Medicine and Health Sciences Commons^™

Leading With Emotional Intelligence In Perioperative Nursing: An Integrative Review, Elise Rhodes, Paula Foran

Journal of Perioperative Nursing

Background: Emotional intelligence has increasingly become synonymous with effective leaders within successful organisations. The perioperative environment is a complex setting within an organisation that requires nurse leaders to possess self-awareness that allows them to understand and control their emotions while using this insight to benefit others. Perioperative nurse leaders can use their emotional intelligence to manage conflict, negotiate between multidisciplinary team members, motivate staff to provide high level safe patient care and promote a positive work culture that can increase staff retention.

Review methods: A literature search of databases of CINAHL, Pubmed, Medline and Scopus was conducted to extract qualitative, …

It’S Time For The Perioperative Community To Recommit To The Who Surgical Safety Checklist, Jed Duff

Journal of Perioperative Nursing

For over a decade, the World Health Organization (WHO) Surgical Safety Checklist has been recognised as an essential perioperative safety tool. The first landmark multi-national study demonstrated a remarkable 47 per cent reduction in mortality and a 36 per cent reduction in surgical complications, which was confirmed in subsequent studies. Although effective in a research environment, the checklist has been challenging to implement. Today, hospitals worldwide still struggle to use the checklist as designed and maintain enthusiasm for its sustained use. Is it time for the perioperative health care community to revisit the checklist and recommit to safer surgery?

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 …

Mothers’ Satisfaction With Distraction As A Postoperative Pain Management Intervention For Their Child: An Interventional Study, Edlin Glane Mathias, Mamatha Shivananda Pai, Vijay Kumar, Vasudeva Guddattu, Ann-Cathrine Bramhagen

Journal of Perioperative Nursing

Aim: This study aimed to investigate mothers’ levels of satisfaction with distraction as a post-operative pain management intervention for their child.

Background: Although the number of studies on paediatric pain management has increased over time, research into non-pharmacological post-operative pain management remains inadequate, indicating that more research is required.

Design: A posttest-only control group design was adopted to measure mothers’ levels of satisfaction with distraction as a non-pharmacological post-operative pain management intervention for their child.

Methods: The study included 160 mothers and their children undergoing elective surgery in a paediatric surgical unit. Mothers and children were randomly allocated to intervention …

One Step Forward Or Two Steps Back?, Toni G. Hains

Journal of Perioperative Nursing

The Surgical Assistant Working Group (SAWG) draft report has been released, which proposes to allow nurses in the surgical assistant role to access a patient rebate from the Medicare Benefits Schedule (MBS). This will address some of the issues affecting access to surgery in Australia. While an initial read of the report has buoyed the spirits of those closely involved, it is with circumspection that we venture forward.

Measuring Surgical Patient Engagement: A Scoping Review, Rebecca Law, Dawn Wong Lit Wan, Sonja Cleary, Wanda Stelmach, Krinal Mori, Zhen Zheng

Journal of Perioperative Nursing

Background

Patient engagement is a patient’s capacity and willingness to participate and collaborate in their own health care. This scoping review aimed to identify tools used to measure engagement among surgical patients, the levels of engagement and the association between engagement and surgical outcomes. We hypothesise that highly engaged patients are more likely to achieve better surgical outcomes.

Review methods

MEDLINE/PubMed, CINAHL, SCOPUS and Embase were searched for studies that assessed adult perioperative patients for engagement. Analysis from charting the data identified the measurement tools, levels of capacity to engage and relationships between engagement and surgical outcomes.

Results

Twelve studies …

Occupational Violence Against Staff In The Perioperative Environment, Jed Duff

Journal of Perioperative Nursing

Occupational violence is a common problem in many workplaces, including health service organisations. In the perioperative environment, we are acutely aware of the problem of lateral violence, such as bullying, harassment and incivility. But as a specialty we rarely acknowledge violence perpetrated against us by patients, relatives or visitors. Anecdotally, this violence has been steadily increasing over the past decade and peaked during the current COVID-19 pandemic. Perioperative nurse leaders must be aware of the risks and implement appropriate mitigation strategies.

Improving Perioperative Communication: Can Labelled Theatre Caps Play A Role?, Maree Yates, Paula Foran

Journal of Perioperative Nursing

Studies have shown that approximately one third of operating room communications fail. This has a negative impact on patient safety, with half of all adverse events being attributed to communication failures. However, human factors have the capacity to protect patients. Aviation’s human factors strategies provide guidance for staff and are beneficial in the operating room. Currently, no intervention is universally applied to improve operating room communication and team performance. Closed loop communication, though poorly utilised, has been demonstrated to counteract communication errors, therefore protecting patient safety. In 2018, calls were made to take advantage of theatre caps to display staff …

Prevention Of Post-Operative Nausea And Vomiting With Honey As A Pre-Operative Oral Carbohydrate: A Randomised Controlled Pilot Trial, Oya Gumuskaya, Ikbal Cavdar Prof., Cigdem Akyol Beyoglu

Journal of Perioperative Nursing

Background

Post-operative nausea and vomiting (PONV) is the secondmost common post-operative complication. Prolonged pre-operative fasting is common in Australia despite guidelines recommending reduced fasting to improve patient outcomes, such as PONV. Commercially prepared preoperative oral carbohydrate (OC) drinks may be used to reduce fasting time. In this study commercial products were replaced with honey, an inexpensive and common food item.

Design

Partially blinded, four parallel arms randomised controlled noninferiority trial compared pre-operative OC loading with overnight fasting.

Methods

Adult elective laparoscopic cholecystectomy and thyroidectomy patients having two or more risk factors for PONV were allocated into intervention and control groups …

Acorn Papua New Guinea Angau Memorial Hospital Redevelopment Clinical Support Program (Part 1), Carollyn Williams, Ruth Melville, Elinor Radke, Sonia Griffiths

Journal of Perioperative Nursing

This article is the first in a series that will describe ACORN’s role in the redevelopment of the ANGAU Memorial Hospital in Lae, Papua New Guinea.

Integrated Simulations To Build Teamwork, Safety Culture And Efficient Clinical Services: A Case Study, Melanie J. Ferguson, Cassandra Sampson, Jed Duff, Theresa Green

Journal of Perioperative Nursing

Background: Simulation methodology and frameworks were used to build teamwork and a safety culture, and to establish efficient clinical services within the procedure centre of a newly constructed, stand-alone, fully digital greenfield hospital. Rapid ramp up of surgical services required significant recruitment, and onboarding necessitated training of nursing and other perioperative support staff.

Methods: A two-day, immersive integrated simulation activity was carried out with the interprofessional onboarding staff participating in their usual roles. During the simulation, staff had the opportunity to apply newly acquired skills and knowledge to all stages of a patient’s clinical journey through the procedure centre, including …

Exploring Risk, Antecedents And Human Costs Of Living With A Retained Surgical Item: A Narrative Synthesis Of Australian Case Law 1981–2018, Sonya Osborne, Tina Cockburn, Juliet Davis

Journal of Perioperative Nursing

Objective(s): This study aimed to critically examine the circumstances contributing to, and the human costs arising from, the retention of surgical items through the lens of Australian case law.

Design, setting and participants: We reviewed Australian cases from 1981 to 2018 to establish a pattern of antecedents and identify long-term patient impacts (human costs) of retained surgical items. We used a modified fourstep process to conduct a systematic review of legal doctrine, combined with a narrative synthesis approach to bring the information together for understanding. We searched LexisNexis, AustLII, Coroner Court websites, Australian Health Practitioner Regulation Agency Tribunal Decisions and …

The Effect Of An Enhanced Recovery After Surgery Protocol On Opioid Consumption, Pain And Length Of Stay Among Patients Undergoing Prostatectomy And Nephrectomy, Lindsay Anne Bowles, Whitney Heet, Jerieka Waterbeck, Lori Chastain, Martha Monroe, Claire C. Davies

Journal of Perioperative Nursing

Objective: To examine the effect of the Baptist Health Lexington Urology ERAS Protocol (BHLEX-UEP) on opioid consumption, pain and length of stay among patients undergoing prostatectomy and nephrectomy.

Methods: A quasi-experiment (N=303) was conducted in a 434-bed Magnet® re-designated community hospital in the south-eastern United States of America (USA). Data on all adult patients who underwent prostatectomy or nephrectomy surgery were retrieved over a 19-month period. Group differences related to morphine equivalents consumed, mean pain score on the day of surgery, and length of stay were examined between patients who experienced the traditional recovery protocol (n=133) and those experiencing the …

Excessive Noise In The Operating Room: Can It Be Improved?, Judith Ellen Bodin

Journal of Perioperative Nursing

Introduction: Excessive noise in the operating room has been a topic of interest since the early 70s. It has been recognised that excessive noise can affect cognitive behavior and impair memory function which can be a health and safety issue. Though different approaches have been explored there remains a deficit in research into the application of noise modification programs within the operating room to combat the issue of noise pollution. This project aimed to identify if a discussion about appropriate noise levels and the use of a safe phrase at ‘time out’ would reduce noise levels in the operating room. …

What Does Integrated Care Look Like In A Perioperative Service?, Jed Duff

Journal of Perioperative Nursing

The traditional approach to planning care based on surgical procedures rather than patient needs is no longer fit for purpose. The typical surgical patient has grown increasingly more complex over the past decade due to a combination of clinical and social factors. If this complexity is poorly managed, it can result in substantial and avoidable increases in length of hospital stay, post-operative complications, hospital readmissions, delayed recovery and reduced quality of life.

Understanding The Use Of Tympanic Thermometry In The Post Anaesthesia Care Unit: A Discussion Paper, James Halford, Paula Foran

Journal of Perioperative Nursing

Inadvertent perioperative hypothermia (IPH) is an uncomfortable, dangerous and costly but preventable complication of surgery. For perioperative nurses to treat this condition, they must first have an accurate means of detecting it. In making clinical decisions based on patients’ temperature, an important vital sign, nurses must understand how different thermometers work and be competent in their use. It is vital that patients have accurate core body temperature recorded when admitted to the Post Anaesthesia Care Unit (PACU). Infrared tympanic thermometers are a non-invasive tool regularly used by PACU nurses and provide a quick and easily obtained measurement that is a …

Uncertainty In Post-Anaesthesia Nursing Clinical Reasoning: An Integrative Review In The Light Of The Model Of Uncertainty In Complex Health Care Settings, Lara Daniela Matos Cunha, Márcia Pestana-Santos, Lurdes Lomba, Margarida Reis Santos

Journal of Perioperative Nursing

Problem identification: Post-anaesthesia nursing plays an important role in the early detection and treatment of clinical deterioration after surgery and/or anaesthesia. Concomitantly, the effectiveness of post-operative care is highly dependent on the accurate analysis, synthesis of patient data and quality of diagnostic decisions through clinical reasoning. Given the dynamic processes required to come to a diagnosis, uncertainty is common in clinical reasoning and expected during practice. Nevertheless, uncertainty may permeate the foundations of clinical reasoning, which can jeopardise diagnostic accuracy and consequently the quality and safety of health care.

Literature search: The objectives of this review are to identify available …

Hospital Costs Of Post-Operative Delirium: A Systematic Review, Md. Parvez Mosharaf, Khorshed Alam, Nicholas Ralph, Jeff Gow

Journal of Perioperative Nursing

Aims: In this systematic review, the primary aim is to investigate the hospital cost burden attributed to post-operative delirium (POD). A secondary aim is to examine how patient length of stay (LOS) in hospital varies across the selected studies.

Background: POD is a common occurrence after major surgery and leads to serious medical complications. It is associated with increased morbidity and double the risk of mortality from surgery compared to non-delirious patients. POD increases patient LOS in hospital and increases the economic burden on patients and the health system.

Design: A systematic review was conducted.

Method: Published articles in English …

Development And Psychometric Evaluation Of A Questionnaire For Measuring Distraction Due To Mobile Phone Use In Operating Rooms, Mehdi Hasanshahi, Mahnaz Rakhshan, Armin Fereidouni, Seyed Alireza Moayedi, Camellia Torabizadeh

Journal of Perioperative Nursing

Aim: Use of mobile phones in health care centres can distract care providers and consequently disrupt the care procedure and risk patient safety. This study aims to develop and evaluate the psychometric properties of a questionnaire for measuring distraction caused by mobile phone use in operating rooms.

Sample and setting: 208 operating room nurses and doctors from five hospitals affiliated to Shiraz University of Medical Sciences participated in the study.

Method: This methodological study was conducted in two stages. In stage one, through a review of relevant texts, articles and books, the different dimensions of distraction as caused by mobile …

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. …

Where Are The Practising Nurse Anaesthetists In Australia? Exploring An Advanced Practice Role For Anaesthesia Nurses, Lucy Michaels, Paula Foran

Journal of Perioperative Nursing

The perioperative environment has seen the implementation of the perioperative nurse surgical assistant as an advanced practice nursing role for the instrument nurse; however, there is currently no recognised equivalent role for the anaesthesia nurse. Anaesthesia nurses complete post-graduate qualifications and learn advanced clinical skills, and yet the authoritative body for perioperative nurses, the Australian College of Perioperative Nurses, does not define a specific role for advanced practice nursing in anaesthesia. Career advancement for the anaesthesia nurse focuses on education and management roles which are a distinct deviation from advanced clinical practice. A new role should be developed to allow …

Awareness Under Anaesthesia: The Role Of The Perioperative Nurse, Dawn Bull, Paula Foran

Journal of Perioperative Nursing

Intra-operative awareness is very rare yet represents a serious complication of general anaesthesia. The ongoing consequences of such an event may cause significant distress and long-term effects such as insomnia, depression, anxiety and post-traumatic stress disorder (PTSD). To provide safer anaesthesia, it is critical to identify contributing factors related to both the patient and the anaesthesia to prevent intra-operative awareness in at-risk patients. It is also vital to provide education to Post Anaesthesia Care Unit (PACU) nurses and surgical ward nurses about the appropriate way to manage a situation when a patient reports intra-operative awareness following anaesthesia.

General anaesthesia with …

Patient, Surgical And Clinical Factors Associated With Longer Stay In The Post Anaesthesia Care Unit, Karen M. Briggs, Mari Botti Emeritus Professor, Nicole M. Phillips Professor, Steve Bowe A/Professor, Maryann Street Dr

Journal of Perioperative Nursing

Aim: To explore patient, surgical and clinical factors associated with readinessfor- discharge and total length of stay in the Post Anaesthesia Care Unit (PACU).

Background: Longer stay in the PACU decreases the flow of patients and is associated with increased risk of adverse events. The time to readiness-fordischarge reflects clinical parameters associated with patient flow in the PACU independent of system delays.

Methods: This retrospective cohort study included a randomly selected sample of 244 post-surgical patients admitted to a large private, Australian health service.

Results: The median and average times to readiness-for-discharge were 48 minutes and 56 minutes respectively with …

How Will The Nursing Profession Remember The Hon Greg Hunt Mp?, Toni G. Hains

Journal of Perioperative Nursing

The Hon Nicola Roxon MP was celebrated as the Minister for Health and Aging who showed courage and conviction for the nursing profession by facilitating legislation, passed in 2010, that allowed nurse practitioners (NPs) and midwives limited access to the Medical Benefits Schedule (MBS) and the Pharmaceutical Benefits Schedule (PBS) 2010. How will the current Minister for Health and Aging, the Hon Greg Hunt MP, be remembered by the nursing profession?

Perioperative Nursing – Exclusive Or Inclusive?, Carollyn Williams

Journal of Perioperative Nursing

Perioperative nursing is very much a multidimensional area of practice that has evolved as models of perioperative patient care, surgery, anaesthetics and their complexity, techniques and equipment have evolved. Within the broad perioperative area there are numerous nursing roles. However, they do not all necessarily identify as being under a singular ‘perioperative’ umbrella and this is largely due to how the roles evolved. Thus the question: is perioperative nursing exclusive, in that it identifies with only one facet of the pre-operative, intra-operative and post-operative phases of the patient’s surgical experience? Or is it inclusive, in that nurses who work in …

Effectiveness Of Family-Centred Educational Interventions In The Anxiety, Pain And Behaviours Of Children/Adolescents And Their Parents’ Anxiety In The Perioperative Period: A Systematic Review And Meta-Analysis, Ines Martins Esteves, Marcia Silva Coelho, Hugo Neves, Marcia Pestana-Santos, Margarida Reis Santos

Journal of Perioperative Nursing

Aim: To evaluate the effectiveness of family-centred educational interventions on the anxiety, pain and behaviours of children and adolescents (three to 19 years old) and their parents’ anxiety during the perioperative journey.

Design: Systematic review of effectiveness and meta-analysis.

Data sources: MEDLINE, CINAHL, PsycINFO, Cochrane Central Register of Controlled Trials, SciELO and Sources of unpublished studies OpenGrey, Open Access Theses and Dissertations, and RCAAP – Portugal were systematically searched from January 2007 to April 2021 for available articles in English, Spanish and Portuguese.

Review methods: This review followed the methodology for systematic reviews of effectiveness from Joanna Briggs Institute (JBI). …