OR Today - July 2018 by MD Publishing

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OR TODAY | July 2018

contents features

46 ACHIEVING PEAK PERFORMANCE IN THE OR Most organizations today strive to achieve peak performance by streamlining operations and improving efficiency. Health care organizations are no exception. We ask experts how to achieve peak performance in the operating room.

SURGICAL CONFERENCE

AUGUST 26-28 NASHVILLE, TN

OR TODAY LIVE PREVIEW

The goal of this continuing education program is to inform nurses about how to use social media to enhance their careers. The information presented here will describe how social media can have a positive impact

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CE ARTICLE

OR Today Live is headed to Music City. The conference runs from August 26 to August 28 when perioperative nurses and SPD professionals from across the country will gather to discover new opportunities, broaden their knowledge and exchange ideas.

CORPORATE PROFILE

OR Today (Vol. 18, Issue #07) July 2018 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 302691530. 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. ÂŠ 2018

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contents features

PUBLISHER John M. Krieg

john@mdpublishing.com

VICE PRESIDENT Kristin Leavoy

OR TODAY CONTEST

kristin@mdpublishing.com

Find out last month's winner and how you could win!

EDITOR John Wallace

editor@mdpublishing.com

ART DEPARTMENT Jonathan Riley Karlee Gower Kathryn Keur

ACCOUNT EXECUTIVES Lisa Gosser Jayme McKelvey Megan Cabot

sales@mdpublishing.com

ACCOUNTING Kim Callahan

Lisa Farace

Beans and Peas in Buttermilk Ranch

SPOTLIGHT ON

DIGITAL SERVICES

RECIPE OF THE MONTH

Travis Saylor Cindy Galindo Jena Mattison

CIRCULATION Lisa Cover Melissa Brand

INDUSTRY INSIGHTS 10 News & Notes 18 OR Today Live Preview 20 Webinar Recap

IN THE OR

WEBINARS Linda Hasluem webinar@mdpublishing.com

22 Suite Talk 25 Market Analysis 26 Product Focus 32 CE Article

OUT OF THE OR

54 Fitness 56 Health 58 Nutrition 60 Recipe 62 IAHCSMM Scrapbook 64 Pinboard 66 Index

8 | OR TODAY | JULY 2018

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

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INDUSTRY INSIGHTS

news & notes

AAAHC Announces New Governance Structure

Innovative Medical Products Improves De Mayo D2 Knee Positioner Innovative Medical Products realized an opportunity for how the De Mayo D2 Knee Positioner could be improved to more effectively and safely position a wider range of patients. IMP saw the need to redesign its original De Mayo Knee Positioner to accommodate the increasing number of obese patients undergoing total knee replacement. To ensure that obese patients experience reduced knee movement during surgery, IMP tested and completely redesigned the D2 carriage with a new locking mechanism that minimizes any knee movement by the patient. The new carriage design, which can be used with existing clamping systems, provides a better gripping capability by holding the positioner’s boot in place more securely than the original version, and the spring-loaded lever on the new carriage allows precise control of flexion, extension, tilt and rotation of the knee during surgery. The De Mayo D2 Knee Positioner also comes with new spring-loaded, fold-down pins for improved ease of use, plus a full line of components and accessories. An additional benefit is the new D2 carriage is designed for easy removal and cleaning. •

10 | OR TODAY | JULY 2018

After nearly 40 years, the AAAHC has enacted a new governance model that transitions the organization to a focused 13-member board of directors. With the new governance structure, the AAAHC is evolving to a model that will better position AAAHC to expand in the health care accreditation industry. The newly appointed 2018-2019 officers are: • Arnaldo Valedon, MD, Board Chair • Ira Cheifetz, DMD, Chair-Elect • Timothy Peterson, MD, Secretary/Treasurer • Kenneth M. Sadler, DDS, MPA, Immediate Past Board Chair “Our governance model will strengthen our ability to best service organizations that are seeking continuous improvement in the quality of patient care delivered in the ambulatory setting,” said Arnaldo Valedon, MD, AAAHC incoming board chair. “The new governance structure will drive the development and implementation of a multi-year strategic plan to better position AAAHC for enhanced growth and to continue its commitment to health care quality through accreditation.” The nine elected non-officers possess a diverse scope of knowledge, and they will continue to focus on engagement and growth opportunities across all specialties. They are: • W. Patrick Davey, MD • Jan Davidson, RN, MSN • Lawrence Kim, MD • Joy Himmel, PsyD • Mark Mandell-Brown, MD • S. Teri McGillis, MD • Dennis Schultz, MD • David Shapiro, MD • Edwin Slade, DMD, JD “This is an historic event in the life of any association,” said Noel M. Adachi, president and chief executive officer. “I am very proud of the action our board has taken to advance AAAHC – a decision which is to the benefit of the organization and in service to our mission. I look forward to working with the new board to help lead our organization as we continue to support high-quality patient care.” •

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INDUSTRY INSIGHTS

news & notes

Action Products Offers Table-length Fluid Management Mat Healthmark Launches Flexible Inspection Scopes Healthmark has announced its launch of the FIS-005SK, the next generation of flexible inspections scopes to its ProSys Optical Inspection product line. The scope is designed with a blue handle that includes a distal tip composed of a light source and camera lens at the end of a 110cm flexible blue shaft, which features white graduation marks. Manufactured for instruments 2.0 mm in diameter or larger, the FIS-005 is a tool to get a visualization of any potentially soiled or damaged item. Starter Kit Software is included, which installs on Windows 7, 8 and 10 PCs which powers the FIS-005 and allows for viewing, recording and documentation. The starter kit includes the scope, USB Drive and case. • For more information, visit www.hmark.com.

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Under the Action umbrella of OR-focused offerings is a line of fluid management absorbent floor mats featuring the DryMax Triple. The patented, three-segment, table-length design offers dual-side absorption, along with maximum coverage and capacity. Its construction absorbs and retains 15 liters of water or 6 liters of NaCl. Clinicians can create a flexible barrier for water intensive areas or wrap the shroud of expensive tables to keep them free from fluids. They can ensure a safe work environment for staff with these “no-hassle, easy clean up, single-use mats,” according to a press release. The release also states that the mats conserve resource consumption, such as cleaning and disposal of linens and hidden labor costs. “Action has always been supportive of the perioperative nurses and these products protect them from slips and falls, decreases clean-up and turn-over times, while saving capital equipment expenses,” says Rick Olin, national OR sales director of Action Products Inc.’s medical products group. •

For more information, visit www.4yourOR.com.

JULY 2018 | OR TODAY |

INDUSTRY INSIGHTS

news & notes

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Encompass Group LLC Names Chief Marketing Officer Encompass Group LLC Chief Executive Officer John Wood has announced that Mark Beran has been named chief marketing officer for Encompass Group LLC. “We are pleased to have Mark join the Encompass team,” said Wood. “He brings more than 20 years of experience in management, domestic and international sales, business development, marketing strategy and product portfolio management. Plus, he’s a savvy guy with a great understanding of the importance of branding in our space. We know he’s going to be a tremendous asset.” Beran was most recently chief commercial officer, senior vice president sales and marketing for TIDI Products LLC in Neehah, Wisconsin. •

ADVANTAGE PLUS Pass-Thru Automated Endoscope Reprocessor Cleared Cantel Medical Corp. has received U.S. Food and Drug Administration (FDA) 510 (k) clearance for its ADVANTAGE PLUS Pass-Thru automated endoscope reprocessor (AER). The ADVANTAGE PLUS Pass-Thru AER has been clinically proven to high-level disinfect the most commonly used endoscopes, including duodenoscopes. The machine also uses a unique pass-through design that supports one-way workflow to ensure the highest quality in infection prevention by reducing the risk of human error, distraction and unintended lapses in cleaning protocols. In addition, the hard-wall separation between dirty and clean reprocessing areas is designed to prevent recontamination of reprocessed endoscopes, ensuring safe, patient-ready endoscopes for every procedure. ADVANTAGE PLUS Pass-Thru AER is the first passthrough AER available in the United States. • For more information, visit https://bit.ly/2ufSyt2.

12 | OR TODAY | JULY 2018

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Case Medical was issued U.S. Patent 9,885,664 for Case Soil, a wash monitoring system that represents the organic soils and bioburden found on surgical instruments that need to be cleaned and prepared for their next use at health care facilities. “When included as part of the cleaning process, the Case Soil indicator provides sterile processing departments an accurate proxy for the cleanliness and safety of the entire load. It may be used for daily monitoring of cleaning effectiveness in automated washers and ultrasonic machines,” according to a news release. “Case Soil provides a consistent, reproducible, ‘go, no-go’ method to visually check the performance of automated washers and ultrasonic cleaners as well as the process parameters of multi-enzymatic cleaners and detergents for reprocessing surgical devices,” Case Medical CEO Marcia Frieze said. “This process is easy to use, and easy to monitor as failures are instantly recognizable.” The indicator contains a mixture of sterile blood components, proteins, fat and carbohydrates typically found on surfaces of used medical devices, dried onto a stainless-steel coupon to simulate bioburden. The coupon – with a defined area for inspection – is placed within a hinged stainless-steel holder, representative of a surgical tray. “Existing wash monitors primarily monitor protein residuals or the effectiveness of alkaline cleaners. However, few, of the currently available indicators monitor pH neutral enzymatic cleaners and the presence of the substrates that they were intended to remove,” according to the news release. “Health care acquired infections have been linked to dirty surgical tools, a major cause of disease transmission from patient to patient. FDA, AAMI and the CDC issued alerts for better infection prevention methods and monitoring for the well-being of patients, staff and the community at large. The medical device industry has previously used test soils that simulate residues commonly found on surgical devices for validation. However, those commonly used in health care facilities are typically composed of blood only or contain no blood products, rather synthetic materials on a plastic substrate. These are not truly representative of the soils or materials they are supposed to simulate.”•

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JULY 2018 | OR TODAY |

INDUSTRY INSIGHTS

news & notes

IMRIS, Hill-Rom Launch New Magnetic Resonance Neurosurgical Table IMRIS and Hill-Rom have commercially launched a new multifunctional operating room table specifically designed for the IMRIS Surgical Theatre. The announcement was made during the American Academy of Neurological Surgeons (AANS) Annual Scientific Meeting in New Orleans. Developed in close collaboration with clinicians, designers and engineers from IMRIS and Hill-Rom Surgical Solution’s Trumpf Medical, the table integrates a new IMRIS magnetic resonance (MR) neurosurgical tabletop with Hill-Rom’s TruSystem 7500 OR Table platform. This innovation was developed in response to requests from neurosurgeons for an ergonomic, MRI-conditional surgical table, and the needs of hospital administration to maximize utilization of the IMRIS Surgical Theatre. The new MR Neurosurgical Tabletop is specifically engineered for cranial and upper-cervical procedures performed using intraoperative workflows within the MRI environment. The Hill-Rom TruSystem 7500 OR Table platform integrates with the IMRIS Head Fixation portfolio, and has a segmented design

for optimal patient positioning. In addition, the multifunctional design of the TruSystem 7500 OR Table platform offers the flexibility of a wide range of interchangeable tabletops, expanding the surgical suite’s capabilities for a broad range of procedures and multi-disciplinary uses with one column. The new MR Neurosurgical Table will be a component of the IMRIS Surgical Theatre – a suite of intraoperative imaging technologies enabling neurosurgeons to see critical anatomical detail during surgery without moving the patient from the operating table. The IMRIS Surgical Theatre features a moving ceiling-mounted iMRI and iCT solution that delivers advanced imaging in the surgical environment. •

InterSystems and Olympus Introduce New Endoscopy Integration Capabilities Olympus is enhancing the capabilities of its Knowledge Exchange System (KE) offering through the implementation of InterSystems HealthShare. Users of the KE HL7 module will now be able to share images taken during endoscopy procedures across health care systems with the click of a mouse, improving care coordination and quality control across the health care ecosystem. Removing the need to have physical media to share patient health data saves time and gives physicians access to the full patient picture sooner. When integrated with HealthShare, Olympus KE simplifies the process of sharing data, and improves the quality of patient care. There are also fewer patient privacy concerns, as the information is contained in the data archive and is not physically transported through the health care facility. “We’re entering the ‘Golden Age of Interoperability,’ where the solutions offered by technology providers such as Olympus and InterSystems allow hospitals to take full advantage of the promise of information sharing,” said Don Woodlock, vice president of HealthShare, InterSystems. “Together, both organizations are bringing next-generation care delivery to the forefront.” •

14 | OR TODAY | JULY 2018

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When Quality Matters

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TSO3 Obtains New Clearance for the STERIZONE VP4 Sterilizer TSO3 Inc. has received clearance from U.S. regulators for its most recent 510(k) submission for the terminal sterilization of multi-channeled flexible endoscopes using the Company’s STERIZONE VP4 Sterilizer. The new clearance for the STERIZONE VP4 Sterilizer will allow a hospital to terminally sterilize gastrointestinal endoscopes that have dimensions within the cleared intended use. The technical characteristics of the devices that could fall within this cleared intended use statement include certain colonoscopes, duodenoscopes and gastroscopes which have 4 or less channels and up to 3.5 meters in length with internal diameters of 1.2 mm or greater. “In 2009, TSO3 set itself on a path to bring about lasting and meaningful change to health care sterilization practices. The recent and highly publicized outbreaks associated with use of flexible endoscopes have highlighted the need for innovative approaches to reprocessing of these complex devices. Today, TSO3 is proud to announce that this clearance enables a significant step forward in achieving this change and our goal to provide a sterile instrument for every procedure. This advancement required significant effort and innovation both in technology and reprocessing practices. I am proud of the TSO3 team who made this possible. This clearance allows TSO3 to partner with health care systems to facilitate the terminal sterilization of these devices,” stated TSO3 President and CEO R.M. “Ric” Rumble. •

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INDUSTRY INSIGHTS

news & notes

Spok, Bernoulli Health Partner to Elevate Clinical Alarm Management Spok Inc. has announced an alliance with Bernoulli Health, the developer of the advanced Bernoulli One clinical surveillance, medical device integration (MDI), and real-time data analytics platform. This partnership, Spok Alarm Surveillance powered by Bernoulli, is designed to elevate clinical alarm management by capturing and evaluating real-time patient data and alarms from multiple clinical systems and delivering actionable alerts to the right caregiver for swift response. “Our partnership with Bernoulli enhances Spok’s clinical alerting capabilities and positions us as the only clinical communication and collaboration vendor able to connect to all medical devices,” said Vincent D. Kelly, chief executive officer of Spok Inc. “We have effectively combined Spok’s world-class health care communication platform with Bernoulli’s state-of-the-art device data and alarm analysis, consolidation, and waveforms, which uniquely benefits our hospital customers and, ultimately, their patients.” Spok Alarm Surveillance powered by Bernoulli is designed to create benefits for hospitals, including: • Reduce alarm fatigue: Spok Alarm Surveillance correlates and combines valid alarms from clinical systems, such as nurse call and patient monitoring, and delivers the alert to the right clinician’s preferred mobile device. The technology recognizes patterns and can correlate patient data and alarms from multiple sources into one clinically relevant alarm and, importantly, suppress non-actionable alarms. Prioritizing clinical alarms and routing them to the

right place helps ensure providers are alerted to respond to critical alarms and remain uninterrupted for alarms that do not require their immediate attention. • View real-time waveforms: Through its expanded integration with Bernoulli, Spok can deliver greater clinical context to providers’ mobile devices by sending real-time patient vital signs and waveforms, enabling caregivers to make accurate clinical decisions and act on them quickly. • Integrate with the EHR and medical devices: Bernoulli technology provides extensive MDI and can support integrated delivery of device data to leading EHR systems. A plug-and-play solution, Bernoulli integrates with freestanding and networked patient care devices and clinical systems including ventilators, pulse oximeters and capnography monitors. “Spok Alarm Surveillance powered by Bernoulli provides care teams with the details they need for fast decision-making with the right information about important clinical events right at their fingertips,” said Janet Dillione, chief executive officer of Bernoulli Health. “Together, we’re helping hospitals address all facets of alarm surveillance and reduction, resulting in improved patient safety across the continuum of care.” •

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INDUSTRY INSIGHTS ORTL

SURGICAL CONFERENCE

AUGUST 26-28

OR Today Live Plans to Rock Music City NASHVILLE, TN

By John Wallace, Editor onfucius is credited with saying “Choose a job you love, and you will never have to work a day in your life.” OR Today feels the same way about continuing education. If you are going to attend a conference, you might as well enjoy yourself, and that is why the magazine holds the annual OR Today Live Surgical Conference.

In 2018, OR Today Live is headed to Music City. The conference runs from August 26 to August 28 when perioperative nurses and SPD professionals from across the country will gather to discover new opportunities, broaden their knowledge and exchange ideas. Whether you need an extra boost of motivation in your career or are looking to earn CE credits – OR Today Live is the conference for you. The annual event brings together world-class speakers in an environment designed to motivate and empower perioperative professionals. Attendees can earn up to 11 CEUs, but that is just one reason to attend. Additional benefits of attendance include a CCI CSSM prep course, super sessions, signature networking events, vendor exhibit hall and a Music City rooftop party featuring live music! “In preparation for the 2018 conference, we compiled a team of industry experts to consult on the education being offered. The chairman of the educational advisory board, David Taylor,

18 | OR TODAY | JULY 2018

MSN, RN, CNOR, brings not only the knowledge gained from over 30 years in the perioperative field, but also the experience from helping plan and coordinate his local AORN Chapter meeting in San Antonio for several years,” Vice President Kristin Leavoy said. “Weston ‘Hank’ Balch is a sterile processing department (SPD) guru! He has written over 100 articles on sterile processing and even hosts a weekly podcast to discuss the latest in industry topics. Pair Hank with Elbridge ‘Eb’ Merritt and the expertise he brings from his military and perioperative background and you have an unstoppable sterile processing duo!” Dawn Whiteside, director of education at the Competency & Credentialing Institute (CCI) has been invaluable in directing the education so that it can help attendees earn continuing education credit and Chris Bolton, clinical educator at St. Rose Dominica Hos-

pital, and Giselle Peters, clinical nurse manager at Sahara Surgery Center, have helped to create a balance of education attractive to professionals from all walks of health care. “Overall, attendees should walk away from the Nashville event with a feeling of accomplishment in earning the continuing education credits they need to renew/maintain their license, knowledge on the latest tools and resources available to them from speaking with the vendors in the exhibit hall, and a renewed passion in their field from talking and networking with their peers in the industry,” Leavoy added. OR Today Live is a well respected conference with rave reviews “I enjoyed the entire conference. It was nice to hear that the problems of my facility are not unique,” Carmen B., a director of surgical services, said after a previous OR Today Live. “High caliber of speakers, intimate WWW.ORTODAY.COM

INDUSTRY INSIGHTS

ORTL

learning sessions,” Director of Clinical Services Elizabeth C. said. “Learned more than I thought I would and met some amazing people too. It was very affordable and exceeded my expectations,” Jenifer N., RN, said. When asked about a previous conference Perioperative Educator Becky S. said, “This was a wonderful experience! Well run with very pertinent, and timely educational topics.” The 2018 version of OR Today Live looks to exceed the high expectations attendees and vendors have after participating in previous years. Pre-conference activities begin on Saturday, August 25 with sign-in and registration as well as the CCI CSSM Exam Prep Course. The purpose of CCI’s CSSM Exam Prep Course is to develop the knowledge and skills required to prepare for the CSSM certification exam. This course focuses on the seven subject areas covered in the CSSM exam including strategic management, professionalism, human resource management, operational management, leadership, communication and financial management. Attendees will be eligible for 12 contact hours upon successful completion of the course, including participation and completion of post-course evaluations. Participants in the course will be provided with electronic copies of CCI’s CSSM Exam Prep book and presentation slides. Participation in this course is not required to apply for the CSSM certification exam. The cost of the two-day CCI CSSM Exam Prep Course is $225. On Sunday, August 26 OR Today Live shifts into a higher gear with registration and exhibitor set up followed by three CE Super Sessions from 1 to 4 p.m. On Sunday evening, a Welcome Reception will be held in the exhibit hall from 5 to 7 p.m. The Welcome Reception is an outstanding networking opportunity as leaders reconnect and make new professional acquaintances in a relaxed setting with delicious food and beverages. OR Today Live continues on Monday with more educational sessions and a complimentary lunch in the exhibit hall followed by the afternoon’s educational session. After a break to recharge, OR Today Live delivers a signature Nashville event with live music at a rooftop party sponsored by AIV. The final day of OR Today Live 2018 features more top-notch educational offerings including a Keynote Luncheon Address by Omnicell Vice President of Healthcare WWW.ORTODAY.COM

Policy Ken Perez. In his presentation, Perez will cover the most salient health policy developments during the first year and a half of the Trump administration and forecast policy changes for the next few years. Additional information about OR Today Live, including registration and hotel information, is available online at ORTodayLive.com.

2018

JULY 2018 | OR TODAY |

INDUSTRY INSIGHTS webinar

Webinars Deliver ‘Innovative Information’ Staff report he recent OR Today webinar sponsored by BD provided a unique perspective on a common issue.

“Pre-Operative Surgical Hair Removal: An Innovative Operating Room Technology For The 21st Century” was presented by Dr. Charles Edmiston Jr., PhD, SM (ASCP), CIC (CBIC), FIDSA, FSHEA, FAPIC. In his presentation, Edmiston reviewed the clinical rationale for surgical clipping, guidelines, the association between HAIs and types of hair removal, timing of surgical clipping and issues associated with surgical hair cleanup. He also discussed the rationale and support for vacuum-assisted surgical clipping. Almost 300 people registered for the webinar with 118 logging in to watch the live presentation. The webinar was well received based on a 4.1 rating on a 5-point scale and positive feedback via a post-webinar survey. “Fabulous and informative webinar,” said M. Pettit, RN. “Great and relevant topic! Very knowledgeable speaker with great slides,” Surgical Technician B. Wilmeth said. “The webinar provided published evidence of the problem as well as the resulting injury and bioburden of various interventions,” said J. Sarmanian, MSL. “It was fantastic and informative. Instructor was very knowledgeable. It helps me keep up with the ever-changing

20 | OR TODAY | JULY 2018

environment. Thanks,” said E. Anderson, RN. “Excellent webinar ... great information that is relevant to our facility,” Specialist One Day Surgery Director R. Cuda said. “The webinar helped put current clipping standards into historical perspective and bolster the importance of skin antiseptic washing,” Manager of Perioperative Services D. Sayer said. “Very good webinar pointing out the risks of incorrectly clipping patients and the use of the clip vac in the OR setting,” Infection Preventionist L. Hoogestraat, RN, said. “Upon completion of the surgical site clipping webinar I feel confident that I can speak to my colleagues about the validity of improving our practice when it comes to clipping patients prior to surgery. I learned a lot of new information about history and infection control that I am very happy to share to encourage others to be vigilant in their own practice improvement,” Senior Surgical Technologist K. Appleby said. “This was innovative information that I will gladly share with fellow OR colleagues. This appears to be best practice for the patient,” said T. Thomas, RN. “Great information not only on hair removal but also on the ClipVac! Great webinar for anyone who is involved in hair clipping,” Administrator L. Malinak, RN, said.

SSI Webinar Sets Record Highs The recent OR Today webinar presented by Melanie Burton, BSN, RN, CNOR, MLSO, Independent Consultant/Nurse Educator shared a wealth of knowledge. In her presentation “Strategies for Reduction of Surgical Site Infections,” she shared valuable insights regarding best practice in SSI prevention. Among the topics discussed were: • How to identify intrinsic factors that contribute to SSIs • The significance of SSIs • How personnel factors contribute to SSIs • How environmental factors contribute to SSIs • The interventions that protect the integrity of the sterile field • The criteria of a back table cover The webinar set a new high for registration and attendance in 2018. Burton’s presentation drew 260 individual registrations and 162 people attended the live webinar. A recording of the webinar is also available online and continues to be viewed by health care professionals. Webinar attendees shared their thoughts regarding the presentation in a post-webinar survey. Comments included high praise for the quality and relevance of information shared. “Great webinar! The presenter was very knowledgeable about the challenges we face daily in the OR with real solutions to our concerns,” Director of Perioperative Services C. Tino said. WWW.ORTODAY.COM

“I just started my new role as infection preventionist at my facility. This is my first webinar and I really appreciated all the relevant information,” wrote M. Gavilanez, OR Circulator & Infection Preventionist. “I felt this was an excellent webinar because it directly relates to what we do at the VA, for the veterans themselves. Myself, I am a veteran and I am very proud to work in the operating room, and work with some very excellent RNs,” said M. Johnson, Certified Surgical Technician. “This was an amazing webinar! It covered every aspect of preventing a SSI from pre-admission to discharge, which is what I try to do in my staff education. I really thought that including the prep solutions, irrigation and closure techniques were great, because I haven’t really ever thought about that,” Infection Preventionist S. White said. “OR Today’s Webinar series is extremely educational and current with what is happening in operating rooms today. I always walk away from these webinars having learned something new which is fantastic,” shared Clinical Nurse Educator J. Mattern. “I love OR Today webinars and was an OR nurse for 17 years. It makes me want to keep up with new updates and recommendations to reduce SSI,” Infection Control Specialist N. Brunelle said. “More importantly, as an infection control nurse, I am focused on high-level disinfectant as well as sterilization. Thank you so much for having me connected.” “The speakers have excellent credentials and for the most part, they all keep to a tight time frame on the presentation. Keep it moving, relevant, and on point. Melanie especially did a great job today with her bullet points. Not too lengthy, so as not to make the slides busy, but all in all just really well put together. Great information on sterile field procedures,” said M. Garrobo, self-employed contractor. “Very good webinar, I am a numbers girl and seeing the facts and statistical data helps me connect the dots, especially if I learn about cost savings,” said A. Reents, Manager of Surgery. “This was my first webinar from OR Today. It was very interesting and exactly what needed to be covered for infection control,” said M. Myers, Clinical Coordinator. “This webinar was informative and interactive, combining evidenced-based practice solutions with a history of vast knowledge of the OR in relation to today’s SSI issues. Great information to bring back to my multidisciplinary team of providers,” said E. Lloyd, Patient Care Manager. “OR Today’s webinar series is an excellent way to keep up with changing topics. And, to earn free CE! The listener participation portion is also great as it provides answers to questions you’ve thought of but never asked. It gives insights to all aspects of the topics,” said E. Anderson, RN. For more information about OR Today webinars, visit ORToday.

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IN THE OR suite talk

Suite Talk

Conversations from OR Nation’s Listserv THESE POSTS ARE FROM OR NATION’S LISTSERV JOIN THE CONVERSATION, VISIT WWW.THEORNATION.COM

Q Q 22 | OR TODAY | JULY 2018

ROOM TURNOVER

I’ve been to one facility where the nurse was in charge of changing out the Anesthesia machine tubing and setting up the A-Line if needed. At another facility, the nurses were not allowed to help with turnover and weren’t allowed in the room until housekeeping personnel were finished. I didn’t know this and tried to help clean. I was reported to the housekeeping union for “trying to take their job.”

A: Union hospitals are different. Talk to your manager and also look at your job description. Is there anything listed regarding “cleaning, etc?” You may be able to perform some “nursing” tasks that cross over to environmental.

A: In our OR, nurses and techs are strongly encouraged to participate in turnover. As the OR

manager, I own the environment and the cleaning crew reports to me. I think everyone should participate when possible. It does show respect and it is teamwork.

A: All our staff participate in turnover.

DISPOSABLE BOUFFANT HAT

One recent study on head coverings (disposable bouffant or skullcap, cloth cap), identified that the commonly available disposable bouffant hat is the least effective barrier to transmission of particles. Does your facility still allow the use of a disposable bouffant hat?

A: That is all we use and we got rid of the skullcap. We allow cloth caps with the bouffant over it.

ASK YOUR QUESTION AT THEORNATION.COM

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SPEAKER SPOTLIGHT My wife and I are huge fans of the German rock band the Scorpions! travel all over so we can see them live. We have seen them several times in San Antonio, Texas. When they announced their 50th Anniversary Tour we made it a point to see them as many times as possible. We traveled to New York in 2015 and saw them at the Barclays Center in Brooklyn. We then traveled to Las Vegas in the spring of 2016 to see them perform. At this show we purchased a DVD of the New York show and discovered we are now and forever a part of Scorpions rock history. If you watch the video you will see my wife and I rocking out near the stage. We then saw them in the summer of 2016 at the River City Rock Fest in San Antonio. After this show, we decided to travel to Europe and see the band and revisit the continent we grew so fond of after living there in the 1980s. In November of 2016 our family traveled to Germany and spent 10 days traveling the southern portion of the country. We showed our children all the places we lived and visited, including the birth place of their Oma (grandmother). We were in a different city each night until we arrived back at Frankfurt and prepared for the Scorpions concert. It was truly a great experience. •

SURGICAL CONFERENCE

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BOOTH 101

IN THE OR

market analysis

Temperature Management Market Heats Up Staff report he global patient temperature management market is anticipated to reach a value of $4.6 billion by 2025, according to a new report by Grand View Research Inc.

An increase in the number of surgeries is anticipated to accelerate the demand for temperature management devices, according to the report. “With growing prevalence of cardiac arrest and other chronic cardiac diseases, there is a rising number of surgeries being undertaken. Hence, this raises the need for patient temperature management, in order to avoid the adverse effects on brain,” according to Grand View Research. “Patient warming systems are also used for cancer patients as adjuncts with chemotherapy and radiation therapy for more effective results. Moreover, in neonatal care, newborns are likely to experience temperature fluctuations and hence, they are kept in incubators to maintain their normal body temperature. As a result, the aforementioned WWW.ORTODAY.COM

factors are giving rise to high demand for temperature monitoring devices.” Advancements in technology have also enhanced the product portfolio of temperature management devices. The blood and fluid temperature management systems have evolved with new technology, facilitating circulation of warm or cool saline with the help of a catheter to the patient’s body. These and other technological advancements have led to market growth. Grand View Research reports that patient warming systems held the largest market share in 2016 due to high usage of these devices before surgery, when provided with general anesthesia. However, the report indicates that patient cooling systems are anticipated to exhibit a lucrative compound annual growth rate over the forecast period due to the introduction of new products like cooling caps and blood and fluid cooling systems. According to a market research report from MarketsandMarkets, the temperature management market is expected to reach $2.72 billion by 2022 from an estimated $2.40

billion in 2017, at a CAGR of 2.5 percent. “The key factors driving the growth of this market include increase in the development of technologically advanced intravascular systems, large number of awareness campaigns/conferences for physicians, growth in research funding, and incidence of chronic conditions are driving the growth of the temperature management market,” according to MarketsandMarkets. “However, the high cost of invasive temperature management systems and product recalls are restraining the growth of this market.” By product, the patient warming systems segment accounted for the largest share of the market in 2017, according to MarketsandMarkets. MarketsandMarkets list of key players in the global temperature management market include 3M Company, Smiths Medical, Medtronic plc, C.R. Bard Inc., Cincinnati Sub-Zero Products Inc., Geratherm Medical AG, Stryker Corporation, ZOLL Medical Corporation and GE Healthcare.

JULY 2018 | OR TODAY |

IN THE OR

product focus

Bair Hugger Temperature Monitoring System To help improve patient outcomes, clinicians can effectively monitor and manage patient temperature with the 3M Bair Hugger Temperature Monitoring System. It’s a noninvasive, consistent and easy-to-use system that accurately and continuously measures core body temperature throughout the perioperative journey with a disposable, single-use sensor. The sensor, which is placed on the patient’s forehead before surgery, helps reduce temperature variability associated with using multiple device types and individual clinician technique. The control unit, which can be connected to the patient’s monitor, displays core body temperature continuously and trends two hours of temperature data. The system is intended for use on both adult and pediatric patients.•

26 | OR TODAY | JULY 2018

Attune Medical EnsoETM

Attune Medical’s EnsoETM is designed to modulate and control patient temperature through a single-use fully enclosed system that is inserted into the esophagus. Two lumens attach to an external heat exchange unit while a third, independent, lumen simultaneously allows gastric decompression, drainage or the administration of enteral fluids such as tube feeds and medications. The EnsoETM can be rapidly placed by most trained health care professionals, in similar fashion to a standard gastric tube, and can be used to control patient temperature in the operating room, recovery room, emergency room and/ or intensive care unit. No other products on the market are cleared for use in the esophageal environment for whole-body temperature modulation. •

WWW.ORTODAY.COM

C Change Surgical SurgiSLUSH

SurgiSLUSH provides the smartest, safest and most economical way to make surgical slush. Sterile surgical slush is used to topically cool organs during complex procedures to reduce tissue damage and allow surgeons more time to operate. Users can position SurgiSLUSH inside or outside of procedure rooms and serve multiple rooms from one machine. SurgiSLUSH creates perfectly smooth slush every time using secure, reusable, hydrophobic containers. SurgiSLUSH creates perfect slush in 35-45 minutes then automatically switches to Maintain Mode to keep slush smooth and clump-free until needed. SurgiSLUSH is ideal for hybrid procedure rooms. The new Protective Container System provides a double-container assembly that assures sterility, simplifies sterile field dispensing and protects against tampering or unintended contamination. Erase the need for slush drapes, save valuable sterile field space and eliminate a potential source of disrupted airflows near the patient. Gain efficiency and free your staff with the newest, smartest way to make and use perfect surgical slush. â&#x20AC;˘

IN THE OR

product focus

Augustine Surgical Inc Hotdog Patient Warming

HotDog is the only system that warms above and below the patient simultaneously resulting in a uniquely versatile and effective temperature management solution. HotDog is ideal for solving hypothermia challenges in difficult procedures like orthopedics, cardiac, plastics and major abdominal (including transplants). Hypothermia rates are also high in robotics due to the minimal surface area to warm. HotDog improves temperature results in robotics by combining blankets and underbody warming with WaffleGrip, an innovative safety positioning pad that prevents the patient from sliding during steep Trendelenburg. The unique waffle pattern evenly disperses grip on patient, reducing localized shearing forces while increasing mechanical hold and friction. WaffleGrip is used in conjunction with a HotDog underbody warming mattress. â&#x20AC;˘

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JULY 2018 | OR TODAY |

IN THE OR

product focus

Encompass Group LLC

Thermoflect Heat Reflective Technology Products Thermoflect Heat Reflective Technology products from Encompass Group LLC are applied preoperatively, begin working immediately and follow the patient throughout the perioperative journey to maintain normothermia and help prevent hypothermia. Data collected from 65 evidence-based practice trials demonstrated the following improvements when incorporating Thermoflect Heat Reflective Technology products compared to standard care: 28 percent reduction in hypothermia upon admission to PACU, 17 percent reduction in perioperative heat loss for enhanced comfort and 30-75 percent savings compared to other protocols. • For more information, visit www.thermoflect.com.

GE Healthcare

Giraffe OmniBed Carestation In the womb, the infant’s body temperature is effortlessly regulated at about half a degree Celsius above that of the mother’s. Once the baby leaves the womb, its temperature falls to within a normal range, but a premature infant’s temperature can fall lower and will require immediate action by the neonatal clinical team. In fact, for every degree below 36 degrees Celsius, the baby’s survival rate drops by 28 percent.1, 2, 3, 4 The Giraffe OmniBed Carestation is designed to address the changing and complex demands of the NICU by utilizing advanced technology to provide supportive, family-centered care solutions, consistently controlled thermal environments, warmth during transport when paired with the Giraffe Shuttle, improved patient access and visibility, and reliable clinical performance. • 1- Miller SS, Gould JB, and Lee HC. Hypothermia in very low birthweight infant: Incidence and risk factors. Pediatric Academic Society Meeting, 5/6/2007, E-PAS2007:616280.31. 2- Bhatt DH, Carlos CG, Parikh AN, White R, Seri I, and Ramanathan R. Prevalence of transitional hypothermia in newborn infants on admission to newborn intensive care units. Pediatric Academic Society Meeting, 5/7/2007, E-PAS2007:617933.23. 3- Barber N, DeCristofaro JD, and Chen J. Hypothermia and re-warming in extremely low birthweight infants and subsequent clinical consequences. Pediatric Academic Society Meeting, May 2006, EPAS2006: 59:365. 4- Laptook AR, Salhab W, Bhaskar B and Neonatal Research Network. Admission temperature of low birthweight infants: Predictors and associated

28 | OR TODAY | JULY 2018

WWW.ORTODAY.COM

IN THE OR

product focus

MAC Medical

D-Series Blanket and Fluid Warming Cabinets MAC Medical’s D-Series (Data Logging) Blanket and Fluid Warming Cabinets are userfriendly temperature recording devices. They are equipped with independent, digitally controlled heating chambers that offer actual temperature and set point displays. Simple plug-and-play data requires no additional software. These warming cabinets are available in single, dual, and triple chamber units and have many optional features including glass doors, seismic braces, roll out baskets, and sloped tops, just to name a few. With its sleek new appearance, the D-Series is sure to enhance and compliment your facility. • For more information, visit www.macmedical.com.

ZOLL

Thermogard XP (TGXP) ZOLL’s Thermogard XP (TGXP) intravascular temperature management system provides health care professionals with the power and control needed to rapidly, safely and accurately manage the core body temperature of critically ill or surgical patients with warming and cooling applications. It offers superior clinical efficiency in reaching and maintaining target temperature 100 percent of the time,1-6 while decreasing demands on nursing staff and reducing nursing workload by 74 percent.7 TGXP offers a variety of catheter options depending upon the specific patient needs. • 1 Idris AH, et al. Circulation. 2012; 126:LBBS-22813-AHA. 2 Hoedemaekers CW, et al. Critical Care. 2007;11:R91.

3 Knapik P, et al. Kardiologia Polska. 2011;69(11):1157-1163. 4 Mayer SA, et al. Critical Care Medicine. 2004;(3)212:2508-2515. 5 Diringer MN, et al. Critical Care Medicine. 2004;(32)2:559-564. 6 Heard KJ, et al. Resuscitation. 2010;81:9-14. 7 Horn CM, et al. Journal of Neurointerventional Surgery. 2014 Mar;6(2):91-95

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JULY 2018 | OR TODAY |

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Dräger Fabius Tiro

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• High performance ventilation w/all major modes • CLIC Absorber systems • Intelligent safety features for enhanced patient protection • Standardized Dräger user interface for easy and intuitive operation

Mindray A5 • 15” Touchscreen • VCV, PCV-VG, PS, SIMV-VC, and SIMV-PC Ventilation Modes • Heated Absorber • Data output compliant with most EMR systems

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GE Datex-Ohmeda S5 ADU Carestation • Several configurations available. • Includes 12” Screens • Complete S5 Monitoring System • Ohmeda ADU certified technician in-house

GE Avance • Complete patient monitoring capabilities: respiratory gas, hemodynamic and adequacy of anesthesia. • Our state of the art electronic gas mixer with pneumatic back-up control. • Advanced Breathing System (ABS) • All modes of ventilation available.

Dräger Fabius GS and Fabius GS Premium

GE Aespire 7100/7900

• Fully upgradeable to add new technologies as your needs change.

• Includes Ventilator modes: Pressure Support, SIMV, Volume and Pressure Control.

• 7100 Ventilator features volume and pressure control modes with Electronic PEEP.

• Can be integrated with your hospital information system.

• Heated Absorber

• Pressure waveform for visual reference on a breath-by-breath basis

• Low circuit volume contributes to a fast response well suited for low flow cases - 2.7 L in vent mode, 1.2L in manual mode.

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GE Aisys • VC, PC, PS w/Apnea Backup, SIMV Volume and Pressure, Electronic PEEP, PCV-VG, PCV-PG.

• Color display

• 7900 Smartvent includes PSV Pro SW

• Advanced Breathing System (ABS)

IN THE OR

continuing education

IN THE OR

CE691

Social Media: Give Your Career a Boost

continuing education

Kathleen Pagana, PhD, RN or many of us, social media is a fun way to stay in touch with friends and family. We share photos and stories with people across town and around the world. But we need to be cautious as we engage in social media. It can affect our careers in ways we never would have imagined. Content taken in the wrong context can damage our professional reputation. This module helps nurses learn how to use social media, including LinkedIn, Facebook, Twitter, and blogs to boost their careers. It also provides tips to avoid social network “career busters” and compares different forms of social media to help nurses choose the site that best meets their needs.

LinkedIn LinkedIn is a professional contact database with more than 500 million users in more than 200 countries and territories. It is growing rapidly with professionals joining at a rate of more than two new members per second. More than 40 million students and recent college graduates use LinkedIn.1 Members create a profile and link their profiles with professionals who may be helpful to have in their “career circle.” For example, suppose you’re at a meeting and strike up a conversation with a nurse from Texas. Later, on the way home, you think that one day you might like to live in Texas. The nurse you met seemed friendly and knowledgeable. You could use LinkedIn to connect with that nurse. You can search for her profile, find out her credentials and background, and send her an invitation to join your network. If she responds, as most people do, you’ll have a connection that may help you if you ever move to Texas. WWW.ORTODAY.COM

The first step to sending invitations to connect on LinkedIn is to be sure your profile is presented so that it highlights your interests, knowledge, expertise, and involvement in the community. LinkedIn guides you through this process. It’s not that hard to do, but it does take some time. Typically, your profile should include current and past employment, education, awards and recognitions, and websites if you have written any articles, books, or blogs. Adding a photo, preferably a headshot, helps others to remember who you are and shows that you made the effort to make your profile complete. If you don’t add a picture, you’ll have a nonspecific silhouette (not very enticing). It’s a good idea to think of your “professional elevator speech” about who you are and what you do and add it as a summary paragraph. Include résumé keywords and skills in your profile so you are easy to find. Recruiters search LinkedIn’s database for people with needed skill sets and experience. If you can get recommendations from people you have worked with, that carries a lot of weight. When soliciting recommendations, think about what would best support your career. Ask the person to comment on something specific, such as your leadership skills, your passion for patient care, or your mentoring ability. Based on suggestions and recommendations from your network, you can use LinkedIn to find business opportunities and jobs. A key advantage of LinkedIn is being able to search, find, and reach people who can help you achieve your professional goals. There are three levels of connections on LinkedIn, and they are based on how well you know others.2 For example: • Primary, or first-degree connections, are members you connect with directly. These people either accepted your invitation to connect or you accepted their invitation to connect.

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.

Goal and objectives The goal of this continuing education program is to inform nurses about how to use social media to enhance their careers. After studying the information presented here, you’ll be able to: • Describe how social media can have a positive impact on your career • Identify ways to avoid career damage with social media • Compare several types of social media

JULY 2018 | OR TODAY |

IN THE OR

continuing education They can be viewed and contacted at any time. • Second-degree connections are members who connect to your first-degree connections. • Third-degree connections are members who connect to your second-degree connections. • Other connections continue as such. The size of your network increases exponentially based on the connections of your connections. You can use these connections to facilitate a desired introduction or connection for you. Connecting with someone via a “warm” connection is easier than a “cold” call. For example, suppose you are writing a book and want to get an endorsement from a well-known nursing author. One of your connections, “Jim,” may be connected to someone who is connected to the author. You might ask “Jim” to arrange an introduction. As another example, you may be looking locally for nurse practitioner opportunities and want recommendations for good places to consider. Someone in your network may even alert you to a potential position before it is even posted. LinkedIn can connect the right person with the right contact at the right time. LinkedIn can also help you connect with people you worked with in the past. For example, when a young man moved from Chicago to the Philadelphia area, he updated his LinkedIn profile with his new address. As a result, several members contacted him to discuss his new position as nursing director in an ED and to offer help. Without LinkedIn, he would not have reconnected with these contacts. These contacts also linked him to other people in the area to begin the networking process. You can search for jobs on LinkedIn, plus you can see who you know at companies where you are interested in working. You can use the job search section of LinkedIn by keywords; location; experience level; date posted; title; company; job function (example, nurse manager); and industry (example, health-

34 | OR TODAY | JULY 2018

care). Jobs that match your search terms will be returned in two clickable tabs to either LinkedIn jobs or web postings. In addition, LinkedIn will display those in your network who can help you with the position. Later, you can expand or refine your query and make changes without losing the information you have already entered. If you see a position that would be a perfect fit for one of your connections, you can pass it on through LinkedIn, Facebook, Google Plus, or Twitter. People appreciate these alerts and will try to help you when they can. According to AMN Healthcare’s 2013 survey, job searching on social media sites increased significantly from 2010 and now reaches 41% of clinicians.3 Just as LinkedIn can help you get a job, it can

have otherwise missed. According to one job-search expert, being a “missing person” on social media means you are out of touch in the 21st century. Seventy-nine percent of employers in the U.S. check out applicants on social media before considering them for a job. People who are not on social media lose job opportunities because they lack understanding of how the business world works today.5 Employers can find out where you worked in the past and who you worked for. They may have contacts that worked at the same place and be able to get inside information about your professionalism and job expertise. Today, one thing is clear: First impressions begin long before the interview process.

Do’s and Don’ts for Social Networking2 DO Evaluate your profile and postings Google your name and see what results occur Have a unique password that is different than your e-mail password

DON’T Use public information (e.g., birthdays, anniversaries, phone numbers) for a password Post anything that you would not want a boss or potential employer to read Post daily schedules, home addresses, hotel room numbers, and social commitments

Post your accomplishments and interests

Post incriminating videos or photos

Tell your friends not to post your photos or videos without permission

Share too much personal information

Use your privacy settings

Trust all users on networking sites

help employers find employees and get background information on them. Employers can get referrals from employees by asking them to broadcast positions on their networks. Referrals from employees are valued because they usually have a higher success rate, sometimes resulting in an employee referral bonus. Many companies use LinkedIn to find “passive” candidates, people who are not currently seeking new positions.4 You may not even be thinking of changing jobs and get a great job opportunity that you would

Facebook Facebook is another site that influences first impressions. Facebook is the most popular social networking site, claiming more than 1.94 billion monthly active users and 1.28 billion average daily users.6 People use Facebook to stay connected to friends and family and to share and express what matters to them. The main function of Facebook is sharing information between “friends,” contacts who have agreed to communicate and permit some level of access to personal information. WWW.ORTODAY.COM

IN THE OR

continuing education

For the most part, Facebook isn’t used for business and professional networking (although occasionally, you might see topics like: What do you do when your boss wants to be your Facebook friend? addressed in the media). You should control what information you share and with whom. It’s best to share with only family and friends. Privacy settings are essential. If your profile is public, anyone can find you and view your profile, pictures, and posts. However, it is still a good idea to make sure nothing in your Facebook profile would be a detriment to your career development. What if a boss or recruiter found inappropriate photos, videos, or posts? This is important professionally because Facebook is a popular site for employers to screen job applicants. In many situations, privacy of employees is threatened by employers asking them for log-in information on password-protected social media accounts. Maryland is the first state to ban employers from collecting this information. Similar laws are pending in other states.7 Employees need to be aware of risks of posting information on social networking sites such as Facebook. Most employers have policies about using social media in and outside of the workplace. As an example, most policies address the following issues:8 • Maintaining the organization’s integrity and reputation • Protecting patient privacy • Engaging in social media activities during work time • Holding employees personally accountable for everything they post • Subjecting policy violators to disciplinary measure, including termination Many nurses have been fired for violating Health Insurance Portability and Accountability Act (HIPAA) guidelines with social media. For example, a nurse practitioner who worked at a health clinic was fired for criticizing its community and patients. Other nurses have lost their jobs for posting pictures and discussing WWW.ORTODAY.COM

patients. Of course, nurses aren’t the only ones losing jobs because of misuse of social media. People have been fired for posting details of jury duty, complaining about customers, describing airplane cabins full of cockroaches, and posting controversial photos.8 Violations can be avoided by practicing with integrity and respecting patient confidentially. Remember that anything you post can be disseminated anywhere and come back to haunt you at any time. You should also check your Facebook wall frequently to see what others have posted or shared there. You may have to “clean up” your wall by deleting some posts. Careless use of social media can put your job and future success in peril. Don’t let your use of social media be a career buster; stop and think before you post. If you have doubts about posting anything, don’t post it. It’s best to follow the main rule of social networking: Assume there is no privacy. While a lot of good comes from social networking, Facebook can be a place where nurses talk about other nurses behind their back. Negative Facebook postings about coworkers are counterproductive to teamwork, don’t address real issues, and may be viewed as cyberbullying. Negative postings can start a wave of negativity that flows into the real workplace, damaging relationships and hurting others. If you see this happening, consider sending a private message via Facebook to the nurses involved. Remind them that the “whole world is watching” and that the Golden Rule, “Do unto others as you would have them do unto you,” also applies to Facebook. An even better solution: Contact the nurses by phone or in person. This way you can exchange thoughts, get a better sense of what’s happening, and clarify things in “real time.” Just because something bad is posted, Facebook is not the best place to resolve the problem. If you’re uncomfortable dealing with this type of Facebook issue, consider talking with someone from human resources. Your organization

may even have a policy about this, making it easier to address.

Social Media Guidelines for Nurses American Nurses Association Fact Sheet: Navigating the World of Social Media http://www.nursingworld. org/FunctionalMenuCategories/AboutANA/ Social-Media/Social-Networking-Principles-Toolkit/ Fact-Sheet-Navigating-theWorld-of-Social-Media.pdf American Nurse Today: How to Avoid the Pitfalls of Social Media https://www.americannursetoday.com/how-to-avoidthe-pitfalls-of-social-media/ National Council of State Boards of Nursing: “A Nurse’s Guide to the Use of Social Media:” https://www.ncsbn.org/NCSBN_SocialMedia.pdf

Blogs Many of the same precautions we have been talking about with LinkedIn and Facebook apply to blogging. “Blog” comes from the words “web log,” which is an online journal. A blog is a website maintained by a person who regularly posts content or messages that may include thoughts, ideas, and commentaries. Photos, videos, graphics, and audio can be part of the posts. Blogs can provide news and content on a specific subject or can act as personal journal.2,9 Blog entries are displayed in reverse chronological order with the most recent post at the top of the page. Blogs are more engaging than websites. Here are some of their key features: JULY 2018 | OR TODAY |

IN THE OR

continuing education •

Blogs are interactive; readers can comment and ask questions. • Blogs are written in a conversational tone. • Blogs are easy to set up and do not require technical expertise. • Blogs alert readers when something new is added without requiring e-mail. • Blogs get higher rankings in search engines than static websites. A blog is easy to create and can be up and running in minutes. Although lengths vary, most posts are short. An essential feature of a blog is an RRS (often called really simple syndication) feed or web feed (see sidebar). WordPress.com and Blogger.com are free software needed to start a blog. By providing good content, blogs can position the blogger as an industry expert. Many people wonder how often they should blog. What you write and how you engage your audience is more important than how often you blog. Maintaining a blog requires dedication and effort. The pressure to write frequently often leads many people to abandon them. Quality is more important than quantity, but keep your blog updated with new content. Updating at least once a week is probably enough for most blogs and try to update on the same day each week for consistency. Don’t go missing for a month without an explanation. Post a reason for your hiatus and tell your readers when you expect to be back. Also, be careful of RSS fatigue. With too many posts you can overwhelm readers with clutter.2,10 Here are some tips for boosting your career by blogging:2 • Focus your blog on a particular theme and a target audience • Share your expertise on a topic, such as joint replacement • Offer unique and helpful information • Write as if you are talking to people

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Really Simple Syndication11 An essential feature of a blog is an RSS (really simple syndication) feed or web feed. RSS is a way to feed your blogs, web pages, podcasts, audio, video, and photos automatically to people who subscribe to your blog. Every time you create something new and hit “publish,” a feed goes out to all your subscribers, who will see your updates within 30 seconds to 30 minutes. Of course, you can also subscribe to blogs and websites of your choice and have updates delivered directly to you within minutes. Getting started with RSS is easy. You direct your web browser to an RSS feed reader site, such as Feedreader (http://feedreader.com). After creating an account, you can begin to add RSS feeds.

•

Be yourself and let your personality shine through on your blog • Comment on other blogs • Link your blog to your social networking sites • Share links to your favorite online resources • Read other blogs • Ask open-ended questions • Reflect on current practice or healthcare issues • Don’t post anything unprofessional and follow HIPAA guidelines for patient confidentiality As an example of how blogging can affect a career, I interviewed Donna Cardillo, MA, RN, (widely known as the career guru for nurses), a blogger with a regular presence and voice on the Inter-

net. Cardillo endorses blogging as a type of writing that can help nurses develop their voice and sharpen their writing skills. She also values its ability to educate, persuade, and serve as a change agent. As she said, “You never know who may read your posts.” For example, she once wrote a guest blog for a nursing journal about nurses’ wearing scrubs. Shortly after, she was contacted and interviewed by a reporter for “The New York Times,” who was writing an article on the same topic. Blogs can be used for personal and for business reasons, and a person can write both types of blogs. You can find some excellent nursing blogs at 40 Best Nursing Blogs You Aren’t Reading Yet (tinyurl.com/yb2h3ass) nursing blog. Some bloggers have published books based on their original blog posts. They are called “blooks.” Two examples are “Diary of a Dysfunctional Flight Attendant: The Queen of Sky Blog,” by Ellen Simonetti, and “The Clandestine Diary of an Ordinary Iraqi,” by Salam Pax.12 Blogging may be a good way for nurses to get a book published. For example, a hospice nurse who blogs about her experiences may have the basics for a book on death and dying. To find blogs for specific interests try Google, Yahoo!, or Blog Search Engine. Blogs are here to stay and are rapidly increasing in number. But be careful not to believe everything you read in a blog. Authors of blogs need to earn your trust. Remember the basics for evidence-based publications. Ask, what are this blogger’s credentials? Does he or she have a vested interest? Does he or she give citations or links to reputable sources to support statements, as indicated?

Twitter In the second quarter of 2017, Twitter had 328 million global monthly active users; 260 million of those users were from outside of the U.S.13,14 Eightytwo percent of the active users are on WWW.ORTODAY.COM

IN THE OR

continuing education

mobile devices. Twitter’s simplicity makes it popular and successful. It is a micro-blogging application that asks the question “What are you doing now?” Users can post “tweets” or updates as often as they want via mobile phones, instant messaging, or a web browser. Tweets must be less than 280 characters. They are displayed on the user’s technology of choice: cell phone, website, Twitter, e-mail, or Facebook. Because of the constraint on the size of a tweet, people use Twitter to update their networks with information that is more concise than a blog post and more casual than an e-mail. When used strategically, Twitter can connect with others, build brands, promote services, provide project updates, and post job openings. Users can follow the Twitter updates of anyone or any organization they choose (i.e., colleagues, book authors, recruiters, hospitals, politicians, athletes, and movie stars). You can “unfollow” anyone or any organization because you choose who can communicate and market to you. It is easy to get an account up and running. Go to www.twitter.com for this free networking service. Here are some tips for using Twitter to boost your career:2 • Follow interesting people, professional organizations, news outlets, and special interest groups to stay current on the latest trends and issues • Follow conversations for a while and then join in • Ask questions and provide answers • Share information (such as journal articles) • Tweet from conferences and tell what you are learning • Provide helpful links • Retweet messages to help you connect to others • Link your Twitter profile to WWW.ORTODAY.COM

• • •

your website or blog. Use Hootsuite to cross-post your updates to sites like LinkedIn. This tool can help nurses who think they don’t have time for social media Create connections Don’t tweet anything unprofessional Minimize promotion of your-

self or your organization Deliver relevant “What’s in it for me?” content Twitter can create a powerful personal and professional network. As an example, a nurse manager went online to find a hotel room in New York City for a nursing conference. She was disappointed that no rooms in Midtown were available. She sent a tweet •

Sample Sites LinkedIn • • • • • • •

American Nurses Association Legal Nurse Consultant and Attorney Network Nurse Entrepreneurs — Group for nurse entrepreneurs or those wanting to be nurse entrepreneurs Nurse Practitioner — Group for networking in the NP community Nursing Beyond the Bedside — Group for nurses working in, or interested in, nonbedside/nonclinical nursing Nursing Jobs — Group for nurses looking for dynamic and diverse career opportunities and healthcare employers in search of high quality nurses Nursing Network — Group dedicated to networking nursing professionals

Facebook • • • •

American Nurses Association Johns Hopkins Medicine Mayo Clinic Nurse Rounds

Blogs • •

Harvard Health Blog Medical News Today

Twitter • • • • • • • •

@Nurse_com — A leading source for nursing news, jobs, and continuing education @NurseZone — Everything nurses need to know. All on one site. @RNCentral — Nursing education, news, and healthy living tips @NursingWorld — The official site for the American Nurses Association @Womenshealth — The Office of Women’s Health is part of the U.S. Department of Health and Human Services @Wiley_Nursing — Global resource for multidisciplinary publications for nursing students, educators, practitioners, and researchers in all areas @TheLancet — One of the world’s leading general medical journals @MedscapeNurses — Provides breaking medical news.

JULY 2018 | OR TODAY |

IN THE OR

continuing education

to her network for help. She quickly heard from several people with suggestions and in minutes had a reservation at a boutique hotel in midtown Manhattan. While at the conference, she shared important findings by tweeting to her network. This story illustrates a good reason to learn and use social networking sites. Social media can play an important and engaging role in your career. It can expand your professional network, connect you with colleagues, and keep you updated about trends and breakthroughs in healthcare. However, there is no getting around the essential building blocks of education, experience, expertise, and interpersonal skills. The sites discussed in this module can help you with networking, career advancement, and professional success. Why not get started? You have nothing to lose by getting into social media if you handle yourself in a professional manner. You have a lot to gain if you add social media as a career-building strategy.

asking for Facebook logins. Washington Post. http://www.washingtonpost.com/blogs/capital-business/post/maryland-becomes-first-stateto-prohibit-employers-from-asking-for-facebook-logins/2012/05/03/ gIQAsE1GzT_blog.html. Published May 3, 2012. Accessed August 10, 2017. 8. Pagana KD. Facebook: know the policy before posting. Nurse.com Web site. http://ce.nurse.com/course/ce630/facebook. Accessed August 10, 2017. 9. Safko L, Brake D. The Social Media Bible: Tactics, Tools & Strategies for Business Success. 3rd ed. Hoboken, NJ: John Wiley & Sons; 2012. 10. Gil P. How RSS works and why you should use it. Lifewire Web site. https://www.lifewire.com/what-is-rss-2483592. Updated July 23, 2017. Accessed August 10, 2017. 11. Fraser R. The Nurse’s Social Media Advantage: How Making Connections and Sharing Ideas Can Enhance Your Nursing Practice. Indianapolis, IN: Sigma Theta Tau International Honor Society of Nursing; 2011. 12. Pagana KD. The Nurse’s Communication Advantage: How BusinessSavvy Communication Can Boost Your Nursing Career. Indianapolis, IN:

OnCourseLearning.com guarantees this educational activity is free from bias.

Sigma Theta Tau International Nursing Honor Society of Nursing; 2011. 13. Number of monthly active Twitter users worldwide from 1st quarter 2010 to 2nd quarter 2017 (in millions). Statistica Web site. https://www.

Kathleen D. Pagana, PhD, RN, is president of Pagana Keynotes & Presentations and professor emerita from Lycoming College in Williamsport, Pa. She is the author of 95 articles and 29 books, most recently the second edition of “The Nurse’s Etiquette Advantage: How Professional Etiquette Can Advance Your Nursing Career.”

statista.com/statistics/282087/number-of-monthly-active-twitter-users. Accessed August 10, 2017. 14. Number of monthly active international Twitter users from 2nd quarter 2010 to 2nd quarter 2017 (in millions). Statistica Web site. https:// www.statista.com/statistics/274565/monthly-active-international-twitter-users. Accessed August 10, 2017.

References 1. About us. LinkedIn Web site. https://press.linkedin.com/aboutlinkedin. Accessed August 10, 2017. 2. Pagana KD. The Nurse’s Etiquette Advantage: How Professional Etiquette Can Advance Your Nursing Career. 2nd ed. Indianapolis, IN: Sigma Theta Tau International Honor Society of Nursing; 2015.

Clinical VignettE ANSWERS

3. Larson J. Survey highlights healthcare professionals’ use of social amnhealthcare.com/latest-healthcare-news/survey-highlightshealthcare-professionals-use-social-media-mobile-technology/. Published November 21, 2013. Accessed August 19, 2017. 4. Heathfield SM. Ten reasons social media should rock your world. http://humanresources.about.com/od/careernetworking/a/social_ media.htm. Updated June 2, 2016. Accessed August 10, 2017. 5. Joyce SP. Over 50: 5 ways to look out-of-date in your job search. Job Hunt Web site. https://www.job-hunt.org/boomer-jobsearch/5-ways-you-look-out-of-date.shtml. Accessed August 10, 2017.

1. Answer: D, LinkedIn is a professional networking site. The photo should be a professional headshot. It is unethical to pad your profile with educational falsehoods. Vacation photos and funny YouTube clips would be more appropriate on a different site, such as Facebook. 2. Answer: A, Primary connections are people the user knows directly. 3. Answer: C, Passive candidates are people not currently looking for a job. Because they are referrals, they are considered valuable potential candidates by employers. 4. Answer: D, Review the hospital’s social media policy. Remind her that she will be held accountable for anything she posts.

media, mobile technology. AMN Healthcare Web site. https://www.

6. Stats. Facebook Web site. https://newsroom.fb.com/companyinfo. Accessed August 10, 2017. 7. Ho C. Maryland becomes first state to prohibit employers from

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WWW.ORTODAY.COM

Clinical VignettE For CE691 Jill was recently promoted to clinical coordinator of her orthopedic nursing unit. To connect with other nurses in similar specialty areas, she joined LinkedIn. Her profile included a listing of her current and past positions, her education, and her professional organizations. She posted a photo of herself waterskiing from a recent vacation.

1 Jill asks you to critique her

LinkedIn profile. What advice would you give her?

a. Add more vacation photos b. Say she is working on her master’s degree even though she has not started yet c. Add some of her funniest YouTube clips d. Change the photo to a professional headshot

ill invites three of her unit colleagues 2 J to connect with her on LinkedIn. What level of connection is this?

a. Primary degree b. Second degree c. Third degree d. Fourth degree

fter being on LinkedIn for several 3 A

years, Jill received some referrals for upcoming positions at a new outpatient orthopedic unit in her area. She was surprised about the referrals since she was not seeking new employment. What kind of a job candidate is she?

a. Active b. Secondary c. Passive

CE691

How to Earn Continuing Education Credit 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 https://www.nurse.com/ sign-up for $49.95 per year.

Deadline Courses must be completed by 8/31/2019 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 In support of improving patient care, OnCourse Learning is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

d. Confidential

new graduate on the unit asked 4 A

Jill about blogging on the local newspaper’s online chat room. The new nurse wanted to comment about the impact of obesity on healthcare costs. What advice should Jill provide?

OnCourse Learning is also an approved provider by the Florida Board of Nursing, the District of Columbia Board of Nursing, and the South Carolina Board of Nursing (provider #50-1489). OnCourse Learning’s continuing education courses are accepted by the Georgia Board of Nursing. OnCourse Learning is approved by the California Board of Registered Nursing, provider #CEP16588.

a. Encourage her to comment b. Suggest that she provide an example from her unit c. Tell her it is against hospital policy to use social media d. Warn her about protecting patient privacy and tell her to read the hospital social media policy

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Questions

Nurse.com/CE You can take this test online or select from the list of courses available. Prices subject to change.

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

JULY 2018 | OR TODAY |

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ince 2009 Let’s Gel, Inc. has been designing, manufacturing, and selling premium antifatigue floor mats for use by surgeons, nurses, and technicians during operating room procedures. The company has rapidly become one of the most respected providers in the medical comfort flooring solutions category, and has garnered praise from all medical divisions for its unique, innovative designs.

a mishandled spoon of spaghetti sauce, or a visit from the family dog, and the mats were headed for the garbage. After several such episodes, Robb, who as you may recall is an engineer, decided he could solve the dilemma himself, much like he had done previously in his career with notebook computers, wheelchairs, and the like. Many endless nights and enumerable prototypes later, Robb developed an innova-

The company has recently introduced a new line of one-time use, disposable comfort floor mats in sizes that are appropriate for use on operating room floors and on surgical stools. More on the company’s latest offering follows below after a brief story of why Let’s Gel has become the most trusted name for comfort flooring products.

FROM THE KITCHEN TO THE OPERATING ROOM It all began in 2002, when Robb McMahan, an engineer by trade, was struck by the pain and discomfort his wife Lisa was enduring after long hours spent in the kitchen preparing meals. The family home included a tile floor in the kitchen – which Robb had installed himself – and although the flooring looked great, it clearly began to wear on Lisa’s legs and back as the time she spent standing on it grew. Robb and Lisa were determined to keep the fantastic looking flooring and solve her discomfort at the same time. Lisa headed to a home improvement store where she bought some foam mats. They were small, did not match her kitchen’s décor, and offered nothing in the way of durability. In fact, a couple of drops of wine,

42 | OR TODAY | JULY 2018

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tive, patentable mat with soft, shock absorbing polymer gel as the cushioning element. GelPro floor mats were born and Lisa’s discomfort problem was solved. Now, sixteen years later, Let’s Gel, Inc., an Austin, Texas-based corporation, is the leading manufacturer and provider of innovative ergonomic flooring products for home, commercial, and medical use. That first GelPro residential mat was the genesis for GelPro Medical Mats and the basis for what has become a thriving relationship between medical professionals and the Let’s Gel team. “The way we got into the medical market space wasn’t a genius move on my part. We constantly had hospitals contacting us about buying quality mats,” Robb says. “We had a surgeon, Dr. James Landman, M.D., contact us about conducting a study on our mats. Dr. Landman stated he would not perform surgery without one. We, of course, agreed and through that research we made modifications and even more improvements to our mat.” Let’s Gel’s next self-imposed challenge was to find a way to improve upon those too small, unattractive foam and rubber mats that were lacking in durability and support for other areas of the hospital. That probWWW.ORTODAY.COM

lem has now been resolved with the company’s NewLife Eco-Pro and NewLife Advantage product offerings. These mats are made of a proprietary Cellulon Polyurethane Technology, which stands up to the tough demands of a hospital environment. They provide a high- energy return factor that puts a little “spring” in your step. The lasting comfort will not bottom out and the mats are certified by the National Floor Safety Institute for a superior high traction bottom surface. Suffice it to say that these mats offer unmatched ergonomic comfort for products of their kind, while featuring low-profile durable edges. Many of Let’s Gel’s NewLife EcoPro mats have found their way into operating rooms, as well as IR, cath, nurse stations, pharmacies and specimen labs across the world.

DISPOSABLE SURGICAL COMFORT MATS When medical professionals speak, Let’s Gel has a history of listening and taking action. The challenge the Let’s Gel engineering team was given was to create a cost-effective, one-time use comfort floor mat product that would be unrelenting in terms of comfort, yet allow hospitals to reduce labor cost on cleaning and re-stocking, reduce cost JULY 2018 | OR TODAY |

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on cleaning agents, and reduce operating room turnover time. For months the company worked on a solution and created the most ergonomic disposable surgical floor mat. The GelPro Disposable Surgical Comfort Floor mat is now available in two sizes – 18”x30” for use on operating room floors and 13”x17” designed specifically for use on operating room stools. Conveniently sized and remarkably portable, the mat is a disposable, one-time comfort solution for surgeons, nurses, and technicians. Each 18”x30” GelPro Disposable Surgical Comfort Floor Mat has a durable polyurethane top surface which makes it fluid, dirt, and stain-resistant. The mats are also phthalate and latex free, provide the necessary friction level for use with damp surgical booties, and include a slipresistant bottom surface. The 13”x17” Surgical Stool versions of the GelPro mats include similar features, but have the additional benefit of beveled edges for added safety.

LEADERSHIP To support the growing medical demand for comfort, GelPro named Will Jones as Vice President of Medical Sales.

44 | OR TODAY | JULY 2018

Jones brings 33 years of experience in medical sales. He has a comprehensive portfolio which includes safe patient handling equipment and services. For additional information on GelPro Medical Products, please contact Will Jones at willj@letsgel.com. You can also visit our website at gelpromedical.com.

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ACHIEVING

PEAK PERFORMANCE

IN THE OR BY DON SALDER

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WWW.ORTODAY.COM

Most organizations today strive to achieve peak performance by streamlining operations and improving efficiency. Health care organizations are no exception. But certain obstacles can hinder this goal, especially when it comes to achieving peak performance in the operating room. “There are many variables that go into improving efficiency and streamlining processes in surgical services,” says David Taylor, MSN, RN, CNOR, the president of Resolute Advisory Group LLC. “It’s nearly impossible to fix only one aspect of a process without making adjustments in other areas as part of the bigger picture, or without having an effect on those areas as well,” Taylor adds.

WWW.ORTODAY.COM

JULY 2018 | OR TODAY |

ACHIEVING PEAK PERFORMANCE IN THE OR Common Efficiency Obstacles Linda Groah, MSN RN CNOR NEA-BC FAAN, the CEO and executive director of the Association of periOperative Registered Nurses (AORN), lists some of the most common obstacles to achieving peak performance in the OR, starting with incorrect case scheduling. Groah cites a recent study examining more than 17,000 surgeries that found that booking errors occurred in 0.86 percent of the surgeries. The most common error was wrong side, which occurred in 36 percent of the booking errors, followed by incomplete labs (25 percent) and a wrong approach (17 percent). Other common obstacles listed by Groah include: • Managing supplies, equipment, instruments and tissue – For example, surgeon preference cards are not accurate or up to date and instrument trays are not managed properly. • OR room utilization – This relates to block vs. open scheduling. “Utilization should be reviewed quarterly to assess compliance to the goal,” says Groah. • Patient readiness and throughput – For example, workups are not completed or patients arrive late to the facility. • Availability of surgical team members – “This can affect the on-time start of the surgery at the beginning of the day,” says Groah. • Change fatigue – “The push to get the next patient in and out as quickly as possible can sometimes cause the surgical team to feel like they are not delivering personal-

48 | OR TODAY | JULY 2018

ized and safe care to each patient,” says Groah.

Importance of Proper Resourcing Elbridge “Eb” Merritt, MSN, RN, CNOR, CHL, CRCST, CIS, lists a few more obstacles to achieving peak OR performance, including proper resourcing. “This includes not only supplies, equipment and infrastructure, but even more important, ensuring that appropriate human capital is present in the OR,” he says. Merritt tells the story of when someone in human resources questioned his need for a patient transporter, saying he had “too many people as it is.” “I had to explain to her that not having an appropriate number of patient transporters was inhibiting my ability to move patients out of the recovery room, which was backing up the ORs and crippling our productivity,” says Merritt. “Our productivity was being hamstrung by one of our lowest paying positions!” Merritt also points to a lack of team play as a major obstacle to achieving peak OR performance. “I’m sure no one in the OR has ever worked with someone who has a ‘I’m the center of the universe’ attitude because everyone in the OR is a team player all the time, right?” he says sarcastically. “Getting the commitment and buy-in of all the OR team members – essentially asking them to leave their ego at the door – and getting them to contribute to a common goal can be difficult, to say the least,” Merritt adds.

Steps to Boosting Performance The good news is that there are many steps you can take to overcome these obstacles in order to boost OR efficiency and achieve peak performance. Taylor suggests emphasizing the importance of teamwork. “This includes not only teamwork among OR personnel, but also collaboration among departments like admissions, preoperative holding and anesthesia,” he says. “Surgery is a team sport,” Taylor adds. “So, it’s important that each touch point is executed flawlessly to avoid costly delays or even case cancellations.” Taylor recommends empowering front-line staff to drive the organizational changes needed to maximize performance of the surgical services department. “Who better to get the job done than the people who do the work day-in and dayout?” he asks. Merritt believes that standardization is critical to boosting OR efficiency and performance. “This can easily be applied to processes, equipment and supplies,” he says. He acknowledges that facilities sometimes have multiple redundant systems for the exact same procedures due to individual preferences. “However, this can have negative consequences when it comes to efficiency,” Merritt says. “If the same system is utilized every day for the same procedure, the entire team will assimilate the knowledge of the system and begin to anticipate what’s needed five or 10 steps ahead,” says Merritt. “This can be a tremendous boost to efficiency.” WWW.ORTODAY.COM

DAVID TAYLOR, MSN, RN, CNOR, President of Resolute Advisory Group LLC

Merritt also stresses the importance of locking in OR schedules at least 48 hours in advance to make sure patients are ready on the day of their surgery. “There should be a plan for filling up any unused blocks prior to the schedule being locked,” he says. “And there should be flexibility in the block schedule to account for emergencies and so-called ‘emergencies of convenience’ so they don’t throw the entire day’s schedule in chaos.”

Boost Efficiency By Using Analytics Groah has more suggestions for achieving peak OR performance, starting with using descriptive, predictive and prescriptive analytics. “These will enable you to assess the problem areas, forecast what might occur and recommend actions based on the forecast,” she says. Other efficiency-boosting ideas from Groah include: • Accurately determining how many ORs need to be running to meet the anticipated volume. • Performing quarterly assessments of surgical blocks. • Running pre-op clinics for patients and checking patient data the day before surgery. • Using electronic scheduling sysWWW.ORTODAY.COM

LINDA GROAH, MSN RN CNOR NEA-BC FAAN, CEO and executive director of the Association of periOperative Registered Nurses (AORN)

tems with hard stops to make sure all required data is entered. • Conducting pre-op briefings and post-op debriefings. • Using clinical pathways.

What About Concurrent Surgeries? Right now, you might be wondering whether concurrent surgeries are an effective strategy for increasing OR efficiency. There are mixed opinions about this, especially in light of high-profile complications and patient lawsuits that have arisen recently due to the practice. Merritt believes that concurrent surgeries can be helpful in maximizing OR efficiency as long as there are guidelines and limitations in place and this is included in the informed consent that the patient signs. “However, the risks of performing concurrent surgery can be significant,” he says. “It’s essential to have everything spelled out in a formal policy that provides guidelines and limitations of when and how concurrent surgeries can take place.” Taylor, however, does not think that concurrent surgeries should be practiced. “I believe attending surgeons should be actively engaged in the surgical procedure they are con-

ELBRIDGE “EB” MERRITT, MSN, RN, CNOR, CHL, CRCST, CIS Clinical Nurse, Officer in Charge of the OR, San Antonio Military Medical Center

sented to perform,” he says. “Surgery is complicated and each patient presents with different needs.” Groah says that AORN’s position on concurrent surgeries is consistent with the definition by CMS and the Joint Commission, which states that “the critical portions of two surgeries performed by the same teaching physician may not take place at the same time.” The definition continues: “If circumstances prevent the teaching physician from being immediately available during noncritical or nonkey portions of the surgeries, then she/he must arrange for another qualified surgeon to be immediately available to assist with the procedure, if needed.”

AORN Seminars Discuss Efficiency AORN’s twice-a-year Nurse Executive Leadership Seminars in 10 cities across the U.S. present an opportunity for perioperative nurses and facility leaders to discuss the rapidly changing influences that affect care delivery and OR efficiencies. To review the fall schedule, including dates and locations, visit AORN.org/nurse-executive-leadership-seminar.

JULY 2018 | OR TODAY |

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OR Nurse at Children’s Hospital of Philadelphia By Matt Skoufalos

competitive horseback rider in her youth, equestrianism taught Lisa Farace the values of responsibility and caring from an early age. She wasn’t much out of her teens before she put those into practice when she decided to study nursing. Farace attended Thomas Jefferson University in Philadelphia and, while there, was recommended to apply for a nurse externship in pediatrics at Children’s Hospital of Philadelphia (CHOP). It wasn’t the first specialty Farace had expected to pursue, but once she entered into it, the field just took.

“I loved it,” she said. “After that, they kept me; I pretty much grew up at CHOP.” “I went into it for the cliché of taking care of people, but it’s true,” Farace said. “Some people are nurturers. I like making people feel better. When I am with a child, I will do everything to make that kid relax, or just smile, or engage. That’s how I started.” Farace has worked at CHOP for more than 20 years. She started as a staff nurse in a medical-surgical adolescent unit, where she cared for children requiring a variety of specialized care, including neurology, gastroenterology, pulmonology and more. Farace later shifted to outpatient program coordination for patients with blood disorders, worked as a clinical nurse, performed case management, discharge planning, gastrointestinal nursing and home care. At one point, she even left Philadelphia for a twoand-a-half-year travel nursing position at Northwest Medical Center, a community hospital in Tucson, Arizona. Farace was hired for an assignment in adult outpatient gastroenterology. She thought she was making a permanent relocation. “I was lock, stock and barrel out to live there until the day I died,” Farace said. “Then, the economy started to take a huge dip. A lot of our patients were elective; a lot of procedures were getting cancelled. That meant my hours got cut back.” At the same time, Farace’s stepfather was having medical issues, and her best friend was diagnosed

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Lisa Farace, BSN, RN, started her career at childern’s hospital of philadelphia.

with cancer. Flying back and forth to Philadelphia had become prohibitive. When her former position reopened at CHOP, she started to think it was time to return home. “I thought maybe this wasn’t supposed to be a lifelong dream,” she said. “Maybe those three things were the universe telling me it was only supposed to be for a short while.” However short-lived, her relocation also offered Farace a great deal of perspective on her career and the beauty of the variety it afforded her. Seeing things with fresh eyes also inspired her most recent assignment: a transfer into the operating room. “After being there for 13 years, I could sit in the same position because I know it and I’m really good at it, or I could shake things up,” she said. “When I was in nursing school, I did a perioperative nursing course. I thought, ‘That’s something I’ve not done yet,’ and it’s such a different level of nursing, and that’s why I ended up in the operating room.” Farace completed a nine-month orientation in April 2018. Now she’s on her own, to scrub or circulate, depending on the needs of the unit on a given day. The position places different demands on her than those of her previous assignments, including rotating shifts on evenings, weekends and holidays. It’s a notable change. “Now I’m almost 50 years old, and I’m going to be taking calls again, doing night shift, doing WWW.ORTODAY.COM

“[Health care] has become a little bit more sensitive to people’s learning and people’s needs, and there’s more education than being sent into the deep end of the water,” Farace said. “But once you’re trained, you will get thrown in.” “Young people coming in need to know self-worth,” she said. “Now I’m almost 50 “Know what your limitations are, what you can afford, what you years old, and I’m going need to do, and really investigate what it’s going to mean for to be taking calls again, you. People now practice with a questioning attitude, which is very doing night shift, doing good. Before, you didn’t question, 12-hours, which I haven’t you just did it.”

Lisa learned about responsibility at a young age wile competing in equestrian competitions.

12-hours, which I haven’t done in 20 years,” Farace said. “In my head, I know I can do this; my body’s saying, ‘I hate you.’ ” After years in the field, Farace has an informed perspective from which she believes younger nurses can benefit. The variety of specializations in which she’s participated afforded her a variety of pay grades, but after a certain number of years in the field, she’s talked about hitting a financial plateau. “The nice thing about nursing is there’s so many things you can do, you’re not pigeonholed,” Farace said. “You can go into pharmaceuticals, you can do research, you can do home care. It’s a great job, it’s very rewarding, but nurses don’t make a lot of money for what they do. You hit a certain plateau in the amount of time and years you work in a place, and you sort of get capped.” The career also invites a certain degree of burnout, an occupational hazard that Farace said can be countered with a bit of mindfulness. She recalls having found herself working to the point of exhaustion as a younger nurse because she thought that’s what the job demanded. Learning “to pull back and do something for yourself” is a skill that Farace said she developed over time. Beyond physical and emotional self-preservation, self-care also enables her to contribute to the greater success of her unit. “I know I’m not going to be good for anyone else unless I can do something for myself,” Farace said. “I think we try to save the world, and I think that it’s really a hard lesson to learn. I would lift patients heavier than I was; I’d get involved in working a lot of hours to help and put the time in.” The sooner young nurses can learn what their limits are and what their rights are in the field, the further they can advance in their careers, Farace said. In addition to the burnout, there’s the old saying that nurses “eat their young.” Finding ways to learn the emotional ins-and-outs of the profession can help alleviate both risks. WWW.ORTODAY.COM

done in 20 years. In my head, I know I can do this; my body’s saying, ‘I hate you.’ ”

LISA FARACE HAS ALWAYS BEEN AN ADVOCATE FOR CHILDREN'S HEALTH CARE.

JULY 2018 | OR TODAY |

OUT OF THE OR fitness

Keep Fit On Your Next Road Trip hether you are traveling for business or pleasure, your health and fitness level can take a big hit. The good news is that you can stay fit as an athlete on the road.

“It’s very easy to get lazy about doing our workouts when we are traveling, as it is to overeat and eat poorly,” explains Sarah Walls, personal trainer and owner of SAPT: Strength and Performance Training Inc., who is also the strength and conditioning coach for the WNBA’s Washington Mystics. “When we do those things, we are doing more harm than we realize. It’s important to make the commitment that you are going to be healthy and fit, and that includes being accountable when you are on the road, just like athletes do.” Athletes travel often, sometimes for weeks on end, depending on the sport they play. Yet they always maintain being fit, because they make it a priority and follow the principles that help them no matter where they may be. Even making small efforts can help keep you fit and feeling good while you are traveling. Here are 6 things to make a priority on your next road trip, so that you maintain an athlete’s routine:

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Sleep According to the National Institutes of Health, sleep plays a vital role in good health and well being. Getting enough quality sleep helps to protect your mental health, physical health, quality of life and safety. When you are sleeping during travel, it can be more difficult to get a good night’s sleep, especially if you went to a different time zone. Try to maintain a bedtime routine, and when it’s time for bed keep the room dark, ensure it’s at a cool temperature, and keep the phones and tablets in a separate room or turn them off. Consider taking melatonin to help with jet lag, better sleep and to help reset the body’s clock. It can be bought over-the-counter at any pharmacy.

Nutrition This is extremely important when traveling. Plan your meals in advance to ensure you will be eating healthy. Use your phone to look up restaurant menus ahead of time, so you can opt for healthier entrees. Carry healthy snacks with you, such as trail mix, nuts, dried fruit, healthy snack bars, fresh fruit, etc. When dining out, steer clear of the dishes that have been deep fried. If you can carry a small cooler with you on the road, keep fresh fruit, veggies and dips such as hummus in

it. Eating healthy when traveling will help you maintain your weight, keep you from feeling guilty and help you avoid gastrointestinal issues. According to the National Institutes of Health, you can still eat healthy when dining out. They recommend avoiding all-you-can-eat buffets, and opting for dishes that have been baked, broiled, grilled, roasted or steamed.

Hydration The American Heart Association reports that keeping the body hydrated helps the heart more easily pump blood through the blood vessels to the muscles, and it helps the muscles work more efficiently. They also report that it is important to keep tabs on your hydration during travel, because you may sweat differently in different climates. Again, this is an extremely important area. It’s important to stay well-hydrated. Opt for water, unsweetened tea or some coconut water. Avoid sugary beverages, and avoid drinking too much alcohol. You can help your body stay hydrated by eating foods that have a lot of water content, such as watermelon, cucumber and pineapple.

Mobility and stretching According to the National Institute WWW.ORTODAY.COM

OUT OF THE OR fitness

on Aging, flexibility and stretching exercises give you more freedom of movement for your physical and everyday activities. Stretching can improve your flexibility. Stick with your normal workout routines as much as possible. Professional athletes have specific routines they adhere to, based on the needs of their bodies, and there are certain time frames within which they try to get it done following a flight. It’s very important to continue your mobility and stretching routines while traveling.

Strength training According to the Mayo Clinic, strength training can help you develop strong bones, manage your weight, enhance your quality of life, manage chronic conditions and sharpen your thinking skills. It can also help you reduce body fat, increase lean muscle mass and help your body burn calories in a more efficient manner. Professional athletes still lift, even lightly, when they are on the road. It’s crucial to maintain doing this in order to meet the goals of an athlete, but for most people it serves as a “reset” of sorts for their body, from a posture perspective, and it helps solidify that proper pattern. You can put together a strength

training routine that uses your own body weight that can be done in hotel rooms or outdoors.

Improvise When traveling, there is a good chance you won’t have all the things you use at home to get in a good workout, but that doesn’t mean you can’t improvise. Plan ahead and see what’s in the area you will be in. Be flexible and use what you will have access to, so that you get that workout in. Check for hotel or nearby gyms, trails where you can go for a run or a brisk walk and parks that offer a free workout system. You can also pack some lightweight fitness gadgets, such as your running shoes, a jump rope and resistance bands. Do what you have to in order to get the activity in. “When you make keeping fit on the road a priority, you will come home feeling great,” added Walls. “Plus, you will maintain your fitness all year long. There’s no better feeling than that. A little planning, effort and commitment go a long way.”

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JULY 2018 | OR TODAY |

OUT OF THE OR health

11 Reasons You’re Tired All the Time BY Sheryl Kraft t’s easy to blame those yawns and feelings of fatigue on being too busy or not getting enough sleep or being overly stressed.

Most times, you’d be correct. But sometimes, it’s not just “normal” fatigue. And that’s when it’s important to take a deeper dive into those persistent, disabling feelings of sleepiness or complete exhaustion. Are you always tired, falling asleep night after night on the couch and struggling to stay awake for your favorite television program? Do you find yourself canceling plans because you have no energy? Does your fatigue get in the way of your life? Then there may be other causes that go beyond the obvious.

Allergies Research published in the Archives of Internal Medicine found that the more severe your allergic symptoms are, the more impaired your sleep will be. Allergies send your immune system into overdrive, which can trigger chronic inflammation and fatigue. Allergies can also interfere with your breathing, cause snoring and keep you up at night. And if you take medications to treat your allergies, like decongestants or antihistamines, some of these may interfere with your sleep patterns as well.

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Anemia When you don’t have enough red blood cells – whether it be through blood loss or a decrease in their production – you can develop anemia, and the cells in your body will not get adequate oxygen to function properly. Anemia is the most common blood condition in the United States. Older adults are especially vulnerable if they have a poor diet or other medical conditions; so are women of childbearing age because of blood loss from menstruation or the increased demands of blood supply that pregnancy puts on their bodies. There are more than 400 types of anemia, which can be temporary or chronic.

Your thyroid When your thyroid doesn’t produce enough of its hormones, the hypothyroidism that follows can make you feel tired and weak (among other things). Left untreated, the symptoms, which develop gradually over time, can worsen. An overactive thyroid (hyperthyroidism) can also cause fatigue for some people. Thyroid issues are easily detected through a simple blood test.

Fibromyalgia This condition that causes constant pain and fatigue is more likely to affect women than men. It can disrupt sleep and has also been associated with other sleep disorders like restless leg syndrome and sleep apnea. Even though people

with fibromyalgia may sleep for a long time, it’s not uncommon for them to awaken tired and feeling unrefreshed, which can impair functioning and lessen their quality of life.

Sleep disorders Sleep apnea occurs when the muscles in the back of your throat are unable to keep your airway open – thus, the loud snoring, tossing and nighttime choking and gasping that can disrupt your sleep (often without you even realizing it). Sleep apnea is associated with being overweight or obese but thin people can suffer from this condition as well. Left untreated, it can lead to hypertension, heart disease and problems with mood and memory. A CPAP machine is often an effective way to deal with the condition. Restless leg syndrome, which affects one in 10 adult Americans, causes an overwhelming and strong desire and urge to move your legs, especially at night while you’re at rest, making it difficult to get a good night’s sleep.

Your Diet If you’re not getting enough calories – or getting calories in the wrong form – your energy levels can lag. A lack of iron can cause you to develop anemia (dark green leafy vegetables, lentils, nuts, seeds and eggs are some good iron sources). A lack of protein, which fuels your body to repair and build tissues, can also mess with your energy levels. Make sure you WWW.ORTODAY.COM

OUT OF THE OR health

get enough with beans, cheese, tofu, fish and lean red meat.

Depression Persistent feelings of sadness, hopelessness or emptiness can cause people to either sleep too much or have trouble sleeping, which can lead to exhaustion.

Diabetes When your body can’t use glucose properly, it builds up in the blood and can drain your energy levels. Fatigue is one of the earliest – and most common – warning signs of diabetes. Diabetes raises your risk for sleep apnea and restless leg syndrome, notes the Joslin Diabetes Center.

Medication There are many prescription and overthe-counter drugs that can interfere with

your sleep patterns or cause chronic fatigue. Most commonly, these include antihistamines, some antidepressants, drugs used to manage anxiety disorders and some blood pressure medications. Other culprits could be seizure or epilepsy medications and muscle relaxants.

Chronic Fatigue Syndrome

Dehydration

The best way to figure out what’s causing your excessive sleepiness is to be aware of the possible underlying causes. A look at your health, your patterns and your habits can give you insight. A sleep study can also be very helpful if an underlying sleep disorder is suspected.

Fatigue could be a sign of dehydration. If your body isn’t getting enough water, it can’t function properly. Your blood pressure drops, your heart rate increases and the blood flow to your brain slows. Older adults, people with diabetes or other chronic illnesses, and people who work or exercise outdoors in the heat are more susceptible to dehydration. Thirst is not always a reliable indicator or warning. You may be dehydrated before you feel thirsty.

This illness is characterized by prolonged, debilitating fatigue that does not improve with rest and worsens with physical or mental activity. It can be hard to diagnose, and its cause or causes are unknown.

For more information on the health topics mentioned in this article, visit HealthyWomen.org.

Visit us at OR Today Live! Booth 203

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JULY 2018 | OR TODAY |

OUT OF THE OR nutrition

Food Synergy Boosts Nutrition By Matthew Kadey, M.S., R.D. ancakes and maple syrup, spaghetti and meatballs, chocolate and strawberries are the “Thelma and Louises” of the food world – items that just belong together. Beyond flavor, when certain foods are eaten together, their nutritional firepower is amplified. It’s called food synergy: a concept where the benefits of two or more foods eaten together can be greater than the sum of their parts. Here’s how to harness the power of food-pairing to make your diet extra nutritious and delicious.

Fatten up your salads Vegetables are already nutritional heavy hitters, but if you really want to reap their rewards, make sure to forgo fat-free salad dressings. A 2017 American Journal of Clinical Nutrition study found that people who consumed salads that included soybean oil improved absorption rates of several key nutrients and antioxidants, including vitamins A, E and K, beta-carotene and lutein, compared to when they munched on salads without oil. Research also shows that other sources of fat, like peanut butter, avocado and whole eggs can increase the absorption of beta-carotene in veggies, such

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as kale and carrots, which leads to higher levels of vitamin A in the body. So, be sure to serve up vegetables with healthy fat sources, like olive oil, avocado, nuts or seeds.

Tag team your spices Spices are increasingly lauded for their potential health-boosting powers. But, science shows they work even harder if they don’t fly solo. While turmeric is praised for its anti-inflammatory powers, we don’t absorb its main bioactive compound, curcumin, well. Yet, a chemical found in black pepper, called piperine, can greatly bolster our curcumin absorption rates. Other research suggests that pairing capsaicin (the phytochemical that gives chili powder its fiery kick) and gingerol (found in ginger) may provide some cancer-fighting properties that are greater than when either is consumed alone. So, remember the spice jars when making dishes like soups, chili and stir-fry.

Fiber-up your probiotics You’ve probably heard that hosting a robust colony of beneficial bacteria is important for digestive, immune and other elements of overall health. And that certain fermented, probiotic-rich foods like yogurt, kefir and sauerkraut offer up a dose of these good-for-you critters. Once the bacteria are in your

system, feed them fiber from plant foods so they can thrive. If you include foods containing probiotics in your diet, be sure to eat plenty of fiber-rich vegetables, whole grains, fruits and nuts.

Raise your iron levels with vitamin C Iron plays a role in transporting oxygen throughout the body so important functions like energy production can occur. Foods like beans, lentils, tofu, fortified cereals, spinach and some whole grains can help keep iron fully stocked. However, the form of iron (nonheme) in these plant-based foods is not well absorbed by our bodies. But Mother Nature has provided an assist in the form of vitamin C (ascorbic acid), which converts plant-based iron into a form that is more readily absorbed. That’s why a study in the British Journal of Nutrition found that women who ate iron-fortified cereal with kiwi fruit, which is especially rich in vitamin C, were able to raise their iron levels. Pair iron-containing foods with sources of vitamin C, such as bell peppers, broccoli and citrus.

– Reprinted with permission from Environmental Nutrition, a monthly publication of Belvoir Media Group LLC. www.EnvironmentalNutrition.com.

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SPEAKER SPOTLIGHT My desire to serve my country came long before I figured out how I wanted to do it. I decided to become an OR nurse after shadowing for a day during nursing school. My dream career was born. I was always attracted to the challenge of working in “the field,” where our injured military men and women needed us most. Nothing tests your skills like the austere conditions of a deployment – wherever in the world it may be. The privilege of serving my brothers and sisters in uniform for nearly 30 years will always be my greatest accomplishment. •

Kimberly Smith

Kimberly Smith, RN, MS, CNOR, CSPDM Manager, Sterile Processing (interim), Palmetto Health Baptist Hospital

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Find out more about Kimberly and the interrelated roles of operating room and sterile processing personnel in delivering sterilized instrumentation to patients as she presents, “Sterile Processing Best Practices: They begin in the operating room” at the 2018 OR Today Live conference being held August 26-28 in Nashville, TN.

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JULY 2018 | OR TODAY |

OUT OF THE OR

Recipe

recipe

the

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Beans and Peas in Buttermilk Ranch

INGREDIENTS:

• Kosher salt • 1/2 pound haricots verts or thin green beans • 1/2 pound sugar snap peas, strings removed • 1 cup fresh or thawed frozen peas (4 ounces) • 1/2 cup buttermilk • 1/2 cup mayonnaise • 1/2 cup snipped fresh chives, plus 1 tablespoon minced • 1 tablespoon minced fresh dill • 3/4 teaspoon garlic powder • 3/4 teaspoon onion powder • Freshly ground black pepper • 1 small head Boston lettuce, cored and leaves torn

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.

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OUT OF THE OR recipe

Book Provides

Simple Side Dish Recipe Justin Chapple has penned a book that I think stands out for its well-sourced pantry and simple, yet utterly delicious recipes. The photographs are vibrant and show off his food in the best possible light. I love that he has a variety of ways on how to present and make crudites. “Just Cook It” (Houghton Mifflin Harcourt, 2018) features fun chapters like “Party Food and Snacks” or “Breakfast, Brunch and Eggy Stuff,” as well as the usual courses we have come to expect from cookbooks. When I went through the book, I wanted to make dishes like Matzo Tartines, All Day Cassoulet, Roasted Carrot, Avocado Panzanella and Hot Chocolate Three Ways, to name just a few. I like the layout of the book and how it

is user-friendly, adding helpful hints like how much hands-on time each dish will require. This is a book I would be proud to give as a gift for a beginning cook or a serious home cook. Chapple shares that he likes to have a go-to summer salad and likes to change it every year. The following is one of them. I think it may even be more delish in spring with peas, green beans and snap peas all at their peak of the season. He suggests serving it alongside grilled steaks or lamb as well as on its own as a main course. The ranch dressing is teeming with fresh herbs and a creamy mix of mayonnaise and buttermilk. This may become your go-to salad this year.

Beans and Peas in Buttermilk Ranch Serves 4 1. 2. 3.

4. 5.

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Fill a medium saucepan with water, and bring to a boil over high heat; then add a generous pinch of salt. Fill a large bowl with ice and water. Add the haricots verts to the boiling water; cook until crisptender and bright green, 2 to 3 minutes. Using a slotted spoon, transfer to the ice bath to cool. Add the snap peas and peas to the boiling water, and cook until crisp-tender and bright green, 1 to 2 minutes. Drain well and transfer to the ice bath to cool. Drain the beans and peas very well and then pat dry with paper towels. In a medium bowl, whisk together the buttermilk, mayonnaise, minced chives, dill, garlic powder and onion powder. Season the ranch dressing generously with salt and pepper. In a large serving bowl, toss the beans and peas with the lettuce, the snipped chives and half the ranch. Season the salad with salt and pepper. Serve right away, passing additional ranch at the table. Advanced preparation: The cooked beans and peas can be covered with a damp paper towel and refrigerated overnight. The ranch can be refrigerated in an airtight container for up to five days.

JULY 2018 | OR TODAY |

OUT OF THE OR scrapbook

IAHCSMM SCRAPBOOK he 2018 IAHCSMM Annual Conference was held in Phoenix, April 29-May 2, and provided attendees with resources needed to elevate their knowledge while promoting ongoing quality and professionalism within their department. From knowledge-building hands-on labs and workshops to timely management and technical updates taught by some of the professions most renowned and respected experts, plus poster sessions, discussion groups, and the largest vendor exposition for the CS profession, it didnâ&#x20AC;&#x2122;t matter if this was an attendeeâ&#x20AC;&#x2122;s first conference or their 20th, it was one of their most memorable. OR Today was on site and hosted Facebook live videos that are available to watch on our facebook page @ortoday.

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OUT OF THE OR pinboard

WalletHub Lists Best States for Nurses The personal finance website WalletHub recently released its report on 2018’s Best and Worst States for Nurses. In order to help new nursing graduates find the best markets for their profession, WalletHub compared the relative attractiveness of the 50 states and the District of Columbia across 21 key metrics. The data set ranges from monthly average starting salary for nurses to health care facilities per capita to nursing job openings per capita.

Best States for Nurses 1 Maine 2 Montana 3 Washington 4 Wyoming 5 New Mexico

6 Minnesota 7 Arizona 8 New Hampshire 9 Oregon 10 Colorado

To view the full report, visit wallethub.com/ edu/best-states-for-nurses/4041/.

Tips for Keeping Kids Fit There are millions of young people who participate in sports, but when their season is over for their sport of choice, they often don’t know what to do to keep fit until it starts back up again. The good news is there are things parents can do to help their kids keep fit during the off-season. “By taking steps to keep fit during the off-season, your young athlete will be a better athlete once the season starts back up,” explains Sarah Walls, a personal trainer and owner of SAPT Strength &Performance Training Inc., who is also the strength and conditioning coach for the WNBA’s Washington Mystics. “It’s important that they don’t hang up their equipment and call it quits for a few months. They need to do things to keep in shape all year long.”

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Here are Walls’ tips for keeping young athletes fit between seasons: Strength train Focusing on strength training during the off season will help create a stronger athlete when the new one begins. Find a sports performance training center that can help young athletes enhance their physical abilities and reduce risk of injury. Cross train It’s always a good idea to get kids cross training by playing other sports during the off season from their main sport. Choose one that compliments the primary one, but works on skills, movement patterns, and conditioning that are similar to the primary one. Stay active Encourage kids to stay active

all week long, aiming to get at least an hour of physical activity every day. Focus on nutrition This is a great time to get kids into healthy eating habits. Get them involved in learning what healthy fuel sources are before they workout. Teach mindfulness Playing sports is often halfmental. Teaching kids mindfulness can give them a huge boost when it comes to playing sports. Don’t overdo it While you want to help keep your kids fit between seasons, you also want to give them some down time to relax. Maintain a balance between keeping them physically active, but giving them the rest their body needs.

JULY 2018 | OR TODAY |

INDEX

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Alphabetical Advance Medical Designs, Inc.………………… 24 AIV Inc.………………………………………………………… 15 Alco Sales Service, Co.……………………………… 23 C Change Surgical……………………………………… 13 Case Medical, Inc.……………………………………… 30 Cenorin, LLC……………………………………………………21 CSZ, A Gentherm Company…………………………17 Cygnus Medical……………………………………………… 9 D. A. Surgical…………………………………………… IBC

Doctors Depot…………………………………………… 31 Encompass Group……………………………………… 19 GelPro……………………………………………………… 42-45 Healthmark Industries Company, Inc.……… 4 IAHCSMM……………………………………………………… 63 Innovative Medical Products…………………… BC MD Technologies inc.………………………………… 55 MedWrench………………………………………………… 50 Microsystems……………………………………………… 51

Mobile Instrument Service & Repair………… 6 Pacific Medical…………………………………………… 40 Paragon Services………………………………………… 41 Parkdale Center for Professionals…………… 59 Ruhof Corporation…………………………………… 2, 3 SIPS Consults……………………………………………… 57 TBJ Incorporated…………………………………………… 5 Tetra……………………………………………………………… 50

HOSPITAL BEDS/PARTS

REPAIR SERVICES

categorical ANESTHESIA

Doctors Depot…………………………………………… 31 Paragon Services………………………………………… 41

ASSET MANAGEMENT

Microsystems……………………………………………… 51

ASSOCIATION

IAHCSMM……………………………………………………… 63

CARDIAC PRODUCTS

C Change Surgical……………………………………… 13

CARTS/CABINETS

Alco Sales Service, Co.……………………………… 23 Case Medical, Inc.……………………………………… 30 Cygnus Medical……………………………………………… 9 Healthmark Industries Company, Inc.……… 4 TBJ Incorporated…………………………………………… 5

CS/SPD

Case Medical, Inc.……………………………………… 30 Cenorin, LLC……………………………………………………21 IAHCSMM……………………………………………………… 63 MD Technologies inc.………………………………… 55 Microsystems……………………………………………… 51

DISINFECTION

Case Medical, Inc.……………………………………… 30 Cenorin, LLC……………………………………………………21 Cygnus Medical……………………………………………… 9 Ruhof Corporation…………………………………… 2, 3

DISPOSABLES

Alco Sales Service, Co.……………………………… 23

INFECTION CONTROL

Advance Medical Designs, Inc.………………… 24 Alco Sales Service, Co.……………………………… 23 Cygnus Medical……………………………………………… 9 Encompass Group……………………………………… 19 Healthmark Industries Company, Inc.……… 4 Ruhof Corporation…………………………………… 2, 3 SIPS Consults……………………………………………… 57 TBJ Incorporated…………………………………………… 5

INSTRUMENT STORAGE/TRANSPORT

Case Medical, Inc.……………………………………… 30 Cygnus Medical……………………………………………… 9

Cygnus Medical……………………………………………… 9 Doctors Depot…………………………………………… 31 Mobile Instrument Service & Repair………… 6 Pacific Medical…………………………………………… 40

REPROCESSING STATIONS

TBJ Incorporated…………………………………………… 5

SAFETY

GelPro……………………………………………………… 42-45 Healthmark Industries Company, Inc.……… 4

SINKS

TBJ Incorporated…………………………………………… 5

STERILIZATION

INSTRUMENT TRACKING

Case Medical, Inc.……………………………………… 30 Microsystems……………………………………………… 51

Cygnus Medical……………………………………………… 9 Healthmark Industries Company, Inc.……… 4 TBJ Incorporated…………………………………………… 5

MONITORS

SURGICAL

Doctors Depot…………………………………………… 31 Pacific Medical…………………………………………… 40

MD Technologies inc.………………………………… 55 SIPS Consults……………………………………………… 57

ONLINE RESOURCE

SURGICAL INSTRUMENT/ACCESSORIES

MedWrench………………………………………………… 50

OR TABLES/BOOMS/ACCESSORIES

D. A. Surgical…………………………………………… IBC Innovative Medical Products…………………… BC

OTHER

C Change Surgical……………………………………… 13 Cygnus Medical……………………………………………… 9 Healthmark Industries Company, Inc.……… 4

TELEMETRY

AIV Inc.………………………………………………………… 15 Pacific Medical…………………………………………… 40

Alco Sales Service, Co.……………………………… 23

AIV Inc.………………………………………………………… 15 Parkdale Center for Professionals…………… 59

ENDOSCOPY

OTHER: FLOOR MATS

GelPro……………………………………………………… 42-45

C Change Surgical……………………………………… 13 CSZ, A Gentherm Company…………………………17 Encompass Group……………………………………… 19

PATIENT MONITORING

WARMERS

Cenorin, LLC……………………………………………………21 Cygnus Medical……………………………………………… 9 Healthmark Industries Company, Inc.……… 4 MD Technologies inc.………………………………… 55 Mobile Instrument Service & Repair………… 6 Ruhof Corporation…………………………………… 2, 3

FALL PREVENTION

Alco Sales Service, Co.……………………………… 23 Encompass Group……………………………………… 19

GENERAL

AIV Inc.………………………………………………………… 15

66 | OR TODAY | JULY 2018

AIV Inc.………………………………………………………… 15 Pacific Medical…………………………………………… 40

PATIENT WARMING

CSZ, A Gentherm Company…………………………17 Encompass Group……………………………………… 19

POSITIONING PRODUCTS

Advance Medical Designs, Inc.………………… 24 Cygnus Medical……………………………………………… 9 D. A. Surgical…………………………………………… IBC Innovative Medical Products…………………… BC

TEMPERATURE MANAGEMENT

CSZ, A Gentherm Company…………………………17

WASHERS

Cenorin, LLC……………………………………………………21

WASTE MANAGEMENT

Advance Medical Designs, Inc.………………… 24 MD Technologies inc.………………………………… 55 TBJ Incorporated…………………………………………… 5

WOUND MANAGEMENT

Tetra……………………………………………………………… 50

WWW.ORTODAY.COM

Patient positioning solutions for MIS & robotic surgery. PatientGuard™ Robotic Positioning System FEATURING

TrenGuard

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. No shoulder braces.

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. Designed for Quality Improvement.

TrenGuard™ Trendelenburg Restraint was developed to improve patient safety while

Visit our website for a link to the latest evidence based nursing practice and research poster: “Preventing Patient Sliding in Steep Trendelenburg”

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Enhanced Humbles LapWrap Positioning Pad ®

Free Sample Evaluation

Call 800-467-4944 and reference promo code “Secure” for your free Humbles LapWrap sample today.* ®

Now even more secure with two-way performance! Anesthesiologist Frank Humbles, M.D. knows the importance of patient positioning. The Enhanced Humbles LapWrap®. • Positions patients arms while allowing easy access for leads and IV’s • Secures patient to OR table • Is dual sided for increased flexibility • Optional extensions can be attached for the extremely obese

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Now you can secure your patient in place. Loop the LapWrap® tab around the side rail of the OR table.

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Keep arms securely positioned. Designed to prevent tissue injury. Arms stay where you put them during the procedure.

Adaptable to all size patients. Use the optional extensions to secure the extremely obese.

The LapWrap® was designed to meet AORN recommendations in “Recommended practices for positioning the patient in the perioperative practice setting” to prevent tissue injury and ischemia that may be caused by tucking a patient’s arms at his or her side.

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