Medicine and Health Sciences Commons^™

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: …

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: …

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 …

Strategies To Prevent Inadvertent Retained Surgical Items: An Integrative Review, Amanda J. Snape, Jed Duff, Oya Gumuskaya, Kerry Inder, Alison Hutton

Journal of Perioperative Nursing

Background: The surgical count process is currently the recommended strategy for preventing unintentionally retained surgical items (RSIs) in Australia. Despite this, RSIs still occur and remain an internationally recognised issue and sentinel event associated with morbidity and mortality. There are numerous new and emerging strategies to prevent inadvertent RSIs, apart from the surgical count, and many involve the use of technology. These strategies are not currently specified in Standards for Perioperative Nursing in Australia (the ACORN Standards).

Aim: To provide an integrative synthesis of the literature to identify current and emerging strategies for preventing RSIs during surgical procedures.

Design: An …

Nurse-Led Randomised Controlled Trials In The Perioperative Setting: A Scoping Review, Judy Munday, Niall Higgins, Saira Mathew, Lizanne Dalgleish, Anthony S. Batterbury, Luke Burgess, Jill Campbell, Lori J. Delaney, Bronwyn R. Griffin, James A. Hughes, Jessica Ingleman, Samantha Keogh, Fiona Coyer

Journal of Perioperative Nursing

Purpose: Nurses provide care at each phase of the complex perioperative pathway and are well placed to identify areas of care requiring investigation in randomised controlled trials. Yet, currently, the scope of nurse-led randomised controlled trials conducted within the perioperative setting are unknown. This scoping review aims to identify areas of perioperative care in which nurse-led randomised controlled trials have been conducted, to identify issues impacting upon the quality of these trials and identify gaps for future investigation.

Methods: This scoping review was conducted in reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. …

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 …

Multidisciplinary Simulation Training For Perioperative Teams: An Integrative Review, Michelle Hibberson, Jessica Lawton, Dean Whitehead

Journal of Perioperative Nursing

Abstract

Background

The perioperative environment is a high-risk and complex area and the provision of safe, high-quality surgical care requires a multifaceted approach provided by multidisciplinary health care teams. However, it is reported that the multidisciplinary nature of perioperative teams can present barriers to patient safety through ineffective teamwork, ineffective collaboration and/ or ineffective communication. Multidisciplinary simulation training creates realistic situations in safe environments to allow perioperative teams to improve teamwork and communication alongside the technical skills needed to manage emergency situations. This integrative review critically examines and reports the effects of multidisciplinary simulation training on perioperative teams and highlights …

The Effects Of Staffing Practices On Safety And Quality Of Perioperative Nursing Care – An Integrative Review, Nick Nijkamp, Paula Foran

Journal of Perioperative Nursing

Problem identification
Patients undergoing invasive procedures are highly vulnerable to adverse outcomes. From 2012 to 2013, 5.5 per cent of all inpatient admissions reported an adverse event. Perioperative nurses play an important role in providing safe patient care and acting as the patient advocate. This review of literature aims to examine the effects of perioperative staffing and patient safety. Three common staffing themes that impact the safety and quality of patient care were identified; namely, nurse-to-patient ratios, staff training and staff fatigue.

Literature search
An integrative literature search to identify empirical data surrounding perioperative nursing staffing was conducted via the …

Smartphones In The Operating Room: Can Perioperative Nurses Be Trusted?, Tarryn Armour, Elyse Coffey

Journal of Perioperative Nursing

Use of hand-held technology, such as smartphones, in health care can provide a pocket-sized and instant means of accessing information and resources related to patient care. A review of the literature identified drawbacks to and benefits of using hand-held technology in the perioperative environment. Drawbacks that limit the use of hand-held technology include potential distraction from clinical activities, negative perceptions that smartphones will be used for activities not related to work such as cyberloafing, interference to patient privacy and infection control risks. Conversely the benefits of using hand-held technology include enhanced mobile learning at the point of care, easy and …

Can The Role Of The Nurse As Surgical Assistant Add Value In The Australian Public Health Care Sector?, Toni Hains, Anojan Navaratnam Dr, Andrew O'Brien, Karen Walsh, Jane Neilsen, Susan Firth

Journal of Perioperative Nursing

While the role of the Registered Nurse/Nurse Practitioner as surgical assistant has been underutilised in the Australian public health care sector, this role adds value by enhancing learning opportunities for medical and nursing staff. This extended practice role also provides a mechanism for increasing nurses’ job satisfaction leading to nursing workforce retention and workforce capacity building. Additionally, a consistent and experienced nurse in the role of table-side assistant for robotic-assisted surgery can improve patient safety, communication and enhance surgical flow.

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).

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 …

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 …

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 …

Implementing A Surgical Site Infection Care Bundle: Implications For Perioperative Practice, Elaine Michelle Proops

Journal of Perioperative Nursing

Surgical care bundles are made up of a group of evidence-based practice interventions which when performed together can have a positive outcome on patient care. The ACORN Standards for Perioperative Nursing in Australia outline practices that should be adhered to in Australia; however, practices can be further refined clinically to ensure best practice. Surgical site infection is one of the most preventable causes of hospital-acquired infections in Australia. Research suggests that care bundles implemented by the perioperative team can reduce the incidence of such infections while also offering additional benefits.Surgical site infection intervention bundles can support nurses in their evidence-based …

Pressure Injury Risk Assessment And Prevention Strategies In Operating Room Patients – Findings From A Study Tour Of Novel Practices In American Hospitals, Lauren Goudas, Steven Bruni

Journal of Perioperative Nursing

Hospital-acquired pressure injuries (HAPI) lead to complications such as increased pain, increased bed days, re-admissions, multiple surgical interventions, possible disfigurement, decreased quality of life, increased healthcare cost and mortality. There are several factors specific to the operating room suite which increase the risk of pressure injury development. Highlighting the need for OR specific pressure injury risk assessment tools. Research indicates that pressure injuries occurring in the OR can appear up to 48-72 hours post-surgery, thus the incidence of pressure injury originating in the OR is likely to be higher than is currently reported. Facilities in the USA are now attributing …

Pressure Injury Prevention In The Perioperative Setting: An Integrative Review, Isabel Wang, Rachel Walker, Brigid M. Gillespie Phd

Journal of Perioperative Nursing

Background: Pressure injury (PI) has a significant impact on patients and their families, and is costly to health care institutions. Perioperative PI remains problematic, although little is reported about current perioperative pressure injury prevention (PIP) strategies.

Aim: To identify the key perioperative PIP strategies, following a systematic review of published research, to describe existing gaps in the literature, and to inform the development of subsequent observational study.

Design:An integrative literature review method developed by Whittemore and Knafl was used.

Method: Research inclusion and exclusion criteria were identified a priori. Six data bases were searched and search terms included pressure …

Technology Stress In Perioperative Nursing: An Ongoing Concern, Judith Smith, Debra Palesy

Journal of Perioperative Nursing

The following discussion will explore the impact of technology on perioperative nursing roles and the development of the phenomenon coined ‘technology stress’. We will begin by reviewing the ongoing debate of technical versus caring nursing practices. The impact of advanced technology on perioperative nursing roles is explored, highlighting the development of technology stress. The paper concludes with some recommendations for further research.

The Collaborative Development Of A Pre-Operative Checklist: An E-Delphi Study, Katherine Murphy, Kim Walker, Jed Duff, Robyn Williams

Journal of Perioperative Nursing

The aim of this study was to identify which items should be included in a pre-operative checklist based on recommendations by nurse experts in order to promote patient safety and effective communication in the perioperative environment.

Method: Thirty-five nurses participated in this e-Delphi study, which was conducted online via SurveyMonkey.. Each survey presented participants with a list of potential items for inclusion in a pre-operative checklist. Participants were asked to identify items they felt should be included in the checklist with the option to include comments. Comments were de-identified and shared with other participants to allow confidential interaction. The surveys …

ผลของการใช้แบบบันทึกการพยาบาลผ่าตัด โดยใช้กระบวนการพยาบาลต่อประสิทธิภาพการบันทึก และการรับรู้คุณค่าของวิชาชีพพยาบาล (Effects Of Using Perioperation Nursing Documentation By Using Nursing Process On Nursing Documentation Efficiency And Perceived Value Of Nursing Profession), จริดาภรณ์ ธนบัตร, ยุพิน อังสุโรจน์

Journal of Nursing Science Chulalongkorn University (วารสารพยาบาลศาสตร์)

การวิจัยเชิงกึ่งทดลองนี้ มีวัตถุประสงค์เพื่อศึกษาประสิทธิภาพการบันทึกการพยาบาลผ่าตัดโดยใช้ กระบวนการพยาบาล และเพื่อเปรียบเทียบการรับรู้คุณค่าของวิชาชีพการพยาบาลก่อนและหลังการใช้แบบ บันทึก กลุ่มตัวอย่างคือ พยาบาลวิชาชีพและพยาบาลเทคนิคทุกคน ที่ปฏิบัติงานในแผนกผ่าตัด โรงพยาบาลระนอง จำนวน 15 คน และแบบบันทึกการพยาบาลผ่าตัด จำนวน 30 ฉบับ \nเครื่องมือที่ใช้ในการศึกษาคือแบบบันทึกการพยาบาลผ่าตัดโดยใช้กระบวนการพยาบาลพร้อม คู่มือการใช้แบบบันทึก แบบตรวจสอบประสิทธิภาพการบันทึกด้านความครอบคลุมตามกระบวนการบันทึก \nด้านการบริหารความเสี่ยงและด้านความถูกต้องตามกฎหมาย แบบสอบถามประสิทธิภาพการบันทึก ด้านความคล่องตัวในการบันทึก และแบบสอบถามการรับรู้คุณค่าของวิชาชีพการพยาบาล ทุกฉบับผ่าน การตรวจสอบความตรงตามเนื้อหาและความเที่ยง วิเคราะห์ข้อมูลโดยหาค่าร้อยละ ค่าเฉลี่ย ส่วนเบี่ยงเบน มาตรฐาน และสถิติทดสอบ Wilcoxon signed rank test \nผลการวิจัยพบว่า ประสิทธิภาพการบันทึกของแบบบันทึกการพยาบาลผ่าตัดโดยใช้กระบวนการพยาบาลด้านความครอบคลุมตามกระบวนการบันทึกอยู่ในระดับปานกลาง ด้านการบริหารความเสี่ยงอยู่ใน ระดับดี ด้านความถูกต้องตามกฎหมายอยู่ในระดับดีมาก และด้านความคล่องตัวในการบันทึกอยู่ในระดับมาก และการรับรู้คุณค่าของวิชาชีพการพยาบาลก่อนและหลังการใช้แบบบันทึกทางการพยาบาลผ่าตัดโดยใช้ \nกระบวนการพยาบาลไม่แตกต่างกัน