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Perioperative, Operating Room and Surgical Nursing Commons

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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 ...


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 ...


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 ...


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 ...


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 ...


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 ...


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 ...


In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel 2016 University of Southern Mississippi

In The Postoperative Cardiothoracic Surgical Patient Being Mechanically Ventilated, Is There A Difference In Outcomes When Comparing Sedation With Dexmedetomidine Versus Propofol?, Benjamin Heinrich Riebesel

Doctoral Nursing Capstone Projects

Patients undergoing a cardiothoracic operation typically require mechanical ventilation in the postoperative phase. Each year approximately 395,000 of these operations are performed in the United States alone. As many as 10% of these patients require reoperation within the first few hours of recovery due to complications (Barash & Cullen, 2013). This comprehensive review of the literature was performed to determine whether postoperative sedation with dexmedetomidine leads to better patient outcomes than sedation with propofol. Inclusion criteria included publications written in the English language, articles available in full text, articles written within the last 10 years, and publications with a focus ...


Noise: Its Impact In The Operating Room, Brennon Wesley Sloan 2016 University of Southern Mississippi

Noise: Its Impact In The Operating Room, Brennon Wesley Sloan

Doctoral Nursing Capstone Projects

Orthopedic and neurologic cases routinely reach noise levels exceeding 120 decibels (Katz, 2014). Modern equipment and monitors used by anesthesia personnel only reach 85 decibels (Katz, 2014). These monitors can go undetected during peak noise levels creating a serious safety concern for patients that could lead to patient injury or death (Gawande, Zinner, Studdert, & Brennan, 2003). A clinical question was developed to determine if the education of noise levels in the operating room affects change in practice. For operating room managers and staff, does education of noise levels in the operating room compared to no education initiate a change in ...


The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar 2016 University of Southern Mississippi

The Effects Of Tranexamic Acid On Mortality Rate In Trauma Patients Compared To Trauma Patients With No Tranexamic Acid Treatment, Bradley Earl Tolar

Doctoral Nursing Capstone Projects

Traumatic injury is the leading cause of death for many age groups. Traumatic accidents caused over 130,000 deaths in the United States in 2014. This DNP project studied the effects of Tranexamic acid on mortality rate in trauma patients. After the completion of a needs assessment at a local level II trauma center, a literature review was performed. The literature showed a decrease in mortality rate when patients were administered Tranexamic acid within 3 hours of injury with statistically significant statistics. Also, the data from the literature showed no correlation between vascular occlusive events and Tranexamic acid use in ...


Optimizing Anesthesia Providers’ Timing Of Administration Of Dexamethasone For The Prevention Of Post-Operative Nausea And Vomiting: Translating Clinical Guidelines Into Practice, Tanner Young Mixon 2016 University of Southern Mississippi

Optimizing Anesthesia Providers’ Timing Of Administration Of Dexamethasone For The Prevention Of Post-Operative Nausea And Vomiting: Translating Clinical Guidelines Into Practice, Tanner Young Mixon

Doctoral Nursing Capstone Projects

Research has shown that post-operative nausea and vomiting (PONV) is a significant contributing factor to extended recovery times and unwanted hospital admissions following ambulatory surgery. The purpose of this DNP project was to assess current practice regarding administration of dexamethasone for the prevention of PONV, provide information based on best practice guidelines, and assess willingness to change practice based on the guidelines set forth by the Society for Ambulatory Anesthesia (SAMBA). Administration of dexamethasone is aimed at decreasing the incidence of PONV, optimizing PACU times, and increasing patient satisfaction regarding perioperative care.

An electronic presentation and survey were emailed to ...


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