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Community-based research requires a special type of review, and so should have its own type of review board, one that balances the responsibilities that IRBs have to individuals with an appreciation for the needs of the community in which research is conducted.
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With individuals who are ages 65 and older undergoing almost one-third of the 25 million surgical procedures performed annually, and with people ages 85 and older representing the fastest growing segment of our population, it is important that any surgical program pay close attention to the special needs of older patients.
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No one enjoys undergoing surgery or approaches surgery without some anxiety, but older patients have physiological reasons that may increase their apprehension and confusion about surgery, according to Patricia Stein, RN, MAOL, CNOR, nurse education specialist for perioperative services at Palomar Pomerado Health System in Escondido, CA.
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Knowing the physiological differences between your older patients and your younger patients is a good start to providing care that addresses their needs, but some of the things you can do to help the patient don't involve clinical skills, says Jim B. Wilkerson, RN, BSN, CCRN, outpatient surgery supervisor at Pomerado Hospital in Poway, CA.
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Question: We have a new surgery center, and I have the job (I am being punished) of taking care of the credentialing of the surgeons. I have a couple of questions.
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In light of a $345,000 out-of-court settlement and a national investigation of implant manufacturers, outpatient surgery managers are looking intensely at spiraling implant costs and their own purchasing agreements and wondering, what exactly is considered illegal or unethical behavior when purchasing implants?
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In the final 2007 rule for the hospital outpatient prospective payment system (OPPS), officials with the Centers for Medicare & Medicaid Services (CMS) decided against linking inpatient quality reporting to the outpatient payment update.
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With implant and other costs spiraling upward and reimbursement falling behind, outpatient surgery managers are always searching for ways to keep down these costs. One idea that has proven success is the establishment of a value analysis program for purchases.
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In a recent study, only 22% of patients surveyed correctly understood the reason for fasting before outpatient surgery.1 Patients who didn't understand the reason were nearly five times more likely to underrate the importance of compliance.