Medical Specialties Commons^™

Innovations In Postgraduate Work Integrated Learning Within The Perioperative Nursing Environment: A Western Australian Experience, Kylie Russell, Tracey Coventry

Journal of Perioperative Nursing

A key expectation from the health care industry in Australia is that nurses engaged in postgraduate specialist education need to be able to apply their extended knowledge and skills to the workplace. For this to succeed, health services need to be involved in the development of course content and learning outcomes to ensure authentic engagement. Essential to this is student participation in workplace learning that provides experience, performance feedback and reflection. This promotes graduate success to meet industry expectations.

The Graduate Diploma of Perioperative Nursing aims to develop graduates with not only the knowledge of good perioperative nursing practice but …

A Personal Perspective On Separating Families Before Surgery, Coralie Steward

Journal of Perioperative Nursing

No abstract provided.

Factors Affecting Surgical Plume Evacuation Compliance, Stephanie Holmes

Journal of Perioperative Nursing

Despite the acknowledgement of the hazards of surgical plume, compliance with smoke evacuation is not routine. This review examines the current literature on factors influencing compliance with smoke evacuation. Factors identified included the design of the smoke evacuation device, surgeon refusal, education and managerial support. Strong leadership, education and policy enforcement from a local facility level are required to improve surgical plume evacuation compliance. More research in this field would help to further strengthen these findings.

Gastrointestinal Stromal Tumor (Gist) Of The Treitz’S Angle– A Very Rare Cause Of High Bowel Obstruction, Mădălina Elena Tobă, Dan Florin Ungureanu, Lota Corina Georgescu, Traian Pătraşcu

Journal of Mind and Medical Sciences

Gastrointestinal stromal tumors (GIST) are somewhat rare gastrointestinal tumors - approximately 1% to 3% incidence, but they are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs are usually found in the stomach or small intestine but can occur anywhere within the gastrointestinal tract, even in extremely uncommon locations like duodeno-jejunal flexure. Only 3% – 5% of GISTs are located in the duodenum and tumors occurring in the angle of Treitz are even rarer, most published studies being case reports. These tumors have a size ranging from small lesions to large masses and can cause digestive bleeding or high …

A Retrospective Surgical Experience Regarding Open And Laparoscopic Procedures Of The Hepatic Hydatid Cyst With An Up To Date Complete Review Of The Literature And A Focus On Original Romanian Techniques, Diana Moldovan, Cosmin Alec Moldovan, Laurentiu Ungurianu, Dan Florin Ungureanu

Journal of Mind and Medical Sciences

Introduction: Even though the development of the recent anti-parasitic drugs has led to a high degree of efficiency, surgical treatment still remains the gold standard for a number of conditions. Material and method. The authors discuss a series of 90 cases in a multicenter and retrospective analysis that stretches over 20 years. Results and discussions. These cases have been diagnosed and treated – through different surgical methods, both classical and laparoscopic – for hepatic hydatid cysts. The paper also presents a short review of the major types of surgical procedures cited in the international literature, with a …

A Proposed Therapeutic Algorithm Based On Multiple Case Analysis Regarding The Repair Options Of Iatrogenic Biliary Lesions Following Open And Laparoscopic Surgery, Cosmin Alec Moldovan, Dan Florin Ungureanu, Vladimir Beliș

Journal of Mind and Medical Sciences

Introduction: the problem of the iatrogenic lesions of the main biliary pathways is far from being completely clarified and still represents a serious surgical situation, during both open and laparoscopic surgeries. The outcome of these situations is closely linked with the actual moment of discovery of the lesion and the surgical methods for repairing such defects and implies a great number of options, such as reconstructive, derivative and substitutive techniques. Objectives: the goal of this paper is to present an algorithm of choices and their consequences for clinical conduit in the case of iatrogenic biliary lesions discovered in …

Helicobacter Pylori: Types Of Diseases, Diagnosis, Treatment And Causes Of Therapeutic Failure, Cosmin Vasile Obleaga, Cristin Constantin Vere, Ionica Daniel Valcea, Mihai Calin Ciorbagiu, Emil Moraru, Cecil Sorin Mirea

Journal of Mind and Medical Sciences

Acute upper gastrointestinal lesions have a multifactorial etiology but, regardless of the cause, they are related to mucosal barrier destruction. Since Helicobacter pylori induces a superficial chronic gastritis with the infiltration of neutrophils in the mucosa, it was speculated that Helicobacter pylori infection could also cause bleeding lesions. The diagnosis, the proper treatment and the revaluation of its effectiveness actually represent the prophylaxis of some diseases such as peptic ulcer, gastric lymphoma or mucosa-associated lymphoid tissue (MALT) and gastric cancer. These diseases and their severe complications are life-threatening for the patient. Periodic renewal of the treatment and knowing the real …

An Opportunity Taken: Sunshine Coast University Private Hospital’S Perioperative Nurse Surgeon’S Assistant Experience, Catherine Smith, Toni Hains, Natasha Mannion

Journal of Perioperative Nursing

No abstract provided.

‘Below Ten Thousand’: An Effective Behavioural Noise Reduction Strategy?, Pete Smith, John Gibbs

Journal of Perioperative Nursing

Noise in the operating theatre environment has remained a persistent and unresolved problem1. The problem currently lacks an effective solution2. In order to partially resolve this issue, the authors created a behavioural noise reduction tool called ‘Below ten thousand’. This study identifies a potential solution to the problem of behavioural noise in the operating theatre, and indicates further research must be undertaken to identify the full scale of benefits this technique can deliver to the team environment in the operating theatre.

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

Journal of Patient-Centered Research and Reviews

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 …

Traumatic Posterior Tibial Pseudoaneursym: A Rare Late Complication Repaired Conventionally, Farzad Amiri, Md, Zachary Sanford, Constantinous Constantinou, Md

Marshall Journal of Medicine

Posterior tibial artery pseudoaneurysms are extremely rare. They commonly present as a late complication of trauma or iatrogenic injury. Diagnosis can be elusive. Treatment has been described in the context of open primary repair, endovascular stenting, and coil embolization. There has been increasing interest in the use of endovascular treatment options for this type of injury. If left untreated, pseudoaneurysms can rupture, partially thrombose, expand and cause adjacent local compression and compartment syndrome. The following case presented is of a young gentleman with a posterior tibial pseudoaneurysm incidentally discovered after stepping on glass and the management of his posterior tibial …

Outcomes Of External Repair Of Heartmate Ii™ Lvad Percutaneous Leads, Jay D. Pal, Claudius Mahr, Jason W. Smith, Todd F. Dardas, Jay Pinette, David J. Farrar, Nahush A. Mokadam

The VAD Journal

Background: The HeartMate II Left Ventricular Assist Device (LVAD) receives power via a percutaneous lead connected to an external controller and batteries. At times, this lead can be damaged during normal wear, as well as by traumatic fracture, which may jeopardize the functionality of the LVAD. If there is significant internal damage, surgical replacement of the LVAD is required. However it is possible to repair externally damaged leads by replacing the distal portion of the lead to avoid pump replacement. We report the overall experience and outcomes in patients with external lead repairs.

Methods: A procedure for full …

Factors That Predict Evidence Use By Australian Perioperative Nurses, Jed Duff, Margaret Butler, Menna Davies, Robyn Williams, Jannelle Carlile

Journal of Perioperative Nursing

Evidence-based practice has been demonstrated to positively impact patient outcomes; unfortunately, there are many factors that hinder the use of research evidence by healthcare clinicians. Our previous study reported a multisite survey assessing Australian perioperative nurses knowledge, practice, attitude, and perceived barriers to evidence use. This subsequent analysis used univariate and multivariate binary logistic regression with odds ratios (OR) and 95% confidence intervals (CI) to compare individual nurse and organisational characteristics with high evidence-basad practice (EBP) use. Two individual nurse characteristics found to be related to EBP were postgraduate qualifications (OR 1.69, 95% CI 1.07–2.6, p=0.02) and previous research experience …

A Failed Perioperative Nursing Journal Club: Reflections On Mistakes Made, And Lessons Learned, Jennifer Austin

Journal of Perioperative Nursing

No abstract provided.

Orthotopic Heart Transplant Following Implantation Of A Systemic Ventricular Assist Device In A Patient With Congenitally Corrected Transposition Of The Great Arteries And Dextrocardia Situs Inversus Totalis, Bree Ann C. Young, Zachariah B. Nealy, Michael F. Mcgrath, John M. Herre

The VAD Journal

Congenitally corrected transposition of the great arteries (CCTGA) is a rare congenital heart disease that commonly results in congestive heart failure due to exposure of the anatomic right ventricle to systemic pressures. Additional anatomic abnormalities, such as situs inversus, in which the viscera are mirror images of normal anatomy, or dextrocardia in which the heart apex is located on the patient’s right, once were contraindications to transplant in the treatment of advanced heart failure. However, recent advancements now allow for the management of heart failure through mechanical circulatory support and subsequent transplant. This case presents a 52 year-old man with …

Management Of Co-Existing Lung Cancer And Endobronchal Hamartomas, Mark H. Cooper, Md

Marshall Journal of Medicine

Abstract:

The coexistence of lung cancer with an endobronchial hamartoma is infrequent, and requires accurate oncologic evaluation of the endobronchial lesion prior to potential surgical treatment of the lung cancer. We describe a patient who presented with an undiagnosed endobronchial mass and and a biopsy-proven lung cancer which were successfully managed by a staged approach using initial bronchoscopic resection of the endobronchial lesion and subsequent lobectomy for squamous cell lung cancer.

Modern Evaluation Of Abdominal Trauma, Errington C. Thompson, Md, Chadwick J. Knight, Md

Marshall Journal of Medicine

Abdominal trauma can be mysterious to some physicians. If patients are evaluated for being stable or unstable, then abdominal trauma can be easily managed. Using a combination of physical examination, ultrasound and CT scans, patients can be quickly and efficiently evaluated.

Conservative Surgery Of Breast Cancer In Women; Psychological Benefits, Razvan V. Scaunasu Md, Traean Burcoș, Ștefan Voiculescu, Bogdan A. Popescu, Șerban V. Bertesteanu, Oana-Denisa Bălălău, Nicolae Bacalbasa, Cristian Bălălău

Journal of Mind and Medical Sciences

Breast surgery was one of the most dynamic fields of medicine which benefited from significant progress during the last decades. The transition from aggressive and mutilating amputations to conservative, oncoplastic and reconstructive techniques has been constant, offering improved and rewarding results, viewed from both, oncological and aesthetical perspectives.

Conservative techniques, especially those which preserve the nipple areola complex, are followed by improved patient’s perception of their body image, confidence and sexuality, with the only drawback of increased anxiety linked to recurrence risk.

Perforated Small Intestine In A Patient With T-Cell Lymphoma; A Rare Cause Of Peritonitis, Petrisor Banu, Vlad D. Constantin, Florian Popa, Mihaela F. Nistor

Journal of Mind and Medical Sciences

The nontraumatic perforations of the small intestine are pathological entities with particular aspects in respect to diagnosis and treatment. These peculiarities derive from the nonspecific clinical expression of the peritonitis syndrome, and from the multitude of causes that might be the primary sources of the perforation: foreign bodies, inflammatory diseases, tumors, infectious diseases, etc. Accordingly, in most cases intestinal perforation is discovered only by laparotomy and the definitive diagnosis is available only after histopathologic examination. Small bowel malignancies are rare; among them, lymphomas rank third in frequency, being mostly B-cell non Hodgkin lymphomas. Only 10% of non-Hodgkin lymphomas are with …

Lung Edema On Va Ecmo, Christof Schmid Md

The VAD Journal

No abstract provided.

The Value Of Guided Operating Theatre Experience For Undergraduate Nurses, Paula Foran

Journal of Perioperative Nursing

Can nurses who have not been involved in guided operating theatre experience care for patients before and after surgery with the same level of knowledge and expertise as those who have?

This paper will present an overview of a national mixed methods research project that investigated these issues, comparing different models of operating theatre education offered in Australia. Transferable skills learned via operating theatre experience that may be useful in the surgical wards will be explored and also possible correlations between students’ experiences in this specialty area and recruitment and retention of staff to this specialist area.

Handover Between Anaesthetists And Post-Anaesthetic Care Unit Nursing Staff Using Isbar Principles: A Quality Improvement Study, Patricia Kitney, Raymond Tam, Paul Bennett, Dianne Buttigieg, David Bramley, Wei Wang

Journal of Perioperative Nursing

A structured approach to communication between health care professionals contains introduction/identification; situation; background; assessment and request/recommendation (ISBAR). ISBAR was introduced into the post-anaesthetic care unit (PACU) of a large Victorian health service in 2013. The aim of this study was to measure the effect of an education program on ISBAR compliance.

Method: A pre/post-test design using a 14-item audit tool was used to measure compliance to ISBAR before and after an education intervention in two acute hospitals in Melbourne, Victoria. The intervention consisted of one 30-minute education session to anaesthetists, and two 30-minute education sessions to PACU nurses, combined with …

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 …