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0, 95% confidence interval [CI] 2.0-4.6, P less then .0001) and 6 months (OR 2.5, 95% CI 1.7-3.8, P less then .0001). Patients receiving therapeutic anticoagulation also experienced increased rates of wound infection at 3 months (OR 1.5, 95% CI 1.1-2.0, P = .007) and 6 months (OR 1.8, 95% CI 1.4-2.3, P less then .0001). Finally, patients receiving therapeutic anticoagulation experienced increased rates of revision surgery at 6 months (OR 1.8, 95% CI 1.3-2.5, P = .0003) and within 9 years (OR 1.5, 95% CI 1.1-2.0, P = .007). CONCLUSIONS Wound complications and revision rates in patients undergoing shoulder arthroplasty who require postoperative therapeutic anticoagulation are significantly elevated compared with controls. BACKGROUND Obtaining postoperative laboratory studies after primary reverse shoulder arthroplasty (RSA) is a common practice. However, justification of this practice remains unclear. selleck products This study assesses the utility of routine postoperative laboratory studies in RSA. METHODS The electronic medical records of 369 patients who underwent RSA over 10 years were retrospectively reviewed. A total of 213 patients qualified for analysis. Primary outcomes were intervention related to abnormal laboratory values, length of stay, and 90-day emergency department visits/readmissions. Multivariate logistic regression analysis was performed to identify risk factors associated with abnormal laboratory values and postoperative visits/readmissions. RESULTS Of 213 patients analyzed, 188 (88.7%) had abnormal postoperative laboratory values 69% had an abnormal hemoglobin (Hgb) or hematocrit level, but only 12% underwent interventions. Lower preoperative Hgb was a significant predictor of receiving a transfusion. A significant association existed between abnormal postoperative electrolyte and creatinine levels with lower body mass index (BMI) and higher Charlson Comorbidity Index (CCI). Only 4 patients (1.8%) received non-transfusion related intervention. Emergency department visits were not statistically different between patients with positive or negative laboratory tests (P = .73). CONCLUSION Because 87.3% of laboratory studies did not influence patient management, we recommend against routine testing for primary RSA. This study demonstrates that the practice of obtaining routine postoperative laboratory studies is not justified. We recommend selectively obtaining a postoperative basic metabolic profile in patients with increased American Society of Anesthesiologists classification and/or CCI with a lower BMI. We also recommend selectively ordering postoperative complete blood count in patients with a lower preoperative Hgb. BACKGROUND The aim of this study was to investigate the pathologies associated with subcoracoid cysts (ScCs) in patients with rotator cuff (RC) tears and the postoperative appearance of ScCs after arthroscopic repair. METHODS A total of 114 patients who underwent arthroscopic RC repair were prospectively evaluated. The inclusion criteria were as follows patients with or without ScCs, patients with Patte class 1 or 2 tears, and patients who were 40-65 years of age. Forty-four patients with ScCs (group 1) were evaluated during the 12-month study period. Fifty-two patients who had no ScCs (group 2) were evaluated as a control group. Preoperative and postoperative cyst volumes were measured on magnetic resonance imaging (MRI), and arthroscopic findings were noted. RESULTS Thirty-one patients (70%) in group 1 had a subscapularis tear vs. 10 patients (19%) in group 2 (P less then .001). Biceps lesions were encountered in 32 patients (72%) in group 1, whereas 12 patients (23%) had a biceps lesion in group 2 (P less then .001). Cyst volume was significantly higher in the following situations (1) patients who had a subscapularis tear compared with patients without a subscapularis tear, (2) patients who had biceps pulley lesions compared with patients without pulley lesions, and (3) patients who had both pathologies (P = .047, P = .01, and P = .002, respectively). Cyst volumes significantly decreased following RC repair in group 1 (P less then .001). CONCLUSION Among patients with small- to medium-sized, full-thickness supraspinatus tears, the prevalence of biceps pulley lesions and/or subscapularis tears is higher in patients with ScCs. OBJECTIVES We examined the relationship between nursing assistant (NA) retention and a measure capturing nursing home leadership and staff empowerment. DESIGN Cross-sectional study using nationally representative survey data. SETTING AND PARTICIPANTS Data from the Nursing Home Culture Change 2016-2017 Survey with nursing home administrator respondents (N = 1386) were merged with facility-level indicators. METHODS The leadership and staff empowerment practice score is an index derived from responses to 23 survey items and categorized as low, medium, and high. Multinomial logistic regression weighted for sample design and to address culture-change selection bias identified factors associated with 4 categories of 1-year NA retention 0% to 50%, 51% to 75%, 76% to 90%, and 91% to 100%. RESULTS In an adjusted model, greater leadership and staff empowerment levels were consistently associated with high (76%-90% and 91%-100%) relative to low (0%-50%) NA retention. Occupancy rate, chain status, licensed practical nurse and certified nursing assistant hours per day per resident, nursing home administrator turnover, and the presence of a union were also significantly associated with higher categories of retention (vs low retention). CONCLUSIONS AND IMPLICATIONS Modifiable leadership and staff empowerment practices are associated with NA retention. Associations are most significant when examining the highest practice scores and retention categories. Nursing homes seeking to improve NA retention might look to leadership and staff empowerment practice changes common to culture change. INTRODUCTION Hemodialysis is a technique of extra-renal purification associated with high level of risk. The objective is to assess infectious risk during a hemodialysis session on hygiene around the patient in hospital. METHODS An a priori risk assessment by Failure Modes, Effects and Criticality Analysis method (FMECA) was carried out from May to August 2018, in order to overview infectious risk during the process of hemodialysis in the Ibn Sina Hospital (Rabat, Morocco). RESULTS Twenty eight failure modes were identified during the hemodialysis process around the patient fourteen criticality level 1, ten level 2, and four level 3. A prevention plan has been drafted. Three of the four level 3 failure modes were reduced to level 1 and one to level 2. DISCUSSION FMECA have enabled us to identify the potential risks, to reconsider certain procedures and to suggest measure matrix for the coverage of the most critical risks. CONCLUSION This analysis makes it possible, through periodic evaluations, to enter a real quality approach, which reinforces the satisfaction of the patients as well as all the actors of the hemodialysis center.