Perioperative, Operating Room and Surgical Nursing Commons^™

Busting Persistent Myths About Perioperative Hypothermia, Jed Duff

Journal of Perioperative Nursing

Perioperative hypothermia occurs when a patient’s core temperature drops below 36 °C during their surgical journey. Research spanning more than thirty years highlights the negative effects of hypothermia on clinical outcomes and patient comfort.

Perioperative hypothermia prevention is a classic example of an evidence–practice gap. Despite proven prevention methods, as many as half of all surgical patients continue to experience perioperative hypothermia.

Pre-Operative Anxiety Of Patients In District Hospitals In Ashanti Region, Ghana, Sawan Dankyi Sa, Million Bimerew Mi, Jennifer-Anne Chipps Ja

Journal of Perioperative Nursing

Objectives: To investigate pre-operative anxiety of patients at district hospitals in Ashanti Region, Ghana.

Method: A descriptive survey was conducted with patients who were being prepared to undergo various surgical operations at ten hospitals. The questionnaire included the Hamilton Anxiety Rating Scale (HAM-A) and questions about factors that may contribute to patients’ anxiety prior to surgery.

Results: Most of the 210 respondents reported anxiety with 189 (90%) reporting some anxiety before the surgical operation (20.57/30, +/-10.07), range 0–26). Respondents reported moderate anxious mood (2.14, +/-1.45), tension prior to surgery (2.00, +/-1.35) and insomnia on the day before the procedure (2.00, …

Exploring The Feasibility Of Using Virtual Reality As A Nonpharmacological Intervention To Alleviate Patient Fear Of Needles During Medical Treatment: A Study Protocol, Craig J. Gilbertson, Tshepo Rasekaba Dr, Irene Blackberry Professor

Journal of Perioperative Nursing

Background: An extreme fear of needles results in patients avoiding procedures that involve needle exposure, potentially compromising their health outcomes. Virtual reality is a simulated three-dimensional environment created using an audio-visual headset that may reduce patients’ level of anxiety during needle exposure.

Aims: The primary aim of the study is to determine the feasibility of using virtual reality to manage anxiety and reduce fear during intravenous cannulation. The safety and experiences of patients and health care professionals using virtual reality will be explored.

Methods: This feasibility study will use mixed methods. Participants will undergo needle exposure with standard care and …

Reduce Extended Length Of Stay By Reducing In-Hospital Falls, Norberto Benitez

Master's Projects and Capstones

Abstract

Problem: Every year, there are many in-hospital falls (IHFs). Nationally there are between 700,000 to 1 million falls recorded each year. Hospital falls financially burden our healthcare industry, costing approximately 34 billion annually. Context: In a local hospital in Northern California, Marin County, the microsystem has had an extraordinary number of in-hospital falls (IHFs). To date (June 2023), 13 falls have been recorded thus far; the microsystem is on track to beat the previous year's record number of 21 falls in a calendar year. Interventions: The MSN–CNL student proposed re-educating staff, resetting expectations, and reestablishing workflow. We also sought …

Robot Revolution: Impacting Adoption Of The Technology, Cece Noland

MSN Capstone Projects

The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.

Enhancing Adherence To Best Practice Guidelines Related To Pressure Injury Prevention In The Operating Room At A Children's Hospital During Comprehensive Dental Procedures., Alyce Bailey Seaver

Doctor of Nursing Practice Papers

Background: 1,600,000 patients develop a hospital-acquired pressure injury every year, and 23% of these originate during surgery. Research has demonstrated that the incidence of hospital-acquired pressure injuries developing during surgery has risen over the past 5 years. This rise has been attributed to nurse circulators exhibiting poor knowledge regarding best practices for intraoperative patient positioning and intraoperative documentation that does not follow standards of care.

Purpose: This quality improvement project aimed to enhance circulator knowledge on best practices for intraoperative patient positioning and improve documentation of intraoperative patient positioning in the electronic medical record to comply with standards of …

Effect Of Pre-Operative Education On Post-Operative Pain Management Among Adult Patients Undergoing Elective Surgery: An Integrative Review, Sameera Liaqat Adam Albalushi, Fadi Khraim Dr., Atef M. M. Al-Tawafsheh Dr., Daniel Forgrave

Journal of Perioperative Nursing

Introduction: Adequate pain control for surgical patients is an important aspect of their post-operative care. To manage pain, health care professionals use pharmacological and non-pharmacological strategies. A significant worldwide increase in the number of surgical procedures and their associated cost has led to a focus on non-pharmacological interventions, like education, to prevent post-operative complications. Education in the pre-operative phase aims to assist patients in overcoming their fears about upcoming surgery, promote pain management and enhance the recovery process.

Objective: This integrative review aims to assess the effectiveness of preoperative education on post-operative pain management among surgical patients.

Method: Whittemore and …

Drug Diversion Education For The Anesthesia Provider Plus One, Denise M. Christie

DNP Projects

The purpose of this quality improvement project was to determine awareness, knowledge, and the value of educating both the anesthesia provider and their spouse/significant other/family member/close friend (plus one) on the risks of drug diversion. Surveys revealed only 20% of plus ones had received previous education on drug diversion. After the educational session, anesthesia providers and plus ones showed increased awareness of the risks of drug diversion (p 0.08), increased knowledge of signs and symptoms, and perceived protection from diversion through education of the plus ones (p 0.08). Further investigation of the persistence of these effects is warranted.

Evidence-Based Practice In Perioperative Nursing: Barriers And Facilitators To Compliance, Benita Ramage, Paula Foran

Journal of Perioperative Nursing

Evidence-based practice (EBP), in combination with clinical expertise and patient values and wishes, enables delivery of exceptional patient-centred care. Providing our perioperative patients care that is informed by best evidence has been proven to provide a safer and higher standard of care.

Best evidence forms the basis for standards and guidelines for nursing practice published by organisations such as Australian College of Perioperative Nurses (ACORN), Australian and New Zealand College of Anaesthetists (ANZCA) and Australian Commission on Safety and Quality in Health Care (ACSQHC). While perioperative nurses strive to provide the best possible care for their patients there is sometimes …

Improving Postoperative Breast Augmentation Patient Education Delivery., Madison Callery

Doctor of Nursing Practice Papers

Background: Effective patient education promotes successful postoperative outcomes. Nurses in an outpatient surgery center lacked consistent patient education practices and materials.

Purpose: The purpose of the project was to implement an evidence-based multimodal educational strategy for patients who undergo breast implant surgeries.

Methods: At an outpatient plastic surgery center, pre- and post-intervention phone calls were tracked; post-intervention education, documentation, and patient satisfaction data were recorded. Nurses were educated on the new materials, delivery procedures, and electronic health record (EHR) documentation. All patients undergoing breast implant surgery received multimodal education at each postoperative appointment. Outcomes included (1) the number of patient …

Establishment Of Unit-Based Council Using A Shared Governance Toolkit For Surgical Clinics, Fica Etienne

Student Scholarly Projects

Practice Problem: Shared governance (SG) is an organizational framework that empowers healthcare professionals by granting them authority over their own professional practice. The absence of a unit-based council (UBC) has been identified as hindering collaborative decision-making and problem-solving approaches.

PICOT: In four surgical clinics requiring a Unit Based Counsel (UBC) structure (P), what is the impact of implementing a Shared Governance (SG) toolkit (I) compared to not implementing an SG toolkit (C) over eight weeks? (T)

Evidence: The existing literature strongly indicates that shared governance (SG) empowers nurses to collaborate as equal partners with nursing leaders within …

Effectiveness Of Virtual Reality Interventions To Reduce Pre-Operative Anxiety In Adult Surgical Patients In The Pre-Operative Period: Systematic Review And Meta-Analysis, Agnes Mulundu Mbewe, Zaneta Smith

Journal of Perioperative Nursing

Aims: To synthesise and evaluate the effectiveness of virtual reality (VR) interventions compared to standard care to reduce pre-operative anxiety in adult surgical patients during the pre-operative period.

Design: Systematic review of effectiveness and meta-analysis.

Data sources: MEDLINE, EMBASE, JBI EBP, PUBMED, CINAHL, SCOPUS, PsycINFO, Cochrane Library, EMCARE, World Health Organisation, WEB OF SCIENCE, Grey Literature, National Institute of Health & Care Excellence were searched with limits between 2010 to 2022.

Review methods: The review followed the Joanna Briggs Institute (JBI) methodology for systematic reviews of effectiveness and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA 2020) guidelines. …

Impact Of Using Personal Mobile Phones In The Operating Theatre: A Scoping Review, Sara Reis, Rita D. Marques, Patrícia Pontífice-Sousa Phd

Journal of Perioperative Nursing

Background: Nowadays, mobile phones are an indispensable tool in multiple settings, particularly in the field of health care. Consequently, it is important to understand the impact of their use by health care professionals in the operating theatre – an environment that should be as ‘sterile’ as possible, to ensure patient safety.

Purpose: To map the available scientific evidence on the impact of the multidisciplinary team’s use of personal mobile phones in the operating theatre.

Methods: A scoping review was conducted, following the methodology recommended by the Joanna Briggs Institute. The bibliographic search was carried out in the ‘PubMed’ and ‘Web …

Amniotic Fluid Embolism Diagnosis & Treatment Pathway, Jeremy May

Doctor of Nursing Practice Projects

Access to care in rural areas can prove difficult for any patient, but especially for the expecting mother. Healthcare providers in these rural settings often lack the staffing and experience to effectively recognize and treat rare obstetric emergencies. Amniotic fluid embolism (AFE) is a rare medical emergency that requires healthcare providers to rapidly diagnose, monitor, and treat the sequela of resulting symptoms in the obstetric patient. After a literature review, a teaching session was developed and implemented as part of the annual training for 20 nursing staff at a small 50-bed rural hospital in central California. An 8-question pre-test was …

The Future Of Cognitive Dysfunction In Elderly Patients: A Clinical Perspective With Recommendations, Laura Taylor

Doctor of Nursing Practice Final Manuscripts

Background: The U.S. Census Bureau projects the number of Americans age 65 years and older will more than double between 2010 and 2050. The geriatric patient population will likely require the use of surgical services at a higher rate than ever before. To best care for the elderly undergoing procedures with anesthesia, it is imperative to follow the most up to date evidence to avoid post-operative complications, and more specifically post-operative cognitive dysfunction.

Purpose: The purpose of this DNP evidence-based practice project is to identify patients that are at high risk for post-operative cognitive dysfunction prior to undergoing anesthesia. Post-operative …

Addressing Burnout And Compassion Fatigue In Perioperative Nursing: An Urgent Call To Action, Jed Duff

Journal of Perioperative Nursing

Burnout and compassion fatigue have a considerable impact on perioperative nurses’ wellbeing and job satisfaction as well as on the quality of patient care. As a specialty, we must act collectively to address this.

Increasing Sepsis Bundle Compliance Through Nurse Education, Parth S. Papaiya

Master's Projects and Capstones

There exists opportunities for improvement in regards to sepsis management and compliance rates in efforts to reduce sepsis-related complications and incidents in the ED. SEP-1 fallouts and requirements linked to education gaps about sepsis bundle protocols, nurses’ attitudes about implementation of the protocols, and differences in nurse/physician order sets present as deterrents for timely sepsis management and improvements in the rates of compliance/adherence. Denouncing the usage of standardized protocols/use of order sets have been identified as a process gap and a much needed opportunity for improvement. It is presumed that the failure to implement, in addition to improper documentation of …

Standardization Of Perioperative Management Of The Breastfeeding Women, Amrutha Panakkal

Doctor of Nursing Practice Projects

Mother's milk is the optimal nutrition for the term and preterm neonates. The psychological and physiological stressors in the perioperative setting can impede a lactating mother's ability to breastfeed in the postoperative setting successfully. A best-practice guideline incorporating a stoplight color-coding chart and categories such as "safe," "caution," and "consider avoidance" was used to group medications according to their safety for anesthesia providers in a large urban academic medical center in Pennsylvania. The evidence-based guideline also provided links to the hospital policy, LactMed, and Hale database to streamline resources and aid in the rapid decision-making of anesthesia providers in identifying …

Utilizing Gastric Point-Of-Care Ultrasound Assessment For Patients With Questionable Npo Status, Carolina Botero

Doctor of Nursing Practice Projects

Perioperative aspiration is a rare but serious complication with high morbidity and mortality for patients. This event often occurs from anesthetic depression of protective airway reflexes. NPO guidelines are implemented before anesthesia to eliminate the presence of any gastric contents. However, patients with certain comorbidities may still persist with a full stomach before an anesthetic. Patients may complicate matters further by not following NPO instructions, the patient’s NPO status may be unknown, or the timing of surgery may prevent adequate NPO times. In these situations, the anesthesia provider is faced with the difficult decision to alter, delay or potentially cancel …

A Comparison Of Erector Spinae Plane Block And Epidural Analgesia For Major Abdominal Surgery, Charles Serrano

Doctor of Nursing Practice Projects

A large tertiary care center in central Illinois saw an increase in erector spinae plane (ESP) block administration for abdominal surgery patients, but many anesthesia providers at the facility were not acquainted with the ESP block. This project aimed to develop a comprehensive educational program concerning the ESP block compared to thoracic epidural analgesia for major abdominal surgery patients and ultimately improve patient care. The program introduced the relevant anatomy, indications, technique, advantages, and disadvantages of ESP block and epidural analgesia. Additionally, the risks, benefits, and costs of both adjunctive therapies were compared. The current literature shows that the thoracic …