Medicine and Health Sciences Commons^™

Effectiveness Of Intra-Operative Gentamicin Irrigation In Reducing Post-Operative Surgical Site Infections: A Systematic Review, Kritika J. Kumar, Zaneta Smith

Journal of Perioperative Nursing

Aim: To evaluate and synthesise the effectiveness of intra-operative gentamicin in reducing post-operative surgical site infections compared to other irrigating solutions or no irrigation.

Background: Surgical site infection has posed challenges to health care providers around the globe. It is influenced by many risk factors, only a few of which are under the control of the surgeon and operating team. Wound irrigation is considered an essential part of the intra-operative process. It aims to minimise the risk of surgical site infection by thorough lavage of the operative site.

Design: Systematic review of effectiveness.

Review methods: The databases CINAHL, Scopus, Embase, …

The Future Of Artificial Intelligence In Perioperative Nursing, Nick Nijkamp, Erin Wakefield

Journal of Perioperative Nursing

Artificial Intelligence (AI) stands poised at the forefront of health care innovation, promising transformative advances across multiple domains. In the field of perioperative nursing, where precision, efficiency and patient safety are paramount, the integration of AI holds immense potential to revolutionise clinical practice.

Defined as the imitation of human acumen, AI enables computers to perform tasks ‘that typically require human intelligence, such as decision-making, problem-solving and learning’. This editorial explores the current landscape of AI, future prospects for AI in perioperative nursing and the ethical imperatives that accompany this transformative paradigm shift.

As technology continues to evolve rapidly, perioperative nursing …

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 …

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 …

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: …

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 …

Nursing Innovation: Improved Perioperative Care With A Redesigned Urological Drape, Olivia Sonneborn, Indra Jolayemi

Journal of Perioperative Nursing

Inventions and innovations have the potential to change lives.¹ Perioperative nurses strive for improved patient care² and are well positioned to develop creative and innovative solutions to clinical challenges faced when caring for patients in the perioperative environment. Fluid leakage during percutaneous nephrolithotomy (PCNL) surgery poses risks to both patients³ and staff. The PCNL drape was developed by a collaborative perioperative team to reduce these risks and improve the quality of care provided to patients.

Bridging The Gap: Preparing And Nurturing Novice Perioperative Nurses, Nick Nijkamp, Pauline Calleja, Ashlyn Sahay

Journal of Perioperative Nursing

Perioperative nursing is a highly specialised area within the nursing profession that relies on high levels of theoretical knowledge, clinical skill and critical thinking to maintain patient safety before, during and after surgical procedures. However, attrition rates and the impending retirement of experienced perioperative nurses have created a need to address the transition of novice nurses into this complex and multi-skilled environment.

Peripheral Nerve Catheter Securement: A Narrative Literature Review, Joshua M. Wiesel, Bernadette R. Findlay, Li Ching Ooi, Jennifer A. Stevens, Renata Hadzic

Journal of Perioperative Nursing

Peripheral nerve catheters are commonly used to provide analgaesia and improve patient outcomes. Catheter dislodgment, displacement or leakage can result in premature cessation of analgaesic effect. There are currently no published guidelines for how to secure peripheral nerve catheters.

This narrative review explores and integrates the available research into the efficacy of peripheral nerve catheter securement products and techniques to reduce catheter dislodgement and displacement.

All studies looking at peripheral nerve catheter securement methods were included from inception until 19 October 2022 across PUBMED, Scopus, Ovid, Google Scholar, EMBASE and The Cochrane Library. The Jadad scale and Newcastle–Ottawa scale were …

Procedural Considerations Of Hysterectomy By Vnotes (Vaginal Natural Orifice Transluminal Endoscopic Surgery): A Literature Review, Maritza Harvey, Paula Foran

Journal of Perioperative Nursing

Problem identification: Transvaginal natural orifice transluminal endoscopic surgery (vNOTES) may be the next evolution in minimally invasive gynaecological surgery. vNOTES is a modernised vaginal approach to accessing the peritoneal cavity that combines the benefits of laparoscopic and traditional vaginal surgery techniques. While much has been written about the technicalities of this procedure, the aim of this review is to look at vNOTES through a perioperative nursing lens, focusing on providing greater understanding and knowledge for perioperative nurses.

Literature search: An electronic database search of EBSCO, CINAHL, Medline, PubMed and Scopus was undertaken. The search delivered 16 articles for inclusion in …

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.

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 …

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, …

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 …

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 …

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 …

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.

Discharge Delay From The Post Anaesthesia Care Unit: A Nursing Perspective, Ruowen Peng, Farida Saghafi, Hazel Maxwell

Journal of Perioperative Nursing

Background: The Post Anaesthesia Care Unit (PACU) is a critical junction between the operating theatre and the wards. It is essential for the close monitoring of patients before they are discharged to their destination wards for recovery. Many clinical and non-clinical factors influence the flow of patient discharge from the PACU to the wards. This study explores PACU nurses’ perceptions of non-clinical factors causing discharge delays and how these impact the work of nurses.

Method: In this study, a descriptive qualitative methodology was implemented. This methodology is widely used in nursing and health care research as it provides a descriptive …

Surgical Plume And Its Associated Hazards To Perioperative Staff: A Review Of Current Standards For Practice And Risk Management, Andrea J. Carrick

Journal of Perioperative Nursing

Surgical plume poses a risk to perioperative nurses and the perioperative team as a whole, as well as the operative patient. Surgical plume contains various hazardous components which pose multiple health risks to the perioperative staff who are exposed to it. Further research is required in order to definitively understand the risks to perioperative staff from long-term exposure to surgical plume and to advance current policies and procedures. The current practice standard on surgical plume management from the Australian College of Perioperative Nurses (ACORN) sets out methods of reducing these risks. However, this standard’s utility in practice and barriers to …

The Impact Of Quality Improvement Interventions On Compliance With Standardised Surgical Count Protocol And Count Discrepancies: A Quality Improvement Study, Sepideh Totonchilar, Akram Aarabi, Aygineh Hairabedian

Journal of Perioperative Nursing

Background: Unintentionally retained surgical items (RSI) are a global problem contributing to adverse events for surgical patients. The Association of periOperative Registered Nurses (AORN) has developed a standardised protocol for the surgical count; however, many hospitals do not follow the protocol for the surgical count. This study was conducted to investigate the effect of implementing quality improvement interventions, for counting surgical sponges, on compliance with the AORN surgical count protocol and occurrence of count discrepancies.

Method: This study was performed as an interventional quality improvement project from 1 February to 20 September 2022 with an intervention and a control group …

Strategies To Optimise Culturally Appropriate Perioperative Care For Aboriginal And Torres Strait Islander Peoples: A Discussion Paper, Maureen Joye, Paula Foran

Journal of Perioperative Nursing

The disparity in health outcomes between Indigenous and non-indigenous Australians continues to increase. Barriers to accessing health care, particularly surgical treatment, contribute to health inequalities among Indigenous Australians. Despite a positive correlation between improved patient experiences and health outcomes, there is little research available on nursing interventions to improve Indigenous patients’ perioperative health care treatment.

This discussion paper investigates culturally appropriate and evidencebased nursing interventions that can be applied in the perioperative setting to improve the surgical experience of Indigenous patients. It was shown that establishing trust among Aboriginal and Torres Strait Islander patients through anaesthetic nurse practices and advocating …

Nurses’ Perceptions Of Screening For Delirium In The Post Anaesthesia Care Unit And Orthopaedic Surgical Wards: A Qualitative Study, Rami Kamel Mustafa Aldwikat, Elizabeth Manias, Pat F. Nicholson Dr

Journal of Perioperative Nursing

Purpose: The aims of this study were to explore nurses’ perceptions of the usability and clinical utility of two screening tools for delirium detection in the Post Anaesthesia Care Unit (PACU) and orthopaedic surgical wards settings, and to identify nurses’ decisions about patient care delivery based on delirium assessment outcomes. The tools studied were the 3D-CAM and 4AT – the three-minute diagnostic interview for CAM (Confusion assessment method) delirium and the 4 ‘A’s test, respectively.

Method: A focus group methodology was used. Five semi-structured focus groups were conducted with 24 nurses working in the PACU and orthopaedic surgical wards. Focus …

Nonpharmacological Interventions For The Reduction Of Post-Operative Pain After Ambulatory Surgery: A Systematic Review Of Randomised Controlled Trials, Kevin E. Tololiu, Jed Duff, Krisztina Csokasi

Journal of Perioperative Nursing

Aims: To examine the effectiveness of nonpharmacological interventions for the reduction of post-operative pain in patients undergoing ambulatory surgery (also known as day surgery).

Background: Post-surgical pain remains prevalent, especially in day surgery cases. When poorly managed, this acute pain can lead to chronic pain and delayed recovery. Nowadays, several nonpharmacological regimens are available for reducing pain after ambulatory surgery. Further investigation is required to assess the quality of these alternatives.

Design: Systematic review

Methods: An electronic search of PubMed, CINAHL (via EBSCOhost), Embase, and Cochrane library was undertaken to screen and assess the studies of nonpharmacological intervention in reducing …

Health Librarians As Part Of The Perioperative Care Team, Gemma Siemensma

Journal of Perioperative Nursing

Chances are you may never find a librarian in the operating suite, unless as a patient, but they do play a vital role in enabling the work of perioperative nurses. A perioperative nurse’s role can encompass a variety of tasks at the pre-operative, operative and post-operative stage and includes the daily use of information resources to ensure evidence-based practice (EBP) occurs. This article explores the role of health librarians in the perioperative environment and highlights resources and services that are offered to assist perioperative nurses.

Optimising Post-Operative Recovery Of Elective Abdominal Surgery Patients: A Multimodal Approach, Jasmine Joseph, Meinam Deepa Devi

Journal of Perioperative Nursing

Aim: This study aimed to identify and validate a multimodal approach for optimising post-operative recovery of patients admitted for elective abdominal surgery.

Background: Identifying the risk of post-operative complications after abdominal surgery enables modification of the risk through targeted interventions and enhanced monitoring. Evidence shows that patients suffer needlessly due to inadequate pre-operative preparation and lack of information regarding the post-operative journey.

Methods and materials: The study was conducted using a quasiexperimental, post-test-only, control group design. The sample comprised 60 participants, 30 each in the experimental and control groups. Four aspects of participant recovery were measured – pain (using a …