Medicine and Health Sciences Commons^™

Undertaking The Surgical Count: An Observational Study, Victoria Ruth Warwick, Brigid M. Gillespie, Anne Mcmurray, Karen G. Clark-Burg

Journal of Perioperative Nursing

Objective

To systematically measure and describe perioperative nurses’ surgical count practices using the Surgical Count Observational Tool, to measure conformity with standardised processes and identify barriers and enablers influencing nurses’ practices.

Sample and setting

A large public tertiary hospital in Western Australia.

Methods

The Surgical Count Observational Tool (SCOT) was developed using the Content Validity Index over two Delphi panel rounds and then pilot tested. Individual observations were analysed according to 14 criteria based on the 2016 Australian College of Perioperative Nurses (ACORN) standard ‘Management of accountable items used during surgery and procedures’¹. Count processes were observed over …

Handover Using Isbar Principles In Two Perioperative Sites – A Quality Improvement Project, Patricia Kitney, Raymond Tam, David Bramley, Koen Simons

Journal of Perioperative Nursing

Background

ISBAR is a structured approach to communication between health care providers, particularly for the purpose of transferring patient clinical care. The ISBAR acronym refers to Identification, Situation, Background, Assessment and Request or Recommendation.

This paper provides the final report on a quality improvement project (QIP) that was carried out in the perioperative unit at two campuses of a large Melbourne metropolitan hospital. The final phase of this project addressed the concluding audits measuring compliance with ISBAR handover principles at selected handover episodes during the patient care journey through the perioperative suite. The previous two phases established baseline data for …

Enhanced Recovery After Surgery In Australia: A Classic Example Of An Evidence–Practice Gap, Jed Duff

Journal of Perioperative Nursing

Enhanced recovery after surgery (ERAS) pathways – often referred to as fast-track programs – are multidisciplinary, evidence-based perioperative pathways, designed to achieve early recovery for patients undergoing major surgery. ERAS has been described as a surgical revolution because of the benefits it produces. A recent systematic review found, on average, ERAS pathways reduce length of stay by 2.3 days and case costs by $639.00, without adverse impact on mortality, adverse events, or readmissions.

Will Robots Make Good Perioperative Nurses?, Jed Duff

Journal of Perioperative Nursing

New technology is always being introduced into health care and nursing as a profession has had to adapt. Technological advances have changed the practice of nursing from the introduction of the stethoscope to the electronic health record, and now robots and artificial intelligence (AI). With technological advancements occurring at an ever-increasing rate, more and more perioperative tasks will be delegated to robots and AI. The main question for perioperative nurses is, how can we remain relevant in the high-tech operating room of the future?

Type 1 Diabetes Perioperative Care: Preventing Harm To Patients, Rebecca Munt

Journal of Perioperative Nursing

Imagine you lived with a chronic condition that required you to make over 100 selfmanagement decisions every day. Imagine you have been admitted to hospital for a day surgery procedure and the health professionals have refused your request for access to a medication you need for survival. Imagine that as a result of missing this medication you have ended up in an intensive care unit (ICU) with a life-threatening condition. The life-threatening condition is diabetic ketoacidosis (DKA) and the medication you needed is insulin, because you have type 1 diabetes (T1D).

What Is The Scope Of Practice Of The Nurse Practitioner As A Surgical Assistant In Australia?, Toni G. Hains, Catherine L. Smith

Journal of Perioperative Nursing

Discussion around the scope of practice of all nurse practitioners (NPs) in Australia was a component of the recent review of NPs’ eligibility to have broader access to the Medical Benefits Schedule (MBS). This review process has been prolonged and, while the MBS review officially concluded on the 30 June 2020, no information regarding decisions about expanded NP access to the MBS for patient rebates had been disclosed at the time of publication. It is anticipated that the MBS review will contribute little change to NP access to the MBS.

The MBS is the primary funding process for private-sector medical …

The Impact Of Distractions And Interruptions In The Operating Room On Patient Safety And The Operating Room Team: An Integrative Review, Sonia Mackenzie, Paula Foran

Journal of Perioperative Nursing

Problem identification: In the operating room (OR), distractions and interruptions are frequent, impacting patient safety, coordination and efficiency and causing errors and patient harm. The OR team is impacted while attempting to perform critical work. This review explores the impact of distractions and interruptions in the OR on patient safety and the OR team.

Literature search: Inclusion and exclusion criteria were determined. Six databases were searched with the search criteria for inclusion being in English, peer-reviewed and published between 2014 and 2019. In total 296 papers were identified.

Data evaluation synthesis: Duplicates were removed, and 195 papers were screened …

A Daily Measure Of Job Satisfaction In The Operating Room: Investigating Its Value And Viability, Miriam S. James-Scotter, Lixin Jiang, Cameron Walker, Stephen Jacobs

Journal of Perioperative Nursing

Objectives: This study aims to explore the value, validity and viability of implementing a daily job satisfaction tool in the operating room setting (OR).

Sample and setting: A daily one-minute survey was developed and trialled with 269 OR staff members (123 nurses) over a three-week period within one New Zealand hospital.

Method: A feedback and validation survey was then administered to staff one week following the trial.

Results: The trial resulted in 569 tool submissions. A daily average of 71% of participants (69% nurses) reported feeling ‘pretty good’ or ‘great’ about their jobs, with ‘relationships and communication with colleagues’ …

Perioperative Nurses’ Engagement With The Surgical Safety Checklist: A Focused Ethnography, Julie A. Rogers, Paul Mcleish, Jan Alderman

Journal of Perioperative Nursing

Purpose

To gain greater insight into how nurses engage with the multidisciplinary team during the surgical safety checklist process.

Participants and setting

Participants were a purposeful sample of eight operating room nurses. The study was conducted in the operating room department of a major tertiary teaching hospital in South Australia.

Methods

Phase 1 employed participant observations while phase 2 employed semi-structured interviews.

Findings

Participants supported the use of the surgical safety checklist and valued its role to enhance patient safety. Multidisciplinary team culture played a significant role in how the checklist was conducted and heavily influenced the level of nurse …

Covid-19 And Perioperative Nursing – Inside The Nsw State Emergency Operation Centre, Sarah-Jane Waller

Journal of Perioperative Nursing

This article is a guest editorial describing how it was to work inside the NSW State Emergency Operation Centre, the COVID-19 response coordinating hub for the Australian state of New South Wales, in the early days of the pandemic.

The Imperative To Build Research Capacity And Promote Evidence-Based Practice In Australian Perioperative Nurses, Jed Duff

Journal of Perioperative Nursing

Evidence-based practice is considered the gold standard of care, and as such it is now an expectation of our patients, regulatory agencies and health care funders. Unfortunately, much of what we do in perioperative nursing continues to be based on tradition and history rather than robust clinical evidence. Even when evidence is available to use, it is often not fully applied in practice. If we want to maintain our standing as a leading nursing specialty, then we need to address this issue by engaging with research and growing our evidence base. To do this, we need to conduct and disseminate …

Pandemics: A Covid-19 Perspective, Lyn Bowen

Journal of Perioperative Nursing

The world is currently gripped by a pandemic, a term that is on everyone’s lips. However, six months ago, many would have found it difficult to define the terms pandemic, epidemic and outbreak, or explain the difference.

The emergence of a novel coronavirus, commonly referred to as COVID-19, has significantly changed our awareness. It has heightened our anxiety, like a primordial fear, leaving us feeling vulnerable, similar to how past generations reacted to pandemics.

Ecg For All Patients In The Pacu: Some Say, Why? I Say, Why Not?, Paula Foran

Journal of Perioperative Nursing

Currently in many Australian hospitals, electrocardiogram (ECG) leads are removed after the operative process and, despite the machines being freely available in the Post Anaesthesia Care Unit (PACU), they are not connected to all patients.

There are many evidence-based reasons why an ECG would be advantageous for perioperative patient safety, including the detection of often asymptomatic conditions such as myocardial injury after non-cardiac surgery (MINS) and new-onset atrial fibrillation, which has been shown to increase the risk of stroke. Advantages may also be seen in saving precious minutes in a cardiac arrest, and the ability for nurses to constantly observe …

Who’S Under The Mask? Colour-Differentiated Identification Labels For Perioperative Staff, Diana Bentley

Journal of Perioperative Nursing

Staff identification in the perioperative environment is difficult when all staff, students and visitors wear the same attire. All attire needs to be laundered to national standards for infection control governance and consequently attire cannot be individualised. In emergency situations it is also difficult to identify the roles of all staff with standard methods of identification.

The aim of the ‘Colour-differentiated identification labels’ project was to improve identification of all staff and visitors in the perioperative environment with the intended result being improved communication and safety among staff, patients and visitors. The project began in February 2018 with project leads …

The Perioperative Nurse Surgical Assitant (Pnsa) Of The Future, Olivia Sonneborn

Journal of Perioperative Nursing

Advanced practice nurse (APN) roles have been implemented across all areas of the Australian health service and have extended into the perioperative environment in the form of the perioperative nurse surgical assistant (PNSA) or non-medical surgical assistant (NMSA). With a growing and ageing population, Australia will see an increased demand for acute care nurses. For the PNSA role to expand to meet this demand, the role requires recognition and regulation in Australia. Education programs also need to meet the increasing demand for acute care nursing and provide quality, accessible and collaborative education programs to meet the needs of all nurses …

Changing Workplace Culture: What Would It Take To Speak Up?, Sandra Millis

Journal of Perioperative Nursing

Bullying in the health care environment historically has been tolerated and, in many cases, expected. The Health and Safety at Work Act 2015 has provided the necessary legislation to stimulate a move toward addressing the bullying culture within New Zealand hospitals. This article takes a reflective look at how speaking up about bullying, although difficult, is important in order to change workplace culture.

Factor V Leiden And Superior Mesenteric Artery Occlusion: A Case Study, Cristina Atayde

Journal of Perioperative Nursing

Factor V Leiden (FVL) is an inherited condition that prolongs the clotting process; this subsequently places individuals at a higher risk of developing a thromboembolism. This case study will discuss a 41-year-old female who developed a superior mesenteric artery occlusion with subsequent small bowel ischaemia on a background of FVL. The discussion will illustrate the rarity of an arterial occlusion, the risk factors that are associated with an ischaemic small bowel, the implications of inheriting FVL and some of the associated social aspects of an ileostomy.

Malignant Hyperthermia In A Regional Facility: A Case Study, Catherine Kleidon

Journal of Perioperative Nursing

Malignant hyperthermia (MH) is a rare hypermetabolic state that may be triggered by both anaesthesia and non-anaesthesia triggers. The main anaesthesia triggers for MH are the depolarising muscle relaxant suxamethonium and volatile anaesthetic gases. MH presents in several ways with not all clinical symptoms being required to make a diagnosis. Safe and efficient patient management of MH requires knowledge and understanding of this inherited disorder. The perioperative team need to be aware of the tasks that are required to manage this emergency. This case study will discuss a suspected episode of MH presenting in a patient late on Christmas Eve …

Climate And Health, Amanda Adrian

Journal of Perioperative Nursing

While being responsible for a relatively high proportion of CO₂ emissions, the health professions also have a professional responsibility to take action to respond to the health threats that climate change is generating.This feature article examines our responsibilities as health professional leaders in mitigating the enormous risk posed by climate change and some of the possibilities for action at both local and national level.

The ‘Human Factor’… Worth Considering?, Geoff Hay

Journal of Perioperative Nursing

On any given day, be it in our professional or personal lives, our predominant thought processes are geared towards outcomes. How often, though, do we allow ourselves time to pause and reflect on the human factors involved in our decision making? This article examines lessons we can learn from human factors training and systems used in aviation and how they can be applied in the perioperative environment.

The Future Of Nurse Education In Australia And Implications For Perioperative Nursing, Jed Duff

Journal of Perioperative Nursing

A national review into nurse education in Australia examined the current educational preparation of Australian nurses to ensure the profession is adequately equipped to meet the future needs of the nation’s evolving health system. This editorial outlines and reviews some of the key recommendations from the report and their potential implications for perioperative nursing and nursing education.

See One, Do One, Teach One: Advanced Perioperative Nursing Practice In Australia, Jed Duff

Journal of Perioperative Nursing

No abstract provided.

Supporting Paediatric Patients: Parental Presence In The Anaesthetic Journey, Salina Blake

Journal of Perioperative Nursing

Objective

This discussion paper explores the use of parental presence during induction of anaesthesia as a method of decreasing paediatric and parental perioperative anxiety.

Setting

A perioperative department in an Australian public hospital.

Subjects

Paediatric patients and parents/guardians.

Primary argument

There is evidence to support the importance of parental presence in the anaesthetic setting; however, this varies between different health care facilities. This paper will argue that the presence of the parent during induction of anaesthesia will decrease the anxiety of the child. However, there has been little discussion about the pivotal role parents can play when participating in the …

Ex Utero Intrapartum Treatment (Exit) Procedure: Indications And Procedural Considerations, Melissa Silva

Journal of Perioperative Nursing

Problem identification

Ex Utero Intrapartum Treatment (EXIT) has become the optimal delivery strategy in fetuses with airway compromise; however, it remains an extremely rare procedure. This review aims to provide perioperative nurses with an overview of EXIT procedure to enable them to be an effective member of the multidisciplinary team.

Literature search

An electronic search of the CINAHL, Medline and Scopus databases was undertaken yielding 19 articles for inclusion in this integrative review. The papers included were case studies, case series or retrospectives and describe 42 EXIT procedures with 43 babies.

Data evaluation synthesis

The most common indication for the …

Cloth Hats: (W)Hat’S The Issue, Elizabeth Mckenna

Journal of Perioperative Nursing

Introduction

The aim of this discussion paper is to consider three issues regarding perioperative attire:

1. whether cloth hats or disposable hats are better for reducing patient risk of acquiring a surgical site infection (SSI)
2. whether the risk of infection is different for the bouffant style of hat compared to the skullcap style of hat
3. whether there is enough evidence available to support a statement that cloth hats are safe to wear in the operating suite.

Background

Hats have been routinely worn in operating suites since the 1950s. The intention of covering the hair has been to reduce the risk of …

The Trusted Source Of Knowledge For Australian Perioperative Nurses, Jed Duff

Journal of Perioperative Nursing

No abstract provided.

Refining Guidelines For The Care Of Paediatric Perioperative Patients In A Rural Health Care Facility, Michelle Hibberson

Journal of Perioperative Nursing

No abstract provided.

Creating And Applying Shared Mental Models In The Operating Room, Alister Wilson

Journal of Perioperative Nursing

A shared mental model is a concept from high reliability environments, like aviation, to help teams develop collective understanding of how they will work together to safely accomplish their goals. Areas of high-risk health care like the operating room have adapted this concept to improve interdisciplinary teamwork and thus improve patient outcomes. Non-technical skills including communication, situational awareness, task management and leadership are employed to produce a functional shared mental model. Nurses play an important role in the change process as traditional hierarchical cultures, differing communication styles between doctors and nurses and an increasingly transient workforce are all challenges to …

The Patient, Case, Individual And Environmental Factors That Impact On The Surgical Count Process: An Integrative Review, Victoria Ruth Warwick, Brigid M. Gillespie, Anne Mcmurray, Karen G. Clark-Burg

Journal of Perioperative Nursing

Problem identification

The surgical count is an integral component of the perioperative nurse’s role designed to reduce the risk of unintentional retained items (URIs) during surgery. Current literature provides statistical data that URIs continue to occur which has exposed a lack of adherence to the surgical count process as a possible contributing factor. This review was undertaken to identify what is currently known about perioperative nurses’ practices in relation to the surgical count and the perceived barriers and enablers when trying to follow best practice as outlined in ACORN’s Standards for Perioperative Nursing in Australia.

Literature search

The objective …

The Value Of A Perioperative Nurse, Nicholas Ralph

Journal of Perioperative Nursing

No abstract provided.