical Products, Inc.………………………………… 42-45, BC

ANESTHESIA Checklist Boards Corp.………………………………

David Scott Company………………………………

Gopher Medical……………………………………………

Infinium Medical, Inc.…………………………………

Paragon Service…………………………………………

HAND/ARM POSITIONERS Innovative Medical Products, Inc.………………………………… 42-45, BC

POWER COMPONETS Interpower Corporation……………………………… 5

INDEX CATEGORICAL

73 64 61 19 30

APPAREL Healthmark Industries………………………… 14,63 ASSOCIATIONS AAAHC………………………………………………………… 13 AORN Works………………………………………………… 9 ASCA…………………………………………………………… 73 BEDS Innovative Medical Products, Inc.………………………………… 42-45, BC CARDIOLOGY C Change Surgical……………………………………… 41 Gopher Medical…………………………………………… 61 CARTS/CABINETS David Scott Company……………………………… 64 Enthermics Medical Systems, Inc.………… IBC TBJ, Inc.………………………………………………………… 52 CLEANING SUPPLIES Ruhof Corporation………………………………………2-3 CLAMPS Innovative Medical Products, Inc.………………………………… 42-45, BC DISINFECTANTS Palermo Health Care………………………………… 64 DISPOSABLES Pacific Medical LLC……………………………………… 6 ENDOSCOPY Anderson Products Inc.…………………………… 50 Bulb Direct Holding, LLC.……………………………21 MD Technologies………………………………………… 73 Ruhof Corporation………………………………………2-3 FLUID MANAGEMENT Flagship Surgical, LLC……………………………… 31

74

HIP SYSTEMS Innovative Medical Products, Inc.………………………………… 42-45, BC INFECTION CONTROL/PREVENTION Belimed Inc.………………………………………………… 61 Covalon Technologies LTD……………………… 53 Palermo Health Care………………………………… 64 Ruhof Corporation………………………………………2-3 Tru-D.…………………………………………………………… 67 INSTRUMENT STORAGE/TRANSPORT Belimed Inc.………………………………………………… 61 KNEE SYSTEMS Innovative Medical Products, Inc.………………………………… 42-45, BC LASERS Checklist Boards Corp.……………………………… 73 LEG POSITIONERS Innovative Medical Products, Inc.………………………………… 42-45, BC MONITORS Jet Medical Electronics……………………………… 72 USOC Medical……………………………………………… 59 ONLINE RESOURCES Medwrench…………………………………………………… 72 OR TABLES/ ACCESSORIES Innovative Medical Products, Inc.………………………………… 42-45, BC ORTHOPEDIC Surgical Power…………………………………………… 65 OTHER AIV Inc.……………………………………………………………21 Ansell…………………………………………………………… 40 Tru-D.…………………………………………………………… 67 SMD Waynne Corp.…………………………………… 58

GEL PADS GelPro…………………………………………………………… 23 Innovative Medical Products, Inc…………… BC

PATIENT MONITORING Gopher Medical…………………………………………… 61 Pacific Medical LLC……………………………………… 6 USOC Medical……………………………………………… 59

GENERAL AIV Inc.……………………………………………………………21 Checklist Boards Corp.……………………………… 73

POSITIONERS/IMMOBILIZERS David Scott Company……………………………… 64 D.A. Surgical………………………………………………… 24

OR TODAY | November 2016

RADIOLOGY Checklist Boards Corp.……………………………… 73 REPAIR SERVICES Pacific Medical LLC……………………………………… 6 REPLACEMENT PARTS Bulb Direct Holding, LLC.……………………………21 SAFETY GEAR David Scott Company……………………………… 64 SHOULDER RECONSTRUCTION Innovative Medical Products, Inc.………………………………… 42-45, BC SIDE RAIL SOCKETS Innovative Medical Products, Inc.………………………………… 42-45, BC STERILIZATION Anderson Products Inc.…………………………… 50 Belimed Inc.………………………………………………… 61 SURGICAL Boss Instruments, LTD.……………………………… 51 Bulb Direct Holding, LLC.……………………………21 Checklist Boards Corp.……………………………… 73 Covalon Technologies LTD……………………… 53 David Scott Company……………………………… 64 Flagship Surgical, LLC……………………………… 31 MD Technologies………………………………………… 73 Ruhof Corporation………………………………………2-3 Surgical Power…………………………………………… 65 SUPPORTS Innovative Medical Products, Inc.………………………………… 42-45, BC TELEMETRY USOC Medical……………………………………………… 59 TUBES Bulb Direct Holding, LLC.……………………………21 WARMERS Belimed Inc.………………………………………………… 61 Enthermics Medical Systems, Inc.………… IBC WASTE MANAGEMENT TBJ, Inc.………………………………………………………… 52

WWW.ORTODAY.COM

Quality care for your patients.

Quality solutions for your facility.

Whether you operate a full-service hospital or a specialty clinic, our ISO-certified patient warming systems are designed to accommodate any footprint, at any location, on any budget. Add unmatched support and service and you have a quality solution for your facility.

www.enthermics.com | 1-800-862-9276

Secure positioning, easy access, unmatched patient safety.

Introducing...

• • • •

Secure positioning Fast easy access to surgical field Single-use pad prevents cross contamination Prevents nerve damage by eliminating pressure on the brachial plexus Arm Strap Functionality

>

• Allows access for leads and IV’s • Prevents potential neurological impairment from sheet tucking • Meets AORN recommendations

The Sticky Pad™

>

delivers superior holding power without a chest strap, improving ventilation and without shoulder bumps to reduce pressure on the brachial plexus

>

TrenMAX™ Clamps

unique design locks the pad securely to the OR table

The right position for you and for the patient: Estape TrenMAX™ You never compromise patient safety, and neither do we. So we designed the Estape TrenMAXTM Trendelenburg Pad to meet AORN recommendations in “Recommended practices for positioning the patient in the perioperative practice setting.” It prevents tissue injury and ischemia that may be caused by tucking a patient’s arms at his or her side and so much more. In other words, it’s the system you would have designed yourself.

Learn more about the unique features of the Estape TrenMAXTM Trendelenburg Pad at www.impmedical.com or call 800-467-4944 for more information or to speak with a representative.

The operative word in patient positioning. www.impmedical.com TrenMAXTM is a trademark of Innovative Medical Products, Inc. – PATENT APPLIED FOR TrenMAXTM Clamp - PATENT APPLIED FOR The Sticky PadTM is a trademark of Innovative Medical Products, Inc.

AORN is a registered trademark of AORN, Inc. AORN does not endorse any commercial company’s products or services.

All Rights Reserved © 2016 IMP