Medicine and Health Sciences Commons^™

Exploring Normalization Of Deviance And Examining Factors That Predict Culture Of Safety In The Operating Room., M. Imelda Wright

Electronic Theses and Dissertations

Patient safety in the operating room is a prodigious responsibility of OR nurses as the OR environment is complex and laden with risk, which increases surgical patients’ risk for adverse events. The dissertation presents the topic of patient safety in the operating room (OR), the concept of normalization of deviance, and a mixed-methods study with an exploratory sequential design that involved three phases. The dissertation comprises of five chapters. Chapter One presents an introductory overview of the salience of patient safety as well as its relevance to the unique environment of the OR. Chapter Two presents a concept analysis of …

First-Case Operating Room Delays: Patterns Across Urban Hospitals Of A Single Health Care System, Callie M. Cox Bauer, Danielle M. Greer, Kiley B. Vander Wyst, Scott A. Kamelle

Callie Cox Bauer, DO, FACOG

Purpose

Operating room delays decrease health care system efficiency and increase costs. To improve operating room efficiency in our system, we retrospectively investigated delay frequencies, causes and costs.

Methods

We studied all first-of-the-day nonemergent surgical cases performed at three high-volume urban hospitals of a large health system from July 2012 to November 2013. Times for patient flow from arrival to procedure start and documented reasons for delay were obtained from electronic medical records. Delay was defined as patient placement in the operating room later than scheduled surgery time. Effects of patient characteristics, late patient arrival to the hospital, number of …

Microbial Colonization Of Pneumatic Tourniquets In The Orthopedic Operating Room, Syed Hamza Mufarrih, Nada Qaisar Qureshi, Rizwan Haroon Rashid, Bilal Ahmed, Seema Irfan, Akbar Jaleel Zubair, Shahryar Noordin

Section of Orthopaedic Surgery

Background: The rate of surgical site infections following orthopedic procedures is approximately 2% globally. Potential sources of contamination in the operating room include pneumatic tourniquets, blood pressure cuffs, and stethoscopes, among others. Our study aims to investigate microbial colonization on reusable pneumatic tourniquets stored and used in the orthopedic department of our institution and evaluate the efficacy of the cleaning protocols employed. Methods: Over a course of two weeks, 26 samples were obtained. A total of 14 pneumatic tourniquets were sampled preoperatively on Monday morning following the weekly cleaning protocol of soaking the tourniquets in sodium hypochlorite for 30 minutes …

First-Case Operating Room Delays: Patterns Across Urban Hospitals Of A Single Health Care System, Callie M. Cox Bauer, Danielle M. Greer, Kiley B. Vander Wyst, Scott A. Kamelle

Aurora Ob/Gyn Faculty

Purpose

Operating room delays decrease health care system efficiency and increase costs. To improve operating room efficiency in our system, we retrospectively investigated delay frequencies, causes and costs.

Methods

We studied all first-of-the-day nonemergent surgical cases performed at three high-volume urban hospitals of a large health system from July 2012 to November 2013. Times for patient flow from arrival to procedure start and documented reasons for delay were obtained from electronic medical records. Delay was defined as patient placement in the operating room later than scheduled surgery time. Effects of patient characteristics, late patient arrival to the hospital, number of …

Operating Room First Start Efficiency Throughout A Large Urban Hospital System, Callie Cox Bauer, Kiley A. Bernhard, Danielle M. Greer, Scott Kamelle

Aurora Ob/Gyn Faculty

Background: Operating room delays decrease health care system efficiency and increase hospital costs. Data on delays in a multihospital system are sparse.

Purpose: In an effort to improve our operating room efficiency, we investigated operating room delays, the causes and the impending financial impact.

Methods: A retrospective analysis on first case-of-the-day surgeries at three hospitals during 2013 was conducted. Delays were defined as in-room time being after scheduled surgery start time. Length of delay and causes were recorded. Patient demographics, body mass index, hospital facility, total number of procedures, provider specialty and time of patient arrival were incorporated into a …

Malignant Hyperthermia, Courtney Stevenson

Nursing Student Class Projects (Formerly MSN)

Malignant Hyperthermia (MH) is a rare but life-threatening medical emergency. It is a skeletal muscle disorder that leads to a hypermetabolic reaction. It occurs in response to the administration of inhaled anesthetics and depolarizing muscle relaxants.

Coaching Operating Room To Pacu Handoff With A Standardized, Multidisciplinary Checklist, Courtney L. Devin, Md, Kathleen Grife, Rn, Ms, Marissa Weber, Md, Richard F. Schmidt, Md, Megan P. Lundgren, Md, Scott W. Cowan, Md

House Staff Quality Improvement and Patient Safety Conference (2016-2019)

Purpose

To pilot a standardized multidisciplinary bedside handoff for any patient admitted to the post-anesthesia care unit (PACU) from the operating room.

Australian Perioperative Nurses’ Attitudes, Levels Of Knowledge, Education And Support Needs Related To Organ Donation And Procurement Surgery: A National Survey, Zaneta Smith, Cindy Woods, Kim Usher, Jackie Lea

Journal of Perioperative Nursing

Objectives: The aim of this study was to examine Australian perioperative nurses’ self-reported knowledge, attitudes, levels of education and support in relation to their participation in organ donation and procurement surgery.

Sample and setting: Data was collected from Australian perioperative nurses who are members of the peak national body Australian College of Perioperative Nurses (ACORN).

Methods: An online survey was distributed to ACORN members on behalf of the researchers. The online survey comprised 67 items encompassing open- and closed-ended questions along with graded Likert and ordinal multicategory scales.

Results: Of ACORN’s 4000 Australian members, 452 (11.3 per cent) responded to …

Utilizing Simulation To Implement Cognitive Aids In The Operating Room, Kaitlyn Brown

Doctor of Nursing Practice Projects

Background: Operating room crises require prompt, efficient action to avoid detrimental outcomes. Research shows that crisis checklists or other cognitive aids assist anesthesia providers in taking prompt action while improving efficiency by decreasing treatment steps missed during critical events.

Objectives: The purpose of this project was to evaluate the effectiveness of incorporating cardiac arrest and malignant hyperthermia crisis checklists into the operating room using high-fidelity simulation-based education.

Methods: Researchers implemented the Stanford Emergency Manual Cognitive Aids for cardiac arrest and malignant hyperthermia to anesthesia staff at a community hospital in southern Illinois with 18 participants. Implementation consisted of an education …

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 …

Delays In Perioperative Patient Flow: An Initial Analysis, David Nelson, Md, Mba, Kent Berg, Md, Mba, Rebecca Barnett, Md, Mbchb, Oren Guttman, Md, Mba

Department of Anesthesiology Posters

• When considering the operating room (OR) suite as a hospital business unit, one must not only acknowledge its revenue-earning contribution to financial solvency but also the potential for margin-eroding cost when utilized inefficiently. 1
• One particularly challenging contributor to perioperative inefficiency is when patients are prevented from moving out of the OR into downstream phases of care once surgery has been completed. These so-called “PACU delays” (also known as recovery room admission delays) are particularly concerning for OR leadership because they increase direct labor costs and result in opportunity cost when additional surgery is prevented from being performed
• At Thomas …