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Perioperative, Operating Room and Surgical Nursing Commons

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Development Of A Nurse Practitioner First Assistant Orientation Program, Romoanetia Lofton 2017 The University of San Francisco

Development Of A Nurse Practitioner First Assistant Orientation Program, Romoanetia Lofton

Doctor of Nursing Practice (DNP) Projects

The demand for surgical services continues to increase, creating a strain in our healthcare system and causing increasing backlog hours for the operating room. Allowing nurse practitioners (NP) to function in an expanded role in the perioperative environment requires additional training beyond the generic NP program. With this additional training, the NP can function as a first assistant, providing delegated medical functions in the perioperative environment. An in-house NP registered nurse first assistant orientation program was developed based on the adult learning theory as a conceptual framework combined with the AORN perioperative standards as a foundation. The cost of using ...


Implementation Of An Evidenced-Based Practice Curriculum To Improve Nursing Practice For Epidural Administration And Monitoring, Chatty O'Keeffe 2017 The University of San Francisco

Implementation Of An Evidenced-Based Practice Curriculum To Improve Nursing Practice For Epidural Administration And Monitoring, Chatty O'Keeffe

Master's Projects and Capstones

Abstract

Epidural analgesia (EA) is one inpatient pain management option prescribed by Acute Pain Services (APS) at VA Puget Sound Health Care Services (VAPSHCS). Historically, EA nursing care at VAPSHCS has been managed by surgical units. However, in the last two years, facility restructuring and budget constraints have led to reorganization and consolidation of units. The reduction in units providing nursing EA care has resulted in an overflow of EA patients to the medical intensive care unit (MICU). A previous gap analysis of the compliance in nursing performance of EA nursing care on the surgical acute care unit demonstrated poor ...


Evaluation Of Laparoscopic Appendectomy Vs. Open Appendectomy: A Retrospective Study At Aga Khan University Hospital, Karachi, Pakistan, Yasmin Vellani, Shaheena Bhatti, Ghina Shamsi, Yasmin Parpio, Tazeen Saeed Ali 2017 Aga Khan University

Evaluation Of Laparoscopic Appendectomy Vs. Open Appendectomy: A Retrospective Study At Aga Khan University Hospital, Karachi, Pakistan, Yasmin Vellani, Shaheena Bhatti, Ghina Shamsi, Yasmin Parpio, Tazeen Saeed Ali

Tazeen Ali

OBJECTIVE: To compare open and laparoscopic appendectomies and to evaluate the level of efficacy of both types of appendectomy performed at Aga Khan University Hospital (AKUH). METHODS: Based on this strong study rationale, a clinical audit of patient's records was performed to evaluate the significance of this technique as a treatment modality. The study population comprised of patients with appendicitis admitted in the Department of Surgery from January 2004 to December 2004. The patients' charts were reviewed to ascertain whether the procedure was done as an acute case or as an elective procedure. The predictor variables explored in this ...


Malignant Hyperthermia, Garrett Erickson 2017 Otterbein University

Malignant Hyperthermia, Garrett Erickson

Master of Science in Nursing (MSN) Student Scholarship

Malignant hyperthermia is known as a pharmacogenetic disorder which manifests itself in the skeletal muscle (Heytens, Forget, Scholtès, & Veyckemans, 2015). When a susceptible patient, who carries the autosomal dominant trait, is exposed to volatile anesthetics and/or the neuromuscular blocker succinylcholine, a detrimental response can occur. This response is a hypermetabolic state with hypercapnia, hemodynamic instability, rigidity, hyperthermia, and signs of rhabdomyolysis (Heytens et al., 2015). MH is a rare condition with incidences between 1/5,000 and 1/50,000 (Nagelhout and Plaus, 2014, p. 829), and often occurs during the induction of anesthesia but can also occur intraoperatively ...


I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam 2017 University of San Francisco

I’M A Big Kid Now: Enhancing Transition Rn Residents’ Confidence During Pediatric Patient Care, Emily W. Lam

Master's Projects and Capstones

The title of the clinical nurse leader project is “I’m a Big Kid Now: Enhancing Transition RN Residents’ Confidence During Pediatric Patient Care”. The project aims to improve the support components for Transition RN residents during their Transition RN Residency at Children’s Hospital Los Angeles. The clinical leadership theme that correlates to this project is communication. The clinical nurse leader’s role is to act as an educator and a facilitator throughout this project. In examining the clinical nurse leader competencies, competencies “use performance measures to assess and improve the delivery of evidence-based practices and promote outcomes that ...


Reducing Operating Room Turnover Times, Marivic Z. Paraz-Lee 2017 University of San Francisco

Reducing Operating Room Turnover Times, Marivic Z. Paraz-Lee

Master's Projects and Capstones

Background

The operating room (OR) in an ambulatory surgery center (ASC) is what generates income for an organization, but it can also be costly if it’s improperly managed. The purpose of this project is to decrease OR turnover time (TOT) in order to increase OR efficiency, patient and staff satisfaction, as well as be cost effective. As defined by Gottschalk et al. (2016), OR turnover time is “the duration of time from a patient exiting the OR to the time the succeeding patient enters the OR” (p. 489).

Methods

The method utilized for this project is gathering weekly average ...


Nasal Antisepsis Methods: Povidone-Iodine Vs Alcohol Based Solutions, Mackenzie McCoy 2017 University of Wyoming

Nasal Antisepsis Methods: Povidone-Iodine Vs Alcohol Based Solutions, Mackenzie Mccoy

Honors Theses AY 16/17

Surgical site infections (SSIs) are unforeseen complications of surgeries as a result of antibiotic-resistant bacteria. Often these SSIs are caused by bacteria that are naturally found on a person’s body, specifically their own personal flora found in the nares. A method of eliminating this colonization is critical in decreasing rates of SSIs. Therefore, the purpose of this research was to determine the best solution of nasal antisepsis to use in my nursing capstone preoperative unit in order to eliminate the colonies of nasal bacteria in patients undergoing surgeries involving implants. Two solutions were identified as most commonly used antiseptics ...


Nasal Antisepsis Methods: Povidone-Iodine Vs Alcohol Based Solutions, Mackenzie McCoy 2017 University of Wyoming

Nasal Antisepsis Methods: Povidone-Iodine Vs Alcohol Based Solutions, Mackenzie Mccoy

Honors Theses AY 16/17

Surgical site infections (SSIs) are unforeseen complications of surgeries as a result of antibiotic-resistant bacteria. Often these SSIs are caused by bacteria that are naturally found on a person’s body, specifically their own personal flora found in the nares. A method of eliminating this colonization is critical in decreasing rates of SSIs. Therefore, the purpose of this research was to determine the best solution of nasal antisepsis to use in my nursing capstone preoperative unit in order to eliminate the colonies of nasal bacteria in patients undergoing surgeries involving implants. Two solutions were identified as most commonly used antiseptics ...


Decreasing Cost In The Gi Endoscopy Suite By Utilizing Best Sedation Practices, Casey Brianne Mancini 2017 University of Southern Mississippi

Decreasing Cost In The Gi Endoscopy Suite By Utilizing Best Sedation Practices, Casey Brianne Mancini

Doctoral Nursing Capstone Projects

Colorectal cancer is a leading cause of cancer death in the United States (Mandel, Tanner, Lichtenstein, Metz, Katzka, Ginsberg, & Kochman, 2008; Siegel, DeSantis, & Jemal, 2014). Because this lethal disease claims lives of many people every year, more patients are undergoing screening colonoscopies, which have greatly aided in decreasing the number of colorectal cancer deaths (Siegel et al., 2014). The most common form of sedation for colonoscopies is moderate sedation with a benzodiazepine and an opioid (Cohen, Hightower, Wood, Miller, & Aisenberg, 2004; Lera dos Santos, et. al., 2013). However, sedation by anesthesia providers using propofol is becoming more common and may aid in reducing recovery and discharge times from the postoperative anesthesia care unit (PACU) as well as reducing overall costs. A retrospective chart review (N=176; 88 in propofol group and 88 in benzodiazepine and opioid group) was performed to determine if propofol sedation did reduce discharge times and decrease overall costs for the patient. Patients included in this study ...


Implementing Evidence Based Practices For Preventing Cardiac Implantable Electronic Device (Cied) Infection And The Role Of Post-Operative Oral Antibiotics, Ingrid Mitchell 2017 California State University, Northern California Consortium Doctor of Nursing Practice

Implementing Evidence Based Practices For Preventing Cardiac Implantable Electronic Device (Cied) Infection And The Role Of Post-Operative Oral Antibiotics, Ingrid Mitchell

Doctoral Projects

Cardiac pacemakers and implantable cardioverter defibrillators (ICD) are standard therapy for patients with a bradyarrhythmia, tachyarrhythmia or heart failure (HF) with a left bundle branch block (LBBB) (Wilkoff, et al., 2008). Millions of cardiac implantable electronic devices (CIED) have been implanted worldwide and this clinical practice has improved the quality of life for millions (Epstein, DiMarco, & Ellenbogen, 2008). With the increase of implants there has been an increase in the infection rates (Klug et al., 2007). Research studies have evaluated pre-procedure, during procedure and after procedure risk and protocols. Studies have also evaluated operative factors, procedural related factors, intravenous preoperative ...


Reported Interventions For Reducing Anxiety And Distress In Adult Oncology Patients Throughout Their Cancer Experience: A Review Of The Literature And An Analysis Of Adults In Remission, Katie Gomez 2017 Dominican University of California

Reported Interventions For Reducing Anxiety And Distress In Adult Oncology Patients Throughout Their Cancer Experience: A Review Of The Literature And An Analysis Of Adults In Remission, Katie Gomez

Honors Theses and Capstone Projects

Background: The purpose of this paper is to identify present methods at relieving anxiety and distress in adult oncology patients. According to the American Cancer Association (2016), 1.7 million American will be diagnosed with cancer in 2016, and therefore, it is important for nurses to be competent caregivers to this growing patient population.

Literature Review: A comprehensive review of current literature showed that consistent, competent caregivers, honest communication from the medical team, back massage, and music therapy were effective at cutting mean anxiety and distress scores by as much as 50 percent. Sixteen peer-reviewed articles from around the world ...


An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin 2017 Auckland University of Technology

An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin

Patient Experience Journal

This journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside ...


Using Evidence-Based Practice To Prevent The Incidence Of Deep Vein Thrombosis In Postoperative Patients, Robbi Grier 2017 Georgia State University

Using Evidence-Based Practice To Prevent The Incidence Of Deep Vein Thrombosis In Postoperative Patients, Robbi Grier

Georgia State Undergraduate Research Conference

No abstract provided.


Scheduling, Heather Ann Paine 2481430 2017 Lynchburg College

Scheduling, Heather Ann Paine 2481430

Student Scholar Showcase

Problem:

Self scheduling via paper sign-up sheets can lead to missed staffing needs for the Operating Room. Paper scheduling lacks the ability to run quick analysis of staffing needs as well as ensure each shift is staffed properly.

Evidence:

Electronic scheduling will improve scheduling efficiency, cost savings, as well as improve moral and staff engagement.

Strategy:

This project will use design and plan, do, study, and act to implement and evaluate project. This project is being conducted take place at Lynchburg General Hospital Operating Room with the current five members of the cardiothoracic team as a pilot, based on post ...


Anesthesia "Hand Off" Process For Patients At High Risk For Obstructive Sleep Apnea, Terry Yeager 2017 Lynchburg College

Anesthesia "Hand Off" Process For Patients At High Risk For Obstructive Sleep Apnea, Terry Yeager

Student Scholar Showcase

No abstract provided.


Application Of The Patient Checklist Tool In Anesthesia Handoffs, Theresa Durley 2017 Northern Michigan University

Application Of The Patient Checklist Tool In Anesthesia Handoffs, Theresa Durley

DNP Scholarly Projects

Accurate and essential communication is required during the transfer of patient care from one health care provider to another. Communication errors during the handoff process have been identified as contributing factors in sentinel events. There is a plethora of literature supporting a standardized transfer of care process as well as several accepted handoff communication tools for the various units within a healthcare institution. However, in the anesthesia domain, there is currently only one protocol specifically created for the transfer of patient care between certified registered nurse anesthetists (CRNAs). The PATIENT protocol, created by Dr. Suzanne M. Wright, CRNA, PhD (2013 ...


Efficacy Of Continuous Passive Motion After Total Knee Arthroplasty In Veteran Patients, Jaimee Riza B. Hare 2017 California State University, Northern California Consortium Doctor of Nursing Practice

Efficacy Of Continuous Passive Motion After Total Knee Arthroplasty In Veteran Patients, Jaimee Riza B. Hare

Doctoral Projects

Since the early 1980s, continuous passive motion has been used as adjunct therapy in patients’ rehabilitation following total knee arthroplasty. Although existing literature challenged the benefits of continuous passive motion claiming it had no added short-term or long-term benefits after knee arthroplasty (Boese et al., 2014; Chen et al., 2012; Herbold et al., 2014; Leach et al., 2006; Maniar et al., 2012), the existing literature is difficult to generalize and apply to the veteran population at San Francisco Veterans Affairs Medical Center. This study was undertaken to determine the efficacy of continuous passive motion in helping veteran patients at San ...


Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale 2016 University of San Francisco

Improving Preadmission Testing Nurses' Knowledge Of Aortic Stenosis And Transcatheter Aortic Valve Replacement, Alberta Lynn Canale

Master's Projects and Capstones

Abstract

The purpose of this Clinical Nurse Leader (CNL) project was to reduce gaps in nursing knowledge through staff education. Guided by the CNL theme of educator and information manager, the goals were to increase PreAdmission Testing (PAT) nurses’ knowledge of severe/critical aortic stenosis (AS), transcatheter aortic valve replacement (TAVR) procedure and patient selection, and satisfaction with knowledge by 10%. Rapid growth of the TAVR program has contributed to a gap in nursing knowledge leading to inconsistent patient care and education. An educational program was developed and spread through a series of Plan-Do-Study-Act cycles. Pre- and post- implementation surveys ...


Improving Pain Reassessment And Documentation Through Nurse Education, Reina Batto 2016 The University of San Francisco

Improving Pain Reassessment And Documentation Through Nurse Education, Reina Batto

Master's Projects and Capstones

The aim of the CNL Internship Project is to improve quality of patient care and pain management through improved pain reassessment and documentation. The project is to be implemented in the surgical unit of a community hospital in the California Bay Area. The unit has a maximum capacity of 38 beds and is staffed by 47 RNs and 4 LVNs. A nurse survey was conducted to assess the needs of the staff and the unit, and an education plan was created for the unit. Educational materials, including: highlighted academic articles, posters, handouts, and small posted reminders at nurse computers were ...


The Effects Of Preoperative Education On Readmission Rates For Total Joint Arthroplasties, Michele Gobble 2016 Gardner-Webb University

The Effects Of Preoperative Education On Readmission Rates For Total Joint Arthroplasties, Michele Gobble

Nursing Theses and Capstone Projects

Background: Primary total hip arthroplasty (THA) and total knee arthroplasty (TKA) are two of the most successful procedures performed in orthopedics. The demand for these procedures is estimated to grow 174% for THAs and 673% for TKAs by 2030, which will have a valued bill of almost $50 billion for Medicare. The bundled payment plan is a way to reduce costs for these procedures, where an estimated 35% of the bill is related to post-discharge care (Schaeffer et al., 2015, p. 723).

Review of the Literature: In 2015, this healthcare reform began including readmission penalties for patients readmitted within 30 ...


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