Perioperative, Operating Room and Surgical Nursing Commons^™

Effectiveness Of Perioperative Ketamine Vs. Opioid Analgesia On Extubation Time And Total Perioperative Opioid Requirement, Robert H. Gray Srna, Sarah S. Hardesty Srna, Heidi E. Higginbotham Srna, Charles A. Hoyt Ii, Srna, Dwayne Accardo Dnp, Crna

Doctor of Nursing Practice Projects

Purpose/Background Opioid analgesics are a primary source of pain control in the perioperative patient. However, all opioids decrease ventilatory drive secondary to mu2 receptor agonism in the brainstem. Ventilatory depression delays extubation after mechanical ventilation in post-operative patients, thus increasing the risk of complications such as ventilator-associated pneumonia and barotrauma. Non-opioid analgesics such as ketamine have been considered for use in order to reduce this risk. Ketamine is a noncompetitive N-methyl-D-aspartate receptor-antagonizing sedative that bears analgesic properties while preserving respiratory drive. Research suggests that ketamine provides effective perioperative pain control and decreases postoperative extubation time when given alone or with …

Development And Psychometric Evaluation Of A Questionnaire For Measuring Distraction Due To Mobile Phone Use In Operating Rooms, Mehdi Hasanshahi, Mahnaz Rakhshan, Armin Fereidouni, Seyed Alireza Moayedi, Camellia Torabizadeh

Journal of Perioperative Nursing

Aim: Use of mobile phones in health care centres can distract care providers and consequently disrupt the care procedure and risk patient safety. This study aims to develop and evaluate the psychometric properties of a questionnaire for measuring distraction caused by mobile phone use in operating rooms.

Sample and setting: 208 operating room nurses and doctors from five hospitals affiliated to Shiraz University of Medical Sciences participated in the study.

Method: This methodological study was conducted in two stages. In stage one, through a review of relevant texts, articles and books, the different dimensions of distraction as caused by mobile …

Indications And Outcomes Of Or Circulators Continually Leaving The Room During Surgery, Kelly Mckay

Symposium of Student Scholars

Abstract

Surgical inefficiencies are a major concern for hospitals due to the fact that they can cause extended OR time, increased costs, and a decrease in patient safety. The primary goal of this research is to understand how operating room circulators leaving the room continuously for missing or needed items can be minimized. In turn, that will increase the efficiency and safety of the surgery. The research will identify and evaluate factors that influence the duration of time in which the circulator is out of the room and how to improve them. The AORN Position Statement states that one perioperative …

Improving Tha (Total Hip Arthroscopy) Patient Satisfaction Scores By Reducing Time Spent In The Pacu From 90 Minutes To 60 Minutes, Jennifer Stultz

Symposium of Student Scholars

BACKGROUND, SIGNIFICANCE & PURPOSE

Total Hip Arthroplasty (THA) reduces pain and improves range of motion in patients with end stage osteoarthritis. Patients whose post-THA outcome matches their pre-surgical expectations report higher patient satisfaction scores. Post-surgical pain is expected, but if patients don’t ambulate soon enough after surgery, the pain escalates. Simply put, early ambulation improves patient satisfaction scores. To promote early ambulation, spinal block and Propofol are favored over general anesthesia to reduce time spent in the PACU (post anesthesia care unit). The current PACU goal for THA patient discharge is within ninety minutes of PACU arrival. Sometimes the spinal …

Rethinking Malignant Hyperthermia Protocols, Kelsey Currie

Symposium of Student Scholars

Rethinking Malignant Hyperthermia Protocols

In person poster

Undergraduate Student: Currie, Kelsey

Research Mentor: Kristi Brannen

Background: Although malignant hyperthermia (MH) is rare, it is a life-threatening event that can have many nurses unprepared to manage due to its irregularity, lack of training, and supplies. MH is considered a severe medical crisis that can happen within 30 minutes of anesthetic induction. To give the patient the best outcome, hospitals have protocols in place so the team can respond quickly and efficiently. Purpose: This study aims to investigate how creating central locations for MH carts, ice, and supplies compares to yearly training …

Roles In Preoperative Planning, Joetta Combs

Epsilon Sigma at-Large Research Conference

This project represents the ever-changing methods surrounding Enhanced Recovery after Surgery and the protocols that compose it. The purpose of this study is to expand education of ERAS guidelines and improve patient outcomes through furthering staff education. Enhanced Recovery After Surgery has been a part of perioperative departments worldwide after being introduced in the 1990s by Northern European general surgeons and has been adapted and modified since its introduction (ERAS Society History, 2022). The preoperative and postoperative process is ever-changing and is difficult for staff to keep up with. Many staff members find it difficult to stay on top of …

An Evidence-Based Practice Handbook For The Reduction Of Perioperative Pressure Injuries: An Implementation Guide, Krystal Dopson

Student Scholarly Projects

The Association of Perioperative Nurses (AORN) Prevention of Perioperative Pressure Injury Tool Kit is a comprehensive set of evidence-based practices that can reduce the development of pressure injuries (PI) (AORN, 2022). A bundled set of prevention strategies is positively associated with reducing the development of injury or ulceration and improved patient outcomes. To effectively implement this Prevention of Perioperative Pressure Injury Tool Kit, there are evidenced strategic practices to support change readiness, including engaging stakeholders around the reasons for the change, gaining leadership support, assembling an interprofessional implementation team, providing compelling information that highlights the need for the change, and …

Prophylactic Administration Of Steroids And The Effect On Post-Extubation Stridor: A Scoping Review, Chelsey Benson Bsn, Rn, Karlene Ferraro Bsn, Rn, Donna Lynch-Smith Dnp, Acnp-Bc, Apn, Ne-Bc, Cnl

Doctor of Nursing Practice Projects

Purpose/Background Stridor occurs due to laryngeal edema which arises when a patient has been intubated for an extended period of time. There are several factors that affect the degree of swelling. Post-extubation stridor signals that a patient requires reintubation because the airway is no longer patent. Corticosteroids, such as dexamethasone, can be used prior to extubation to minimize complications and overall length of stay if a patient is at high risk for stridor. This scoping review will evaluate the literature and the association between the use of prophylactic steroids on mechanically ventilated adult patients and the occurrence of post-extubation stridor. …

The Anxiolytic Effects Of Aromatherapy On Preprocedural Anxiety: An Integrated Review, Rebekah Smith

Senior Honors Theses

Anxiety before procedures can negatively impact patients by increasing cortisol levels which delays wound healing and increases infection risk, increasing pain and sedation medication needs, and increasing hospitalization time. This review was conducted to find how inhaled essential oils affect pre-procedural anxiety of adults in acute care settings. Nine databases and some gray literature were searched within the past ten years, and documented using the PRISMA flow chart. Ten articles fitting the inclusion criteria were retrieved. Nine of the articles found a significant difference between the aromatherapy group and control group and pre- and post- intervention anxiety scores, and none …

Nurse-Led Randomised Controlled Trials In The Perioperative Setting: A Scoping Review, Judy Munday, Niall Higgins, Saira Mathew, Lizanne Dalgleish, Anthony S. Batterbury, Luke Burgess, Jill Campbell, Lori J. Delaney, Bronwyn R. Griffin, James A. Hughes, Jessica Ingleman, Samantha Keogh, Fiona Coyer

Journal of Perioperative Nursing

Purpose: Nurses provide care at each phase of the complex perioperative pathway and are well placed to identify areas of care requiring investigation in randomised controlled trials. Yet, currently, the scope of nurse-led randomised controlled trials conducted within the perioperative setting are unknown. This scoping review aims to identify areas of perioperative care in which nurse-led randomised controlled trials have been conducted, to identify issues impacting upon the quality of these trials and identify gaps for future investigation.

Methods: This scoping review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. …

Where Are The Practising Nurse Anaesthetists In Australia? Exploring An Advanced Practice Role For Anaesthesia Nurses, Lucy Michaels, Paula Foran

Journal of Perioperative Nursing

The perioperative environment has seen the implementation of the perioperative nurse surgical assistant as an advanced practice nursing role for the instrument nurse; however, there is currently no recognised equivalent role for the anaesthesia nurse. Anaesthesia nurses complete post-graduate qualifications and learn advanced clinical skills, and yet the authoritative body for perioperative nurses, the Australian College of Perioperative Nurses, does not define a specific role for advanced practice nursing in anaesthesia. Career advancement for the anaesthesia nurse focuses on education and management roles which are a distinct deviation from advanced clinical practice. A new role should be developed to allow …

Awareness Under Anaesthesia: The Role Of The Perioperative Nurse, Dawn Bull, Paula Foran

Journal of Perioperative Nursing

Intra-operative awareness is very rare yet represents a serious complication of general anaesthesia. The ongoing consequences of such an event may cause significant distress and long-term effects such as insomnia, depression, anxiety and post-traumatic stress disorder (PTSD). To provide safer anaesthesia, it is critical to identify contributing factors related to both the patient and the anaesthesia to prevent intra-operative awareness in at-risk patients. It is also vital to provide education to Post Anaesthesia Care Unit (PACU) nurses and surgical ward nurses about the appropriate way to manage a situation when a patient reports intra-operative awareness following anaesthesia.

General anaesthesia with …

Patient, Surgical And Clinical Factors Associated With Longer Stay In The Post Anaesthesia Care Unit, Karen M. Briggs, Mari Botti Emeritus Professor, Nicole M. Phillips Professor, Steve Bowe A/Professor, Maryann Street Dr

Journal of Perioperative Nursing

Aim: To explore patient, surgical and clinical factors associated with readinessfor- discharge and total length of stay in the Post Anaesthesia Care Unit (PACU).

Background: Longer stay in the PACU decreases the flow of patients and is associated with increased risk of adverse events. The time to readiness-fordischarge reflects clinical parameters associated with patient flow in the PACU independent of system delays.

Methods: This retrospective cohort study included a randomly selected sample of 244 post-surgical patients admitted to a large private, Australian health service.

Results: The median and average times to readiness-for-discharge were 48 minutes and 56 minutes respectively with …

How Will The Nursing Profession Remember The Hon Greg Hunt Mp?, Toni G. Hains

Journal of Perioperative Nursing

The Hon Nicola Roxon MP was celebrated as the Minister for Health and Aging who showed courage and conviction for the nursing profession by facilitating legislation, passed in 2010, that allowed nurse practitioners (NPs) and midwives limited access to the Medical Benefits Schedule (MBS) and the Pharmaceutical Benefits Schedule (PBS) 2010. How will the current Minister for Health and Aging, the Hon Greg Hunt MP, be remembered by the nursing profession?

Perioperative Nursing – Exclusive Or Inclusive?, Carollyn Williams

Journal of Perioperative Nursing

Perioperative nursing is very much a multidimensional area of practice that has evolved as models of perioperative patient care, surgery, anaesthetics and their complexity, techniques and equipment have evolved. Within the broad perioperative area there are numerous nursing roles. However, they do not all necessarily identify as being under a singular ‘perioperative’ umbrella and this is largely due to how the roles evolved. Thus the question: is perioperative nursing exclusive, in that it identifies with only one facet of the pre-operative, intra-operative and post-operative phases of the patient’s surgical experience? Or is it inclusive, in that nurses who work in …

Effectiveness Of Family-Centred Educational Interventions In The Anxiety, Pain And Behaviours Of Children/Adolescents And Their Parents’ Anxiety In The Perioperative Period: A Systematic Review And Meta-Analysis, Ines Martins Esteves, Marcia Silva Coelho, Hugo Neves, Marcia Pestana-Santos, Margarida Reis Santos

Journal of Perioperative Nursing

Aim: To evaluate the effectiveness of family-centred educational interventions on the anxiety, pain and behaviours of children and adolescents (three to 19 years old) and their parents’ anxiety during the perioperative journey.

Design: Systematic review of effectiveness and meta-analysis.

Data sources: MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, SciELO and Sources of unpublished studies OpenGrey, Open Access Theses and Dissertations, and RCAAP – Portugal were systematically searched from January 2007 to April 2021 for available articles in English, Spanish and Portuguese.

Review methods: This review followed the methodology for systematic reviews of effectiveness from Joanna Briggs Institute (JBI). …

Improving Patient Safety In The Post-Anesthesia Care Unit By Identifying Nurses’ Perceived Barriers To The Implementation Of Barcode Medication Administration, Colleen Gauvin

Master's Theses and Capstones

Background: In the landmark report To Err is Human: Building a Safer Health System published by the Institute of Medicine in 1999, it was estimated that 98,000 Americans die annually due to medical mistakes (Institute of Medicine et al., 2000). Since then, major advancements have been made to improve patient safety in the United States relating to safe medication administration. Barcode medication administration (BCMA) is a technology that was designed to help decrease medication errors by automating the five rights of medication administration (Thompson et al., 2018). BCMA was first utilized at a Veteran Affairs (VA) Medical Center in …

Improving The Patient Repositioning Process: A Quality Improvement Project, Sydney Elizabeth Mcgough

Master's Theses and Capstones

Background: Research has shown that visual turn reminders can improve patient repositioning to prevent pressure injuries. The aim of this quality improvement project was to improve adherence to repositioning by increasing the perceived usefulness of the visual turn reminder.

Methods: A pre-intervention survey was distributed to 70 staff members with 22 responses. Staff were given the opportunity to recommend changes to the visual reminders and were informed that feedback would lead to the identification of common themes. Based on feedback, high visibility turn reminders were developed and implemented on the unit. A post-intervention survey was distributed to the same 70 …

Open All Hours!: Bariatric Surgery Patients Love Csc, Naomi Schneider, Mallory Mondloch

Nursing Posters

During the fall and winter of 2020, St. Cloud Hospital saw a dramatic increase in the number of COVID-19 patients. Additionally, elective surgeries in Minnesota were on hold during the early months of the pandemic, and later in 2020 there was a significant backlog of these patients, waiting for their procedure. To serve patients and their families, St. Cloud Hospital teams planned for a way to safely and professionally offer surgical care needs to Central Minnesota.

Perioperative Glucose Monitoring Protocol, Nicole Helgeson

Nursing Posters

Currently, there is no established glucose management protocol for our surgical patients. Poor outcomes related to hyperglycemia may include increased morbidity/mortality, surgical site infection (SSI), sepsis, renal, and cardiac concerns. The purpose of this protocol is to improve the care and outcomes for surgical patients through a consistent standardization of glucose management.