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Evidence vs. Industry: Challenging ASHRAE's Grip on Hospital Ventilation Standards: Hospitals across the nation are facing a critical dilemma: spend millions on facility upgrades or severely limit their ability to perform bronchoscopies. This predicament stems from a guideline endorsed by the Joint Commission, requiring all non-emergency bronchoscopies to be performed in negative pressure rooms. The source of this requirement? The American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE). Surprisingly, there is almost no evidence supporting this guideline, especially for bronchoscopies under general anesthesia and those with a low probability of infectious etiology. A recent NHS evidence review concluded that bronchoscopy should be considered aerosol-generating only when performed on awake patients, excluding anesthetized patients with secured airways. The same review identified awake upper GI endoscopy and ENT procedures involving respiratory suctioning as aerosol-generating procedures, yet these don't face the same stringent requirements. ASHRAE has become the de facto authority on hospital ventilation requirements, and the Joint Commission has outsourced policies to ASHRAE, forcing compliance under threat of losing accreditation. A closer examination reveals a troubling reality: the standards committees developing these guidelines consist mainly of industry representatives, not healthcare professionals. Over half of the Ventilation for Healthcare Facilities committee, including the chairman, are CEOs or owners of companies benefiting from stricter regulations. There isn't a single doctor or nurse representative on the committee. ASHRAE members don’t publicly disclose conflicts, necessitating a manual search of members' LinkedIn profiles and other public sources to uncover their industry affiliations. It's time for healthcare professionals to challenge this industry influence and demand evidence-based guidelines that reflect current medical practices. If the Joint Commission is willing to delegate its requirements to an industry-led organization, perhaps it's time to scrutinize their practices and "audit the auditors." At the very least, we must demand change when policies exist to serve interests other than patient and staff health and safety. For your reference, I've included a list of some notable voting members and their affiliations.

The Perfect Trifecta: Medical Air, Medical Vacuum, and Compressed (Lab) Air in Sterile Processing In the healthcare industry, maintaining a sterile environment is non-negotiable. The perfect trifecta of medical gas equipment—medical air, medical vacuum, and compressed (lab) air—plays a pivotal role in ensuring the highest standards of cleanliness and safety in sterile processing departments (SPD). Here’s how these systems work together to enhance healthcare outcomes: 1. Medical Air: Medical air is a clean, dry, and contaminant-free supply of compressed air used in various healthcare applications: - Respiratory Support: Providing life-sustaining breathing air for patients - Mechanical Ventilation:?Medical air is essential for operating mechanical ventilators that support patients who are unable to breathe on their own. It ensures a controlled and safe environment for respiratory assistance - Drug Delivery via Nebulizers:?Medical air powers nebulizers to aerosolize medications, allowing for efficient and direct lung delivery, especially crucial for respiratory conditions 2. Medical Vacuum: Medical vacuum systems are indispensable in healthcare settings for: - Surgical Suction: Removing blood, fluids, and debris during surgical procedures, enhancing visibility and reducing infection risks. - Wound Care: Assisting in negative pressure wound therapy, promoting faster healing and reducing infection risks. - Intensive Care Units (ICUs):?In ICUs, medical vacuums are used for continuous suction to manage secretions in patients who are critically ill, helping to maintain clear airways - Respiratory Support:?Medical vacuums provide suction for tracheostomy tubes or airway management in cases of respiratory distress, ensuring patient safety 3. Compressed (Lab) Air: Compressed lab air is a versatile utility in sterile processing, used for: - Cleaning and Sterilization: Providing clean, dry air to sterilizers, cart washers - Maintaining Sterile Conditions: Removing contaminants and ensuring that the sterile processing environment remains uncontaminated - Operational Efficiency: Powering various equipment and processes, enhancing the overall efficiency of the SPD By leveraging this perfect trifecta of medical gas equipment and adhering to regulatory standards, healthcare facilities can ensure that the patient environments and sterile processing departments operate at peak efficiency, safeguarding patient health and improving outcomes. Let's continue to innovate and uphold the highest standards in healthcare! #HealthcareInnovation #SterileProcessing #MedicalAir #MedicalVacuum #CompressedAir #PatientSafety #RegulatoryCompliance

Patients with tracheostomy are becoming more common in long-term care facilities. Unfortunately I have seen patients accepted to long term care facilities without the appropriate equipment and training in place. In fact, one facility did not have a single spare tracheostomy tube in the entire facility! Long term care facilities should ensure readiness for a wide range of medical emergencies to providing comprehensive patient care. As part of this preparation, having appropriate emergency tracheostomy equipment readily available is crucial. Equipment includes the following: -Tracheostomy Tube: The same size and a size smaller - Suction Catheter: Essential for clearing secretions and maintaining airway patency -Oxygen Source : Long-term care facilities must have portable oxygen sources on hand to provide immediate respiratory support post-tracheostomy. - Dressing Materials: Sterile gauze, tape, and antiseptic solutions are necessary for securing the tracheostomy tube and maintaining a clean environment around the insertion site. Scissors as needed to cut any trach tie if needed. -10ml syringe for inflated and deflated the cuff (if present) of the tracheostomy tube Training and Protocol Implementation: Beyond equipment availability, staff training in emergency tracheostomy procedures is vital. Facilities should establish clear protocols for identifying patients who may require emergency tracheostomy, initiating the procedure, and providing post-tracheostomy care. Equipping long-term care facilities with emergency tracheostomy equipment and ensuring staff readiness through training and protocol implementation are essential steps in providing comprehensive patient care. By prioritizing preparedness, facilities can effectively manage airway emergencies and improve patient outcomes. Check out our in person Tracheostomy MasterClass and Virtual Tracheostomy Training Lab for more information about tracheostomy care, emergencies, communication, swallowing, decannulation, mechanical ventilation and more!

NEW addition to training resource catalogue - Bariatric Care - Wound Care - A Guide for Nurses and Healthcare Staff Health and Social Care Teaching/Training Resources All fully editable. Presentation in sections you can choose which sections to use. Aims and Objectives included if you want to use the presentation as it has been written. Comes with 7 Handouts and a multiple choice end of session assessment. Overall Aim: To equip healthcare professionals with comprehensive knowledge and skills in wound care management to optimise patient outcomes. Learning Objectives: Understand the principles of wound assessment, classification and management to tailor treatment plans effectively. Implement advanced wound care techniques and innovative solutions to address complex wound healing challenges. Presentation (69 Slides) https://lnkd.in/ehs44Zui #hsctraininglink #healthandsocialcare #bariatriccare #woundcare #teachingresources #trainingresources

?? ???????? ?????? ???????????????????? ???????????????????? ???? ?????? ?????????????????? ???????? ???????????? ???????????????? ?????????????? (????????-????) ?????????????????????????? ?????? ?????????????????? ?????????????? (??????) ??????????????????! ?? We are excited to introduce two Inaugural Training Programs (STERI and SHARP) from the TORG-NG SIC Team in collaboration with Safe Surgery Innovation (SSI). These programs are open to healthcare professionals globally. ?? Introducing STERI: Earn a globally recognized certification in sterilization technology through an interactive online training program designed for healthcare settings in Low- and Middle-Income Countries (LMICs). Who Should enrol in STERI? - Perioperative Nurses - Surgical Assistant - Surgical Technologists - CSSD Technicians - Infection Preventionist and - OR Professionals ?? STERI Training and Certification Cost: - Regular Price: $300 USD - TORG Member Price (30% Off): $210 USD ================ ?? Introducing SHARP The world’s first training program for surgical instrument repair, combining hands-on learning and e-learning modules to improve equipment maintenance in LMICs (Low- and Middle-Income Countries). Who Can Benefit from SHARP? - Ministries of Health Hospital in Low Resource Environments - Global Surgery Organization - International Health Organization - Surgical Nurses and OR Staff. ?? SHARP Training and Tool Kit Costs: - Regular Price: $5000 USD - TORG Member Hospital Price (5% Off): $4750 USD Discounts are automatically applied at checkout, don’t miss this opportunity to advance your skills and improve healthcare standards globally! ?? For STERI or SHARP enrolment and discount codes, contact the TORG-NG SIC Team: [email protected] More details in the attached flyer. Be part of this groundbreaking initiative to elevate sterilization and infection control standards around the world! Safe Surgery Innovation (SSI) is an Official Partner of The Operating Room Global (TORG) TROGSS - The Robotic Global Surgical Society Magister Chirurgiae K. Miles #TORGCommunity #SterilizationAndInfectionControl #GlobalHealthcare #SafeSurgery #STERI #SHARP #LMICs #HealthcareInnovation #SafeSurgeryInitiative #SafeSurgeryInnovation

Explore how our strategic approach is future-proofing anesthesia services. Our strategies have saved clients over $1.5 million. Check out how we prepare hospitals for tomorrow: https://bit.ly/44xwnMi #AnesthesiaLeadership #HealthcareInnovation

Treating a dental patient under general anesthesia involves careful preparation and management. Here are key considerations: Preoperative Assessment: Conduct a thorough medical history review, including allergies, medications, and any underlying health conditions. Obtain necessary lab tests and imaging. Informed Consent: Explain the procedure, risks, benefits, and alternatives to the patient and obtain informed consent. Anesthesia Team Coordination: Collaborate with anesthesiologists to ensure proper monitoring and management throughout the procedure . Patient Monitoring: Continuously monitor vital signs, oxygen saturation, and anesthetic depth during the procedure. Surgical Preparation: Ensure the dental team is prepared with all necessary instruments and materials before starting. Postoperative Care: Provide clear postoperative instructions and arrange for recovery in a safe environment, ensuring the patient is stable before discharge. Follow-Up: Schedule a follow-up appointment to assess recovery and address any concerns.

Quality Indicators for Anesthesia as per NABH_202410161000: Quality indicators for anesthesia as per the National Accreditation Board for Hospitals and Healthcare Providers (NABH) are designed to ensure the safety, quality, and efficiency of anesthesia services. Some key indicators include: Adverse Anesthesia Events Percentage: Tracks the percentage of adverse events occurring during or immediately after anesthesia administration. This helps monitor patient safety and implement corrective measures. Medication Error Rate: Measures the incidence of medication errors related to anesthesia drugs, typically reported per 1,000 patient days. This indicator helps in identifying and reducing errors through staff training and process improvements. Monitoring Compliance: Ensures that patient monitoring during anesthesia, such as temperature, heart rate, respiratory rate, blood pressure, end tidal CO2 and oxygen levels, is done as per the standards. Surgical Site Infection Rates: Evaluates the rate of infections at surgical sites post-anesthesia, indicating the effectiveness of sterile procedures and perioperative care. Time to Initial Assessment: Monitors the time taken from patient arrival to the initial anesthesia assessment. Shorter times can indicate better workflow and preparedness. Close monitoring during the anesthesia must me monitored continuously and documented every 10 minutes. Anesthesia is one of the most complex specialty to monitored and followed. Data Collection for these indicators are challenging for so many institutes. #AkashTiwari #JCI #NABH #AACI #PatientSafety #Healthcare #Excellence

Kingman Regional Medical Center has earned an “A”?Hospital Safety Grade from The Leapfrog Group,?an independent national nonprofit watchdog focused on patient safety.?Leapfrog assigns an “A,” “B,” “C,” “D” or “F” grade to general hospitals across the country based on over 30 performance measures reflecting errors, accidents, injuries and infections, as well as the systems hospitals have in place to prevent them. KRMC is the only hospital in the region to earn an A from The Leapfrog Group. ? “Patient safety is the top priority for Kingman Regional Medical Center,” said Heath Evans, Chief Executive Officer, KRMC.?“The Leapfrog A rating combined with the recent CMS 4-Star rating are indications of the hospital’s commitment to patient safety.” ? “Achieving an ‘A’ Hospital Safety Grade is a significant accomplishment for Kingman Regional Medical Center,” said Leah Binder, president and CEO of The Leapfrog Group. “It reflects enormous dedication to your patients and their families, and your whole community should be proud. I extend my congratulations to Kingman Regional Medical Center, its leadership, clinicians, staff and volunteers for their tireless efforts to put patients first.” ? The Leapfrog Hospital Safety Grade stands as the only hospital ratings program focused solely on preventable medical errors, infections and injuries that kill more than 500 patients a day in the United States. This program is peer-reviewed, fully transparent and free to the public. Grades are updated twice annually, in the fall and spring.

?? How hospital pharmacy is tackling climate change in Canada The Canadian Society of Hospital Pharmacists (CSHP)/Société canadienne des pharmaciens d’h?pitaux (SCPH) is highlighting the efforts of hospital pharmacy professionals in addressing climate change and reducing the environmental footprint of pharmaceuticals. Please read recent publications in Hospital News athttps://lnkd.in/d7wEvrcV 10 CLIMATE ACTION RECOMMENDATIONS: CSHP and CPhA joint climate action recommendations: 1. – Don’t prescribe greenhouse gas-intensive metered-dose inhalers (MDIs) for asthma and/or COPD where an alternative inhaler with a lower carbon footprint (e.g. dry powder inhaler (DPI), soft-mist inhaler, or MDI with a low greenhouse gas potential propellant) containing medications with comparable efficacy is available, and where the patient has demonstrated adequate technique and patient preference has been considered. 2. – Don’t start or continue medications without an indication or where the risks outweigh the benefits. 3. – Don’t pour any pharmaceuticals or chemicals down sinks, toilets, drains or dispose of in the trash. 4. – Don’t print prescription or educational materials when providers and patients have access to digital communication 5. – Don’t use disposable gloves when standard hand hygiene disinfection practices are safe and sufficient. CSHP climate action recommendations: 6. – Don’t continue an intravenous medication when and if clinically appropriate to step down to oral therapy. 7. – Don’t use desflurane when other anesthetic drugs and techniques are equally effective and less harmful to the environment. 8. – Don’t discard medications that are appropriate for re-dispense. 9. – Don’t continue medications upon hospital transitions (admission, transfers, and discharge) unless there is a clinical indication. 10. – Don’t make formulary decisions without consideration of environmental impact #hospitalpharmacy FIP Hospital Pharmacy Section Canadian Society of Hospital Pharmacists (CSHP)/Société canadienne des pharmaciens d’h?pitaux (SCPH) Canadian Pharmacists Association #hospitalpharmacysustainability Choosing Wisely Canada Karen Dahri, Kirsten Tangedal Kiet-Nghi Cao Ariane Blanc FIP Hospital Pharmacy Section Jody Ciufo Rita Dhami