CORPORATE PROFILE // PG 30
Getinge recently acquired Healthmark, a leading provider of innovative instrument care and infection control consumables. This strategic step enhances Getinge’s presence within sterile reprocessing in the U.S.
The Next Generation Of Contamination Monitoring Technology
For the cleaning verification of surgical instruments, endoscopes, and surfaces, ATP Complete 2 by Ruhof is a cloud-based cleaning monitoring system used to help hospitals and other healthcare organizations achieve optimal standardized cleaning levels.
Electro Lube™ anti-stick solution is clinically demonstrated to keep tissue from sticking to electrosurgical instrumentation during use, leading to less tim e spent on handbacks to remove eschar buildup during the procedur e. Electro Lube is packaged sterile, and ready to use. To obtain samples and schedule a product trial at y our facility, visit www.steris.com/healthcare.
Electro Lube™ anti-stick solution is clinically demonstrated to keep tissue from sticking to electrosurgical instrumentation during use, leading to less tim e spent on handbacks to remove eschar buildup during the procedur e. Electro Lube is packaged sterile, and ready to use. To obtain samples and schedule a product trial at y our facility, visit www.steris.com/healthcare.
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OR TODAY | Fall 2024
The global disposable medical supplies market will reach $429.1 billion by 2030.
Getinge recently acquired Healthmark, a leading provider of innovative instrument care and infection control consumables. This strategic step enhances Getinge’s presence within sterile reprocessing in the U.S.
Employees from different generations bring different work expectations to the OR. The different perspectives can be challenging for perioperative leaders tasked with leading multigenerational teams.
Stress, the physical or mental response to external causes like overwhelming work assignments or difficult life moments, can add unnecessary pressure to your day to day.
OR Today (Vol. 24, Issue #4) Fall 2024 is published quarterly by MD Publishing, 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. POSTMASTER: See address changes to OR Today at 1015 Tyrone Rd., Ste. 120, Tyrone, GA 30290. 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. © 2024
PUBLISHER
John M. Krieg
john@mdpublishing.com
VICE PRESIDENT
Kristin Leavoy kristin@mdpublishing.com
VICE PRESIDENT OF
Jayme McKelvey jayme@mdpublishing.com
EDITOR
John Wallace editor@mdpublishing.com
ART DEPARTMENT
Karlee Gower
Taylor Hayes Kameryn King
ACCOUNT EXECUTIVES
Megan Cabot
Emily Hise
DIGITAL SERVICES
Cindy Galindo
Kennedy Krieg EVENTS
Kristin Leavoy
ACCOUNTING
Diane Costea
WEBINARS
Linda Hasluem
EDITORIAL BOARD
Vangie Dennis, MSN, RN, CNOR, CMLSO Assistant Vice President, Perioperative Services, AnMed
Justin Fontenot, DNP, RN, NEA-BC, FAADN Associate Professor, Tulane University School of Medicine, New Orleans, LA
Natalie Lind, Education Director for the Healthcare Sterile Processing Association, HSPA
Pat Thornton, MSM, RN, CNOR Perioperative Consultant, RNFA Dermatology Institute
Dawn Whiteside, DNP, MSN, RN, CNOR, NPD-BC, RNFA, Director of Education, CCI
Julie Williamson, BA Director of Communications, HSPA
• Enclosed and vented dispensing chamber for complete operator and specimen safety
• Built-in scale for automatic specimen weighing
• Programmed maximum and minimum formalin levels for correct ratio
• Printed labels with customizable fields for complete documentation
• One-way valve lids for automatic filling and formalin fume protection
• Easy to use touchscreen with on-board tutorial videos for training
Tampa General Hospital (TGH) recently launched Apella, a technology platform that leverages artificial intelligence (AI) to provide data and insights that enhance safety, increase efficiency and elevate the patient experience in the operating room.
“We have some of the most talented surgeons and clinical teams in the world right here at Tampa General. The question is – how do you make the best better?” said John Couris, president and CEO of Tampa General Hospital. “Through innovation and technology such as Apella, we’re giving our teams the tools and information to enhance quality, strengthen safety and improve patient outcomes. We’re also increasing access for more patients to benefit from the exceptional, academic-based care we offer at TGH.”
Apella offers perioperative teams a 360-degree view of operating rooms in real time so they can make more informed decisions, respond to immediate needs, anticipate next steps and plan future operations. The technology utilizes AI, computer vision and cutting-edge communications to offer predictive case durations, turnover durations and staffing suggestions. It also captures highlights to identify patterns, determine opportunities for improvement
and support continuous learning and training efforts. With improved scheduling workflows, teams can better meet patients’ needs in a timely manner.
“Apella is a well-respected partner, and our opportunities to deepen this exciting partnership are extensive. The technology’s ability to look deeper into process efficiencies, predict workflow improvements and find opportunities for quality improvement in our cases are just a few ways we can use this technology to work toward better patient outcomes and improved efficiencies,” said Dr. Murray Shames, medical chief of staff at Tampa General and the Richard G. Connar Professor and Chair, Department of Surgery at the USF Health Morsani College of Medicine.
The data and insights from this technology bring the promise of better patient outcomes. Increased efficiencies mean that patients will spend less time in an operating room, which lowers risk and accelerates recovery. Improved turnover of rooms and equipment also helps to increase the efficiency of each operating room, which enables Tampa General to strengthen access to high-quality surgical care for more patients.
This collaboration with Tampa General follows news of Apella’s recent expansion with Houston Methodist.
Press Ganey – a provider of experience measurement, data analytics and insights to health systems and health plans –recently announced an expansion to its PX Connect Suite. The solution allows health care organizations to capture and act on patient sentiment and feedback right within Epic.
Driving innovation in patient and consumer engagement, along with optimizing electronic health records have become some of health care executives’ top priorities. By connecting experience data into Epic, caregivers will have more information and greater insights about each patient so they can provide that exceptional care.
The added capabilities to the PX Connect Suite will enable the collection of patient surveys in Epic’s MyChart, speeding up the time between feedback, insight and action. For example, if a patient voices frustration about scheduling a follow-up appointment, Press Ganey can identify the issue using natural language processing capabilities and automatically notify the appropriate teams directly within Epic.
“Pulling experience data directly into Epic will transform the ability to act on patient feedback.” said Darren Dworkin, president and chief operating officer at Press Ganey. “Using AI to understand and analyze sentiment and
emotion means we can turn what patients tell us into opportunities to meaningfully impact experience and outcomes.”
Nationally leading health systems, including Vanderbilt University Medical Center and New York University Langone Health, are early adopters of the PX Connect Suite for Epic.
PX Connect Suite for Epic now includes the ability to provide:
• Patient Portal (MyChart) Surveys: Delivers PX surveys directly into Epic’s MyChart. This provides an additional delivery mode for collecting patient experience data. It currently includes targeted surveys that track patient sentiment across specialties.
• Patient Experience Summaries: Press Ganey analyzes open-ended comments from patients using natural language processing capabilities to surface a summary of insights within Epic, offering individualized guidance to the care team.
• Service Recovery: Issues flagged by a patient in a survey can be automatically routed into Epic’s customer service tool, Cheers, so it can be assigned to the right teams to resolve.
Families in the surrounding area have better access to topranked pediatric health care with the opening of Phoenix Children’s Hospital-Arrowhead Campus on August 7. Located in Glendale, this state-of-the-art, 175,000-square-foot hospital offers a comprehensive range of services, including inpatient care, a 24/7 emergency department, surgical care and advanced imaging services.
The new hospital will treat up to 72,000 patients annually and answers a pressing need for high-quality pediatric services in the West Valley.
“Our expansion plans in the West Valley have been decades in the making,” said Robert L. Meyer, president and CEO of Phoenix Children’s. “Today’s opening is the culmination of years of effort to build a comprehensive campus that addresses the unique needs of children and ensures West Valley families can access the care they need, much closer to home.”
Phoenix Children’s Hospital-Arrowhead Campus provides 24 inpatient beds with plans to expand to 48 beds in early 2025, a 24/7 emergency department with 30 treatment rooms, six operating rooms, two minor procedure rooms, an onsite laboratory and a full suite of imaging services. The campus represents an investment of $195 million and the creation of more than 400 jobs.
The opening of the hospital marks the completion of Phoenix Children’s Hospital-Arrowhead Campus. In November 2023, the health system opened a 45,000-squarefoot multispecialty clinic at this campus, providing care in more than 20 high-demand pediatric subspecialties. This includes 10 specialties not previously available in the Northwest Valley such as psychology, neuropsychology and a neurodiagnostic sleep and electroencephalogram laboratory.
Phoenix Children’s Hospital-Arrowhead Campus is
part of the health system’s long-term expansion strategy to bring world-class care closer to home for Arizona families.
Phoenix Children’s-Avondale Campus, located 20 miles south of the new Arrowhead campus, opened last summer and provides a 24/7 pediatric emergency department and a large multispecialty clinic for Southwest Valley families.
On the other side of the Valley, construction continues at Phoenix Children’s Hospital-East Valley to answer the needs of families in that region. In addition, the health system recently completed a series of expansion projects at Phoenix Children’s Hospital-Thomas Campus, adding 97 new patient rooms, 88,000 square feet of clinical space and a newly designed Level IV neonatal intensive care unit.
“Our goal with this expansion is to improve access, comfort and care for families throughout our fast-growing metro,” said Meyer. “It’s not just about opening new sites; it’s about fulfilling our promise to bring the highest-quality pediatric health services to the communities where our patient families live and work. It’s health care they need and deserve.”
For more information, visit phoenixchildrens.org.
Royal Philips and Carilion Clinic, a not-for-profit health care organization serving more than one million people in Virginia and West Virginia, recently announced Carilion will adopt the Philips cardiovascular care ecosystem of solutions at the future home of its Cardiovascular Institute at Crystal Spring Tower.
Carilion’s new facility will have 11 specialized Philips interventional suites, allowing physicians to treat patients with complex cardiovascular conditions closer to home while optimizing the clinical, operational and overall performance of the health system’s cardiovascular service line. This investment illustrates Carilion’s commitment to empowering its clinicians with innovative technology to provide quality care for its communities.
Carilion’s comprehensive hospital network, primary and specialty physician practices and other complementary services deliver high-quality, patient-centered care. The flagship hospital, Carilion Roanoke Memorial Hospital, totals 718 beds. The Carilion Clinic Cardiovascular Institute will relocate to this new facility and provide state-of-the art heart, lung and vascular services to the region. Services include inpatient nursing care, cardiovascular ORs, cardiac catheterization and electrophysiology labs.
Along with caring for the local community, Carilion Roanoke Memorial Hospital is the major referral center and only Level 1 Trauma Center for patients in the region who require specialized medical care. It also has the only hybrid operating
rooms available in Southwest Virginia. Equipped with these new Philips solutions, the highly skilled medical staff will be able to continue handling complex cases or procedures that may not be available at surrounding healthcare facilities.
“At Carilion Clinic, we are committed to improving the health of the communities we serve. We know that collaboration is an essential component to realizing this vision,” said Marguerite Underwood, vice president for the Carilion Clinic Cardiovascular Institute. “Working with Philips ensures that we will be able to set the standard in cardiovascular care, not only today, but well into the future.”
The new labs are the foundation of the integrated Philips ecosystem of solutions for cardiovascular care and include the Philips Azurion Image-Guided Therapy System, along with EPIQ CVx cardiology ultrasound system with ultrasound enabled AI capabilities, IntraSight with SyncVision for IVUS imaging and physiology and interventional tools.
Together, the technology provides exceptional imaging with reduced X-ray dose, improved workflow and more efficient turnaround times, offering a high level of clinical confidence. A service program will reduce maintenance complexity, keeping systems up to date with the latest software. Furthermore, Carilion will be able to leverage ongoing clinical education for its staff.
“Periop Connect has been approved for 6.5 CE credits by the Association of Surgical Technologists, Inc. (AST) for continuing education for the Certified Surgical Technologist, Certified Surgical First Assistant, and Associate members of AST,” a letter from Kevin B. Frey, CST, of the organization states.
AST recently informed the AORN Connecticut Chapter 1 of its continuing education credit approval and the chapter is excited to share this news with prospective and current attendees.
“The planning committee for Periop Connect decided to bring surgical technologists into the fold of the conference and in doing so knew the importance of offering education that would pertain specifically to them and have continuing education credits approved by their certification organization, AST, explained Cassandra Eilers, past president, AORN Connecticut Chapter 1. “
The AST Review Panel consists of members of the AST Education & Professional Standards Committee who hold the
Certified Surgical Technologist (CST) credential. During the process, the Review Panel uses the criteria stated in the “AST Continuing Education Approval Policies” to complete an objective review of the application. The Review Panel returns their decision and comments to AST to be communicated to the applicant. This recognition does not imply that AST approves or endorses any product or products that are included in presentations.
“This is a huge accomplishment for our conference and a step towards our goal of offering valuable, CE-approved education for our attendees,” Eilers continues.
The education offered at Periop Connect is also approved for continuing education credit by the California Board of Registered Nurses, the Healthcare Sterile Processing Association (HSPA), and the Certification Board for Sterile Processing and Distribution (CBSPD).
Periop Connect will be held October 25-26 at the Omni New Haven Hotel at Yale in New Haven, Connecticut. To learn more visit periopconnect.com.
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R ight now, pharmaceutical and biopharmaceutical manufacturers often rely on outdated best practices related to radiation sterilization and routine control of single-use systems. Fortunately, there is new industry guidance that will help streamline these processes.
AAMI has announced the release of, AAMI CR513:2024; Guidance on radiation sterilization validation and routine control of single-use systems used for pharmaceutical and biopharmaceutical manufacturing, a new guidance document that updates best practices for manufacturers of pharmaceuticals and biopharmaceuticals. The guidance outlines alternative, simplified approaches to radiation sterilization validation and routine control for single-use systems.
“This report addresses a real need to appropriately adapt our radiation sterilization validation methodologies to products that challenge the concept of what a medical device looks like,” explained Emily Craven, director, sterility assurance at Boston Scientific, who helped shape the document. “Single-use-systems used in bioprocesses need to be sterile in order to manufacture products which will be safe for patient use, but they can be cumbersomely large, which becomes impractical when sampling for routine
testing. The beauty of this consensus report is that it provides practical guidance on sampling methodologies and use of sample item portions for complex multi-component systems in order to provide an accurate picture of sterility assurance based on the use of the system.”
New Needs Arise with Size
Manufactured in a cleanroom, packaged, and sterilized by radiation or EtO sterilization methods, single-use technologies reduce product crosscontamination risks by eliminating the need for cleaning between batches. Seemingly the antithesis of an economic solution, these are drug delivery or biologic containment systems that are disposed of after their first use. However, proponents of single-use technologies will laud the fact that disposable systems – such as bags, filters, and sterile tubing – save health systems the time, money, and even the water that reprocessing traditional stainless-steel systems may require. Today, this technology has seen growing popularity in pharmaceutical and biopharmaceutical manufacturing, where difficult-to-maintain components of the drug-manufacturing process can be replaced with disposable systems.
“The single-use system industry continues to grow as these systems become better understood as a viable option for replacing the previous
systems used for manufacturing pharmaceuticals and biopharmaceuticals,” explained Martell Winters, director of scientific competency at Nelson Laboratories, who helped develop the new guidance document.
According to Winters, older manufacturing systems usually included “meters and meters of stainless-steel pipes and large stainless steel vats, all which all of which needed to be cleaned and sterilized between each manufacturing batch. The use of single-use systems allows for great flexibility in carrying out the manufacturing process and increases patient safety by providing a process that has virtually no option for cross-contamination and in many cases is a completely closed or nearly closed system.”
However, as these systems have grown in size and complexity, new questions arose.
“The current practices as written for radiation sterilization validation and control testing can be difficult to implement for large, complicated single-use systems and are often cumbersome and can lead to contamination in the test vessels,” explained Kimberly Patton, sterilization staff engineer and auditor of the MedAccred Program at the Performance Review Institute. Some manufacturing practices may even be “overly conservative in some cases, where large equipment might not come into contact with the patient.”
Establishing An Industry Stopgap AAMI CR513 is a Consensus Report (CR), a special class of AAMI guidance document that provides concise, prompt and practical guidance on narrowly focused topics of high importance to the health technology community. A CR is intended to respond to an urgent/immediate need for guidance while more robust data/ information develops about emergent or changing technologies such as single-use systems.
CRs are traditionally developed by a small team of renowned industry experts. AAMI CR513 was produced by the AAMI Radiation Sterilization Working Group, a diverse team of sterility assurance and microbiological quality professionals, regulators and
scientists. The group is co-chaired by Patton and Niki Fidopiastis, director of microbiology for global laboratory services at Medtronic.
AAMI CR513:2024 provides guidance on:
1. Sterilization dose, addressing which products should be selected for testing, and best practices for testing.
2. Sterile claim, providing guidance on estimating sterility assurance level and how to select sterile claims.
3. Dose application, including information on the proper delivery of a verification dose and sterility testing.
4. Risk assessment, establishing the correct components of risk
assessment for single-use systems, considering the specific system and its needs.
5. User verification, focusing on how to independently verify the sterility assurance level of a single-use system.
According to Fidopiastis, AAMI CR513 is a much-needed stopgap, and its “simplified approaches for validation and routine control of single-use systems” will provide manufacturers with the clear guidance they need. Patton added that the working group’s next step will be to monitor how the CR is used and whether a thorough Technical Information Report is desired by stakeholders.
The document can be accessed or purchased on AAMI ARRAY.
By donna gorby, mld, bsn, rn
I nformed consent, when done properly, encourages transparency and trust between all parties. Despite this, many U.S. states and medical institutions do not require explicit consent for exams when the patient is under anesthesia. Recent lawsuits and state reforms have exposed concerning practices where providers-in-training conduct sensitive examinations without obtaining informed consent prior to anesthesia.
A startling 2023 survey revealed that nearly 20% of hospitals affiliated with medical schools performed intimate exams under anesthesia without obtaining explicit consent.¹ These exams, often carried out by doctors or medical trainees for educational purposes, are sometimes done without the patient’s knowledge – a troubling practice that has persisted for years. A 2005 survey at the University of Oklahoma exposed that most medical students had performed pelvic exams on unconscious patients, with nearly three-quarters believing the patients had not given consent.²
Since his medical student days in the 1990s, Dr. Ari Silver-Isenstadt wrestled with the unsettling ethical
dilemma of being asked to perform intimate exams during gynecological procedures, and even during unrelated surgeries. His discomfort ignited a determination to spark change, ultimately leading to his landmark 2003 study, “Don’t Ask, Don’t Tell,” which paved the way for California to become the first state to regulate this controversial practice.
4
The issue came into sharper focus when Dr. Phoebe Friesen became aware of unauthorized sensitive examinations during her bioethics work at Mount Sinai Hospital around 2014. Friesen’s research culminated in a study published in the journal Bioethics in 2018, which shed light on women who felt violated by unauthorized examinations while under anesthesia.³ This research led to the #MeTooPelvic movement and prompted testimonies before state legislatures, demanding action.
As of 2019, 11 states, including Maryland, Utah, New York, and Delaware, had passed laws mandating informed consent for pelvic exams, addressing the ethical concerns that have long plagued this practice. States like Illinois, Virginia, Oregon, Hawaii, and Iowa have joined the ranks, marking a significant shift in the medical field’s approach to patient autonomy and consent. 4
Some medical faculty defend the practice as essential for training; they raise concerns that requiring disclo -
sure of educational examinations will impair student learning. However, recent studies suggest that patients are generally willing to participate in educational exams when asked. 5 Being included in the plan of care fosters agreement and trust. Moreover, some in the medical community argue that the educational value of these exams under anesthesia is limited. The use of paid non-patient volunteers for teaching purposes is gaining popularity and could be a viable alternative. 6
CMS weighs in
On April 1, 2024, HHS officials sent a letter to teaching hospitals and medical schools emphasizing the importance of setting clear guidelines to ensure providers and trainees obtain and document informed consent from patients before performing sensitive examinations in all circumstances. 7
Increasing concerns led CMS to revise its Acute Care Hospital interpretive guidance in the State Operations Manual, Appendix A-Hospitals, effective April 19, 2024. The updated language in the Surgical Services CoP at 482.51(b) (2) instructs surveyors to review hospitals’ informed consent policies, processes, and forms to ensure consent is obtained for any provider and learner performing sensitive examinations. 8
Enhance the informed consent process, ensure compliance with CMS requirements, and promote patient safety by:
• Ensuring true understanding. Verify that patients genuinely understand their treatment plan and that consent forms reflect all procedures and exams.
• Achieve agreement. Discuss, document and agree upon all procedures and examinations prior to surgery, including those for educational purposes.
• Use accessible terminology. Avoid medical jargon and use layman’s terms.
• Simplify consent documents. Make documents straightforward and easy to understand.
• Avoid assumptions. Do not assume patients understand; encourage feedback and use decision aids, interactive media and graphic tools.
• Overcome language barriers. Use health literacy screening tools and medical interpreter services; provide forms in the patient’s preferred language.
• Promote informed consent as a process. Treat informed consent as an ongoing communication process, not just a formality.
• Conduct training. Educate staff and providers about informed consent and CMS requirements.
• Enforce accountability. Do not delegate consent tasks to other staff.
• Engage with patients. Ask openended questions to understand patients’ needs and preferences; encourage them to ask questions.
• Support the right to refuse. Clearly
state that patients have the right to refuse consent for any examinations while under anesthesia.
A patient’s right to self-determination is a cornerstone of medical ethics, especially for intimate exams involving the most sensitive areas of the body. Informed consent encompasses both clinical and legal dimensions. Clinically, it represents a crucial conversation between physician and patient. Legally, it is enshrined in jurisprudence, highlighting the necessity for proper communication and documentation to avoid legal repercussions. Violations of informed consent can lead to professional liability and significant costs, including compensation and court expenses. As health care systems prioritize patient involvement and decisionmaking autonomy, informed consent becomes increasingly important. All activities, including educational examinations, must be disclosed and agreed upon by all parties. Transparent communication and shared decision-making improve the adequacy of the informed consent process, leading to a trusting partnership between patient and provider.
– Donna Gorby, MLD, BSN, RN, is a standards interpretation specialist for acute care and critical access hospitals at Accreditation Commission for Health Care (ACHC). She holds a master’s degree in leadership development, a bachelor’s degree in nursing, and a Lean Six Sigma Black Belt.
1. Kempf, A. M., Pelletier, A., Bartz, D., & Johnson, N. R. (2023). Consent policies for pelvic exams under anesthesia performed by Medical Students: A National Assessment. Journal of Women’s Health, 32(11), 1161–1165. doi:10.1089/jwh.2023.0369
2. Schniederjan, S., & Donovan, K. (2005). Ethics versus education: Pelvic exams on anesthetized women. Retrieved from https://pubmed. ncbi.nlm.nih.gov/16206868/
3. Friesen, P. (2018). Educational pelvic exams on anesthetized women: Why consent matters. Bioethics, 32(5), 298–307. doi:10.1111/bioe.12441
4. Greene, H. H. (2019). Medical students allowed to do pelvic exams on unconscious, non-consenting patients. Retrieved from https:// www.vice.com/en/article/43j59n/ medical-students-allowed-to-dopelvic-exams-on-unconscious-patients-without-consent
5. Jushchyshyn, J. A., MulugetaGordon, L., Curley, C., Polite, F. G., & Merz, J. F. (2023). Patient consent for medical student pelvic exams under Anesthesia: An exploratory retrospective chart review. Retrieved from https://www.medrxiv. org/content/10.1101/2023.04.17.2328 8694v2.full
6. Eli Y. Adashi, M. (2019). Teaching pelvic examination under Anesthesia Without Patient Consent. Retrieved from https://jamanetwork.com/journals/jama/fullarticle/2725671
7. Becerra, X., Rainer, M. F., & BrooksLaSure, C. (2024). Letter to the nation’s teaching hospitals and medical schools. Retrieved from https://www.hhs.gov/about/ news/2024/04/01/letter-to-thenations-teaching-hospitals-andmedical-schools.html
8. Survey & Operations Group, & Directors, Quality, Safety &Oversight Group. (2024). Revisions and clarifications to Hospital Interpretive Guidelines for Informed Consent. Retrieved from https://www. cms.gov/files/document/qso24-10-hospitals.pdf
By Tony Thurmond, CRCST, CIS, CHL, FCS
S terile processing departments (SPDs) and operating rooms (ORs) are no strangers to the challenges of missing instruments. Such incidents can be attributed to numerous causes, both within the SPD and OR, and when the causes aren’t addressed promptly and effectively, procedures can be negatively impacted, along with interdepartmental relationships and satisfaction.
To manage the problem of missing instruments, it’s necessary to first attempt to uncover the cause – and understand how the facility responds when devices go missing. Do sterile processing (SP) technicians search for them or is a replacement device ordered promptly? Is the SPD tracking technicians to the specific trays they assemble? Is there confusion about a device’s proper name, which leads to the wrong device being placed in the set?
Instrument trays have a recipe or checklist of items needed for a complete set for a procedure. The recipe should include the catalog number of the instrument and the item description or name. Device nicknames used by OR staff can be included on the recipe in parenthesis, but it is essential to always include the manufacturer’s name of the device. Ideally, the SPD
will have similar instruments that can be used in another’s place as needed. The quantity of suitable replacement instruments should be documented, along with pertinent instructions (e.g., the need for tip protectors).
Whenever a recipe change occurs, such as adding or removing a device or changing the manufacturer or quantity, those updates and the date they occurred must be documented and shared during team huddles and meetings. Poorly developed or insufficiently detailed recipes can contribute to tray errors and missing devices. Including instructions for disassembly and reassembly is also beneficial. Sometimes, technicians prepare trays so routinely that they may assemble trays without a thorough count or fail to follow the steps exactly as indicated on the recipe.
When trays arrive in the decontamination area, they are sorted and organized for proper visibility when going through the washers. It is not uncommon to find a missing instrument from one tray inside another tray used for the same procedure. Tracking tray usage is an effective way to locate missing instruments. Most technicians know when an instrument does not belong or when a cart arrives from the OR with mixedup trays. Keeping devices together with a color-coded tab placed on
each tray from the case cart is an effective approach. For example, if a cart enters the SPD with six trays, the same color tabs could be placed on each of the trays. When trays tagged with the same color go through the washer, and one has a missing DeBakey forceps, for example, the technician processing that color tab can check to see if it is in another tray. Effective resolution for missing or misplaced instruments take ongoing communication and education across all SP teammates as well as for interdisciplinary colleagues.
Tracking trays for accuracy
Facilities with a computer-based instrument tracking system can review multiple reports daily to examine tray availability and review missing devices and the technician who assembled the tray. When a missing item is noted and identified, the first step should be to search for it. If not readily located, technicians should check the repair bin. Trays with missing items can also be placed on a separate cart to prevent them from being mixed with complete trays. The trays should be tagged to indicate the missing devices.
If the missing instrument cannot be found, the tray can be opened to verify it is missing and not simply overlooked during the check. Of course, it is best to count correctly
the first time to prevent having to open and reprocess the tray. SP technicians should stay focused and not allow time pressures to interrupt proper counts and documentation.
SP managers, supervisors and educators should ensure technicians understand what is required and whether they have the tools needed to manage their responsibilities effectively. This is essential to determine if additional training and resources are necessary. Sometimes, technicians may have the correct training and tools but express that tray recipes are too challenging to read or follow. In such cases, the manager should work to evaluate and improve the process. Auditing trays is also important for ensuring
the correct instruments are present. It is better to audit trays before they are sterilized to ensure accuracy, as well as checking trays sent out for repair.
It is important to recognize that instruments are often lost during surgical procedures. In fact, instruments are often accidentally thrown out with surgical drapes or the back table cover. OR staff must be reminded to take caution when throwing away disposable items to ensure instruments and other reusable items are not tossed with them.
Missing or misplaced instruments are difficult to manage, but SPD and OR staff must work together
to try and prevent its occurrence. Properly prepared tray recipes, effective communication, ongoing education and quality checks are the keys to ensure the correct devices are included in the correct tray.
– Tony Thurmond, CRCST, CIS, CHL, FCS , is an HSPA Past-President who serves as Sterile Processing Manager for Dayton Children’s Hospital.
By James X Stobinski, Ph.D, RN, CNOR, CSSM(E), CNAMB(E)
ing Henry, in the play
K“Henry V” by William Shakespeare, exhorts his followers to return to the fray once again with the phrase, “Once more unto the breach …” 1 Building on previous columns, I would like to return to the topic of rural health care.
Hospital closures and reorganizations continue in rural facilities with regular announcements in the industry press.², ³ Health care facility realignments are increasingly common and typically involve discontinuation of service lines such as emergency care and maternal services. Short of closure some rural facilities may attempt a transition to a smaller, more efficient organization such as a critical access hospital. Rural facilities continue to be challenged in the post pandemic recovery.
Dyrda reports that while some larger health care organizations are reporting record profits many rural facilities continue to struggle.²
The American Hospital Association reports, “…continued significant financial pressures for hospitals nationwide.”² The most pressing issue is that inflation continues to outpace the growth of Medicare inpatient reimbursement rates. In addition, labor costs continue to rise and some facilities struggle to
successfully transition to valuebased care models. The closure or downgrades of facilities have special significance in rural communities. Patients and families incur significant expenses for travel and resources when care is not available in the community. There are also patient safety concerns with emergency care for cases such as obstetrical emergencies.
The rural health care dilemma is part of a larger picture of consolidations and mergers in American health care. This trend makes it increasingly difficult for rural facilities to remain independent and offer a wide range of services. Survival in any form may require joining a larger system with an eventual downgrade or elimination of services as complex, technologically intensive care is moved to a larger, centrally located care site. But these changes in service levels have larger, downstream implications.
The lack of health care facilities also translates into a lack of clinical sites for the education and training of health care professionals to include nurses. Often in rural communities the only pre-licensure program is a community college which are dependent on local clinical sites. Ultimately, the lack of health care facilities degrades the education experience for students and also lessens the ability to de -
liver culturally competent care for rural patients. A critical source of staffing for rural facilities is the local population. It is difficult to recruit staff to rural sites. The lack of clinical sites will worsen the already considerable staffing challenges for these facilities and limit the employment opportunities for nurses.
For those of us approaching retirement the availability of health care services is an important consideration. The lack of locally available health care then becomes a quality of life issue which impacts housing and relocation choices. The same impact is possible for younger families needing obstetrical and pediatric services. This leads to a spiraling effect. The lack of local health care may keep retirees and early career families from living in rural areas but also cause an out migration to areas with better access to health care. The lack of patients and resources then makes it increasingly difficult to maintain health care services leading to more closures or downgrades in rural areas. The impact of rural health care challenges are wide-ranging to include workforce issues and population shifts. The lack of comprehensive local health care may influence who can live in a region. Viable solutions will require an investment of resources, political consensus and changes in reimbursement processes. Access issues for rural
populations may continue to worsen on the near horizon until this issue comes to the forefront and there is political will for meaningful solutions and investment.
References
• Poetry Foundation (2024). Speech: “Once more unto the breach, dear friends, once more”https://www.poetryfoundation.org/poems/56972/ speech-once-more-unto-thebreach-dear-friends-once-more
• Ashley, M. (August 11, 2024). 17 hospital closures in 2024. https://www.beckershospitalreview.com/finance/5hospital-closures-in-2024. html?origin=BHRSUN&utm_ source=BHRSUN&utm_ medium=email&utm_ content=newsletter&oly_enc_ id=0705J2387567B1E
• Gamble, M. (August 5, 2024). 703 hospitals at risk of closure, state by state. https:// www.beckershospitalreview. com/finance/703-hospitals-atrisk-of-closure-state-by-state. html?origin=BHRE&utm_ source=BHRE&utm_ medium=email&utm_ content=newsletter&oly_enc_ id=4467F0926923B3Y
• Dydra, L. (August 9, 2024). The truth about hospital profitability. https://www. beckershospitalreview. com/finance/the-truthabout-hospital-profitability. html?origin=BHRE&utm_ source=BHRE&utm_ medium=email&utm_ content=newsletter&oly_enc_ id=4467F0926923B3Y
By Dawn Whiteside, DNP, MSN-Ed, RN, CNOR, NPD-BC, RNFA
Have you ever wondered what it truly means to earn a “certificate?”? Terms like “certification,” “credential,” “certificate,” and “micro-credential” are often used interchangeably, but they represent different levels of achievement. In this discussion, we’ll clarify the meaning of a “certificate” and its significance in professional development.
Educational content that results in a certificate comes in various forms, each with its own criteria and significance. These certificates include training certificates, nursing continuing professional development (NCPD) certificates, college certificate courses, and certificates of mastery (COM). The requirements for each type vary in terms of knowledge depth and time commitment, so it’s crucial not to use the term “certificate” loosely. It’s important to note that the criteria for certificates are standardized, ensuring that every recipient has received consistent knowledge and training. This differs from “certification” programs, where the content delivery may vary, but proficiency must be demonstrated regardless of the learning method.
• Training Certificate: Validates completion of training in a specific area, typically measured in hours or days. Examples include basic life support and laser safety.
• Nursing Continuing Professional Development (NCPD) Certificate: Supports nursing licensure or national certification, focusing on clinical skills and patient care. Examples include substance abuse, dementia care and pharmacology.
• College Certificate Course: Provides education in a specific field, often as an extension of current academic subjects. These programs can range from several months to a year, such as the perioperative leadership graduate certificate course developed by the Competency & Credentialing Institute (CCI) in collaboration with Edgewood College.
• Certificate of Mastery (COM): Demonstrates expertise in a specialized field, building on prior knowledge and requiring a more extended period of study. COMs are designed to show mastery in a particular area through evidence-based education.
(COM)
A COM program is a focused course that provides advanced education and skill development in
a specific area. At CCI, we identified gaps in training for educators, preceptors, and leaders, leading to the creation of specialized COM courses.
For example, the Professional Educator Practicum (PEP COM) course was developed based on the role delineation study and test content outline by the American Nurses Credentialing Center (ANCC). It covers critical competency domains such as research, instructional design, staff development and leadership.
Similarly, the Perioperative Services Preceptor (PSP COM) course was created using data from a national study based on the Ulrich Precepting Model. This COM encompasses the seven preceptor roles identified by Ulrich, ensuring comprehensive preceptor training.
Looking ahead, we’re developing the Foundational Leadership Practicum COM (FLP COM) to address gaps in basic leadership training. This course will cover essential topics like communication, human resources, finance, and strategic management, tailored for new or aspiring leaders in various roles.
To be accredited by the Accreditation Board of Specialty Nursing Certification (ABSNC), a COM course must include both educational content and outcomes-based
assessment. At CCI, our COM programs are intensive 6-month courses with assignments designed to demonstrate mastery and provide practical takeaways for the learner’s current role. We are actively pursuing accreditation for these programs.
Choosing the Right Certificate for Your Growth
With so many certificate options available, selecting the one that aligns with your professional goals is a personal decision. While these certificates may not confer credentials or post-nominal letters, the knowledge and dedication required to earn them are significant accomplishments to be proud of.
NOTE: Gen AI software was used to improve readability and grammatical accuracy of the content.
Harper, Mary G. PhD, RN, NPDBC; Ulrich, Beth EdD, RN, FACHE, FAONL, FAAN; Whiteside, Dawn MSN-Ed, RN, CNOR, NPD-BC, RNFA; Warren, Joan Insalaco PhD, RN, NPD-BC, NEA-BC, FAAN; MacDonald, Ryan PhD. Preceptor Practice: Initial Results of a National Association for Nursing Professional Development Study. Journal for Nurses in Professional Development 37(3):p 154162, 5/6 2021. | DOI: 10.1097/ NND.0000000000000748
– Dawn Whiteside, DNP, MSN-Ed, RN, CNOR, NPDBC, RNFA is the Director of Education and Professional Development of the Competency & Credentialing Institute. Dr. Whiteside has over 35 years of experience as a perioperative nurse in many roles including circulator, scrub, first assistant, team leader, charge nurse, manager, and educator. She serves on the ABSNC Board of Directors as well as the editorial board for OR Today . As an educator, Dr. Whiteside is passionate about developing educational materials for all members of the perioperative team.
Staff report
A global disposable medical supplies market report from ResearchAndMarkets.com’s covers the market from 2022 to 2030.
The global disposable medical supplies market will reach $429.1 billion by 2030, according to the report.
The market is fueled by the growing incidence of disease and disorders coupled with aging population, rising incidence of hospital acquired infections (HAIs), impact of COVID-19 pandemic, a growing preference for low-cost disposable medical supplies that reduce contamination and HAIs. Favorable government regulations are also pushing the market to new heights, according to the report.
Grand View Research’s report on the market also forecasts continued growth.
The global medical disposables market size was valued at $318.3 billion in 2020 and is expected to expand at a compound annual growth rate (CAGR) of 16.7% from 2021 to 2028, Grand View Research reports. Grand View Research states that the
growth is fueled by an increase is the number of surgical procedures being performed, an increased incidence of HAIs, the growth of chronic diseases leading to longer hospital admission and the continuing impacts of COVID-19.
The COVID-19 virus continues to impact the market.
“The COVID-19 outbreak and increasing hospital admissions across the globe have significantly increased the demand for medical disposables,” according to Grand View research. “The WHO has appealed to industries and governments to increase the manufacturing of personal protective equipment, including hospital gowns, gloves, medical masks, face shields, aprons, respirators and goggles, by 40% to meet the increasing global demand. It also reported that the increase in demand for these accessories has increased their prices to a major extent. For instance, the price of surgical masks has increased six-fold and the price of hospital gowns has increased two-fold. Furthermore, the WHO has
shipped around half a million sets of personal protective equipment to around 47 countries. Therefore, the outbreak of COVID-19 has immensely impacted the market and is a highly effective driver for this market.”
Grand View Research also shared some product insights.
“The sterilization supplies segment dominated the market for medical disposables and held the largest revenue share of over 13.0% in 2020. Based on product, the market is segmented into wound management products, drug delivery products, diagnostic and laboratory disposables, dialysis disposables, incontinence products, respiratory supplies, sterilization supplies, non-woven disposables, disposable masks, disposable eye gear, disposable gloves, hand sanitizers and others,” Grand View Research said.
Mordor Intelligence predicts growth in the market as well.
“The disposable medical supplies market is projected to register a CAGR of 9.4% during the forecast period (2022-2027),” Mordor Intelligence states.
Safe Cord Roll is a durable, disposable safety product designed to cover cables and cords on operating room floors, thereby reducing the risk of tripping hazards and staff injuries. Adhesive strips on the underside secure Safe Cord to the floor, with no residue left behind. It is bright yellow for added staff safety. It offers simple set-up, removal and disposal. There is a sleek wall-mount option dispenser with attached safety cutting tool for ease-of-use. Just cut-to-size and use! All mounting hardware is included with the dispenser, making it simple for your facility to install.
The new Swann Morton retracting sheath safety scalpel combines retracting sheath technology with the trusted quality of a world-leading surgical blade manufacturer. Engineered with the trademark Swann Morton blue handle and ring pattern, this scalpel is intended to improve sharps safety in every surgical setting. The safety scalpel is available in a variety of blade sizes, so there is an option for most surgical procedures. Swann Morton blades and scalpels are manufactured to ISO 13485, ISO 14001 and ISO 50001 standards with an open edge grinding technology for a better tactile feel. All blades go through 200 percent visual inspection, meaning there are no defects in the finished product. Swann Morton blades and scalpels are recognized for their consistency, reliability and durability. The newest safety scalpel addition compliments the high-quality blades, scalpels and handles already manufactured by Swann Morton.
Encompass Group LLC offers a wide variety of single-use apparel for patients and staff, including specialty products such as pediatric and behavioral health. The Encompass non-woven portfolio also includes single-use bedding, patient care, washcloths, cleaners, personal protective equipment (PPE) and bedside accessories. Every item is developed with high-quality performing materials and fabrics. Disposable patient apparel features generously sized garments, which help reduce the incidence of cross-contamination, and are available in blue and green nonwoven fabrics. All items meet the required standards and specifications and are available in a variety of sizes, colors, and prints, in SBPP or SMS fabrics.
For more Information, visit encompassgroup.com
Exclusively available from Cardinal Health, SmartGown EDGE Breath able Surgical Gown with ASSIST Instrument Pockets is the first surgical gown with instrument pockets. Invented by Mayo Clinic surgeons and designed in collaboration with Cardinal Health, SmartGown EDGE was created to provide surgical teams with safe and convenient instrument access in the operating room. SmartGown EDGE is made with chest pockets that can keep frequently used surgical instruments* within easy reach while surgeons and clinicians operate across complex sterile fields. The gown’s unique design, featuring two pockets and one holster, helps minimize potential contamination and unintentional instrument drops outside the sterile area. It may also help to reduce instrument handoffs or exchanges during a procedure.
*Sharp, hot, heavy or long instruments should not be placed in the pockets or holster.
Since 1969, Healthmark, a Getinge company, has developed and marketed innovative solutions to aid healthcare facilities in their delivery of surgical instruments and other lifesaving medical devices to patients. These solutions include products for the effective cleaning, validation and verification of the cleaning process; packaging and other accessories for the proper sterilization, storage and delivery of surgical instruments; tools to identify and secure emergency and other lifesaving supplies and equipment.
Getinge recently acquired Healthmark, a leading provider of innovative instrument care and infection control consumables. This strategic step enhances Getinge’s presence within sterile reprocessing in the U.S. and ensures it is positioned to better serve customers and gain greater control over its supply chain and finished products.
On May 1, 2024, Getinge fully transitioned its supply chain and product support responsibilities to Healthmark’s location in Fraser, Michigan. Because of this operational change, there were some modifications to the business processes for certain Getinge Infection Control Consumables
products. Impacted product codes can be found at https://tinyurl. com/2xe6bd25
If customers have any questions or need additional support to make these changes, please call 800-5216224.
Getinge RECENTLY announced the launch of XEN, a new and improved range of cleaning chemistries designed to optimize equipment performance, extend the lifespan of surgical instruments, and improve safety and efficiency in sterile processing departments (SPDs) across the U.S.
The XEN product line features 16 advanced chemical solutions
designed to support SPDs in every stage, from pretreatment and manual cleaning to ultrasonic cleaning, automated cleaning, final rinsing and maintenance. Each formula is crafted to ensure thorough cleaning and decontamination, supporting safe and compliant sterile reprocessing workflows.
“Every procedure and patient in a health care system rely on the sterile processing department, and Getinge is dedicated to continually innovating and providing our customers with the tools they need to maintain the highest standards of safety and efficiency,” said Stefan Runnström, director, commercial operations, surgical workflows, North America at Getinge. “The XEN family of products is the latest example of Getinge’s commitment to keeping patients and healthcare workers safe while supporting efficient workflows.”
XEN Enzymatic+, just one in XEN’s product line of next-gen formulas, is designed to meet the exacting standards of medical
instrument cleaning. With its low-foam, pH-neutral, and highly concentrated formulation, XEN Enzymatic+ provides effective cleaning for a variety of medical instruments, including delicate devices.
“XEN represents a significant advancement in cleaning chemistries, offering comprehensive documentation, performance verification, and a reduced environmental footprint,” said Erin Maxwell, senior product manager at Getinge. “XEN provides a cost-effective and sustainable solution that benefits both our customers and the environment.”
The XEN product is sold and shipped by Healthmark.
SafeStep-ATP Monitor
Healthmark is now offering the SafeStep-ATP Monitor. Healthcare-associated infections (HAIs) continue to flourish, despite dedicated efforts to reduce them, potentially compromising patient and staff safety throughout health care facilities. Biofilm,
bioburden and contaminants can be found everywhere from the CSSD to the OR. Everything – from a light, in an operating room; a partition curtain or chair in a patient room; a clipboard, exam glove or an endoscope can be invisibly hazardous and pose a potential threat. Is it clean?
Be sure in just 15 seconds.
The SafeStep ATP Monitor verifies the cleanliness of surfaces, endoscopes and cannulated instruments in just 15 seconds. By detecting ATP (adenosine triphosphate) – the energy molecule found in all humans, animals, plants, bacteria, yeast and mold cells. SafeStep gives you the testing power to minimize HAIs and improve patient and staff safety!
and green colors distinguish the UnderGuard Dry Advanced from sterilization wraps. The UnderGuard Dry Advanced is offered in 6 different sizes and available in either purple or green.
New UnderGuard Dry Advanced Healthmark now offers UnderGuard Dry Advanced. They recently added it to their sterilization product line. Specially designed for moisture wicking, the non-linting UnderGuard Dry Advanced helps to prevent tears in wraps, as well as to protect instruments internally. The UnderGuard Dry Advanced liner provides optimum protection from dust, moisture and handling, while simultaneously providing an absorbent inner layer for the dispersion of condensate during the autoclaving process. This liner is particularly useful for the protection of barrier-wrapped heavy plastic boxes and trays, as well as standard stainlesssteel baskets. The unique purple
Healthmark will continue to innovate, continue to support and continue to serve the health care provider and the support services that make it possible to deliver quality health care.
Healthmark continues to provide free educational opportunities to health care professionals with a library of interactive and fun games!
The launch of their newest
game on Crazy4Clean.com is “The Power of Instrument Integrity Testing.” Individuals will go on a guided adventure through the world of instrument integrity testing. On the journey, individuals will meet a powerful ally that will take them on an electric learning adventure! Participants will learn important terms, tools and processes for testing the integrity of instruments.
Go to crazy4clean.com today to play “The Power of Instrument Integrity Testing” and earn a free CEU when you complete the quiz at the end of the game.
Moving forward, Healthmark will continue to innovate, continue to support and continue to serve the health care provider and the support services that make it possible to deliver quality health care.
For more information, visit hmark.com or call 800-521-6224.
By Don Sadler
Many perioperative teams today include employees from four or maybe even five different generations: Traditionalists, who were born between 1925 and 1945; Baby Boomers, who were born between 1946 and 1964; Generation X, who were born between 1965 and 1980; Millennials, who were born between 1981 and 2000; and Generation Z, who were born between 2001 and 2020.
Employees from these generations bring different expectations and life experiences to any work environment including the OR. While these different perspectives can be beneficial, they can also be challenging for perioperative leaders tasked with leading multigenerational teams.
“In today’s diverse workforce, understanding and respecting generational differences is essential for effective leadership, especially when it comes to surgical patient care,” says Christina McDonald, MHA senior director of ASC operations at Trias MD. “It’s crucial for perioperative leaders to recognize the unique perspectives, values and communication styles each generation brings to the team.”
Justin Fontenot, DNP, RN, NEA-BC, FAADN, Editor-in-Chief of Teaching and Learning in Nursing, believes that society evolves largely by the influence of up-and-coming generations.
“It’s critical that leaders in health care understand the work-related viewpoints of various generational groups,” says Fontenot. “This can provide leaders with perspective to improve the workplace setting for all team members, regardless of the generation they were born into.”
“Perioperative leaders must understand the worldview and communication styles of each generation and motivate them to work together as a high performing team,” says Deborah Marie Ebert, MSN, RN, NEA-BC, CNOR,
CCRN-K, CPAN, CAPA, associate vice president, perioperative services at Memorial Hermann Texas Medical Center in Houston, Texas.
But this has become more challenging than ever, notes Ebert.
“As leaders, we must support each team member in connecting to their purpose, as well as their value to the perioperative team,” she says.
Vangie Dennis, MSN, RN, CNOR, CMLSO, believes that intergenerational conflicts in the workplace often result from not understanding different value systems, communication styles and expectations, such as work-life balance.
“This can stem from misconceptions about each individual’s unique experiences and the different perspectives held by members of different generations,” she says.
“Each generation brings their own life experiences, education and exposure to technology into the workplace,” says Patricia A. Duclos-Miller, MSN, RN, NEBC, nursing professional development specialist at Bristol Hospital in Bristol, Connecticut. “Hence, unconscious biases may interfere with working together as we hold onto our own generation’s preferences, work and life experiences.”
According to Ebert, perioperative leaders who can’t effectively address generational differences risk creating a work environment of silos and dysfunction. “We know that a positive team culture promotes better patient outcomes, as well as retention of team members,” she says. “Therefore, understanding the dynamics of a multigenerational workforce has become a core requirement for successful perioperative leadership.”
“Understanding generational differences is not unlike understanding differences between individuals,” says Fontenot.
“Personalized leadership and work settings that are person-centered are critical for all members of the health care organization,” he says. “Leaders who acknowledge this and work with their staff to understand personality and generational differences can be trailblazers and game-changers.”
Some common characteristics have been attributed to each generation, including the following:
Traditionalists: Dependable, straightforward and loyal, Traditionalists are also sometimes referred to as the “silent” generation. They were largely shaped by the Great Depression and World War II and tend to be motivated by respect and recognition, placing a high value on organizational structures and respect for authority. Their worldview stresses obedience over individualism, advancing through hierarchy and trust.
Preferred communication style: Formal with a personal touch,such as handwritten notes instead of texts or emails.
Percent of workforce:Traditionalists currently make up just 2% of the total U.S.workforce,which isn’t surprising when you consider that the youngest Traditionalists are 79 years old.
Management tip:Provide employment stability,satisfying work and opportunities to contribute to the greater good.
Baby Boomers: Optimistic, competitive and team-oriented, Baby Boomers are sometimes viewed as workaholics who are committed to climbing the “ladder of success.” They were shaped largely by the Vietnam War, the Civil Rights Movement and Watergate. Baby Boomers tend to be motivated by company loyalty, duty and teamwork. Their worldview stresses achievement after paying one’s dues and sacrificing to achieve success.
Preferred communication style: Whatever is most efficient,whether it’s face-to-face or a phone call,text or email.
Percent of workforce:Baby Boomers currently make up a quarter of the total U.S.workforce.The oldest Baby Boomers are well past retirement age while the youngest are approaching retirement age.
Managementtip:Givespecificgoals anddeadlinesandoffercoaching-stylefeed-
back.Alsoanswerquestionsthoroughly andexpecttobepressedfordetails.
Generation X: Flexible, informal and independent, Gen Xers were largely shaped by the AIDS epidemic, the fall of the Berlin Wall and the dot-com boom. They tend to be motivated by diversity and work-life balance – many possess an entrepreneurial spirit and are willing to invest in themselves. Their worldview stresses diversity and they value access to information and continuous feedback.
Preferred communication style: Whatever is most efficient,whether it’s face-to-face or a phone call,text or email.
Percent of workforce: Generation X currently makes up one-third of the total U.S. workforce. Most Gen Xers are midcareer and at or near their career earnings peak.
Management tip:Provide immediate feedback,flexible work arrangements
Management tip:Take the time to get to know Millennials personally and be flexible with their schedules and work assignments.Also manage by results,provide immediate feedback and encourage them to take risks.
Generation Z: Global, entrepreneurial and progressive, Gen Zers were largely shaped by the Great Recession and access to digital technology at a very young age. They tend to be motivated by diversity, personalization and opportunities to be creative. Their worldview values independence, individuality and new technologies.
Preferred communication style:Informal digital communication including not just email,text and instant messaging,but also social media,especially Instagram.
Percent of workforce: Gen Zers currently make up just 5% of the total U.S. workforce,which isn’t surprising when
from different generations or willing to understand what each generation can bring to the table,” adds Duclos-Miller. “For example, the stereotype that Gen Z is lazy doesn’t consider that these employees place a value on work-life balance that many Baby Boomers could learn from.”
To dismantle generational stereotypes, Duclos-Miller suggests that perioperative leaders recognize the unique value of each individual.
“Leaders should also recognize the synergies that can be created between employees with different life experiences and perspectives,” she says.
Duclos-Miller outlines a five-step process from author Haydn Shaw’s book “Sticking Points: How to Get 4 Generations Working Together in the 12 Places They Come Apart” for managing a multigenerational workforce and resolving
“In today’s diverse workforce, understanding and respecting generational differences is essential for effective leadership, especially when it comes to surgical patient care.”
– Christina McDonald,
and work-life balance.Also extend opportunities for personal and professional development and keep them in the loop on important decisions.
Millennials: Competitive, optimistic and achievement-oriented, Millennials were largely shaped by Columbine, 9/11 and the widespread adoption of the Internet. They tend to be motivated by unique work experiences, positive reinforcement, autonomy and the opportunity to assume more responsibility. Their worldview values using technology as a multi-tasking tool, personal growth and development, and a healthy worklife balance.
Preferred communication style:Informal digital communication,whether it’s email,text or instant message.
Percent of workforce: Millennials currently make up 35% of the total U.S.workforce.Most are in the early or middle stages of their careers.
you consider that the oldest Gen Zers are just 23 years old.
Management tip:Offer opportunities to work on multiple projects at the same time,along with a high degree of independence.Also,many Gen Zers prefer to work with Millennial managers.
Of course, these are just broad generalizations. One of the biggest mistakes leaders can make is stereotyping employees based on their age and generation.
“Common and harmful generational stereotypes include Gen Z lacks work ethic, Millennials are entitled, Gen X are disengaged and Baby Boomers are resistant to change,” says McDonald. “These stereotypes should not be part of the perioperative culture as they create division and hinder teamwork.”
“Stereotypes like these indicate that managers aren’t listening to employees
generational differences in the workplace. The five steps are:
1. Acknowledge and talk about generational differences.
2. Appreciate generational differences. Focus on the why, which is a uniter, instead of the what, which a divider.
3. Agree on how to accommodate different approaches to working together productively.
4. Leverage and maximize the strengths of each generation.
5. Resolve generational differences by determining which solutions will yield the best results and implementing them.
Fontenot says most of the intergenerational conflicts and misunderstandings he sees are related to work-life balance. “Every generation has different views on this,” he says. “For example, a Gen X
“Most importantly, perioperative leaders must have self-awareness and tailor their leadership styles to meet the needs of the everchanging and complex workforce.”
– Deborah Marie Ebert
eryone else that they didn’t already know.
“This exercise will help improve trust by giving team members an opportunity to demonstrate vulnerability in a low-risk way so they can avoid making false assumptions about behaviors and intentions,” says Duclos-Miller.
employee might be more willing to work later without additional pay while a Gen Z employee might refuse. Issues like this can lead to conflicts and accusations of an employee not being a team player.”
Ebert sometimes sees intergenerational conflicts arise due to differences in communication styles.
“Each generation possesses a different preference and style of communication,” she says. “In extreme cases, incivility and bullying may result due to unresolved communication differences.”
McDonald stresses that managing a multigenerational perioperative team effectively requires open and effective communication among all team members.
“Leaders must be curious and involved in the team’s daily operations,” she says. “Encourage team members to share their perspectives and preferences and provide a safe forum for doing this.”
Fontenot agrees.
“Being mindful, self-aware and leading with open communication is key. The more we all work together,
the better we get at understanding one another, growing together and working as a cohesive team,” he says.
According to Ebert, successfully leading multigenerational teams requires perioperative leaders to acknowledge and appreciate team members’ differences across generations.
“Encourage intergenerational discussion and build a culture of inclusivity and continuous learning for everyone,” she says.
“Most importantly, perioperative leaders must have self-awareness and tailor their leadership styles to meet the needs of the ever-changing and complex workforce,” says Ebert.
Duclos-Miller recommends performing a personal histories exercise in which team members answer three questions about themselves: Where they grew up, how many siblings they have and where they fall in the order, and a unique challenge from their childhood.
Once everyone has spoken, ask them to share something they learned about ev-
Another tip from Duclos-Miller: Have team members bring in vacation photos or pictures of their pets. “This opens up conversations about things they have in common,” she says.
Yet another idea is to have team members take the, “What generation am I really?” challenge.
“This can be a real eye opener as everyone doesn’t necessarily line up with their age,” says Duclos-Miller. “It opens up the conversation on how one generation’s traits can align with those of another generation.”
In the end, uniting team members around a common purpose may be the best way to minimize intergenerational conflicts and build a highly functional multigenerational team.
“Striving together toward a common purpose and set of goals will help unite everyone on the team, regardless of which generation they’re in,” says Duclos-Miller. “Make sure you’re leveraging everyone’s strengths and truly working together as a team.”
“Each generation brings their own life experiences, education and exposure to technology into the workplace.”
– Patricia A. Duclos-Miller
Dr. Raynetta Stansil, DHA, MHA, ST, CRCST, CIS, CER, CHL, SME Director of Sterile Processing-Surgical Services, University of Illinois Chicago
By matt skoufalos
In a health care career marked by consistent achievement, multiple advanced degrees and professional certificates distinguish Raynetta Stansil’s commitment to education as a path to success.
But years before she would go on to earn her doctorate in healthcare administration, Stansil was set upon an educational pathway in surgical technology at Olympia College in Merrillville, Indiana. She had intended to pursue a career in law, but was redirected by her mother, who, while working as a qualified medication
aide, suggested that Stansil might enjoy a career as a surgical technologist.
In 2008, Stansil joined Lurie Children’s Hospital of Chicago, where she would remain for a little less than a decade, as a certified surgical technologist. There, she worked with a renowned surgical team, assisting on complex procedures that were uncommon to find in a community hospital.
“Surgery is exciting,” Stansil said. “I loved it there, which is why I stayed close to nine years. I thought I was going to retire there.”
Despite the talent of the surgical team and the best available resources,
not every patient survives the procedure they undergo. After one such sad circumstance, representatives from Gift of Hope Organ and Tissue Donor Network arrived to recover organs and tissue from the body. Even for Stansil, who worked in the operating room daily, witnessing the organ recovery process was a departure from the norm.
“You don’t see that,” she said. “You’re not removing something in surgery, and not replacing it.”
The feeling stuck with her, and down the line, when a former coworker from Lurie told Stansil that she’d gone to work with Gift of Hope, Stansil thought
Stansil remains a fervent advocate of continuing education. Having completed her doctorate at 42, she proudly proclaims that “It’s never too late to go back to school,” while also emphasizing the value of establishing a firm support system around the effort.
to follow suit. That choice led to her taking a position that was simultaneously the most labor-intensive job she’d ever had, and the one whereby she learned the most about the body.
“Some of the things I learned is what diseases the individual can and can’t have before donating,” Stansil said. “You have to look at the medical record, strategically match with what this donor can give and cannot give, and you cannot make a mistake. It’s a very detailed job. You’re a very much underpaid surgeon.”
The days were long, sometimes more than 12 hours, including preparing bodies both pre-surgically and surgically. The work was physically demanding, and time-sensitive, with removal teams on a rapid response call to nursing homes, funeral homes, coroner’s offices and hospitals as needed. The highest aim of their efforts was precision, such that the organs and tissues removed could be grafted successfully into the bodies of their recipients. Stansil would work three days one week, and four the next, alternately; on those extra days off, she was “in the house, stuck to the couch or the bed,” recovering from the effort.
While working for Gift of Hope, Stansil was recruited by a company called Surgical Solutions, for which she worked as a clinical educator. She traveled in support of their accounts at 30 hospitals in eight different states, training staff onsite, and then moving on to the next facility.
“They offer OR and sterile processing staff members to assist with surgery, setting up the room with a surgical tech, or going to sterile processing, where they clean and sterilize instruments,” Stansil said.
She enjoyed the work, but travel-
ing three days a week was difficult with school-aged children. In 2020, Stansil found an opportunity as a sterile processing manager at Methodist Hospital, which was mere minutes from her home, while also working part-time with Surgical Solutions. She remembers being interviewed remotely for the position during the onset of the novel coronavirus (COVID-19) pandemic, and being hired literally sight unseen. In 2021, Stansil went full-time at Methodist Hospital, where she worked until January 2024, when she took her most recent position as the director of sterile processing for surgical services at the University of Illinois Chicago.
“That’s my new adventure there,” she said. “I love it there. It’s still new; I’m still learning the facility, but it’s a good experience.”
While at Lurie, Stansil had continued her education, pursuing a bachelor’s degree in healthcare administration. She worked three years of night shifts to complete it, coming home in the earlymorning hours to do homework after she was done working. After transitioning to Gift of Hope, Stansil returned to school to pursue her master’s degree in health administration at Ohio University, thinking she might someday become the manager of a nursing home. Earning that degree motivated her to pursue a doctorate in health administration, which she completed in the summer of 2024, graduating from Virginia University of Lynchburg.
“I said, ‘I’m going to be a CEO of a hospital or a center,’ and that was my motivation to go get my doctorate,” Stansil said. “That’s still my goal ultimately. I started getting different opportunities, so I never got to where I ‘wanted’ to go
because different things opened up.”
Stansil remains a fervent advocate of continuing education. Having completed her doctorate at 42, she proudly proclaims that “It’s never too late to go back to school,” while also emphasizing the value of establishing a firm support system around the effort.
“If I was to go back at 50 or 60, I think I would still have the drive to do that, and I think others should have that drive as well,” Stansil said. “My main support is my husband, Joseph, and the friends and family who understood [what I was pursuing], because they definitely got neglected. Work-life balance, now I appreciate it more.”
In her off-hours, Stansil works as a healthcare consultant for the Gerson Lehrman Group of Chicago; she also owns a moving, hauling, and junk removal company, Stansil and Sons, which she established with Joseph in September 2021. She enjoys travel, spending time with family, horror movies and documentaries, and, until she’s fully recovered from her DHA program — catching up on sleep.
F
ish oil supplements are a multi-billion dollar industry in the U.S. and abroad, with about two out of every 25 people popping the popular omega-3 pills.
And a new study from the University of Georgia might encourage a new population to start looking into the supplements as well: people with a genetic predisposition to high cholesterol.
Using genetic data from more than 441,000 participants, the researchers calculated a score to predict the genetic likelihood of high levels of total cholesterol, high LDL cholesterol (which is often referred to as “bad” cholesterol), triglycerides and HDL cholesterol (or “good” cholesterol).
“Recent advances in genetic studies have allowed us to predict someone’s genetic risk of high cholesterol,” said Yitang Sun, a recent doctoral graduate from UGA’s Department of Genetics. “But the current prediction has room for
improvement because it does not consider individual differences in lifestyles, such as taking fish oil supplements.”
The researchers found that participants who reported taking fish oil supplements have lower blood lipid levels than predicted, especially for total cholesterol, LDL cholesterol and triglycerides.
“Our study shows that considering lifestyles will improve genetic prediction,” said Kaixiong Ye, corresponding author of the study and an assistant professor of genetics in UGA’s Franklin College of Arts and Sciences. “Our findings also support that fish oil supplements may counteract the genetic predisposition to high cholesterol.”
Fish oil counters effect of family history of high cholesterol It’s no secret that high cholesterol is bad for the body. Arteries start to harden, and the risk of heart attack or stroke increases.
While a healthy diet and exercise can help prevent it, the Centers for
Disease Control and Prevention estimates that more than 86 million American adults – or about one in four – have high cholesterol.
Millions more are at risk of developing high cholesterol due to a variety of factors including one they can’t control: genetics.
For people whose families have a history of high cholesterol, the study’s findings offer another possibility to help safeguard their health.
“Taking fish oil is associated with a shift toward a healthy lipid profile,” Ye said.
The researchers also analyzed the effects of fish oil on HDL cholesterol and found the supplements are beneficial in raising the so-called “good” cholesterol.
Published in the American Journal of Clinical Nutrition, the study was led by Yitang Sun, a doctoral student in UGA’s Department of Genetics. Additional co-authors include Tryggvi McDonald, Abigail Baur, Huifang Xu and Naveen Brahman Bateman, of UGA’s Franklin College; Ye Shen of UGA’s College of Public Health; and Changwei Li, of Tulane University.
By famlily features
Stress, the physical or mental response to external causes like overwhelming work assignments or difficult life moments, can add unnecessary pressure to your day to day. While everyone feels stress from time to time, when left untreated or unrecognized, it can begin to wreak havoc in the form of anxiety.
The National Institutes of Mental Health suggests these strategies to combat stress.
1. Learn Your Triggers
Different events and situations cause stress for different people. Knowing what triggers your stress to kick in – mounds of office paperwork, important financial decisions or hectic mornings, for example – can help you plan and prepare for stress-inducing moments.
2. Exercise and Eat Right
Maintaining physical health can be beneficial for mental health, too. Find time to do exercises you enjoy like walking, jogging, yoga or playing a sport. Identifying activities that bring you joy can make it easier to fit 30-60-minute workouts into your schedule without adding even more stress. Complement your workout routine with nutritional meals that help you stay on track with your fitness goals.
3. Practice Relaxation
Whether you find inner peace through journaling, breathing exercises, reading or some other form of slowing down, find what works for you and prioritize fitting it into your daily schedule. Relaxing activities help you slow down the pace of life, providing a chance to reset by doing something you enjoy.
4. Get Enough Sleep
A lack of quality sleep can add to stress. Creating a bedtime routine
can increase your sleep habits and help you achieve the expertrecommended 7-9 hours per night. Put away electronics, which can interfere with your ability to calm your mind, and find an activity that puts you at ease like reading a book or listening to relaxing music. Ensure your bedroom is optimized for comfort by making it cool, dark and quiet.
5. Create a Network of Support
Everyone experiences stress. Reach out to family members and close friends you can lean on in stressful and frustrating moments. Share your feelings and encourage others to do the same, which can increase trust and help everyone in your circle cope in a positive way. Find more ways to combat stress and care for your mental health at eLivingtoday.com.
By Daniel Bobinski
Some coworkers are tall, others are short. We have different eye colors and skin pigmentations, too. Obviously, these differences exist because of unique genetics, but did you know that genetic differences are also the cause of extraversion and introversion?
When discussing personality styles among people, it’s not uncommon to hear extraverts say they wish their introverted coworkers would be more engaged and talk a little more. Of course, the opposite also occurs. Introverts will sometimes say they wish their extraverted coworkers would tone down their intensity. In truth, wishing for people to change their extraversion or introversion style is like wishing a person was taller or shorter. That change isn’t going to happen. Why? Because research shows that those different facets of our cognitive style occur because of our brain’s unique electro-chemical composition.
One of the main differences in extraverts and introverts is how their brains process dopamine. Every new experience is accompanied by a release of dopamine. If your brain processes dopamine easily, it’s like your brain can’t seem to get enough of it, so you crave new interactions and new, different situations. Extraverts love the
dopamine rush. It gives their brains a euphoric happiness. Thus, people with this brain chemistry thrive on new experiences and meeting new people. People with brains that do not process dopamine quickly tend to be introverts. Because dopamine is released with every new encounter or activity, dopamine overloads occur in relatively short order for these people. This overload actually causes physical discomfort. Thus, introverts tend to avoid new situations or places with a lot of people.
Another chemical that impacts our tendency towards extraversion or introversion is the neurotransmitter acetylcholine. Different than dopamine, the presence of acetylcholine enables feelings of calm focus. Both dopamine and acetylcholine provide a sense of reward, but the different ways our brains process those neurotransmitters results in different cognitive styles.
If your brain processes information through a longer acetylcholine pathway, you’ll tend to enjoy a calm, internal peace if you steer clear of stimulating external activities. This manifests outwardly as introversion. But if your brain processes acetylcholine quickly, then you tend to be attracted to new and exciting things. The result is extraversion. Knowing these things helps with emotional intelligence. Just like we
wouldn’t criticize someone for their height or their eye color, we shouldn’t criticize people for the different ways their brains process dopamine or acetylcholine.
One vital key in exercising emotional maturity is valuing differences instead of criticizing them. We always have a choice. Every style has strengths, and we always do better when we choose to value strengths.
Whether you’re an extravert or an introvert, know that those who process differently than you are likely to see workplace problems a little differently than you do, too. By working with those perspectives instead of against them, it’s more likely you’ll find better solutions. With that mindset, you can go beyond merely valuing the differences; you can capitalize on them.
Daniel Bobinski, is author of the bestselling book, “Creating Passion-Driven Teams,” and president of Leadership Development, Inc. He’s been helping organizations of all shapes and sizes since 1989. Learn more at www.eqfactor.net or reach him at DanielBobinski@protonmail. com or 208-649-6400.
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• Surgery, endoscopy, SPD
• Requires vacuum, electrical & drain
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• 1 1/4 cups white whole-wheat flour
• 1 teaspoon baking powder
• 1 teaspoon baking soda
• 1/8 teaspoon salt
• 1 large egg
• 1/2 cup maple syrup
• 2 teaspoons vanilla extract
• 3/4 cup plain nonfat Greek yogurt
• 3/4 cup unsweetened applesauce
• 1/2 cup chopped strawberries
• 1/2 cup blueberries
By family features
OUT OF THE OR recipe
G etting kids up and out the door is a challenge all on its own, and on those busy school mornings when nothing seems to run smoothly, healthy breakfasts can go by the wayside. While it’s widely recognized as the most important meal of the day, that doesn’t always mean you have time to sit down and enjoy it.
Solving your morning rush with grab-and-go breakfasts you can make ahead of time accomplishes both goals at once: staying on schedule and fueling your kiddos (and yourself) for the day ahead. These delicious and nutritious recipes come from Healthy Family Project’s 2024 Back to School Campaign, which is raising $12,000 for the Foundation for Fresh Produce to support children’s accessibility to fresh fruits and vegetables.
These Mixed Berry Whole-Wheat Muffins are a perfect solution when you need to hustle out the door. As a healthy, delicious treat kids can take with them to school or eat during the commute, they’re quick and easy to make. Loaded with blueberries – a bona fide superfood that’s high in fiber, low in calories and high in vitamin C, potassium and vitamin K – you may even need to make a double batch so you have plenty for breakfasts and after-school snacks. Discover more ways to manage school-day schedules with easy, nutritious recipes at healthyfamilyproject.com
Instructions
Servings: 12
1. Preheat oven to 400 F. Grease muffin pan and set aside.
2. In medium bowl, whisk flour, baking powder, baking soda and salt. In separate large bowl, mix egg, maple syrup, vanilla, yogurt and applesauce.
3. Add dry ingredients to wet ingredients and stir until just combined. Do not overmix. Fold in strawberries and blueberries.
4. Pour batter into prepared muffin tin, filling cups about 3/4 full.
5. Bake 15 minutes, or until tops are golden brown and toothpick inserted in center comes out clean.
6. Remove from oven and let cool in muffin tin 5 minutes before removing.
Christina Longo Bergen New Bridge Medical Center
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Christina Longo
