or today magazine - march 2016

SPOTLIGHT ONJAVARIS SINGLETON

PAGE 54

CEBILL OF RIGHTS

PAGE 32

PINBOARDNEWS & PHOTOS

PAGE 68

MARCH 2016 www.ortoday.com

READ OURCORPORATE PROFILE

ON PAGES 42-44

TAKE GOOD CARE NURSES • SURGICAL TECHS • NURSE MANAGERS

Your Guide To The 2016 Conference

HANG 10Your Guide To The Your Guide To The Your Guide To The Your Guide To The Your Guide To The Your Guide To The Your Guide To The Your Guide To The Your Guide To The

HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10HANG 10AT AORN

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March 2016 | OR TODAY 9WWW.ORTODAY.COM

OR TODAY | March 2016

CONTENTSfeatures

OR Today (Vol. 16, Issue #2) March 2016 is published monthly by MD Publishing, 18 Eastbrook Bend, Peachtree City, GA 30269-1530. POSTMASTER: Send address changes to OR Today at 18 Eastbrook Bend, Peachtree City, GA 30269-1530.

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

46 54GUIDE TO AORNAre you ready for the AORN Surgical Conference & Expo 2016? The annual conference will be held April 2-6 in Anaheim, California. More than 4,600 perioperative nurses expected to attend along with at least 500 exhibitors. We talked to the experts to fi nd out how to plan for the conference to get the most out of your time in Anaheim.

SPOTLIGHT ON: JAVARIS SINGLETONThe fi rst time neurosurgeon Andrew Reisner met Javaris “Terrell” Singleton, Singleton was a 16-year-old emergency-room patient at Children’s Healthcare of Atlanta at Emory. Find out about their unlikely reunion and how that fi rst encounter forever impacted Singleton’s life.

CORPORATE PROFILE: RUHOFOR Today interviews Ruhof Healthcare to fi nd out the latest developments at the cleaning solutions company responsible for creating the very fi rst enzymatic detergent for cleaning surgical instruments. We asked what makes their products unique and what customers can expect in 2016.

42

1603_ORT-Mag.indd 9 1/28/16 11:03 AM

10 OR TODAY | March 2016 WWW.ORTODAY.COM

PUBLISHERJohn M. Krieg | [email protected]

VICE PRESIDENTKristin Leavoy | [email protected]

EDITORJohn Wallace | [email protected]

ART DEPARTMENTJonathan Riley Jessica Laurain

Kara Pelley

ACCOUNT EXECUTIVESMike Venezia | [email protected]

Warren Kaufman | [email protected] McKelvey | [email protected] Parker | [email protected]

ACCOUNTINGKim Callahan

WEB SERVICESBetsy Popinga Taylor Martin

CIRCULATIONLisa Cover

Laura Mullen

MD PUBLISHING | OR TODAY MAGAZINE18 Eastbrook Bend, Peachtree City, GA 30269

800.906.3373 | Fax: 770.632.9090Email: [email protected]

www.mdpublishing.com

PROUD SUPPORTERS OF

INDUSTRY INSIGHTS13 News & Notes18 AAAHC Update

IN THE OR20 Suite Talk23 Market Analysis24 Product Showroom 32 CE Article

OUT OF THE OR60 Health62 Fitness64 Nutrition66 Recipe 68 Pinboard

70 Index

14

32

24

CONTENTSdepartments

66

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According to a scientifi c study published in the December print publication of the American Journal of Infection Control (AJIC), 87 percent of tested sterilized rigid containers – used in the sterilization of surgical instru-ments – allowed ingress of aerosol-ized bacteria under the test condi-tions used. This study calls into question the assumption that rigid containers, regardless of duration of use, can maintain the sterility of their contents post-sterilization.

Approximately 300,000 surgical site infections (SSIs) occur annually in U.S. hospitals, resulting in an estimated 9,000 attributable deaths. Maintaining a sterile environment in the operating room (OR) is essential for SSI prevention and may be achieved through the use of sterile packaging systems (SPS). SPS are designed to protect surgical instruments post-sterilization until use in the OR. The two primary types of SPS include rigid contain-ers and sterilization wrap. Rigid

containers are reusable and come in a variety of materials (various metals, aluminum and polymers) and sizes, while single-use steriliza-tion wrap is often composed of polypropylene.

The study, “Sterility Maintenance Study: Dynamic Evaluation of Sterilized Rigid Containers and Wrapped Instrument Trays to Prevent Bacterial Ingress,” used a dynamic aerosol test method that allowed for air exchanges to occur in SPSs that may simulate normal air exchanges in hospital settings. The study found that:• Rigid containers, both used and

unused, failed to maintain barrier performance under these test conditions: 87 percent (97 out of 111) of the rigid containers failed to maintain barrier performance, allowing ingress of the challenge microorganism.

• Rigid containers may be less e� ective the longer they are in use: Contamination rates of rigid containers increased as duration

of use increased.• Rigid containers with 5-9 years of

use were signifi cantly more likely to have bacterial ingress than unused rigid containers (p = 0.04).

• Sterilization wraps provided no detectable ingress of bacteria: 100 percent (161 out of 161) of the wrapped trays using sterilization wrap maintained barrier perfor-mance, preventing any bacterial ingress and protecting sterility.

The study was conducted by Harry L. Sha� er of Sterilization Consulting Services LLC, High-lands Ranch, Colorado; Reid A. Vernon of the United States Air Force Academy, Colorado Springs, Colorado; and Delbert Harnish, Michael McDonald and Brian K. Heimbuch of Applied Research Associates, Panama City, Florida.

The study was funded by Halyard Health (formerly Kimberly-Clark Health Care). •

INDUSTRY INSIGHTSNEWS & NOTES

STUDY: WRAPPED INSTRUMENT TRAYS PREVENT CONTAMINATION

STAFF REPORTS

Medtech has received 510K clearance from the United States Food and Drug Administration to market the ROSA Spine robot in the U.S.

Obtaining FDA clearance is a major step in Medtech’s development strategy and will allow the company to market the ROSA Spine robot in the United States for minimally invasive surgical procedures on the spine. Around 3 million such procedures are performed world-wide each year.

“We are thrilled to have FDA approval for ROSA Spine,” Medtech CEO Bertin Nahum said. “Building on the

success that ROSA Brain has encountered on the Ameri-can market, this new key regulatory milestone will allow us to strengthen our position in the world’s leading market for spine surgery. In addition, the FDA approval again refl ects our capacity to respect the commitments we made at the time of our IPO, growing as a company while o� ering innovative robotic technology.”

The ROSA platform was previously approved in the U.S. for brain surgery in 2012.

There are currently 27 ROSA Brain systems installed in American facilities. •

MEDTECH RECEIVES FDA CLEARANCE FOR ROSA SPINE

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Key Surgical Inc. now o� ers cleaning brushes for fl exible bone reamers. The Key Surgical bone reamer brush features a 31-inch rigid stainless steel handle/shaft with medical-grade nylon bristles designed for e� ective manual cleaning of a fl exible bone reamer – a challenging instrument to clean.

Bristle diameters include 3mm (.118”), 5mm (.197”), and 7mm (.276”). Key Surgical’s bone reamer brushes are reusable, can be used to clean other general use instruments, and are available in packages of three.

Bone reamer brushes are a new addition to the extensive line of instrument cleaning brushes from Key Surgical. For information about instrument cleaning brush-es, visit www.keysurgical.com or call 800-541-7995. •

For surgeons who require arthroscopic ankle procedures from a posterior approach or who need to use an alternative surgical tech-nique because of a patient’s anatomy, Innovative Medical Products has designed the De Mayo Ankle Distractor “ladder” accessory.

The attachment fi ts the end of the De Mayo Ankle Distractor frame and consists of six rungs or levels of elevation from which the ankle strap can be attached – the higher the rung or position allows for more distraction of the ankle. Unlike some other ankle distractors, the design of the IMP ankle distractor and accessory helps to prevent patients from sliding o� the operating table.

The De Mayo Ankle Distractor gives the surgeon a better ap-proach to the surgical site while distracting the joint space to insert the surgical scope and instruments. The distractor is unlike other ankle distractors by reducing the counter pressure placed against the thigh in a typical procedure. Such pressure can lead to post-operative complications. The De Mayo Ankle Distractor is reliable and designed for all patients. Its ergonomic design allows the surgeon to face the ankle at the end of the OR table rather than working from the side of the ankle •

KEY SURGICAL INTRODUCES NEW BONE REAMER BRUSHES

ACCESSORY ALLOWS ALTERNATIVE TECHNIQUE IN ANKLE ARTHROSCOPIES

Censis Technologies announced recently that Univer-sal Health Services Inc. has selected Censis as sole source provider for surgical instrument and asset management software throughout the entire UHS system. The multiyear contract allows all facilities associated with UHS to purchase the Censitrac solution that includes all professional services.

Censis Technologies also recently announced that Adventist Health System has selected Censis as sole source provider for surgical instrument and asset management software.

Censis Technologies, based in Franklin, Tennessee, is a leader in surgical instrument and asset management software. Censis o� ers multiple solutions, including Censitrac, which is a highly advanced, web-based software system focused on maximizing OR throughput and regulatory compliance. Censis Technologies’ software is deployed in hundreds of hospitals in the United States, Canada and Australia. •

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NEWS & NOTES

Lima Memorial Health System (LMHS) recently welcomed a second Tru-D SmartUVC, a UVC germ-elim-inating robot, to its infection preven-tion team.

With the support of PotashCorp, LMHS purchased its fi rst Tru-D SmartUVC robot in August and has been using the technology daily to disinfect patient areas before surgery at the hospital, as well as in the hospital’s isolation rooms, as a part of the terminal cleaning process. Community members rallied together at a recent fundraising event, sponsored by the Lima Memorial Foundation, to fund a second disinfecting robot.

“We are committed to patient safety. This innovative technology adds another layer of protection against infection. We are thankful to our community members who share our vision of advancing health care in our region and came together to support the purchase of the Tru-D,”

said Mike Swick, president and CEO of Lima Memorial Health System.

In October, research leaders in UVC disinfection released the results of the fi rst randomized clinical trial on UVC disinfection, in which Tru-D SmartUVC was the only device used. Overall, results of the landmark “Benefi ts of Enhanced Terminal Room Disinfection” study, which was funded by the Centers for Disease Control and Prevention, showed that enhanced terminal room disinfection strategies decreased the cumulative incidence of multidrug-resistant organisms by 10 to 30 percent, and the largest decreases were seen when Tru-D was added to the standard cleaning strategy, (Daniel J. Sexton, MD, et al., 2015). It also showed that the process of incorporating Tru-D into hospital disinfection protocols for highest risk rooms was seamless, and adding a cycle of UVC dosing only added up to 10 minutes to the total room turnover. •

In a peer-reviewed study published in the December issue of American Journal of Infection Control, researchers documented that using Infection Preven-tion Technologies (IPT) NextGen UV disinfection robots and a dedicated team of trained operators resulted in signifi cant reductions of healthcare-ac-quired infections. The study was conducted over a six-month period at Hollywood Community Hospital/Brotman Medical Center Campus.

Several factors make the study notable. It is peer-reviewed and demonstrated signifi cant reductions in multiple harmful pathogens including a 42.7 percent decrease in the incidence of Clostridium di� cile infections, 71.4 percent decrease in Acinetobacter baumannii infections, and a 100 percent drop in Klebsiella pneumoniae infections. The overall HAI

incidence rate was reduced 34.2 percent during the intervention period.

“While many studies highlight a disease reduction in a small area of the hospital, this study was conducted hospital-wide,” Tom Kenny, IPT’s CEO noted. “Ninety-fi ve percent of the rooms in the entire facility were treated. These results are compelling evidence for the e� cacy of our state-of-the-art UV robots and the benefi ts of using skilled robot operators.”

“Not only is the ROI demonstrably high but based on the total reduction of HAI incidents and the average cost of an HAI re-admission, the derived cost-savings is nearly $250,000 in just six months. That’s huge,” Kenny continued. “The bottom line is serious cost avoidance and a much safer environment for both patients and sta¤ .” •

HOSPITAL ENLISTS SECOND GERM-KILLING ROBOT

NEXTGEN UV TECHNOLOGY REDUCES INFECTIONS

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Sealed Air’s Diversey Care division announced that Jim Gauthier, MLT, CIC, has joined the North American healthcare team as senior clinical advisor, infection prevention. In this role, Gauthier will serve as an infection prevention and control resource and an industry organiza-tion liaison to assist with the expansion and improvement of environmental hygiene solutions and science-based best practices.

Gauthier joins Diversey Care with more than 35 years of experience in medical laboratory technology and infection prevention. His focus has been across many areas including acute care, ambulatory care settings, behavioral health and long term care, and he has played an active role in consulting and sharing expertise with stakeholders across the infection control spectrum. Gauthier has also served as a board member and president of Infection Prevention and Control (IPAC) - Canada, and has delivered lectures and training to numerous institutions and organizations throughout the world.

Diversey Care is a division of Sealed Air Corp., a leader in food safety and security, facility hygiene and product protection. •

FOR MORE INFORMATION about Diversey Care, visit www.diversey.com.

GAUTHIER JOINS SEALED AIR’S DIVERSEY CARE

naviHealth Inc., a Cardinal Health company, recently announced the acquisition of RightCare Solutions Inc., a health care decision support software service provider specializing in hospital discharge planning software and readmissions management. RightCare’s software is pow-ered by proprietary, evidence-based decision-support technology developed in conjunction with the University of Pennsylvania School of Nursing.

RightCare licenses its proprietary software to hospitals and health systems to assess patients for post-acute care needs, determine risk of readmission, and coordinate patient discharges to high-quality post-acute care provid-ers, with the ultimate goal of improving care transitions and health outcomes. The company also licenses its software to post-acute care providers, allowing them to save signifi cant time and money in managing referrals from nearby hospitals by automating many of the administrative tasks involved in accepting referrals.

naviHealth has grown rapidly since its founding and currently provides post-acute management solutions in 28 states. naviHealth pioneered a “high tech, high touch” model to manage post-acute care, matching local market clinicians with proprietary decision support technology and analytics.

The company serves nearly 2 million health plan mem-bers and over 75 hospitals and physician groups.•

NAVIHEALTH ACQUIRES RIGHTCARE SOLUTIONS

STERIGENICS INTERNATIONAL EXPANDS IRRADIATION FACILITY

Sterigenics International has announced expansion at its Fort Worth, Texas location, with the addition of a new gamma cell that will increase capacity by 30 percent. Expan-sion will be complete by Q2 2017.

“We have committed more than $80 million in capital investments in the past year to support our customers’ growth strategies,” said Michael Mulhern, CEO of Sterigenics International. “In addition to our Fort Worth expansion, we tripled sterilization capacity at the Sterigenics West Memphis, Arkansas location; signifi cantly expanded our Gurnee, Illinois irradiation facility and increased our global service capabilities with the acquisition of leading Latin American sterilization fi rm Companhia Brasileira de Esterilização (CBE).”

“The Fort Worth expansion is the direct result of increased regional demand for Sterigenics irradiation services,” Sterigenics International President Philip Macnabb said. “We are adding gamma processing capacity of up to 5 million cubic feet per year in Texas, with a product overlap system which will provide the capability to process numerous dose ranges and a wide variety of densities.” •

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

THE BEST ONE FOR YOU DESIGNED BY YOU!

WE ONLY MAKE ONE SINK…

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BLEED 8.5”

TRIM 8.25”

SAFETY 7.75”

BLEED 11”

TRIM 10.75”

SAFETY 10.25”

FULL PAGE

LOGO PHONE NUMBER WEBSITE ADDRESS SPELLING GRAMMAR

PROOF APPROVED CHANGES NEEDED

CLIENT SIGN–OFF:

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NOTES

PLEASE CONFIRM THAT THE FOLLOWING ARE CORRECT

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MEDICAL DEALER TECHNATION ORTODAY

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J F M A M J J A S O N D


1603_ORT-Mag.indd 16 1/28/16 11:03 AM

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

THE BEST ONE FOR YOU DESIGNED BY YOU!

BEST ONE FOR YOU DESIGNEDDESIGNEDONE FOR YOU DESIGNED

WE ONLY MAKE ONE SINK…

OPTIONAL FEATURES INCLUDE

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

Integrated Ultrasonic System

Air and water pistols

Hydro-Force rinse Endo-Flush SystemSystem pistols

717.261.9700 • [email protected] • www.tbjinc.com

BLEED 8.5”

TRIM 8.25”

SAFETY 7.75”

BLEED 11”

TRIM 10.75”

SAFETY 10.25”

FULL PAGE



CLIENT SIGN–OFF:

AD SIZE

NOTES


PROOF SHEET


BUYERS GUIDE OTHER

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In April 2009, Modern Medicine published an article online titled, “Drug addiction among nurses: Confronting a quiet epidemic,” which quoted the American Nurses Association stating that approximately 10 percent of nurses in the USA are drug depen-dent. This calculates out to ap-proximately 300,000 nurses. The general population as a whole is estimated to have a drug depen-dence rate of as high as 10 percent. However, physicians and nurses are more likely than the general population to abuse and/or be-come dependent on legally con-trolled substances and other prescription medications.

With numbers like those noted above, chances are you will at some point encounter a profes-sional at your center who is in some stage of substance depen-dence. When a provider shows up with slurred speech or unusual motor activity, you would obvi-ously look into this immediately. But does your staff know what to look for in the early stages?

In ASCs, the first clues often come

from unusual patterns of drug administration, poor or missing documentation of administration of controlled substances; undocument-ed “waste;” “lost” ampoules or vials of controlled substances; empty syringes with very fine needles are discovered in lockers; and requests such as, “just get me the medication and syringe and I will administer it myself so I can see how it is working and titrate the dose.” There are many opportunities in the workplace and the list above is not meant to cover all the subtle signs of drug diversion.

Certain medications, especially those that come in ampoules, have a small amount of over-fill which is easy to access. Fentanyl is an

excellent example and may be the most abused drug in the ASC setting. A busy anesthesia provider could draw up small amounts of over-fill, or even a little more from many ampoules in any one day, still giving the patients all or most of what they were supposed to receive without drawing suspicion because the patients are not in pain.

Is your staff taught that addiction is a treatable disorder with best results when the treatment starts early? Do you educate them on what to look for in fellow staff members? Health care providers are often very good at hiding their abuse. Subtle signs such as unusual episodes of impatient behavior,

INDUSTRY INSIGHTSAAAHC UPDATE

Our standards require – and essentially every organization we survey has this in place – a policy on impaired heath care professionals. But how e�ective is your policy? Do you educate your sta� on the signs to look for which may be early indicators of alcohol or

drug (prescription and/or illegal) abuse or dependence? A recent article in Medscape cited several papers indicating that 15.3 percent of physicians surveyed met diagnostic criteria for alcohol abuse or dependence. Additionally, another article was cited which noted that female surgeons had almost twice the rate of abuse or dependence than their male colleagues.

HOW EFFECTIVE IS YOUR IMPAIRED

PROFESSIONAL POLICY?

BY JACK EGNATINSKY, MD

Is your staff taught that addiction is a treatable disorder with best results when the treatment starts early? Do

you educate them on what to look for in fellow staff members?

1603_ORT-Mag.indd 18 1/28/16 8:56 AM


mood swings, sleepiness, irritabil-ity, shifting blame or responsibility to another to divert attention from themselves: all these are often early signs that deserve closer attention, indicating that you need to look more closely at their activities.

These symptoms are not defini-tive proof. But they should not be ignored. Impaired performance or unusual behavior does not always mean drug abuse or dependence. But whatever the cause, close follow-up observation is vital and active investigation of atypical performance or behavior should be done. At the start of employ-ment, part of the orientation should be to review with them the corporate impairment polices and their staff responsibilities under those policies. Periodic perfor-mance appraisals must take into consideration current behavior and actions. As I mentioned, however, impairment can result from other situations so your policies should leave the door open for this possibility.

Based on my experiences over the years, emotional distress and sleep deprivation should be included. The latter is often noted in anesthesia providers who come to the ASC after a night on call for a “short” or “easy” day and, as a consequence, might sometimes be guilty of dosing o during a case. Emotional distress can be short term and situational or

part of a more serious problem. Whatever the cause, don’t ignore the signs. Early intervention can help prevent problems from becom-ing more serious.

In this day and age of workplace stress, ready availability of phar-maceuticals, and people tending to not want to get involved, you need to educate your staff on how to recognize the telltale signs of substance abuse – information that goes above and beyond the regular training they receive during orientation as new employ-ees. Impaired providers are more than likely good people going through difficult times. Helping them will help you and your patients.

ABOUT THE AUTHORDr. Jack Egnatinsky is an anesthesiologist with extensive experience in the ambulatory surgery arena, both HOPD and ASC. He is a Past President of the Board of FASA, a predecessor to the ASC Association, and Past President of AAAHC. He is also the Board Chair of the Accreditation Association for Hospital and Health Systems (AAHHS) and is a representative of Acreditas Global, the international arm of AAAHC. He remains extremely active as a Medical Director for AAAHC, in addition to being a well-travelled AAAHC accreditation surveyor, both in the USA and internationally.

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A: I do believe it is a requirement. On our last Joint Commission survey the team asked us for our policy and the audits to demonstrate that this is monitored. Per our policy, any adverse event triggers an audit. At other facilities, for every moderate sedation event a report was completed even if no adverse event occurred.

A: Vocera is awesome.

A: We use ASCOM phones and this has helped to diminish overhead paging.

A: We used the Vocera. If set up correctly and enough Vocera’s are purchased, then it works great for the area or the whole facility. If interested, I can share the PPT that was made about it.

IN THE ORSUITE TALK

SUITE TALKConversations from the OR Nation’s Listserv

PACU MODERATE SEDATION AUDITS

INTERCOM SYSTEM IN OR

Does anyone know if audits for moderate sedation cases are required to be performed for CMS COP? If so, how often?

Has anyone found a way to communicate with everyone in the OR without using an intercom system? Just wondering if ASCOM phones are an option or if by going electronic soon will help reduce the need?

Q

Q

A: Ours, if they need to “refresh” their skills, go out to the pre-/post-op area and start some of their IVs. Also, anesthesia is always happy to do some in-services with the sta.

A: Consider rotating them through OPS monthly or quarterly and you could make this part of annual competency programs.

STARTING IVSIt is not uncommon to lose IV start skills as an OR RN. Patients going to the OR usually arrive with an IV in place. When pediatric cases are booked, an IV usually gets started in the OR, however the patient is more often than not masked down and doesn’t feel the stick. Are there any suggestions on how to help OR RNs keep up their IV start skills?

Q

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INTERCOM SYSTEM IN OR

SUITE TALK

A: We double documented (paper during case and electronic in-between cases) during the testing phase for a month prior to “go live” and did not diminish case loads … by the end of the month the RNs were so happy to go to electronic documentation that it was a smooth transition.

A: We asked that elective cases be at a minimum the first day of “go live,” it de-creased stress for sure.

TRANSITION TO ELECTRONICQ When transition was made from paper to electronic was the case volume limited during this time to get adjusted?

1603_ORT-Mag.indd 21 1/28/16 8:56 AM

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Sterilization wraps are one tool in the fi ght against infection. These sometimes overlooked items play a key role in protecting patients and caregivers by ensuring that surgical instruments are kept clean and safe before use.

The Centers for Disease Control and Prevention include sterilization wraps in its discussion about infec-tion control.

“Packaging materials (e.g., wrapped or container systems) allow penetration of the steriliza-tion agent and maintain sterility of the processed item after steriliza-tion. Materials for maintaining sterility of instruments during transport and storage include wrapped perforated instrument cassettes, peel pouches of plastic or paper, and sterilization wraps (which can be either woven or unwoven),” according to the CDC website. “Packaging materials should be designed for the type of

sterilization process being used. Packaging materials also should be appropriate for the items being sterilized. For example, nonpaper materials should be used to package sharp instruments which can easily puncture paper packaging. Avoid using metal closures (e.g., staples, paper clips) that can puncture packaging materials.”

A recent report by Research and Markets forecast continued growth in the sterilization and infection prevention market.

“The global infection control market is estimated to reach $16.7 billion by 2020, growing at a CAGR

(Compound Annual Growth Rate) of 6.7 percent during the forecast period (2015 to 2020),” according to Research and Markets.

“The rise in chronic diseases, increase in the number of surgeries performed, increase in the occurrence of hospital-acquired infections, and aging population are the major drivers for the growth of infection control market,” the report states. “Hospitals and medical devices play a vital role in the infection control market. However, stringent regulations and saturation in developed economies are restraining the growth of the market.”

The disposable medical nonwoven market is projected to reach $20 billion by 2017, according to a report from Global Industry Analysts. This is another indication that the steriliza-tion wrap market should see growth. An aging population and other demographics that point toward an increase in surgical procedures bodes well for the sterilization wrap market.

“The medical non-wovens segment accounted for the largest share of nearly 45 percent of the global disinfection market in 2014; whereas, endoscope reprocessors is the fastest growing market among disinfectors/reprocessing equipment market,”

according to Research and Markets.Hospitals and original equipment

manufacturers are fueling market growth.

“On the basis of end user, the infection control market is segmented into hospitals, life sciences, medical device companies, pharmaceutical companies, food industry, and others,” according to Research and Markets. “In 2014, the hospitals segment accounted for the largest share of the infection control market, whereas the medical device companies segment is expected to grow at the highest CAGR from 2015 to 2020.”

P atient safety and positive patient outcomes are among

the many reasons the sterilization sector of the health care market is on the rise. Hospital-acquired infections, readmissions and negative outcomes can impact a health care facility’s reputation and its bottom line under the A� ordable Care Act.

MARKET ANALYSISSterilization Wrap Market on the Rise

IN THE ORSTAFF REPORTMARKET

ANALYSIS

“The global infection control market is estimated to reach $16.7 billion by 2020, growing at a CAGR (Compound

Annual Growth Rate) of 6.7 percent during the forecast period (2015 to 2020).”

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stainless steel need

MAC Medical, Inc. manufactures the highest quality healthcare equipment available. Our engineering capabilities allow us to custom design any specific product your facility may have. With no project too large or too small for our capability, we are committed to providing solutions for your custom needs with our American made products. Some of our products include:

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IN THE ORPRODUCT

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Cardinal Health o�ers a full selection of sterilization wrap that is durable, reliable and cost e�ective. Choose the wrap that best meets your goals of maximizing e�ciency, safety and quality of care. • Options available: single layer, dual layer and two color (dual layer with two colors, green and blue) • Made from SMS polypropylene, non-woven material for strength and sterility maintenance • Designed with a simple, “cross-stich” bond pattern for clear, visual feedback of breaches that may occur

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Single Use Sterilization Wraps by Crosstex/SPSmedical are constructed of blue, non-woven ma-terial for use in packaging instrument trays and equipment packs. Made of natural, fiber-based materials, each sheet is biodegradable, odor-free and non-toxic, and does not emit residue when incinerated. Single Use Sterilization Wraps by Crosstex/SPSmedical are puncture resis-tant, tear-resistant, memory free, conform easily and maintain a breathable yet impervious barrier to airborne bacteria, saline, blood and water. Available in multiple sizes. •

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IN THE ORPRODUCT

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DEFEND Sterilization Wrap (CSR) is perfect for general purpose sterilization, as it provides a barrier against air and water-borne bacteria. This CSR wrap conforms easily around various shapes and sizes of cassettes, allowing excellent penetration of various methods of sterilization. Compatible with steam, ETO and gamma. Petroleum- and memory-free material with a cloth-like feel. •

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MEDLINE GEMINI

Medline’s Gemini wrap is the next generation of sterilization wrap. In an independent, side-by-side strength test, Gemini wrap was shown to have greater material strength to resist punctures and tears compared to the ster-ilization wrap of the next closest competitor. It is constructed with two sheets of 100 percent polypropylene fused together to provide greater strength and improved e�ciency. This wrap comes in five weight grades from lightweight to heavyweight, and is easy to handle and fold. It can also be used with all major sterilization cycles, including pre-vacuum steam cycles, gravity steam cycles, ethylene oxide (ETO) sterilization, STERRAD and STERIS sterilization. Gemini wrap is also available in a unique dual-color wrap with a pink-colored sheet on the outside and blue on the inside, which can help di�erentiate between instrument sets. •

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HALYARD HEALTHSMART-FOLD STERILIZATION WRAP

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IN THE ORCONTINUING EDUCATION

CE655B

BY BY CONNIE GOLDSMITH, MPA, RN, AND DIANA SWIHART, PHD, MSN, DMIN, APN CS, RN-BC

1603_ORT-Mag.indd 32 1/28/16 8:56 AM


Most people know about the U.S. Bill of Rights, the first 10 Amendments to the U.S. Consti-tution, guaranteeing American citizens certain freedoms, such as the right to free speech and assembly, and protection against unreasonable search and seizure. Bills of rights

have been developed for patients, such as nursing home patients, dying patients and cancer patients, among others. Most nurses are aware of the Patients’ Bill of Rights. While these rights may vary by state and facility, they generally guarantee patients the right to privacy and confi-dentiality, and the right to make informed decisions about their own medical care.

The purpose of this program is to inform nurses about the Bill of Rights for Registered Nurses as developed by the American Nurses Association, how those rights may be reflected in position statements, how they may a�ect professional practice, and how they a�ect hospitals seeking American Nurses Credentialing Center (ANCC) Magnet Recognition Program designation. After studying the information presented here, you will be able to:

• List the seven rights found in the ANA’s Nurses’ Bill of Rights

• Explain how the rights may be used to influence professional practice

• Describe how the rights link to ANCC Magnet hospital status

ContinuingEducation.com guar-antees 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.

CONTINUING EDUCATION 472C

THE NURSES’ BILL OF RIGHTS Do You Know Your Rights?

However, not every nurse is familiar with the Nurses’ Bill of Rights (also called the Bill of Rights for Registered Nurses). The ANA held a nurs-ing sta�ng summit in Washington, D.C., in 2000. In a survey before the summit, 75% of nurses reported the quality of nursing care at their facili-ties had declined because of inad-equate sta�ng and decreased nurse satisfaction.1 More than 200 summit attendees called for a document to detail what nurses need and deserve to do the best for their patients.1 This led to the development of the Nurses’ Bill of Rights, which was approved by the ANA Board of Directors in 2001. Then-ANA President Mary E. Foley, MS, RN, stated, “The ANA Bill of Rights is a powerful statement of the rights that every registered nurse must have to provide high-quality pa-tient care in a safe work environment. This is a tangible reminder to employ-ers of what nurses should be able to expect in their workplaces.”1

“Registered nurses promote and restore health, prevent illness and protect the people entrusted to their care,” the ANA said in a statement on the Nurses’ Bill of Rights and workplace safety.2 “They work to alleviate the su�ering experienced by individuals, families, groups and communities. In so doing, nurses provide services that maintain respect for human dignity and embrace the

uniqueness of each patient and the nature of his or her health problems, without regard for social or economic status. To maximize the contributions nurses make to society, it is necessary to protect the dignity and autonomy of nurses in the workplace.”2 The Nurses’ Bill of Rights seeks to satisfy that need.

PROFESSIONAL RIGHTSThe Nurses’ Bill of Rights, which lists seven rights, is a statement of professional rights rather than a legal document. It establishes an informal covenant between nurses and their employing institutions to help guide development of organizational policy and to focus discussions between nurses and employers on issues related to patient care and working conditions. Nurses can advocate more e�ectively for the rights of patients if they have critical information about their own professional rights.

The Nurses’ Bill of Rights supple-ments other ANA documents, such as the Code of Ethics for Nurses with Interpretive Statements, Nursing’s Social Policy Statement and Nursing: Scope and Standards of Practice.3 In addition, nurses and their employ-ers must be familiar with the nurse practice act and professional practice regulations for their own states, as these documents do set forth the legal requirements for nursing practice in a

1603_ORT-Mag.indd 33 1/28/16 8:56 AM


given state. Nurses should also be familiar with

the “2010 Future of Nursing Report,” developed by the Institute of Medi-cine in conjunction with the Robert Wood Johnson Foundation, as it also addresses some of the barriers nurses face in responding to today’s rapidly evolving complex adaptive health care systems. Overcoming these bar-riers will ensure nurses are well po-sitioned to lead change and advance health care through academia and clinical practice.

READ ME MY RIGHTSThe Nurses’ Bill of Rights can help nurses settle work-related issues with employers. The use of such widely recognized consensus documents adds credibility to nurses who need

to discuss di�cult situations, such as safety, sta�ng and workplace violence with administration. Nurse educators can refer to the ANA Bill of Rights when addressing important topics related to professional practice and when seeking guidance in devel-oping nursing school curriculum and continuing education programs inside and outside of hospitals. Employers can refer to the Nurses’ Bill of Rights to ascertain what nurses need to fully meet their professional responsibili-ties. Many of ANA’s policies and pub-lications are relevant to the Nurses’ Bill of Rights. Following are the seven rights that make up the Nurses’ Bill of Rights:

1NURSES HAVE THE RIGHT TO PRACTICE IN A MANNER THAT

FULFILLS THEIR OBLIGATIONS TO SOCIETY AND TO THOSE WHO RECEIVE NURSING CARE.2,3

Two ANA publications delineate these obligations. The first, ANA’s Nursing’s Social Policy Statement, says the authority for the practice of nursing is based on a social contract that acknowledges professional rights and responsibilities. The second document, ANA’s Code of Ethics for Nurses with Interpretive State-ments, is a “… succinct statement of the ethical obligations and duties of every individual who enters the nursing profession; it is the profes-sion’s nonnegotiable ethical standard; it is an expression of nursing’s own understanding of its commitment to society.”4 (Nurses might reference this right if there is a dispute with the em-ployer about their obligations toward patients.)

2NURSES HAVE THE RIGHT TO PRACTICE IN ENVIRONMENTS

THAT ALLOW THEM TO ACT IN ACCORDANCE WITH PROFES-SIONAL STANDARDS AND LEGAL-LY AUTHORIZED SCOPES OF PRACTICE.2,3

The ANA’s Nursing: Scope and Standards of Practice sets forth the professional standards that apply to the practice of all professional nurses. Nurses should have a copy of the practice act, the regulations and any other o�cial documents governing nursing practice for each state where they are employed and/or licensed. These documents define the legal scope of nursing practice and guide and protect nurses in the perfor-mance of their duties. The ANA has also published or endorsed standards for specialty nurse practice.5 (Nurses might reference this right if the employer is reluctant to allow nurses to perform jobs for which they are legally authorized and fully trained to perform.)


655B

BILL OF RIGHTS FOR REGISTERED NURSES

1 Nurses have the right to practice in a manner that fulfills theirobligations to society and to those who receive nursing care.

2 Nurses have the right to practice in environments that allow them to act in accordance with professional standards and legally authorized scopes of practice.

3 Nurses have the right to a work environment that supports and facilitates ethical practice, in accordance with the Code of Ethics for Nurses with Interpretive Statements.

4Nurses have the right to freely and openly advocate for them-selves and their patients, without fear of retribution.

5 Nurses have the right to fair compensation for their work, consistent with their knowledge, experience and professional responsibilities.

6 Nurses have the right to a work environment that is safe for themselves and for their patients.

7 Nurses have the right to negotiate the conditions of their employment, either as individuals or collectively, in all practice settings.

1603_ORT-Mag.indd 34 1/28/16 8:56 AM


3NURSES HAVE THE RIGHT TO A WORK ENVIRONMENT THAT

SUPPORTS AND FACILITATES ETHICAL PRACTICE IN ACCOR-DANCE WITH CODE OF ETHICS FOR NURSES WITH INTERPRETIVE STATEMENTS.2,3

The Code of Ethics for Nurses and its interpretive statements establish ethical standards for the nursing profession and help nurses determine whether their workplaces support ethical practice. (Nurses might refer-ence this right if they believe they are being forced into an unethical plan of care.)

4 NURSES HAVE THE RIGHT TO FREELY AND OPENLY ADVO-

CATE FOR THEMSELVES AND THEIR PATIENTS WITHOUT FEAR OF RETRIBUTION.2,3

The ANA’s Code of Ethics for Nurses states the nurse promotes, advocates for and strives to protect the health, safety and rights of the patient as one of its nonnegotiable tenets. Some nurses have experienced adverse con-sequences for stepping forward with concerns. Some states have enacted whistle-blower laws to protect em-ployees who report unsafe or unethi-cal situations. State nurse practice acts include mandatory reporting provisions that hold nurses account-able for implementing state hospital laws and regulations as advocates for their patients. (Nurses might refer-ence this right if they believe they are being punished for trying to advocate for vulnerable patients or if the safety of a patient is in jeopardy.)

5 NURSES HAVE THE RIGHT TO FAIR COMPENSATION FOR

THEIR WORK CONSISTENT WITH THEIR EDUCATIONAL PREPARA-TION, KNOWLEDGE, EXPERIENCE AND PROFESSIONAL RESPONSI-BILITIES.2,3

While there are no laws that define

fair compensation (other than federal and state minimum wage require-ments), nurses are in an enviable position compared with many other professions. Nurses who do not believe their employer is paying them a wage commensurate with their experience, knowledge and educational preparation can often seek employment elsewhere. Nurses should familiarize themselves with current market wages in their re-gion, as salaries vary greatly from state to state. For example, RNs in California averaged $96,980 annually in 2013, compared with $56,030 in North Da-kota for the same year.6,7 It is illegal for employers to artificially control wages by collaborating with other employers in their region. (Nurses might refer-ence this right as they negotiate with employers about salary or benefits.)

6NURSES HAVE THE RIGHT TO A WORK ENVIRONMENT THAT IS

SAFE FOR THEMSELVES AND THEIR PATIENTS.2,3

The Occupational Safety and Health Act of 1970 requires employers to pro-vide workplaces free from recognized hazards that could cause harm or death to employees.8 Some states have requirements that exceed federal standards. The right to a safe work environment includes many factors, such as su�cient sta�ng to ensure patient safety, programs to protect sta¤ against infection and needle-sticks, protection against workplace violence, adequate training to ensure safe performance of assigned duties, and recognition of the inherent dan-ger of nurses working while overly fa-tigued. The ANA has even developed a position statement relating patient safety to nurse fatigue.9 Numerous studies over the past few years have shown a strong correlation between better nurse sta�ng and improved patient outcomes.10, 11, 12 (Nurses might reference this right whenever they believe a patient safety issue or a

workplace safety issue arises, includ-ing mandatory overtime.)

7NURSES IN ALL PRACTICE SETTINGS HAVE THE RIGHT TO

NEGOTIATE, EITHER AS INDIVIDU-ALS OR COLLECTIVELY, THE CONDITIONS OF THEIR EMPLOY-MENT.2,3

Not only do nurses have the right to negotiate terms of employment; they have the right to receive written descriptions setting forth wages, work schedules and how their performance will be evaluated. Under the National Labor Relations Act, employees — including registered nurses — may form, join or assist labor organizations and engage in collective bargaining over wages, hours and other terms and conditions of employment.13 Com-pared with other occupations (such as manufacturing and industry), nurses came relatively late to collective bar-gaining and unionization. Many nurses still have mixed feelings about union-ization: In 2010 about 23% of RNs reported they belonged to unions.14

Studies have shown that hospitals with RN unions have higher nurse retention rates, but report greater job dissatisfaction, possibly because unionized nurses may be more vocal and less fearful about voicing con-cerns.15 (Nurses might reference this right if their employer seems reluctant to allow for unionization and collective bargaining.)

THE PIONEERThe ANA Nurses’ Bill of Rights was not the first such document. The National Student Nurses’ Association (NSNA) developed its Bill of Rights and Responsibilities for Students of Nursing in 1975 and last updated it in 2006.16 As with the ANA Bill of Rights, the rights for student nurses can serve as a basis to resolve issues of concern and to clarify expectations of all par-ties. The National Student Nurses’ As-

CONTINUING EDUCATION 472C

1603_ORT-Mag.indd 35 1/28/16 8:56 AM


sociation also suggests state student nursing associations use their bills of rights when developing policy and procedure manuals.

The first three of the 21 rights and responsibilities set forth in the National Student Nurses’ Associa-tion Bill of Rights for Students of Nursing are:

1. Students should be encouraged to develop the capacity for critical judgment and engage in a sus-tained and independent search for truth.

2. The freedom to teach and the freedom to learn are inseparable facets of academic freedom. Students should exercise their freedom in a responsible manner.

3. Each institution has a duty to develop policies and procedures that provide and safeguard the students’ freedom to learn.16

The list of rights is augmented with a detailed grievance procedure for use among educational institu-tions that have adopted the rights.16

Such documents can help nurses learn to advocate for themselves early in their careers.

RIGHTS OF NURSES, RIGHTS FOR PATIENTSThe ANA Nurses’ Bill of Rights helps to protect both the rights of nurses and the right for patients to receive quality nursing care. These rights naturally flow into and enhance standards established by specialty nursing organizations, such as the American Association of Critical-Care Nurses. Implementation of the AACN Standards for Establishing and Sus-taining Healthy Work Environments ensures that acute care and critical care nurses have the skills, resources, accountability and authority to make decisions that lead to excellent pro-fessional practice and optimal care

for patients and families.17 The six AACN standards are skilled commu-nication, true collaboration, e�ective decision making, appropriate sta�ng, meaningful recognition and authentic leadership.17

Some state nursing associations have incorporated ANA’s Nurses’ Bill of Rights into their own pro-fessional practice documents. For example, the New York State Nurses Association says on its website that the organization believes the rights must be a�orded to registered nurses and they must know those rights. In addition, the association states that to exercise these rights, RNs must assess the assignment, clarify the facts and assess their own knowl-edge, ability and experience. After evaluating and choosing an option, the nurse must notify the appropri-ate people of the chosen option in a timely manner.18 These actions, for example, would provide an ethical and professional way in which to handle sta�ng disparities.

The Maryland Nurses Association recommends using the ANA Nurses’ Bill of Rights as a “decision tree” when accepting or rejecting an as-signment that appears to preclude safe care or that requires nurses to practice beyond their scope.19

Maryland reminds nurses they open themselves to disciplinary action by accepting an assignment they are not qualified to perform.19 Using the bill of rights in this way may mitigate adverse outcomes for both patient and nurse.

Other organizations, such as the Academy of Medical/Surgical Nurses, support the Nurses’ Bill of Rights as a foundation for discussion of patient and worker safety concerns by the nurse and health care employer, while the American Academy of Ambula-tory Care Nursing has developed a similar but not identical list of rights

for registered nurses.20,21 Hospital websites may reference or feature the Bill of Rights as well.

ATTRACTIVE MAGNETSHospitals achieving or seeking Magnet designation recognize the importance of the Nurses’ Bill of Rights in fostering a positive work en-vironment. Developed by the ANCC, the Magnet Recognition Program recognizes health care organizations for quality patient care, nursing excel-lence and innovations in professional nursing practice.21

Hospitals seek Magnet status to help them attract and retain top talent; to improve care, safety and satisfaction; to foster a collaborative culture; to advance nursing standards and practice; and to grow business and financial success.22 According to the ANCC, about 390 hospitals had achieved Magnet status as of Febru-ary 2012. Eight out of 10 of the top-rated medical centers in the U.S. are Magnet facilities.22

The Magnet Recognition Program advances three goals within health care organizations: (a) promote qual-ity in a setting that supports profes-sional practice; (b) identify excellence in the delivery of nursing services to patients; and (c) disseminate best practices in nursing services.22,23

One study of more than 26,250 RNs showed that Magnet hospitals have better work environments, a more highly educated nursing sta�, better nurse-to-patient sta�ng ratios and overall higher nurse satisfaction than do non-Magnet hospitals.24 Hospitals must address five Magnet compo-nents in the application process:22,23

• Transformational leadership• Structural empowerment• Exemplary professional practice• New knowledge, innovation and

improvements• Empirical quality


655B

1603_ORT-Mag.indd 36 1/28/16 8:56 AM


The section on structural empow-erment references the Nurses’ Bill of Rights. To fully meet the criteria of that section, hospitals must provide a list of continuing education programs and the number of nurses complet-ing the programs over the past 24 months. A program designed to ensure nurses understand the Nurses’ Bill of Rights must be among the program topics.22 A study showed that structural empowerment is positively correlated with nursing job satisfac-tion and high-quality patient care.24

Studies of attributes of Magnet hospitals — which by definition in-corporate the Nurses’ Bill of Rights into their cultures — are measur-ably correlated with improved outcomes in a number of areas. Studies of Magnet hospitals have provided evidence of improved patient care outcomes and in-creased patient satisfaction, as well as improved nurse satisfaction and nurse retention.24 The best example of environments supporting profes-sional nurse practice are Magnet hospitals.25 Patients in such opti-mized environments have lower risks of death and fewer episodes of failure to rescue. Nurses work-ing in healthy work environments rate patient care more highly, with Magnet hospitals being markedly skewed toward excellence.26

A STANDARDIZED STRUCTUREThe Nurses’ Bill of Rights provides a standardized and recognized struc-ture within which nurses can advo-cate for themselves, a fundamental right for any profession. While nurs-es have always vigorously advocated for their patients, they have not al-ways done so for themselves. Today, nurses are independent practicing professionals with well-defined roles and responsibilities, and account-ability and authority for the care and

safety of their patients. They work collaboratively with other health care professionals. They advocate for themselves and their patients.

Are copies of the Nurses’ Bill of Rights prominently posted where they are readily viewable by sta�, such as in nursing stations, the human relations department and nursing administration o�ces? If not, why not? Do nurses at your facility know about the ANA Nurses’ Bill of Rights and how the rights relate to their professional practice? If not, ask your education department or administra-tion to provide appropriate training as needed. Nurses can more e�ectively advocate for their patients’ rights if they are familiar with their own rights.

RESOURCESAmerican Nurses Association: http://www.nursingworld.org

American Nurses Credentialing Center/Magnet Recognition Program: http://www.nursecredentialing.org/Mag-net.aspx

Institute of Medicine Future of Nurs-ing Report: http://www.iom.edu/re-ports/2010/the-future-of-nursing-lead-ing-change-advancing-health.aspx

National Council of State Boards of Nurs-ing: http://www.ncsbn.org/index.htm

Purchase a poster of the ANA’s Bill of Rights for Registered Nurses: http://www.nursesbooks.org/Main-Menu/Specialties/Staffing Workplace/Bill-of-Rights-.aspx

Find Magnet hospitals in your state: http://www.nursecredentialing.org/Mag-net/FindaMagnetFacility.aspx

CONNIE GOLDSMITH, MPA, RN, is a freelance health and medical writer and a frequent contributor to Gannett Educa-tion.

DIANA SWIHART, PhD, MSN, DMin, RN-BC, APN CS, is the chief executive offi er for the American Academy for Preceptor Advancement and a health care strategist and consultant with the Forum for Shared Governance.

REFERENCES1. Wiseman R. The ANA develops bill of rights for registered nurses: Know your rights in the workplace. AJN. 2001;101(11):55-56. 2. American Nurses Association (ANA). Nurses’ Bill of Rights. Nursing World Web site. http://www.nursingworld.org/Nurses-BillofRights. Accessed November 26, 2014.3. ANA. Bill of Rights FAQs. Nursing World Web site. http://nursingworld.org/Docu-mentVault/NursingPractice/FAQs.aspx. Accessed November 26, 2014. 4. ANA. Revision of the Code of Ethics for Nurses with Interpretative Statements. Nursing Work Web site. http://www.nursing-world.org/MainMenuCategories/EthicsStan-dards/Revision-of-Code-of-Ethics-Panel. Accessed November 26, 2014.5. ANA. Recognition of a nursing specialty, approval of a specialty nursing scope of practice statement and acknowledgment of specialty nursing standards of practice. http://nursingworld.org/MainMenuCatego-ries/ThePracticeofProfessionalNursing/NursingStandards/3-S-Booklet.pdf. Ac-cessed November 26, 2014. 6. U.S. Department of Labor, Bureau of Labor Statistics. State occupational employment and wage estimates, Califor-nia. http://www.bls.gov/oes/current/oes_ca.htm#29-0000. Published 2013. Accessed November 26, 2014. 7. U.S. Department of Labor, Bureau of Labor Statistics. State occupational employ-ment and wage estimates, North Dakota, May 2013. http://www.bls.gov/oes/current/oes_nd.htm#29-0000. Published May 2013. Accessed November 26, 2014.

CONTINUING EDUCATION 655B

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8. U.S. Department of Labor. Occupational Safety and Health Act of 1970. http://www.osha.gov/pls/oshaweb/owasrch.search_form?p_doc_type=OSHACT&p_toc_level=0. Accessed November 26, 2014.9. ANA. Position statements: assuring pa-tient safety: Registered nurses’ responsibility in all roles and settings to guard against

working when fatigued: position statement. http://gm6.nursingworld.org/MainMenu-Categories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Archives/Copy-of-AssuringPatientSafety-1.pdf. Accessed November 26, 2014. 10. Aragon Penoyer D. Nurse staffing an patient outcomes in critical care. Crit Care

Med. 2010;38(7):1521-1528. 11. Aiken LH, Sloane DM, Cimiotti JP, et al. Implications of the California nurse staffin mandate for other states. Health Serv Res. 2010;45(4):904-921. 12. Patton RM. Safe staffing s ves lives. American Nurse Today. http://www.americannursetoday.com/Article.

The nurses at Jana’s hospital often disagree with management decisions. Nurses have too many patients to care for during their shifts and feel rushed and stressed. Mandatory overtime is common. Meetings between sta� and management are contentious and end without resolution. And Jana, a team leader on a med/surg unit, recognizes the incidence of hospital-acquired infections on her unit is higher than it should be. She recently completed a continuing education module about the ANA Nurses’ Bill of Rights. She asks around and learns that many nurses are unfamiliar with the rights described in that document.

Based on the information in this module, what might Jana do first?A. Complain to her state nursing board B. Talk to hospital administration about the Nurses’ Bill of RightsC. Go directly to the hospital CEO to talk about the issuesD. Complain to The Joint Commission

Based on the complaints the nurses are making, which right is most germane to the meeting?

A. No. 5: the right to fair compensationB. No. 1: the right to practice in a manner that fulfills nurses’ obligation to societyC. No. 4: the right to a work environment that is safe for nurses and patients D. No. 7: the right to negotiate the conditions of employment

To help keep the lines of communication between staff and management open, Jana suggests that: A. The hospital educate the nursing sta� about the Nurses’ Bill of RightsB. The nurses join a unionC. The hospital apply for Magnet statusd. The nurses report on their progress to the state board of nursing

CLINICAL VIGNETTE

2

1

3

IN THE OR

1. Correct Answer: B — In the CE module, Jana learned that the ANA Nurses’ Bill of Rights can facilitate discussions between staff and administration about problems.

2. Correct Answer: C — While most of the rights have some relevance to the nurses’ current concerns, the nurses can make a strong case for a decline in patient safety because of understaffing, mandtory overtime and the high infection rate on Jana’s unit.

3. Correct Answer: A — As neither the nursing staff nor administration seems familiar with the Nurses’ Bill of Rights, it is appropriate for the education department to offer training to all parties on its provisions.

1603_ORT-Mag.indd 38 1/28/16 8:56 AM


HOW TO EARN CONTINUING EDUCATION CREDIT1. 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 takethis test at no additional charge. You can sign up for an Unlimited CE membership at www.nurse.com/unlimitedCE for $49.95 per year.

DEADLINECourses must be completed by 12/15/2016.3. 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.

ACCREDITEDContinuingEducation.com is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.

Accredited status does not imply endorsement by the provider or ANCC of any commercial products displayed in conjunction with this activity.

ContinuingEducation.com is also accredited by the Florida Board of Nursing and the Georgia Board of Nursing (provider # 50-1489). ContinuingEducation.com is approved by the California Board of Registered Nursing, provider # CEP16588.

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

QUESTIONSQuestions or for a complete listing of our coursesPhone: 800-866-0919Email: [email protected]

aspx?id=4756&fid= 728. Published April 24, 2010. Accessed November 26, 2014.13. U.S. National Labor Relations Board. National La-bor Relations Act. http://www.nlrb.gov/national-labor-relations-act. Accessed November 26, 2014.14. Buerhaus PI. It’s time to stop the regulation of hospital nurse staffing dead in its t acks. Nurs Econ. 2010;28(2):110-113.15. Seago JA, Spetz J, Ash M, Herrera CN, Keane D. Hospital RN job satisfaction and nurse unions. J Nurs Admin. 2011;41(3):109-114.16. National Student Nurses’ Association. Bill of Rights and Responsibilities for Students of Nursing. https://www.google/#q=Bill+of+Rights+and+Responsibilities+for+Students+of+Nursing. Accessed November 26, 2014.17. American Association of Critical-Care Nurses. AACN Standards for establishing and sustaining healthy work environments: a journey to excellence. Am J Crit Care. 2005;14(3):187-197.18. New York State Nurses Association. Know your rights. http://www.nysna.org/strength-at-work/know-your-rights#.VDxFlPnF-So . Accessed November 26, 2014.19. Maryland Nurses Association. Workplace issues. http://www.marylandrn.org/Main-Menu-Category/Professional-Resources/Workplace-Issues, Accessed November 26, 2014.20. Academy of Medical/Surgical Nurses. Position statements: Nurses’ Bill of Rights. https://www.amsn.org/practice-resources/position-statements/archive/nurses-bill-rights. Accessed November 26, 2014.21. American Academy of Ambulatory Care Nursing. Position statement. http://www.aaacn.org/sites/default/files documents/PositionStatementRN.pdf. Accessed November 26, 2014.22. American Nurses Credentialing Center. Program overview. http://www.nursecredentialing.org/Magnet/ProgramOverview.aspx. Accessed November 26, 2014. 23. ANCC. Application Manual, Magnet Recognition Program. Silver Spring, MD: American Nurses As-sociation, 2008:39.24. Kelly L, McHugh MD, Aiken LH. Nurse outcomes in Magnet and non-Magnet hospitals. J Nurs Admin. 2011;41(10):428-433.25. Spence Laschinger HK. Effect of empowerment on professional practice environment, work satisfac-tion, and patient care quality. J Nurs Care Quality. 2008;23(4):322-330.26. Kramer M, Maguire P, Brewer RR. Clinical nurses in Magnet hospitals confirm p oductive, healthy work environments. J Nurs Management. 2011;19(1):5-17

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42 OR TODAY | March 2016 WWW.ORTODAY.COM42 OR TODAY

OR TODAY: PLEASE SHARE A LITTLE BIT ABOUT YOUR COMPANY’S HISTORY AND HOW YOU ACHIEVED SUCCESS.The Ruhof Corporation was estab-lished in 1976 when Frank Bass and Bernard Esquenet became a team. Frank Bass’s role in the company is one of sales, marketing and research while Bernard Esquenet is the chemist behind Ruhof’s success. Prior to the launch of Ruhof, Frank recognized the need for hospitals to use more than simple dishwashing detergent in cleaning surgical instruments. Bernard had created cleaning solutions for the Navy, which were used to clean barnacles and other crustaceous marine residues from the heat ex-changers and water evaporators of submarines and other naval vessels. When Frank Bass approached him to develop cleaning solutions for hospital instruments, Esquenet realized that the enzymes he was using to eat away at the marine organism residues would also dissolve proteins o� of surgical instruments. Thus, Protozyme, the very fi rst enzymatic cleaner for surgical instrumentation was born

along with Surgi-Stain, a product for refurbishing corroded stainless steel instruments.

Today Ruhof has a full line of surgical instrument cleaners and scope care and cleaning products which include our multi-tiered enzymatic detergents, enzymatic foam sprays, rust remover and lubricants, autoclave descalers, enzymatic sponges, and more. We also o� er our ScopeValet™ line of products comprised of our PULL THRU™ Endoscope cleaning devices, endoscopy procedure kits, scope transport bags, Eco-Bedside kit, etc. providing a safe, convenient and e� cient way to prepare, begin and perform a scope reprocessing proce-dure while meeting all reprocessing guidelines. New from Ruhof is our channel/lumen fl ushing devices , the Ruhof InstruFlush™ and Flushtech GI™ for e� ective pre-cleaning & fl ushing. We have also recently launched dispensing systems for our

liquid chemistries, Fast Foam™ and DoseValet(TM), which can help Sterile processors increase workfl ow while achieving high marks for instrument cleanliness. Ruhof not only provides the most e� ective decontamination products on the market today, we also allow you to verify it with the Ruhof ATP Complete® Contamination Monitoring System and the Clean Check Complete™ Monitor for both automated and manual enzymatic cleaning process.

OR TODAY: WHAT ARE SOME ADVANTAGES THAT YOUR COMPANY HAS OVER THE COMPETITION?Ruhof Healthcare sells the only enzymatic detergent on the market (ENDOZIME® BIO-CLEAN) clinically tested to pass the di� cult ISO stan-dard 15883 Annex F by dissolving biofi lm and exposing underlying bacteria to high-level disinfectants or

This month, OR Today sat down with Ruhof Healthcare to fi nd out

the latest developments at the cleaning solutions com-pany responsible for creating the very fi rst enzymatic de-tergent for cleaning surgical instruments. Read on to fi nd out more about the com-pany, including what makes their products unique and what you can expect from them in 2016.

RUHOF HEALTHCAREInstrument & Scope Cleaning SolutionsF R O M T H E O R I G I N A L I N V E N T O R S O F E N Z Y M A T I C D E T E R G E N T S

CORPORATE PROFILE

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liquid chemical sterilants. Our prod-ucts are of the highest quality available and we o� er the most complete line of surgical instrument and scope cleaning and reprocessing supplies in the marketplace. In addition the company is innovative, continually developing new technologies to meet the needs of our customers.

OR TODAY: WHAT ARE SOME HEALTHCARE CHALLENGES OVER THE LAST YEAR THAT YOUR COMPANY WAS ABLE TO ADDRESS?Recent reports to the U.S. Food & Drug Administration (FDA) of processing errors with fl exible endoscopes have brought much attention to the impor-tance of this issue. In general, while fl exible endoscopes are inherently di� cult to clean e� ectively due to their long narrow lumens and because they are used in highly contaminated areas of the body, the manual compo-nent of endoscope reprocessing appears to be the area most prone to error. As a result newly revised guidelines from both the CDC and the AORN recommend the used of cleaning verifi cation tests such as ATP bioluminescence, which has been shown to be both a rapid and e� ective method for assessing the e� cacy of the cleaning process. The Ruhof ATP COMPLETE® is a quick, simple, and reliable method for verifying the e� ectiveness of the cleaning and decontamination process for the outer surfaces and internal channels of

scopes and cannulated instruments along with all non critical facility surfaces. The ATP Complete® System consists of a lightweight hand held device, sampling tools-- Ruhof Test ® Swab and Ruhof Test® Instrusponge™ —and easy to use software for tracking results. The System can also be used to test the e� cacy of the cleaning process for the especially complex Duodenoscope, an endoscope associ-ated with recent outbreaks of carbape-nem-resistant Enterobacteriaceae (CRE) infections.

OR TODAY: PLEASE EXPLAIN YOUR COMPANY’S CORE COMPETENCIES AND UNIQUE SELLING POINTS.We are the only supplier of enzymatic detergents that manufactures its own product, guaranteeing consistency and quality. Ruhof is a registered ISO 14001 manufacturer and we pride ourselves on the superior products we manufacture.

OR TODAY: WHAT PRODUCT OR SERVICE THAT YOUR COMPANY OFFERS ARE YOU MOST EXCITED ABOUT RIGHT NOW?We are most excited about our new Valveafe™and Aquabrush products. Valvesafe™ is a single-use endoscope valve cage for the safe storage of endoscope valves ensuring they remain as part of a unique set with the parent endoscope. Assisting with the traceability of the scope and its valves, Valvesafe enables compliance with national and international recom-

mended guidelines (AORN, ANSI/AAMI, SGNA, BSG, ESGE) stating endoscope valves (including rinsing valves) stay with the named endoscope throughout the cleaning process.

In addition we are very enthusiastic about the launch of the Ruhof Aqua-Brush™, a rechargeable, completely submersible surgical instrument cleaning brush, which eliminates manual scrubbing for easier, more e� cient instrument reprocessing. Available with both large and small brush heads to accommodate various instrument sizes, the AquaBrush™also keeps hands away from sharp instru-mentation which helps prevent possible injuries.

OR TODAY: PLEASE SHARE SOME COMPANY SUCCESS STORIES WITH OUR READERS-ONE TIME THAT YOU “SAVED THE DAY” FOR A CUSTOMER.Ruhof often receives positive feedback from customers regarding cost savings. Perioperative and sterile processing professionals regularly tell us that they get better results and more cleaning e� cacy using much less of our detergent than other brands. In addition we receive many reports about product e� ectiveness. Recently a nurse contacted us about how Ruhof really “saved the day” for her. All other detergents failed to remove an unusual yellow/orange oily deposit from the scopes she was cleaning but our Endozime SLR® enzymatic cleaner — which specializes in removing syn-

SPECIAL ADVERTISING SECTION

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thetic lipid residue – did the trick and she has been a loyal customer since.

OR TODAY: HOW DOES RUHOF SUPPORT ITS CUSTOMERS?Ruhof has a most knowledgeable and responsive customer service depart-ment and sales team ready to help our customers with questions, orders, troubleshooting, etc. Our user friendly website and informative technical data sheets/IFUs also provide support. This past year we began a program of free accredited continuing education for nurses and CS/SPD techs, as we understand that ongoing education, training and mentoring are critical to the success of any clinical department. These CE opportunities – o� ered at both national and local trade shows — were so well received that we now o� er multiple CE programs to help our customers continually advance their knowledge.

OR TODAY: PLEASE TELL ME ABOUT YOUR EMPLOYEES.MARC ESQUENETMarc Esquenet joined the Ruhof Corp. in 1996 as a quality control and formulation chemist and in 2001 was named chief chemist. It was in this role that Marc formulated the unique and innovative products that have given Ruhof its competitive advan-tage. Marc has developed new

technologies such as enhanced multi-tiered enzymatics, synthetic lipid removal products, Prepzyme® spray for removing dried on bio-bur-den, Endozime® SLR Bedside Kit, EndozimeTM Xtreme Power and Endozime APA enhanced detergent, and most recently Endozime® Bio-Clean biofi lm solubilization formulations. Marc’s responsibilities in this position included research and development projects in which he now holds several patents. In 2010 Marc was named Vice President of Research and Development, a role requiring him to meet with distribu-tion and customers world-wide in order to better develop new product research, development and commer-cialization for the company.

DOUG MACKAYJoining Ruhof in 1993, Doug Mackay, Vice President of Sales & Marketing, has been instrumental in providing strategic leadership for the company. In 2009 Doug successfully launched ATP Complete, which then represented the fi rst ATP system used in North America to test the cleanliness of scopes and surgical instruments. In 2012 he also launched ScopeValetTM as well as a complete line of new endoscopy care products. His innovative product launch has been received extremely well by the market and has further strengthened Ruhof’s standing in the endoscopy and medical communities.

JOSE OBREGONA Ruhof employee since 1984, Jose Obregon became International Sales Manager in 1990 and Chief Operating O¢ cer in 2000. It was during this time that he successfully took part in opening new markets in South Ameri-ca, Europe and Asia and participated in the launch of more than 20 new

products and four new product lines. Moving forward, Jose’s goal is to continue to grow both the international and domestic markets for Ruhof with the aim of developing product lines which improve the quality of instru-ment care and patient safety.

JACK KINVILLEA 20-year veteran of the Ruhof Corp., Jack Kinville has played a major role in generating sales for the company while also assisting the president with many aspects of marketing. Over the years, he has been featured in many trade publication articles for his expertise regarding instrument and scope cleaning. Jack’s experience, skills and successful sales record recently landed him a promotion to the position of Ruhof Sales Manager. “Jack is a strong leader who’s been working closely with our sales team to motivate them to ever greater achievements” stated Doug Mackay, Vice President of Sales & Marketing.

OR TODAY: WHAT IS YOUR COMPANY’S MISSION STATEMENT, OR IF YOU DON’T HAVE A SPECIFIC ONE, WHAT IS MOST IMPORTANT TO YOU ABOUT THE WAY YOU DO BUSINESS?At Ruhof we understand the impor-tance of cleanliness in the healthcare fi eld and are guided by our commit-ment to excellence. We demonstrate this by o� ering reliable solutions and individualized service to help health-care facilities meet and exceed their decontamination and infection prevention challenges. We are always fi nding new solutions and new ways to help fi ght HAIs and to provide a safe work environment for patient and sta� . We value our customers as much as the patients that they care for.

44 OR TODAY | March 2016

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Opt

ical

Insp

ectio

n

Moisture

& Tear

Management

healthmarkIntelligent Solutions for Instrument Care & Infection Control

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Opt

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healthmarkIntelligent Solutions for Instrument Care & Infection Control

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Instrument CareLabeling & Tracking

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Sterilization Packaging

Visit usat AORN!Booth 1219

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HANG 10

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Your Guide to the 2016 Conference By Don Sadler

AT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNAT AORNHANG 10

The theme for the AORN Surgical Conference & Expo 2016, which will be held April 2-6 in Anaheim, California, is “Thriving Through Transformation.” Indeed, this year’s AORN conference will present a unique opportunity for attendees to be transformed in their profession at the largest international gathering of perioperative registered nurses in the world.The 2016 AORN conference looks to be one of the biggest in recent memory, with more than 4,600 perioperative nurses expected to attend. In addition, at least 500 exhibitors will set up shop on the 120,000 square feet of exhibit hall space.

“ This presents a great

opportunity to meet new

people, share experiences, and

bounce around new ideas.”- Renae Battié, MN, RN, CNOR,

1603_ORT-Mag.indd 47 1/28/16 1:30 PM

“ There’s something here for

every perioperative nurse,

regardless of your role or the

type of facility you work in.”- Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN


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BROADENING YOUR ROLE“Perioperative nurses today are expected to do more and more in their jobs,” says Linda Groah, MSN, RN, CNOR, NEA-BC, FAAN, the Executive Director and CEO of the Association of periOperative Registered Nurses (AORN). “Whether they’re sta� , managers or educators, they are expected to broaden their roles within the facility. We’re striving to help them do this at the AORN Surgical Conference & Expo.”

“The myriad changes occurring in the health care fi eld – from new regulations to changing fi nancial objectives and reimbursement schedules – are all a� ecting perioperative nurses,” adds AORN President Renae Battié, MN, RN, CNOR. “The AORN Surgical Conference & Expo is designed to support perioperative nurses by providing outstanding education, training and networking opportu-nities during four intensive days.”

AORN CONFERENCE DETAILSAt this year’s AORN conference, you can choose from among 65 di� erent educational sessions organized along eight di� erent tracks:1. Ambulatory2. Clinical3. Educator4. Evidence-Based Practice/

Research5. Infection Control/Infection

Prevention6. Leadership/Management7. Professional Development8. Quality Indicators

“There’s something here for every perioperative nurse, regard-less of your role or the type of facility you work in,” says Groah. “Attendees will have the opportu-nity to deep dive into each one of these specifi c areas.”

In addition, the conference will once again feature the popular OR Executive SummitTM and Leader-ship Development SummitTM. The Executive Summit will bring together a highly tuned mix of the brightest and most-respected leaders in the industry. It will o� er the opportunity for leaders to collaborate with peers about the most pressing and urgent issues currently facing health care.

The Leadership Development Summit, meanwhile, is designed for today’s perioperative leaders and those new to leadership roles. It will teach the necessary skills and provide the resources required for attendees to be successful and e¢ cient perioperative leaders.

A UNIQUE EXHIBIT HALLThe exhibit hall at this year’s AORN conference will be unlike any other exhibit hall. It will have a beach theme and attendees are encour-aged to “Surf the Hall,” riding the party wave through the hall to discover new products, hot jobs and CE credits while meeting face-to-face with exhibitors so you can better understand how their products might fi t into your facility.

While surfi ng the hall, attendees will be able to collect points from exhibitors via the conference’s mobile app to win hourly give-

2016 AORN Keynote Speakers

Amy Purdy inspired a nation on the hit TV

show “Dancing with the Stars.” She will reveal the

intimate details of her triumphant comeback from the brink of death to making

history as a Paralympic snowboarder.

Astronaut Mike Mullane will recount his near-death

experience in a fi ghter jet to describe individuals’ roles in

keeping themselves and their teams safe in hazardous

environments.

Mark Thompsonan expert on executive leadership and business

strategy, will share valuable and practical advice for

leaders at all levels of any organization, including health

care facilities.

WWW.ORTODAY.COM March 2016 | OR TODAY 49

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aways and then chill out at “The Shore,” where lifeguards will be serving refreshments.

“This presents a great opportu-nity to meet new people, share experiences, and bounce around new ideas,” says Battié.

The new expanded mobile app for this year’s conference will serve as an interactive conference manage-ment tool. It will give you access to the entire conference schedule as well as games, quizzes, prizes, networking opportunities and important AORN Congress informa-tion – all from the convenience of your smart device.

Simulation learning is another popular returning feature at this year’s AORN conference. Attend-ees are able to explore dynamic learning experiences at several di� erent simulation stations set up in the exhibit hall.

“This way, you can practice new skills in an environment where you can make mistakes without actually harming patients,” says Groah.

PRE-CONFERENCE CERTIFICATION PROGRAMSOnce again, the AORN conference will o� er a number of di� erent pre-conference certifi cation programs during the two days prior to the o¢ cial conference launch on April 1 and 2. These will include:

• CCI’s Fundamentals of OR Management – This “mini-MBA” course will provide current and aspiring periopera-tive leaders with the tools needed to e� ectively and profi tably lead a surgical services department.

• TeamSTEPPS® Master Training Course – This evidence-based program will o� er strategies, techniques and tools to help individuals teach others the TeamSTEPPS system to improve patient safety and communication.

• Perioperative Medical Malprac-tice Mock Trial – This interac-tive, all-day workshop will encourage audience participa-

tion in a mock medical mal-practice trial involving a hospital/ASC and a periopera-tive registered nurse.

Groah says that given the intensity of the four-day AORN conference, it’s important to work in a few opportunities for fun and relaxation. This year’s conference will feature the AORN Foundation Silver Soiree, a celebration of the 25th anniversary of the AORN Foundation; the AORN Founda-tion Zumba Fitness Class; and a 5k Run/3k Walk Race for Patient Safety through the streets of beautiful Anaheim.

ATTENDEE TESTIMONIALSLinda Gardner, MSN, MED, BA, RN, CNOR, attended the AORN Surgical Conference & Expo for the fi rst time last year in Denver.

“I returned to my facility energized with new ideas and excellent educational resources,” she says.

“ Attending the conference was amazing and opened

my eyes to new opportunities and best practices for

myself, my staff and our patients. I have implemented

several new practices with my co-workers. The AORN

conference was an amazing opportunity!”- Linda Gardner, MSN, MED, BA, RN, CNOR

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“Attending the conference was amazing and opened my eyes to new opportunities and best practices for myself, my sta and our patients,” Gardner adds. “I have implemented several new practices with my co-workers. The AORN conference was an amazing opportunity!”

When asked about the greatest takeaway from last year’s AORN conference, returning attendee Karen Rustermier, BSN, RN, CNOR, replies: “I was particularly inter-ested in the products and education sessions that dealt with pressure ulcer prevention. I also learned that some of the ‘sacred cows’ of patient positioning have been proven otherwise through research.”

“After returning from Expo, my sta discussed the adoption of a pressure risk scale in our pre-op assessment,” Rustermier adds. “I have also changed some of my routine positioning as well.”

START PLANNING NOWIf you’re planning to attend the 2016 AORN Surgical Conference & Expo, Groah suggests that indi-viduals not wait until arriving in Anaheim to start planning out a conference agenda.

“Use the new expanded mobile app to plan out the sessions you want to attend ahead of time,” she advises. “Also start thinking about how you will bring everything you learn at the AORN conference back with you to share with your colleagues to help make positive changes in your OR environment.”

Get complete details and register for the 2016 AORN Surgical Conference & Expo online at http://www.aorn.org/surgicalexpo.

1603_ORT-Mag.indd 51 1/28/16 8:57 AM

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Edward McKay, Jr.Surgical Technician, Johns Hopkins Hospital Pediatric OR

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FULL CIRCLE

Pediatric technician works with doctor who treated

him as a teenSPOTLIGHT ON: JAVARIS SINGLETON

By Matthew Skoufalos

1603_ORT-Mag.indd 55 1/28/16 8:57 AM


The first time neurosur-geon Andrew Reisner met Javaris “Terrell”

Singleton, Singleton was a 16-year-old emergency-room patient at Children’s Health-care of Atlanta at Emory. A CT scan revealed a significant tumor that had caused hydro-cephalus (a medical condition in which there is an abnor-mal accumulation of cerebro-spinal fluid [CSF] in the brain), and doctors placed a shunt in Singleton’s brain to drain the fluid.

Once the pressure was relieved, “He woke right up,” Reisner said. “That gave us time to get an MRI, which revealed a fi st-sized tumor in the middle of his brain.”

Singleton remembers that period of his life as confusing and debilitating. He was su� ering through headaches that wouldn’t resolve on their own. He thought they came from having pushed himself at football practice, or that they were migraines that his Excedrin was no longer addressing.

“My mother said I was walking funny and my steps were not in line,” he said. “Every time I would walk, I would jump, but I didn’t pay atten-tion, so I didn’t know. I was failing my classes because I wasn’t doing my work. I would come right home from school and sleep all the way through to the next morning.”

Reisner cleared out the tumor with microscopic surgical tools, as well as a second “nubbin” that recurred a year or so later, but Singleton had a long road to recovery. The tumor had paralyzed the left side of his body, and he had to learn to walk and use his arms again. Third and fourth surgeries

helped revise the positioning of the shunt that fl ushes the fl uid out of his head, but by the time Singleton turned 21, he had undergone fi ve surgeries and six weeks of radiation on top of the physical rehabilitation sessions.

By 21, Singleton was symptom-free, and Reisner, who specialized in pediatrics, stopped following him as a patient. As Singleton’s physical recovery got underway, he also battled depression, anger, and frustration over the time he’d lost.

“I didn’t know what I was going to do with my life,” he said. “It was very tough.”

Singleton’s friends at Centennial High School in Roswell, Georgia would probably have remembered him as being sick, throwing up, or passing out, he said. His illness had kept him behind in classes, and pulled him o� the same graduation track as other students in his peer group. Yet Singleton was

determined to rally because of all that his mother had done to care for him. He pulled himself together to fi nish high school with a general diploma.

“I failed the graduation test fi ve times,” he said. “I had two chances in the 11th-grade year, two more in the summer, and I was able to come in that 12th-grade year and do it again. I was trying to graduate with everybody.

When I got that diploma, it was a relief. I couldn’t really enjoy my high school.”

At 19, Singleton had saved up enough money from working to get his fi rst car. He attended a technical college for two semesters, and was paying his own way through school with a part-time job. But the days and weeks Singleton had spent in the hospital had acquaint-ed him intimately with the needs of the sta� and patients, and it made him eager to pursue a career in health care. He wanted to start working at Chil-dren’s Hospital of Atlanta, but was denied repeatedly for a lack of relevant work experience. Undaunted, Single-ton continued to apply, and fi nally landed a job.

“I never thought I would ever get to that,” he said. “It’s all I wanted to do.”

In his role as a pediatric techni-cian, Singleton’s responsibilities include setting up operating rooms

for doctors and technicians, provid-ing patient transportation and engagement, and assisting physi-cians as needed. He said he gets the most patient calls of any of his cohorts, but takes particular care in building a rapport with children headed into neurosurgery.

“I tell some of the kids my story whenever I see them, and to the

“My mother said I was walking funny and my

steps were not in line,” he said. “Every time

I would walk, I would jump, but I didn’t pay

attention, so I didn’t know.”

SPOTLIGHT ON JAVARIS

SINGLETON

1603_ORT-Mag.indd 56 1/28/16 11:03 AM


parents when the patients go in the back,” Singleton said. “I sit down with them for a few minutes and tell them my story and just to relax. Some of the kids, when I was sick, they didn’t make it. I remember that, too, being in the hospital. I felt bad about it. That’s why I wanted to really come here and give back.”

Singleton said he’s been told by his coworkers that he may be the fi rst patient to have completed a pediatric course of recov-ery and return to work at the hospital as an adult. He is certain, however, that he is the fi rst of Dr. Reisner’s patients to return to work with him in that setting; a happy coincidence that was realized last year, nearly 10 years after having undergone surgery at Reisner’s hands.

“It was remarkable to see him in that context,” Reisner said. “It was such a great reunion, and it was just nice to see him, but it was not a huge surprise that he grew to be a very productive person. He was such a level-headed, calm, thoughtful young manto everybody.”

Reisner also described Singleton as being “fabulous in the OR; as good as anybody I’ve worked with.” But he gave “99.9 percent of the credit” to Singleton and his “incredible fi ghting spirit.”

“He was wonderful, kind to the patient, very atten-tive,” Reisner said. “He has a very kind disposition to all.”

If Singleton had any nerves about working alongside his former physi-cian, they evaporated on the strength of his daily routine. When the job was done, he allowed himself to feel the excitement of the moment, he said.

“I fi nally made it,” Singleton said. “I had been saying it since I was 16 that I wanted to work at Chil-

dren’s, but even better [to be] with my doctor who’s been working with me for all those years. It was like teacher and student.”

“A lot of people think the toughest part of our job is surgery, and it certainly is technically challenging,” Reisner said. “The hardest part of my job is to give bad news to decent folks like Terrell’s mom. I saw her recently and it was gratifying to see such a nice lady relieved of what could have been a huge

tragedy in her life.”Far from being a tragedy,

Reisner said, Singleton’s recovery “has turned into a wonderful blessing times three,” as the 26-year-old is now happily married and expecting his fi rst child.

“Unfortunately, I think back to the many patients who didn’t have such a happy ending,” he said. “It is nice to have a story end like this, although I would like to say, in his case, I think it ’s just the beginning.”

remember that, too, being

he may be the fi rst patient

the hospital as an adult. He is certain, however, that he

having undergone surgery

Reisner said. “It was such “He was wonderful, kind to the patient, very atten-tive,” Reisner said. “He has a

dren’s, but even better [to be] with my doctor who’s been working with me for

tragedy in her life.”Far from being a tragedy,

Reisner said, Singleton’s


the hospital as an adult. He is certain, however, that he

“He was wonderful, kind dren’s, but even better [to tragedy in her life.”

parents when the patients go in the back,” Singleton said. “I sit down with them for a few minutes and tell them my story and just to relax. Some of the kids, when I was sick, they didn’t make it. I remember that, too, being

parents when the patients go in the back,” Singleton

and just to relax. Some of the kids, when I was sick,


parents when the patients


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60 OR TODAY | March 2016 WWW.ORTODAY.COM60 OR TODAY | March 2016 WWW.ORTODAY.COM

OUT OF THE OR BY MARILYNN PRESTON

10 WAYS TO FIND YOUR BALANCE AND DITCH

YOUR PAIN

HEALTH

Aches and pains are part of life. You wake up one morning and your back

is tight, your knee is pinched, your neck is jammed between two stone pillars. We usually accept these limitations and move on the best we can, with or without an Advil. But here’s the good news. Many of the aches and pains we live with are caused by muscular imbal-ance. And muscular imbalance is often curable. By us, no prescription required.

Without spoiling your day with anatomical details, muscle imbal-ance is what happens when you use one set of muscles too much, and the opposing muscles a lot less.

The overused muscles – over time – become inflamed and irritat-ed. The underused muscles weaken and become vulnerable. The combo

leads to sore joints, nagging pain and visits to doctors, all of which could have been avoided if you paid attention to muscular imbalance and learned to prevent it.

Here are 10 everyday habits that create muscular imbalance, com-piled by fitness expert Beverly Hosford for the American Council on Exercise website.

Read and observe. Once you realize how locked in you and your body are to repetitive patterns, you can begin to reprogram. It takes intense body awareness – also known as somatics training – which is probably why attention rhymes with prevention:

1Sleeping on the same side every nightIf you always sleep on one side,

or on your stomach with your head always turned the same way, switch sides. At first, it will feel odd. Explore that feeling. Remind yourself that you’re on a path to a

more balanced body. Then let go into dreamland.

2Always leading with your dominant side when climbing

It’s all about awareness. What foot leads going up stairs and what foot leads going down? Pay attention, and do what we’re always doing in yoga to stay in balance – switch to the opposite foot.

3Crossing your legs with the same leg on topIf you cross your knees or

ankles when you sit, notice which leg sits on top. Do the old switch-eroo.

4Carrying bags on the same shoulderWhich shoulder do you

normally use to carry stuff – gro-ceries, kids, man bags? Consciously shift your load to the other shoul-der. What does that feel like? If you

BY MARILYNN PRESTON

10 WAYS TO FIND YOUR BALANCE AND DITCH

HEALTH

1603_ORT-Mag.indd 60 1/28/16 9:19 AM


HEALTH


HEALTH

ever feel pain, stop. If you feel your shoulder is hunched and tense, release. Experiment with smaller loads, both sides.

5Using the same hand to hold thingsWhich hand holds your

phone, your fork, your toothbrush? Switch from time to time. This cross over trick is also good for your brain, breaking up old pat-terns, sparking new pathways. It will feel weird. Accept that and move on with enthusiasm.

6Always putting your weight on one leg while standing

You’re not an ostrich. Where is your weight when you’re standing or leaning? Muscle Imbalance Alert! Stand tall, your legs hip width apart, maybe close your eyes. Shift your weight left and right, front to back, and settle into balanced, relaxed weight distribu-tion from your feet to your head.

7Locking your knees. Keep your knees soft when standing

Locking means you’re blocking the flow of energy. Unlocked knees are happy knees, juicy knees, and when they’re connected energeti-cally to your feet, ankles, hips and shoulders, alignment happens effortlessly. Relaxed and balanced muscles allow for more energy to flow throughout your body.

8Holding your phone or tablet at waist levelText Neck is the next big

thing in preventable, debilitating injuries. We all do it to see the screen – head down, neck scrunched, shoulders slouched – and we all will suffer the conse-quences ... UNLESS we lift the screen to eye level and relax our neck and shoulders.

9One-sided training in sportsFor this one, just picture Venus

William’s right forearm. Tennis, golf and bowling are sports that obvi-ously overdevelop one side of the body. Assess your sport for one-sid-edness and correct the imbalance with focused weight training.

10Too much drivingYou may not be able to put a stop to your

driving schedule but you can learn to proceed with caution. Take stretching breaks. Make adjust-ments – mentally and physically – so your body is doing the driving in a balanced, alert way.

Marilynn Preston – healthy lifestyle expert, well being coach and Emmy-winning producer – is the creator of Energy Express, the longest-running syndicated fitness column in the country. She has a website, marilyn-npreston.com, and welcomes reader questions, which can be sent to [email protected].

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BY HARVARD HEALTH

ACCURACY, ACCOUNTABILITY AND MOTIVATIONUnlike logs, journals or standard pedometers, fitness trackers accurately record objective data about your workout, including the pace, distance, intensity and duration of your exercise.

They send the information to a software application on your smart-phone or computer, where you can view it in graphs and even compare activity day by day on calendars. And there are benefits to knowing that something is following your every move, namely motivation and compliance.

“When you can see what your activity levels are, there’s account-ability, and you’ll want to stick with a workout,” explains Arslanian. “It motivates you to keep building on what you’ve accomplished.”

ANOTHER BENEFITSome fitness trackers can also record your heart rate, which is important for determining the intensity of your workout.

“If you’re doing aerobic exercise, you want to exercise at 60 percent to 80 percent of your maximum heart rate for at least half an hour, three to five times per week,” says Arslanian. “Do that, and your endurance will improve.”

Having a device that gives you that information, or alerts you if

you’re below or over your estab-lished training heart rate, can make workouts more effective. It can also make workouts safer, especially if you have heart problems or other medical conditions.

The most accurate way to deter-mine your maximum heart rate is to undergo a stress test. But for healthy individuals, it is possible to simply estimate your maximum heart rate. To calculate an estimat-ed maximum heart rate, subtract your age from 220. (For example, if you’re 60 years old, your maximum heart rate is 160 beats per minute.) You’ll want to exercise at 60 percent to 80 percent of that number:

• 60 percent of 160 (0.60 x 160) is 96 beats per minute.

• 80 percent of 160 (0.80 x 160) is 128 beats per minute.

So, when exercising, you’d want to keep your heart rate between 96 and 128 beats per minute.

WHAT YOU SHOULD DOArslanian warns that you shouldn’t embark on an exercise program without advice.

Y ou’ve probably seen people wear-ing digital fitness

trackers, small gadgets that come in wearable styles such as wristbands and pendants or hand-held versions you can slip into a pocket. Why are they popular? The devices record your workout data, and they track your prog-ress on those measures. “We’ve seen them make a big difference in people’s workouts,” says Linda Ars-lanian, director of rehabili-tation services at Harvard-affiliated Brigham and Women’s Hospital.

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“You need the OK from your doctor first, and you need someone to craft an exercise program that is in your training range and your safety zone, with a range of intensity and duration that will have the greatest chance of being effective,” she says.

Using a fitness tracker can make it easier to stay within that train-ing range.

WHERE DO I GET ONE?You’ll find fitness trackers wher-ever fitness equipment is sold, such as big box stores, electronics stores, sporting goods stores and Internet sites. Features may be simple – counting the number of steps you take or calories you burn – or they

may be more sophisticated, using sensors to capture your heart rate, perspiration, skin temperature and sleep patterns.

Prices increase with the amount of bells and whistles available. The majority are in the range of $50 to $200.Best bet: Look for something that’s easy to use and charges quickly. And decide in advance how much information you want and whether you want to wear the device on your wrist or clip it onto your clothes. Once you start using it, share the information with a partner for extra account-ability and motivation. And tell your doctor about your progress at your next visit.

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OUT OF THE ORNUTRITION

DIETARY GUIDELINESFOR EGGS,

CHOLESTEROLRE-EVALUATED

BY CLARE TONE, M.S., R.D.ENTRÉE

Recommendations on egg intake have lightened up, but eggs Benedict for

breakfast every morning still isn’t a good idea.

Scrambled, fried or baked into pastries, Americans love their eggs. But what about all that cholesterol? One large egg has about 200 milligrams of cholesterol. Until last year, the Dietary Guidelines (DG) placed a 300 mg cap on daily cholesterol intake, but the new

2015 DG Advisory Committee Report dropped that recommendation, stating cholesterol is no longer a nutrient of concern. So is that a green light for eggs Benedict every day?

A closer look at the DG Advisory Committee report, along with guide-

BY CLARE TONE, M.S., R.D.

1PER DAYEGG

on daily cholesterol intake, but the new A closer look at the DG Advisory

Committee report, along with guide-

1603_ORT-Mag.indd 64 1/28/16 8:57 AM


DIETARY GUIDELINESFOR EGGS,

CHOLESTEROLRE-EVALUATED

BY CLARE TONE, M.S., R.D.ENTRÉE

NUTRITION

lines from the American Heart Association and the American College of Cardiology, reveal a shift away from focusing on single nutrients, like cholesterol, toward diet patterns such as the Mediterranean and DASH (Dietary Approaches to Stop Hyper-tension) diets. These well-researched diets – rich in fi sh, whole grains, vegetables and fruits – naturally contain lower cholesterol levels.

It’s easy to think that eating foods high in cholesterol will lead to high blood cholesterol, but research suggests it is actually a pretty weak link for most people. A meta-analysis (American Journal of Clinical Nutrition, 2001) that pooled results from 17 studies on the relationship between dietary cholesterol and blood cholesterol concluded that for every additional 200 mg cholesterol consumed, LDL (“bad”) cholesterol in

the blood increased by about four points. A recent 12-year prospective study found that daily egg consump-tion was not associated with risk of heart attack or stroke (American Journal of Clinical Nutrition, 2015).

However, among people with diabetes there may be a stronger link. Among women with diabetes, each increase of 200 mg cholesterol per 1,000 calories resulted in a 37 percent increased risk of developing heart disease (American Journal of Clinical Nutrition, 2004). And eating eggs daily was associated with 77 percent increased risk of developing type 2 diabetes (Diabetes Care, 2009). A 2013 meta-analysis concluded that egg consumption may be linked with an increased risk of type 2 diabetes among the general population and cardiovascular disease among people with diabetes.

THE BOTTOM LINEThe best advice is to eat eggs in moderation. For healthy adults, that’s no more than one egg a day; if you’re at higher risk for type 2 diabetes limit yourself to four to fi ve per week. But instead of focusing on eggs, aim for a Mediterranean or DASH eating style, which reduces red and processed meats and emphasizes vegetables, legumes, whole grains, fruits and plant-based oils like olive oil.

Environmental Nutrition is the award-winning independent newsletter written by nutrition experts dedicated to providing readers up-to-date, accurate information about health and nutrition in clear, concise English. For more information, visit www.environ-mentalnutrition.com.

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BRAISED LAMB SHANKS FILL THE BILL FOR A RUSTIC DINNER

BY DIANE ROSSEN WORTHINGTON

OUT OF THE ORRECIPERECIPE

1603_ORT-Mag.indd 66 1/28/16 11:03 AM


RECIPE

Lamb shanks are perfect for a slow cooked meal. They

may be the toughest part of the lamb, but braising them slowly yields a tender, falling-off-the-bone result.

The longer they cook, the more tender they become.It’s important to brown the

shanks first so they take on a rich color and give extra flavor to the sauce. Once browned, vegetables and herbs are sautéed along with red wine and dried fruit for a slow braise. This is best prepared up to two days ahead, covered and refrigerated. Remove the layer of fat before reheating.This is one of those dishes that I crave when it’s cold outside and I am looking for

cozy comfort. The couscous is my recommended accompaniment for a satisfying meal. I also like the toasted slivered almonds in the cooked couscous for a welcome crunch.I always like to serve a similar wine that I used for cooking as the accompanying beverage. A full-bodied merlot will do the trick. Some crusty bread will be welcome to soak up any extra sauce.

• 1/4 cup olive oil• 6 (3/4 to 1 pound) lamb shanks• All-purpose flour for dusting• 2 medium carrots, peeled and

finely chopped• 1 medium onion, finely chopped• 1 rib of celery, finely chopped• 3 tablespoons finely chopped

fresh basil• 2 tablespoons finely chopped

fresh thyme• 4 cloves of garlic, minced• 1 1/2 cups chicken stock• 1 1/2 cups dry red wine,

preferably merlot• 1/2 cup dried apricots• 1 (9-ounce) container moist

packaged prunes (sometimes called dried plums), cut into bite size pieces

• 1 cup canned crushed tomatoes• 3 tablespoons tomato paste• 2 tablespoons parsley, for

garnish• Salt and freshly ground

black pepperEatingWell is a magazine and

website devoted to healthy

eating as a way of life. Online at

www.eatingwell.com.

METHOD:INGREDIENTS:

BRAISED LAMB SHANKSSERVES 6

1 Preheat the oven to 325 F. Dredge the lamb lightly with the flour and season it with salt and pepper. Heat 2 table-spoons of oil in a large Dutch oven on medium-high heat. Add the lamb, in two batches, and brown on all sides, about 8 minutes per batch. Transfer to a large roasting pan.

2 Reduce the heat and add the remaining olive oil to the Dutch oven. Add the carrots, onion, celery, basil and thyme and sauté for about 6 to 8 minutes or until the vegetables are tender, stirring occasionally. Add the garlic and cook another minute.

3 Stir in the stock, wine, the apricots, prunes, crushed tomatoes and tomato paste. Bring to a simmer. Pour sauce over the lamb in the roasting pan. Cover tightly with foil and place in oven. Cook the lamb until the meat is very tender and beginning to fall o� the bones, about 2 hours. (Adjust the cooking time for larger or smaller lamb shanks).

4 Transfer the lamb to a platter and tent it with foil to keep warm. Pour the pan juices into a saucepan and bring to a simmer. Reduce the sauce by half to make a thick sauce-like consistency, about 15 to 20 minutes on medium-high heat. Watch toward the end. Taste for seasoning.

5 Pour the sauce over the lamb. Garnish with parsley and serve immediately with couscous.

1603_ORT-Mag.indd 67 1/28/16 8:58 AM

68 OR TODAY | March 2016 WWW.ORTODAY.COM68 OR TODAY | March 2016 WWW.ORTODAY.COM

OUT OF THE ORPINBOARD

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Sweet & Salty Curried PopcornFreshly popped popcorn1/4 cup unsalted butter2 tablespoons curry powder1 teaspoon salt1 tablespoon turbinado or demerara sugar, plus more to taste

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PIN BOARD

You probably already know that tea is an incredibly healthy

beverage. In fact, studies show

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you may reduce your risk of Alzheimer’s and diabetes, plus

have healthier teeth and gums

and stronger bones. But not everything you’ve heard about

tea is true.







tea is true.







“ There is a humanitarian impulse that one aspires to and there are days when one doesn’t do it very well.” – Ralph Fiennes

Adding milk to tea negates the health benefits. Although some

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adding milk to tea undoes its heart-healthy

benefits, recent research

says that’s not necessarily the case.

Tea doesn’t go bad. Actually, tea has a shelf life of six months. After that, it starts to lose its antioxidants.

The citric acid in a squeeze of lemon

juice will help to preserve the

fl avanoids in tea if you’re brewing it

ahead (such as if you’re making iced

tea). The fl avanoids are the

compounds deemed responsible for

many of tea’s health boons. Also,

adding honey to your tea may make

you more productive on the job,

suggests a small study published in

2010.

MYTH 1

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TEA IT UP

March 2016 | OR TODAY 69

1603_ORT-Mag.indd 69 1/28/16 8:58 AM


ELECTRONIC ORDERING AVAILABLE THROUGH:

Key Surgical has been providing sterile processing, operating room and instrument care supplies to our valued

customers for over 25 years and our philosophy has remained consistent: offer a wide variety of high-quality

products, deliver them on time and at the right price, all with unbeatable customer service. These seemingly small

and simple things are why our customers keep coming back. If you are already a customer, we sincerely appreciate your

business and thank you for your continued support. If not, consider this an invitation to call

us or visit our website – it could be the start of a great relationship for many years to come!

call 800.541.7995 or visit keysurgical.com

YOU WILL LOVE OUR BOOTHSIDE MANNER.

In t ent eanin

o e

i e and in ana e ent

In t ent

od ct

In t ent otection

Ta

e ona otection

te i e oce in od ct

Identification Tape

In t ent T ac in

KEY SURGICAL PROUDLY OFFERS:

BOOTH 201

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VISIT US IN

AORNAPRIL 2-6

AnaheimCaliforniaAnaheimCalifornia

H

INDEXALPHABETICAL

AAAHC ………………………………………………… 59Action Products, Inc. ……………………………21AIV Inc. ………………………………………………… 65C Change Surgical ………………………………… 11Censis Technologies, Inc ……………… 29, 31Cincinnati Sub-Zero …………………………… 29Coast 2 Coast Medical, Inc …………………… 4Dabir Surfaces……………………………………… 63David Scott Company ……………………… 59Encompass Group, LLC ……………………… 40

Enthermics Medical Systems, Inc. ……… 7GelPro …………………………………………………… 53Gopher Medical …………………………………… 40Healthmark Industries………………………… 45Innovative Medical Products, Inc ……………BCInterpower Corporation ……………………… 5Jet Medical Electronics …………………………31KAPP Surgical Instrument ………………… 53Key Surgical …………………………………………IBCMAC Medical ………………………………………… 22

MD Technologies ……………………………………41MedWrench ………………………………………… 58Pacific Medical LLC ……………………………… 6Paragon Service …………………………………… 8Ruhof Corporation ………………… 2-3, 42-44Sealed Air …………………………………………… 30SMD Waynne Corp. …………………………… 58Summit Medical Inc. ………………………………12Surgical Power …………………………………… 40TBJ, Inc. ……………………………………………………17

ACCREDITATIONAAAHC ………………………………………………… 59

ANESTHESIACoast 2 Coast Medical, Inc …………………… 4David Scott Company ……………………… 59Gopher Medical …………………………………… 40Paragon Service …………………………………… 8

APPAREL Healthmark Industries………………………… 45

ASSOCIATIONSAAAHC ………………………………………………… 59

BEDSInnovative Medical Products, Inc …… BC

CARDIOLOGYC Change Surgical ………………………………… 11Coast 2 Coast Medical, Inc …………………… 4Gopher Medical …………………………………… 40

CARTS/CABINETSDavid Scott Company ……………………… 59Encompass Group, LLC ……………………… 40

CLEANING SUPPLIESRuhof Corporation ………………… 2-3, 42-44

CLAMPSInnovative Medical Products, Inc …… BC

DISINFECTANTSSealed Air …………………………………………… 30

DISPOSABLESPacific Medical LLC ……………………………… 6

ENDOSCOPYCoast 2 Coast Medical, Inc …………………… 4MD Technologies ……………………………………41Ruhof Corporation ………………… 2-3, 42-44TBJ, Inc. ……………………………………………………17

FALL PREVENTIONEncompass Group, LLC ……………………… 40

GEL PADSGelPro …………………………………………………… 53Innovative Medical Products, Inc …… BC

GENERALAIV Inc. ………………………………………………… 65Coast 2 Coast Medical, Inc …………………… 4GelPro …………………………………………………… 53MedWrench ………………………………………… 58

Surgical Power …………………………………… 40

HAND/ARM POSITIONERSInnovative Medical Products, Inc …… BC

HIP SYSTEMSInnovative Medical Products, Inc …… BC

INFECTION CONTROL/PREVENTIONCensis Technologies, Inc ……………… 29, 31Encompass Group, LLC ……………………… 40Ruhof Corporation ………………… 2-3, 42-44Sealed Air …………………………………………… 30

INTERNET RESOURCESMedWrench ………………………………………… 58

INSTRUMENT TRANSPORTCensis Technologies, Inc ……………… 29, 31Key Surgical Instrument, Inc. ……………IBCMAC Medical ………………………………………… 22

KNEE SYSTEMSInnovative Medical Products, Inc …… BC

LABORATORYTBJ, Inc. ……………………………………………………17

LEG POSITIONERSInnovative Medical Products, Inc …… BC

MONITORSCoast 2 Coast Medical, Inc …………………… 4Jet Medical Electronics …………………………31

OR TABLES/ ACCESSORIESAction Products, Inc. ……………………………21Coast 2 Coast Medical, Inc …………………… 4Dabir Surfaces……………………………………… 63Innovative Medical Products, Inc …… BC

ORTHOPEDICSurgical Power …………………………………… 40

OTHERAction Products, Inc. ……………………………21AIV Inc. ………………………………………………… 65Coast 2 Coast Medical, Inc …………………… 4Encompass Group, LLC ……………………… 40Key Surgical Instrument, Inc. ……………IBCSMD Waynne Corp. …………………………… 58TBJ, Inc. ……………………………………………………17

PATIENT MONITORINGCoast 2 Coast Medical, Inc …………………… 4Gopher Medical …………………………………… 40Pacific Medical LLC ……………………………… 6

POSITIONERS/IMMOBILIZERSAction Products, Inc. ……………………………21David Scott Company ……………………… 59Innovative Medical KAPP Surgical Instrument ………………… 53Innovative Medical Products, Inc …… BC

POWER COMPONETSInterpower Corporation ……………………… 5

REPAIR SERVICESCoast 2 Coast Medical, Inc …………………… 4Pacific Medical LLC ……………………………… 6

SHOULDER RECONSTRUCTIONInnovative Medical Products, Inc …… BC

SIDE RAIL SOCKETSInnovative Medical Products, Inc …… BC

SOCIAL MEDIA MedWrench ………………………………………… 58

STERILIZATIONTBJ, Inc. ……………………………………………………17

SURGICALAAAHC ………………………………………………… 59Coast 2 Coast Medical, Inc …………………… 4KAPP Surgical Instrument ………………… 53MD Technologies ……………………………………41Surgical Power …………………………………… 40

SURGICAL SUPPLIESCincinnati Sub-Zero …………………………… 29Coast 2 Coast Medical, Inc …………………… 4David Scott Company ……………………… 59KAPP Surgical Instrument ………………… 53Key Surgical Instrument, Inc. ……………IBCRuhof Corporation ………………… 2-3, 42-44

SUPPORTSInnovative Medical Products, Inc …… BC TEMPERATURE MANAGEMENTC Change Surgical ………………………………… 11Cincinnati Sub-Zero …………………………… 29

WARMERSCoast 2 Coast Medical, Inc …………………… 4Encompass Group, LLC ……………………… 40Enthermics Medical Systems, Inc. ……… 7

WASTE MANAGEMENTSealed Air …………………………………………… 30

CATEGORICAL

1603_ORT-Mag.indd 70 1/28/16 1:30 PM

ELECTRONIC ORDERING AVAILABLE THROUGH:

Key Surgical has been providing sterile processing, operating room and instrument care supplies to our valued

customers for over 25 years and our philosophy has remained consistent: offer a wide variety of high-quality

products, deliver them on time and at the right price, all with unbeatable customer service. These seemingly small

and simple things are why our customers keep coming back. If you are already a customer, we sincerely appreciate your

business and thank you for your continued support. If not, consider this an invitation to call

us or visit our website – it could be the start of a great relationship for many years to come!

call 800.541.7995 or visit keysurgical.com

YOU WILL LOVE OUR BOOTHSIDE MANNER.

In t ent eanin

o e


In t ent

od ct

In t ent otection

Ta

e ona otection

te i e oce in od ct


Identification Tape

In t ent T ac in

KEY SURGICAL PROUDLY OFFERS:

BOOTH 201

AT

VISIT US IN

AORNAPRIL 2-6

AnaheimCaliforniaAnaheimCalifornia

H

1603_ORT-Mag.indd 71 1/28/16 8:58 AM

Enhanced Humbles LapWrap® Positioning Pad

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

Designed by an Anesthesiologist who understands patient and surgeon needs

The operative word in patient positioning.

www.impmedical.com

Now even more securewith two-way performance!

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

© 2016 IMP. US Patent No. 8,001,635

Bariatric Patients are no problem. The LapWrap’s® tab configuration also makes positioning bariatric patients easier.

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

For more info or to order call 1-800-467-4944

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

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

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

Please visit us at the AAOS Annual Meeting Booths 4135 and 4235 and AORN Booth 622

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

Free Sample Evaluation

Designed to meet

AORNrecommendations

*While supplies last

Humbles_LapWrap_OR Today_MAR2016_Layout 1 1/8/16 3:28 PM Page 1

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