Jean A. Simonson MD
Safety corner: Did you know there is an order for Implantable Cardioverter Defibrillator (ICD) and pacemaker interrogation?
Situation: Patients with pacemakers and/or ICDs are frequently scheduled for procedures, including MRIs. Background: There is a Nebraska Medicine policy, NM MS49 Surgical Patients with Cardiac Implantable Electronic Devices (CIEDs), and an order available for pacemaker and/or ICD interrogation. Assessment: All patients with a CIED are to be identified preoperatively and the device clinic and […]
Apr 19, 2023
Capnography during PACU sedation procedures
Safety Tip – Capnography during PACU Sedation Procedures During moderate or deep sedation, the adequacy of ventilation shall be evaluated by continual observation of qualitative clinical signs and monitoring for the presence of exhaled carbon dioxide unless precluded or invalidated by the nature of the patient, procedure, or equipment. (ASA Standards for Basic Anesthetic Monitoring, […]
Mar 14, 2023
Arm “Tucking” Aids
Situation: Positioning a patient’s arms safely and securely can be challenging. Background: All patients are vulnerable to injury. For many procedures, the surgeon’s preference is for “tucking” a patient’s arms. The width of OR surgical beds/tables is 20 inches. By comparison, seat widths at Memorial Stadium at the University of Nebraska Lincoln range from 18 […]
Feb 21, 2023
Single-dose or multi-dose vials of injectable medication: “one patient and done”
Situation: Medication supply issues have resulted in single-dose and multi-dose vials of parenteral medications and local anesthetics available to anesthesia providers. This can present confusion with regard to the utilization and wasting of unused medication. Background: Medication vials are labeled by the manufacturer based on the intended use. Assessment: Single-dose vials are preferred over multi-dose vials whenever available. Anesthesia […]
Jan 31, 2023
QIPS Terminology: Failure Mode and Effects Analysis (FMEA) vs. Root Cause Analysis (RCA)
Do you: If you answered “yes” to any of those examples, you are practicing FMEA. Do you: If you answered “yes,” you are practicing RCA. FMEA: Failure Mode and Effects Analysis RCA: Root Cause Analysis Basic summary of steps utilized by performance improvement teams: FMEA RCA Select a process for analysis Identify the event to […]
Dec 5, 2022