Today’s Top Story
Study: Perioperative medication error rates may be higher than previous estimates.
Findings from a study published online in the journal Anesthesiology suggest that the rate of perioperative medication errors (MEs) may be higher than previously reported. The authors conducted a prospective, observational study of 277 surgical procedures covering 3,671 medication administrations at a single institution. They noted 193 MEs or adverse drug events (ADEs). Of those, they determined that 153 (79.3 percent) were preventable and 40 (20.7 percent) were nonpreventable. Of 153 errors, 99 (64.7 percent) were serious, 51 (33.3 percent) were significant, and 3 (2.0 percent) were life-threatening. The authors write that the rates determined in the study are “markedly higher than those reported by retrospective surveys.” Read more…
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Other News
Study: Nonsurgical treatment for acute AC joint dislocation may return patients to activity sooner than surgical treatment.
According to data published in the November issue of the Journal of Orthopaedic Trauma, patients who undergo nonsurgical treatment for acute acromioclavicular (AC) joint dislocation may experience fewer complications and return to work sooner than those who undergo surgical treatment. The researchers conducted a prospective, randomized, multicenter trial of 83 patients with acute (<28 days from the time of injury), grade III, IV, or V dislocations of the AC joint. At 6-week and 3-month follow-up, they found that Disabilities of the Arm, Shoulder and Hand (DASH) scores were significantly better in the nonsurgical cohort, with no significant difference in DASH score between cohorts at 6 months, 1 year, or 2 years. Overall, Constant scores were statistically similar across cohorts at all time points. The researchers note that radiographic results were better in the surgical group, but also that the reoperation rate was significantly lower in the nonsurgical group.> Read more…
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Study: Minority and Medicaid patients less likely to receive regional anesthesia during hip and knee arthroplasty.
Findings presented at the annual meeting of the American Society of Anesthesiologists suggest that minority patients and those on Medicaid may be less likely to receive regional anesthesia during hip and knee arthroplasty surgery. The research team reviewed information from a national claims database on 1,062,152 hip and knee arthroplasty procedures. They found that 22 percent of patients were given neuraxial anesthesia, 18 percent a peripheral nerve block, and the rest received general anesthesia. Overall, Hispanic patients were 24 percent less likely, Medicaid patients 20 percent less likely, uninsured patients 16 percent less likely, and black patients 10 percent less likely to receive either form of regional anesthesia. Read more…
Study: Pediatric patients prescribed opioids more likely to misuse such drugs later.
Data from a study published online in the journal Pediatrics suggest that use of prescribed opioids in pediatric patients may be associated with future opioid misuse. The authors examined prospective data on 6,220 individuals who were surveyed in school in 12th grade and followed up through 23 years of age. They found that legitimate opioid use before high school graduation was independently associated with a 33 percent increase in risk of opioid misuse after high school. The authors note that the association was concentrated among individuals with little to no history of drug use and strong disapproval of illegal drug use at baseline. Read the abstract…
Study: Informal brochures may help patients discuss anesthesia and pain relief options.
According to information presented at the annual meeting of the American Society of Anesthesiologists, use of decision aids in the form of informal brochures may help patients discuss their anesthesia and pain relief options. The research team gave informational brochures to 67 patients who were scheduled to undergo surgery using regional anesthesia. A control group of 59 patients was not given the decision aids. The research team found that 64 percent of patients who received brochures discussed regional anesthesia with clinic staff, compared to 49 percent of those in the control cohort. Overall, patients who received a brochure were more likely to discuss anesthesia choices (78 percent versus 52 percent) and ask questions about regional anesthesia (70 percent versus 32 percent). The research team notes that even though the brochures included risk information, there was no associated increase in anxiety and uncertainty among patients given the decision aids. Read more…
How does one negotiate with insurers from a position of strength?
An article in Medscape looks at techniques used by insurers to negotiate with healthcare providers. A speaker at the annual meeting of the Medical Group Management Association who formerly worked in the managed care industry negotiating contracts with medical practices offers anecdotes and suggestions for dealing with private insurers. Among other things, he suggests that providers understand their own position in the local healthcare market, research the financial standing of insurers, and understand how each insurer’s fee schedule compares to those of other payers. Read more…(registration may be required)
OKOJ November updates now online!
Check out the new topics and video in the Orthopaedic Knowledge Online Journal (OKOJ) on the AAOS OrthoPortal website. The following topics have been recently added or updated: “Current Concepts Review: The Use of Regional Anesthesia in Pediatric Orthopaedic Surgery,” “Growth-Friendly Techniques for Managing Early-Onset Scoliosis,” and “Percutaneous Thermal Ablation Techniques for the Treatment of Musculoskeletal Metastases.” OKOJ now offers full-text, downloadable PDFs of articles in recent issues, with more on the way! View these topics and more…(member login required)
Call for volunteers: FDA Network of Experts program.
AAOS seeks to nominate multiple candidates to participate in the U.S. Food and Drug Administration (FDA) Network of Experts program. The agency is currently seeking input from those who have experience with or choose not to use cemented total metatarsophalangeal joint implants. Applicants for this position must be active fellows, candidate members, candidate members osteopathic, candidate member applicants for fellowship, or candidate member applicants for fellowship osteopathic. In addition, all applicants must provide the following: an online AAOS CAP application, a current curriculum vitae, a statement of interest, and a completed AAOS Conflict of Interest form. All supporting materials must be submitted by Nov. 2, 2015, to Kyle Shah at: shah@aaos.org
Learn more and submit your application…(member login required)
