Nursing Implications For Transgender And Gender Diverse Perioperative Patients: A Discussion Paper, Oona O'Shea, Paula Foran

Journal of Perioperative Nursing

Perioperative nurses must provide culturally competent care to all surgical patients, and understanding gender identity and gender diversity may be the first step to creating an inclusive perioperative practice for transgender and gender diverse patients. In the nurse–patient relationship, limited exposure to and knowledge of diverse populations may negatively affect the health of this important demographic.

When nurses are unaware of how care can be affected by explicit (conscious) or implicit (unconscious) bias, they may use transphobic stereotyping behaviours or act with microaggressions, like using excessive protective attire. Such care may invalidate gender identity and impede trust. In contrast, nurses …

Preoperative Warming To Improve Patient Outcomes: Implementation Of A Warming Protocol, Tiara Switzer-Houston

Student Scholarly Projects

Practice Problem: Inadvertent perioperative hypothermia (IPH) is noted to be the most common surgical complication. IPH is associated with a variety of complications which are known to impact the well-being of the patient, family, and healthcare system.

PICOT: The PICOT question that guided this scholarly project was scheduled for total hip and knee arthroplasty surgical procedures under general or neuraxial anesthesia greater than 60 minutes (P), how effective is the implementation of an evidence-based pre-surgical warming protocol including forced-air warming (FAW) (I) compared to current practices (C) in improving normothermia readings within 15 minutes of arriving to the PACU, …

Barriers To And Facilitators Of Using Cognitive Aids In Perioperative Emergencies: An Integrative Review, Simon Almoite, Paula Foran

Journal of Perioperative Nursing

Problem identification: Perioperative emergencies, although infrequent, may lead to significant morbidity and mortality associated with anaesthesia and/or surgery. Human factor errors account for between 43 to 65 per cent of sentinel events in the perioperative environment. Cognitive aids were introduced to reduce a user’s cognitive workload and assist in adherence to key interventions during emergencies. Despite the availability of these aids, implementation of their use remains low. This integrative literature review will identify the barriers to and facilitators of the implementation of cognitive aids during perioperative emergencies.

Literature search: An electronic database search of EBSCO databases (CINAHL Complete, Health Source: …

Effect Of Using Virtual Reality To Manage Needle Phobia In Adults Undergoing Medical Procedures: A Rapid Review, Craig J. Gilbertson, Tshepo Rasekaba, Irene Blackberry

Journal of Perioperative Nursing

Background: Needle phobia, also known as blood–injection–injury (BII)phobia, is a severe form of needle fear that affects from 20 to 50 per cent of adolescents, 20 to 30 per cent of young adults and less than 5 per cent of the older adult population. When faced with venepuncture, approximately 75 per cent of patients with needle phobia will undergo an extreme physiological response which can lead to a vasovagal or fainting episode. An emerging therapy for medical phobias is the use of virtual reality, a three-dimensional environment generated by a computer that creates a sense of immersion.

Aim: To evaluate …

Australian Elective Surgery Patients’ Pre-Operative Preparation, Health Literacy, Learning Preferences And Knowledge Resource Needs: A Cross-Sectional Survey, Cory J. Williams, Jed Duff, Chloe Tannagan

Journal of Perioperative Nursing

Aim: To investigate self-reported health literacy levels, learning preferences and knowledge resource needs of Australian elective surgery patients.

Background: Surgery contributes significantly to global health care, but surgical waitlists, cancellations and delay remain major challenges for health care systems. Pre-operative preparation and patient education about the surgical journey are essential to reducing these disruptions. Unfortunately, preparation and education are limited by short timeframes and one-size-fitsall approaches. Limited information exists about Australian surgical patients’ health literacy levels, learning preferences and knowledge resource needs.

Design and methods: This cross-sectional waiting room survey investigated patient health literacy, preferred education mode and learning styles …

‘I Want To Be A Member Of My Heart Team’: Insights From Patients’ Experiences Of Minimalist Transcatheter Aortic Valve Implantation, Celeste G. Percy, A. Fuchsia Howard Dr., Bobby Lee Dr., Janarthanan Sathananthan Dr., David A. Wood Dr., John G. Webb, Sandra B. Lauck Dr.

Journal of Perioperative Nursing

Background: Internationally, transcatheter aortic valve implantation (TAVI) is the most common approach for treating aortic stenosis. There is growing evidence to support the implementation of a streamlined clinical pathway to optimise outcomes, improve capacity and facilitate safe early discharge home. Best practices that are emerging include adopting a minimalist approach and transition from general anaesthesia to conscious sedation or local anesthesia only. We aimed to explore what could be learned from patients’ experiences of their care in this rapidly evolving context

Methods: We conducted a qualitative study of patients in the first week after TAVI to explore their perspectives of …

Effects Of Compassion Fatigue On Surgical Staff Productivity, Marcy I. Harris

Electronic Theses and Dissertations

Compassion fatigue is a psychological phenomenon affecting many healthcare professionals; however, many professionals are unaware of compassion fatigue or its signs and symptoms. Individuals suffering from compassion fatigue may experience mental and physical side effects and a decline in their work productivity. This quality improvement project was aimed at determining if implementing Vintapatr’s compassion fatigue education and management program would improve perceived levels of compassion fatigue and reduce operating room turnover time. The researcher utilized a descriptive correlational design to identify the relationship between compassion fatigue levels and operating room turnover times. This quality improvement project was implemented at a …

Thermoregulation In Colorectal Patients: Heating Co2 Insufflation Gas, Alejandro Conde, Alieu Jawara, Laura Savage, James Alberding Dnp, Michael Godbold

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

BACKGROUND: 600,000 colorectal surgeries are performed annually in the United States, with 26-90% experiencing some form of unintended hypothermia. Consequences of hypothermia include surgical site infections (SSIs), delayed wound healing, cardiac dysrhythmias, and increased hospital length of stay. Utilization of the laparoscopic approach to intra-abdominal colorectal surgery uses un-warmed CO₂ gas. Multiple studies demonstrate the addition of heated CO₂, for insufflation, reduces intraoperative hypothermia.

LOCAL PROBLEM: This project was implemented at a facility in Tennessee. On average, 250 laparoscopic colorectal cases are performed at this facility annually. Participants were adult colorectal surgical patients, 18 years …

The Effects Of An Educational Intervention On Nursing Knowledge Of Post-Operative Care Of Patients After Minimally Invasive Esophagectomy Surgery, Kelli Curry

DNP Projects

Abstract

Background: Minimally invasive esophagectomy surgery is commonly performed by thoracic surgeons on patients with esophageal cancer. The post-operative care of these patients is meticulous and follows a protocol developed by the thoracic surgeons at the University of Kentucky. At UK Chandler Medical Center, concerns have been raised regarding nurses’ lack of education of the protocol, and therefore decreased implementation. Increasing nursing knowledge pertaining to this protocol by performing educational in-services periodically and standardizing and implementing formal education as part of nursing orientation will decrease the knowledge gap and improve patient outcomes and increase utilization of the post-operative protocol.

Purpose: …

Why We Should Be Counting In The Cardiac Catheter Lab: A Discussion Paper, Stephanie Biggs, Paula Foran

Journal of Perioperative Nursing

The cardiac catheter laboratory, which in many health care facilities falls under the umbrella of perioperative services, generally sits geographically outside the traditional operating suite. Perhaps due in part to this geographical distance, standards that are routinely applied in the operating suite may not be applied in the cardiac catheter laboratory. One such standard is the management of accountable items such as swabs, surgical instruments, sharps and sheaths. Well-known standards and guidelines for managing accountable items recommend mandatory counting and documentation of all accountable items in environments where a surgical item may be left behind; yet, despite this, counting is …

Multidisciplinary Simulation Training For Australian Perioperative Teams: A Qualitative Descriptive Exploratory Study, Michelle Hibberson, Jessica Lawton, Dean Whitehead

Journal of Perioperative Nursing

Background: Perioperative units are complex and high-risk environments in which teams of multidisciplinary health care professionals work collaboratively. Multidisciplinary simulation training is a form of education that allows perioperative teams to practise the non-technical and technical skills essential for managing emergency events within the perioperative environment. Despite the benefits of multidisciplinary simulation training, there is a paucity of literature about it; therefore, this study examined the experiences of Australian multidisciplinary perioperative team members who had undertaken simulation training.

Objectives: This study examined the experiences of Australian multidisciplinary perioperative team members who had undertaken multidisciplinary simulation training with the aim of: …

Depression Screening Tool For Hysterectomy Patients, Dede C. Mihedji

Doctor of Nursing Practice (DNP) Projects

Abstract

Background: The prevalence of hysterectomies in the United States ranges from

5.1 to 5.8 per 1000 women (Harnod et al., 2018). A standardized screening tool for assessing

depression preoperatively could mitigate the worsening of postoperative depressive symptoms in patients scheduled for a hysterectomy.

Local Problem: Currently, there is no standard of practice to routinely screen for depression in preoperative patients scheduled for hysterectomy surgeries. However, as with any surgical intervention, there are risks of long-term complications. Studies have identified that a hysterectomy may increase the risk of cardiovascular events, menopause, depression, and other outcomes (Madueke-Laveaux et al., 2022). …

Non-Clinical Perspectives On Sepsis: A Project For Enhanced Awareness, Anjali Kumari Singh

Master's Projects and Capstones

Problem: This project aimed to enhance non-clinical staff knowledge of sepsis through a targeted awareness campaign, while also seeking to uphold or enhance the organization's sepsis-related performance.

Context: Clinical Nurse Leader students conducted a microsystem assessment in five crucial non-clinical departments of an urban Bay Area hospital, each playing a vital role in the organization's efficiency at different levels.

Intervention: During Sepsis Awareness Month, a sepsis awareness campaign was implemented. This involved a concise presentation on sepsis, its consequences, and the significance of awareness in each department. Additionally, informational fliers detailing sepsis signs and symptoms were distributed.

Measures: A pre-and …

Evaluation Of Registered Nurses’ Knowledge And Confidence In Encouraging Cardiac Surgery Patients To Participate In Digital Education, Katelin A. Welch, Jewyl Gibson

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Abstract

Background: Cardiac surgery remains a necessary means of medical management for cardiac disease. Patient anxiety is a common mental health challenge experienced by cardiac surgical candidates. Preoperative educational videos can reduce anxiety and improve the surgical experience.

Local Problem: This project was conducted for hospital nurses caring for cardiac surgery patients. Cardiac patients are assigned digital education to educate them about their procedures. Regardless of availability, nurse and patient engagement of the material is low. Competing nursing priorities prevent nurses from disseminating education to cardiac surgery patients, thus increasing patient anxiety. Educating nurses on utilizing digital surgery …

Evidence-Based Pain Management With Inclusion Of Music Therapy For Post-Surgical Patients: A Benchmark Study, Ashleigh Rowan

MSN Capstone Projects

Improper pain management in the postsurgical patient can delay proper healing, increase frustration for the patient, and prolong hospital stays (Córcoles-Jiménez et al., 2021). Moderate to severe pain can pose a greater risk for complications such as deep vein thrombosis, pneumonia, and delayed recovery (Kolaczko et al., 2019). Music therapy is an underutilized pain intervention in the PACU environment. Music therapy has been shown to lower pain and anxiety scores in many different clinical settings (Lee et al., 2017). Pain management can radically improve a patient’s outlook and recovery (Luo & Min, 2017). Patients who return to wakefulness and receive …

Perceptions And Awareness Of Operating Room Staff Regarding Surgical Smoke: Implications For Safety And Health, Karla Flores

MSN Capstone Projects

In the ever-evolving landscape of modern medicine, surgical procedures have become increasingly complex and reliant on energy-based devices, leading to the ubiquitous presence of surgical smoke in ORs. This phenomenon, while a byproduct of technological advancement, poses significant concerns regarding the health and safety of OR personnel, including surgeons, nurses, anesthesiologists, surgical technicians, and ancillary staff. This paper presents a meticulous examination of the multifaceted impacts of surgical smoke, emphasizing the urgency for comprehensive intervention and systemic change.

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

Promoting The Adoption Of Double Gloving Among Nurse Anesthetists: An Educational Intervention Based On The Theory Of Planned Behavior, Nguyet Tran

Doctoral Projects

Abstract

Background: The role of anesthetists in the transmission of pathogenic and non-pathogenic organisms from their work station to the patient has been well established in research. The proposed study aims to test the efficacy of an educational intervention in promoting double gloving in an effort to minimize the risk of cross-contamination.

Methods: This pilot study explored if multi-component educational intervention facilitates the adoption of double gloving and the prevention of cross-contamination in the anesthesia workstation. Student Registered Nurse Anesthetists (SRNAs) and Certified Registered Nurse Anesthetists (CRNAs) were followed in three evaluation phases; the first test was done before the …

Improving Access To Cardiac Catheterization, Sunitha Dharman

Student Scholarly Projects

The American Heart Association lists cardiovascular disease as the underlying cause of death for 874,613 people who lost their lives in 2019 (Tsao et al., 2022). On average, someone in the United States has a myocardial infarction every 40 seconds, and someone dies of a stroke every 3 minutes and 30 seconds. Studies support coronary artery disease as a significant contributor to cardiac arrest in a non-hospital setting (Yannopoulos et al., 2019). The authors provide evidence supporting the importance of early cardiac catheterization. There is a 10-15% survival rate with a higher level of functioning compared to delayed or no …

Getting The Balance Right: Family Visitation In The Post Anaesthesia Care Unit, Felicity Hennessy, Paula Foran

Journal of Perioperative Nursing

The standard practice in Australia is to restrict family visitation for adult patients in the first-stage Post Anaesthesia Care Unit (PACU). While research on this topic in the Australian context is lacking, there is international evidence, particularly from the United States of America (USA), that demonstrates benefits to both patients and family members. These benefits include high satisfaction rates, reduced anxiety and an improvement in patient haemodynamic markers, pain and nausea. The facilitation of family visitation in the PACU may also enhance the delivery of not only personcentred care but also patient- and family-centred care. Despite this, the literature documents …