Medicine and Health Sciences Commons^™

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 …

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 …

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?

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’ …

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.

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 …

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 …

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 …

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.

Organ Procurement Processes In The Operating Room: The Effects Of An Educational Session On Levels Of Confidence And Understanding In Operating Room Registered Nurses And Surgical Technologists, Ann Ross, Janet Reilly, Emily Halla, Kathryn Anderson

Journal of Perioperative Nursing

Objectives: This project aimed to determine the effects an online educational course about organ procurement procedures (OPPs) in the operating room (OR) had on the levels of confidence and understanding among OR registered nurses (RNs) and surgical technologists (STs).

Sample and setting: Data were collected from OR RNs and STs in the United States (US) at a Level II trauma centre with 19 operating rooms that completes eight to ten OPPs per year. A graduate nursing leadership student in this hospital created a Microsoft PowerPoint educational course about OPPs as her capstone project.

Methods and variables: The course was developed …

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 …

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.

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 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.

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 …

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.