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J U LY 2 0 1 4 | O U T P AT I E N T S U R G E R Y M A G A Z I N E O N L I N E
Evidence-Based Practice
◗ Re: "Do You Follow AORN Recommended Practices?" (June, page 6). Yes, the choice is
yours to follow AORN's Recommended Practices, but as healthcare providers we have an
ethical responsibility to minimize potential risks to patients and provide care that keeps them
safe. Healthcare providers cannot practice on the premise of "that is how I have always
done it." Practice has to be based on evidence. AORN's Recommended Practices are
reviewed and accepted by National Guideline Clearinghouse and follow the standards of
guideline development set forth by the Institute of Medicine. AORN's Recommended
Practices are used by CMS and other accrediting bodies. Facilities may be cited if they are
not followed. As healthcare reform continues to evolve, quality and value will be expected at
every facility. It is imperative that we practice based on the evidence and not how we have
always done it at our facility.
Lisa Spruce, RN, DNP, ACNS, ACNP, ANP, CNOR
Director of Evidence-Based Perioperative Practice,
Association of periOperative Registered Nurses
lspruce@aorn.org
The "Karwoski Calculator"
◗ Re: "Know When Multi-Use Vials Expire at a Glance" (June, page 9). As a consultant phar-
macist, I've seen variations of the 28-day calendar. The downfall is you must place the calen-
dar in all areas and look it over at the time you open the vial. I've come up with a quick cal-
culation that is efficient for everyone — regardless of where they are in the facility. When
you open a multi-dose vial, take the current date, go 1 month ahead and subtract 3 days. This
becomes your new expiration date. There are a few months when it will be less than 28
days, but it is never more than 28 days. Some of my clients have coined this the "Karwoski
Calculator."
John Karwoski, RPh, MBA
Wenonah, N.J.
john@jdjconsulting.net
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