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Error in Antibiotic Recommendations
LETTERS
TO
THE
EDITOR
Error correction, clinical nurse specialists, fragmented research ERROR IN ANTIBIOTIC RECOMMENDATIONS
Y
ou have published a serious error in the January 2007 AORN Journal (“Improving compliance with prophylactic antibiotic guidelines,” vol 85). The table on page 177 indicates that 100 mg cefazolin administered subconjunctivally is the recommended antibiotic prophylaxis for all ophthalmic procedures. This is incorrect. Please refer to the Treatment Guidelines from the Medical Letter from April 20041 and December 2006.2 What you should have published is “there is no consensus supporting a particular choice, route, or duration of antimicrobial prophylaxis.”1(p31),2(p87) The incorrect antibiotic recommendation that you have published may be misinterpreted as the standard of care for ophthalmic surgical procedures and could be misused by lawyers in malpractice cases, hospital or ambulatory surgery center surgical review committees, or credentialing organizations like Medicare or the Accreditation Association for Ambulatory Health Care. STEPHEN P. KELLEY MD OPHTHALMIC SURGERY BROWNWOOD, TEX
References
1. Antibiotic prophylaxis for surgery. Treat Guidel Med Lett. 2004;2:27-32. 2. Antibiotic prophylaxis for surgery. Treat Guidel Med Lett. 2006;4:83-88.
Editor’s response. Thank you for bringing this to our attention. The Journal regrets the error.
THE CLINICAL NURSE SPECIALIST ROLE
I
was disappointed with the article “Perioperative clinical nurse specialist role delineation: a systematic review” (December 2006, vol 84). I am
© AORN, Inc, 2007
presently a clinical nurse specialist (CNS) in the perioperative setting and know this role from a very personal perspective. I would agree that the role has not been delineated as clearly as I would like and that many people both inside and outside of the perioperative setting do not understand the CNS role. There are some misconceptions that have been portrayed in the article, however, that provide substantiation and validation to incorrect information in the national forum provided by this publication. There are several areas of inaccurate information to which I take exception. My first and greatest concern is the statement made in the article that CNSs and nurse practitioners (NPs) have similar roles. I am not an NP, but I understand that most NPs define their role as medical diagnosing, prescribing medication, and providing direct patient care. The NP role is clearly needed in order to increase access to the health care system for patients in need, and at times, I feel the role is performed better by an NP than by a physician. A CNS, however, is very different than an NP. My role as a master’sdegree prepared CNS is to be the clinical expert who practices nursing in a specialty area identified in terms of a population, setting, disease, type of care, or type of problem.1 I find the suggestion of merging the NP and CNS roles to be an affront to both roles. They are different, both are much needed, and both provide strength to the provision of patient care. The authors state that the major benefit of merging the two roles would be an increased validation of the CNS role, but in the same paragraph, they state that the NP works in the medical realm and the CNS works
The AORN Journal welcomes letters for its “Letters to the Editor” column. Letters must refer to Journal articles or columns published within the preceding six months. All letters are subject to editing before publication. Authors of articles or columns referenced in the letter to the editor may be given the opportunity to respond. Letters that are included in the “Letters” column must contain the reader’s name, credentials if applicable (eg, RN, BSN, CNOR), position or title, employer, and employer’s address.
APRIL 2007, VOL 85, NO 4 • AORN JOURNAL • 711
TO
THE
EDITOR
Error correction, clinical nurse specialists, fragmented research ERROR IN ANTIBIOTIC RECOMMENDATIONS
Y
ou have published a serious error in the January 2007 AORN Journal (“Improving compliance with prophylactic antibiotic guidelines,” vol 85). The table on page 177 indicates that 100 mg cefazolin administered subconjunctivally is the recommended antibiotic prophylaxis for all ophthalmic procedures. This is incorrect. Please refer to the Treatment Guidelines from the Medical Letter from April 20041 and December 2006.2 What you should have published is “there is no consensus supporting a particular choice, route, or duration of antimicrobial prophylaxis.”1(p31),2(p87) The incorrect antibiotic recommendation that you have published may be misinterpreted as the standard of care for ophthalmic surgical procedures and could be misused by lawyers in malpractice cases, hospital or ambulatory surgery center surgical review committees, or credentialing organizations like Medicare or the Accreditation Association for Ambulatory Health Care. STEPHEN P. KELLEY MD OPHTHALMIC SURGERY BROWNWOOD, TEX
References
1. Antibiotic prophylaxis for surgery. Treat Guidel Med Lett. 2004;2:27-32. 2. Antibiotic prophylaxis for surgery. Treat Guidel Med Lett. 2006;4:83-88.
Editor’s response. Thank you for bringing this to our attention. The Journal regrets the error.
THE CLINICAL NURSE SPECIALIST ROLE
I
was disappointed with the article “Perioperative clinical nurse specialist role delineation: a systematic review” (December 2006, vol 84). I am
© AORN, Inc, 2007
presently a clinical nurse specialist (CNS) in the perioperative setting and know this role from a very personal perspective. I would agree that the role has not been delineated as clearly as I would like and that many people both inside and outside of the perioperative setting do not understand the CNS role. There are some misconceptions that have been portrayed in the article, however, that provide substantiation and validation to incorrect information in the national forum provided by this publication. There are several areas of inaccurate information to which I take exception. My first and greatest concern is the statement made in the article that CNSs and nurse practitioners (NPs) have similar roles. I am not an NP, but I understand that most NPs define their role as medical diagnosing, prescribing medication, and providing direct patient care. The NP role is clearly needed in order to increase access to the health care system for patients in need, and at times, I feel the role is performed better by an NP than by a physician. A CNS, however, is very different than an NP. My role as a master’sdegree prepared CNS is to be the clinical expert who practices nursing in a specialty area identified in terms of a population, setting, disease, type of care, or type of problem.1 I find the suggestion of merging the NP and CNS roles to be an affront to both roles. They are different, both are much needed, and both provide strength to the provision of patient care. The authors state that the major benefit of merging the two roles would be an increased validation of the CNS role, but in the same paragraph, they state that the NP works in the medical realm and the CNS works
The AORN Journal welcomes letters for its “Letters to the Editor” column. Letters must refer to Journal articles or columns published within the preceding six months. All letters are subject to editing before publication. Authors of articles or columns referenced in the letter to the editor may be given the opportunity to respond. Letters that are included in the “Letters” column must contain the reader’s name, credentials if applicable (eg, RN, BSN, CNOR), position or title, employer, and employer’s address.
APRIL 2007, VOL 85, NO 4 • AORN JOURNAL • 711