Nursing Commons^™

See One, Do One, Teach One: Advanced Perioperative Nursing Practice In Australia, Jed Duff

Journal of Perioperative Nursing

No abstract provided.

Cloth Hats: (W)Hat’S The Issue, Elizabeth Mckenna

Journal of Perioperative Nursing

Introduction

The aim of this discussion paper is to consider three issues regarding perioperative attire:

1. whether cloth hats or disposable hats are better for reducing patient risk of acquiring a surgical site infection (SSI)
2. whether the risk of infection is different for the bouffant style of hat compared to the skullcap style of hat
3. whether there is enough evidence available to support a statement that cloth hats are safe to wear in the operating suite.

Background

Hats have been routinely worn in operating suites since the 1950s. The intention of covering the hair has been to reduce the risk of …

Ex Utero Intrapartum Treatment (Exit) Procedure: Indications And Procedural Considerations, Melissa Silva

Journal of Perioperative Nursing

Problem identification

Ex Utero Intrapartum Treatment (EXIT) has become the optimal delivery strategy in fetuses with airway compromise; however, it remains an extremely rare procedure. This review aims to provide perioperative nurses with an overview of EXIT procedure to enable them to be an effective member of the multidisciplinary team.

Literature search

An electronic search of the CINAHL, Medline and Scopus databases was undertaken yielding 19 articles for inclusion in this integrative review. The papers included were case studies, case series or retrospectives and describe 42 EXIT procedures with 43 babies.

Data evaluation synthesis

The most common indication for the …

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 …

Seven Steps To Successful Change: How A Large Academic Medical Center Prepared Patients For Organizational Change, Brian Carlson, Madison Agee, Terrell Smith, Paul Sternberg Jr, Jason Morgan

Patient Experience Journal

Vanderbilt University Medical Center (VUMC) launched a new electronic health record (EHR) in a “big bang” implementation that saw the new software go live across multiple hospitals, clinics and geographic locations in a single morning. The organization rightly focused most of its energy on preparing its nearly 25,000 employees for the impacts of the transition, but it also considered the effects that would be felt by its patients and families. Survey data indicate that patient satisfaction scores demonstrably dip before, during and after an EHR implementation, and take approximately a year to recover. A team at DMC employed a seven-step …

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

Is It Fair To Compare? A Patient And Family Experience Of Two Healthcare Systems And Neurosurgical Teams Within A Two-Week Period, Laura Miller Cpxp

Patient Experience Journal

As the mother of a 28-year-old son with cerebral palsy and hydrocephalus, and as a healthcare consultant focused on patient experience and professional development, I have a unique perspective and skill set. Recently he experienced symptoms that included an excruciating headache, neck pain and lethargy. Fearing his ventriculoperitoneal shunt had malfunctioned, he went to the emergency room and was later admitted on the neuro inpatient floor for a three-day hospitalization. His original shunt had been placed in 1991, and he never had an issue with until August 2018. While in the hospital, he was informed that he was no longer …

Improving The Workflow And Partnership Between Registration And Clinical Staff In An Outpatient Urgent Care Center, Melissa Fairfield, Bailey Eells, Faye Collins, Joyce Cornish, Stephen Tyzik, Joy Moody, Wendy Osgood, Suneela Nayak, Ruth Hanselman, Amy Sparks

Operations Transformation

An outpatient urgent care unit was experiencing challenges in balancing the need to register patients and delivering care in the timeliest manner as possible. Upon examination, it was found that delays were being experienced in patient triage and discharge that resulted in low patient satisfaction scores.

A team of providers was established to review all process steps and a quality improvement project was created to attain a goal of 100% of the time discharge would not be delayed due to incomplete registration.

Baseline metrics demonstrated current numbers of delayed discharges, median time from door to triage as well as door …

The Trusted Source Of Knowledge For Australian Perioperative Nurses, Jed Duff

Journal of Perioperative Nursing

No abstract provided.

Creating And Applying Shared Mental Models In The Operating Room, Alister Wilson

Journal of Perioperative Nursing

A shared mental model is a concept from high reliability environments, like aviation, to help teams develop collective understanding of how they will work together to safely accomplish their goals. Areas of high-risk health care like the operating room have adapted this concept to improve interdisciplinary teamwork and thus improve patient outcomes. Non-technical skills including communication, situational awareness, task management and leadership are employed to produce a functional shared mental model. Nurses play an important role in the change process as traditional hierarchical cultures, differing communication styles between doctors and nurses and an increasingly transient workforce are all challenges to …

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 …

Refining Guidelines For The Care Of Paediatric Perioperative Patients In A Rural Health Care Facility, Michelle Hibberson

Journal of Perioperative Nursing

No abstract provided.

Challenges To Diabetes Self-Management For Adults With Type 2 Diabetes In Low-Resource Settings In Mexico City: A Qualitative Descriptive Study, Robin Whittemore, Mireya Vilar-Compte, Selene De La Cerda, Denise Marron, Rosabelle Conover, Roberta Delvy, Annel Lozano-Marrufo, Rafael Pérez-Escamilla

Department of Public Health Scholarship and Creative Works

Background: The prevalence of type 2 diabetes (T2D) in Mexico is one of the highest in the world, with high morbidity and mortality, and difficulty meeting glycemic targets. The purpose of this study was to identify the challenges for T2D self-management as perceived by both adults with T2D and health care providers in primary health clinics from Seguro Popular in Mexico City.

Methods: This was a qualitative descriptive study conducted in three Seguro Popular primary care clinics in Mexico City using convenience sampling. Semi-structured interviews were conducted with participants and data were analyzed using a content analysis approach.

Results: The …

Medication Self-Management Behaviors Of Community-Dwelling Adults With Chronic Disease, Michelle Yvonne Williams

Theses and Dissertations

MEDICATION SELF-MANAGEMENT BEHAVIORS OF COMMUNITY- DWELLING

ADULTS WITH CHRONIC DISEASE

by

Michelle Y. Williams, PhD, MSN, RN

The University of Wisconsin-Milwaukee, 2019

Under the Supervision of Professor Rachel Schiffman, PhD, RN, FAAN

Chronic conditions threaten public health, individuals, and families and affect all areas of a person’s life and require significant self-management from the individual with the disease, care from the healthcare provider and team, and support from the individual’s family. The relationship of selected risk and protective factors and communication with healthcare providers to medication self-management behaviors and quality of life was examined in 616 adults with chronic disease …

Academic Center Tiered Operating Room Strategy (Action): Comparing A High Efficiency Or To The Conventional Or, Moaz Bin Yunus Chohan

Electronic Thesis and Dissertation Repository

Canadian healthcare system is under immense economic pressure. In an attempt to resolve the problem, outpatient surgical services were offered to patients presenting with orthopaedic surgical complaints. An observational cohort study was carried out, comparing the conventional surgical setup to the newly designed high-efficiency setup that provided similar care, with a significantly lower operating cost. A total of 200 patients were enrolled in the study. Standardized and unstandardized questionnaires were used to evaluate pre-operative and post-operative patient data that reflected quality of life outcomes. Data was collected at enrolment and during post-operative follow-ups of up to 6 months. Results indicate …

Improving Hand Surgery Pain Management Results Using A Key Phrase And Patient Feedback: A Quality Improvement Project In A United States Ambulatory Surgery Site, Janet E. Reilly, Brenda Tyczkowski, Stacie Murley

Journal of Perioperative Nursing

Objective: The objective of this study was to report changes in patient pain satisfaction and quality indicator scoring of post-operative pain using key phrasing, or standardised scripts, as the nursing intervention.

Sample/setting: Data was collected from an ambulatory surgery clinic in an American non-profit, 185-bed community hospital which is part of a nationally ranked health system.

Method: This study used a before-and-after design in which quality improvement data was collected from the Press Ganey™ ambulatory surgery surveys completed by patients undergoing hand surgery. Changes in outcomes were measured three months before and during the key phrase intervention.

Results: Data indicated …

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 …

The Value Of A Perioperative Nurse, Nicholas Ralph

Journal of Perioperative Nursing

No abstract provided.

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 …

Patient Perception Of Telephone Follow-Up After Resection For Colorectal Cancer: Is It Time For An Alternative To The Out-Patient Clinic?, Marcus Gilmartin, Nicholas Leaver, George Hall, Helena Fawdry, Seung Lee, James Nicholson, Ramya Kalaiselvan, Raj Rajaganeshan

Patient Experience Journal

The economic reality of modern healthcare provides a timely reminder to clinicians of their duty to provide outstanding and cost-effective care. Although multiple guidelines outline investigation, management and surveillance of colorectal cancer, none advocate a particular delivery method. Nurse-led telephone follow-up in multiple specialties has demonstrated equivalent clinical outcomes and patient satisfaction when compared to traditional outpatient department follow-up. This paper aims to compare nurse-led telephone and outpatient follow-up, following surgical resection of colorectal cancer (CRC), focusing on patient perceptions. This cross-sectional study distributed adapted patient satisfaction questionnaire (PS-Q 18) to patients undergoing surveillance following CRC resection via either nurse-led …

Activating Nursing To Address Unmet Needs In The 21st Century, Patricia Pittman

Health Policy and Management Faculty Publications

No abstract provided.

Interprofessional Collaboration During Discharge Planning For A Large Midwestern Hospital, Sarah Shepler

Doctoral Projects

Introduction: Interprofessional collaboration (IPC) improves the quality of healthcare delivery. IPC enhances communication during discharge planning, through use of structured daily rounds to reduce readmissions, length of stay (LOS), cost, and mortality. A $240 billion reduction in cost could be achieved with IPC. The Joint Commission, Institute of Medicine, and World Health Organization emphasize use of IPC to reduce errors, improve patient outcomes, and refine transitions of care for patients.

Objectives: The goal of this project was to determine how IPC within structured daily rounds during discharge planning impacts patient LOS and staff satisfaction.

Methods: This quality improvement project was …

Preventing Perioperative Hypothermia Is Clinically Feasible And Cost Effective, Nicholas Ralph

Journal of Perioperative Nursing

No abstract provided.

Improving Antibiotic Prescribing For Surgical Prophylaxis – The Role Of Perioperative Nurses, Pat Nicholson

Journal of Perioperative Nursing

No abstract provided.

The Impact Of Improved Surgical Safety Checklist Participation On Or Efficiencies: A Pretest-Posttest Analysis, Brigid M. Gillespie Phd, Emma Harbeck Phd, Joanne Lavin Mn Rn, Therese Gardiner Bn Rn, Teresa Withers Fracs, Andrea Marshall Phd

Journal of Perioperative Nursing

Objective:To describe changes in day of surgery (DOS) cancellations and procedural delays following introduction of a practice improvement intervention to improve team members’ participation in the surgical safety checklist (SSC).

Methods:Pretest—posttest electronic audit of secondary data collected 12 months before and 12 months after implementation. A consecutive sample of patients who underwent elective surgeries were included. Elective surgeries over two periods (November 2014 to September 2015, and November 2015 to October 2016) were included in the audit and data was collected retrospectively. The practice improvement intervention coined ‘pass the baton’ was implemented over four weeks in October 2015. …

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 …

Patient-Centered Medical Homes In Community Oncology Practices: Changes In Spending And Care Quality Associated With The Come Home Experience, Teresa M. Waters, Cameron M. Kaplan, Ilana Graetz, Mary M. Price, Laura A. Stevens, Barbara L. Mcaneny

Health Management and Policy Faculty Publications

PURPOSE:

We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality.

PATIENTS AND METHODS:

We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for …

Peer Support For Addiction In The Inpatient Setting, Rebecca Sweeney

DNP Scholarly Projects

Background: In 2006 the Institute of Medicine reported that combined mental illness and substance use disorder was the second leading cause of disability and death in women and the highest cause in men. More recent data obtained from the 2016 National Survey on Drug Use and Health (Ahrnsbratz et al 2016) indicates in 2016 only one in ten of the people who need treatment, receive it. At Cambridge Health Alliance’s Everett Hospital, the site of this pilot project, opioid overdose and acute alcohol intoxication comprise one in every ten visits in the Emergency Department. In January of 2018, CHA partnered …

Ua66/13/2 Ogden College Of Science & Engineering Public Health Centers, Wku Archives

WKU Archives Collection Inventories

Records related to Public Health Centers.

Patient-Centered Medical Homes And Hospital Value-Based Purchasing: Investigating Provider Responses To Incentives, Lauryn Walker

Theses and Dissertations

Provider incentives are a commonly used policy tool to mold provider behaviors.¹ However, while we frequently measure the change in patient outcomes, failure to consistently produce changes in outcomes does not mean that providers are not changing their behavior. This paper focuses on two programs with null or inconsistent quality outcomes to try to identify why such inconsistency occurs. The two programs, both ratified in the Affordable Care Act, are 1) patient-centered medical homes (PCMHs), and 2) the Medicare Hospital Value-Based Purchasing (HVBP) program.

Chapter 1: Using data from the Medical Expenditure Panel survey (MEPS), I match provider characteristic …