Nursing Commons^™

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 …

Enhanced Recovery After Surgery In Australia: A Classic Example Of An Evidence–Practice Gap, Jed Duff

Journal of Perioperative Nursing

Enhanced recovery after surgery (ERAS) pathways – often referred to as fast-track programs – are multidisciplinary, evidence-based perioperative pathways, designed to achieve early recovery for patients undergoing major surgery. ERAS has been described as a surgical revolution because of the benefits it produces. A recent systematic review found, on average, ERAS pathways reduce length of stay by 2.3 days and case costs by $639.00, without adverse impact on mortality, adverse events, or readmissions.

Bystanders’ Perspectives On The Provision Of Informal, Hospital-Based Care To Bedridden Patients With Cancer In Sri Lanka, B. Sunil S. De Silva

Nursing ETDs

Due to the nursing shortage in Sri Lanka, patients need informal caregivers, known as bystanders, to help provide patient care. This study described bystanders’ perspectives on informal, hospital-based care to bedridden patients with cancer in Sri Lanka. In this qualitative descriptive study, 17 bystanders at Apeksa/Cancer Hospital, Sri Lanka, were recruited using snowballing sampling. Data were collected through telephone interviews and analyzed using content and thematic analyses. Findings showed that paid and unpaid bystanders cover all caregiving tasks with minimum interaction with nurses. Unpaid bystanders described the need for same-sex bystanders and additional help with patients’ mobilization and specialized care. …

Improving Clinicians’ Access To Patient Education And Va Resource Information, Ella Bermudez

Doctor of Nursing Practice (DNP) Projects

Abstract

Problem: In a western US Veterans Administration (VA) hospital system, patient education materials are provider-specific, not standardized, and not located in a central, readily available location.

Context: How does a patient education tool affect the clinicians' delivery of health education in increasing health literacy compared to written information alone in the US veteran population? An integrated literature review was performed using Cochrane, Joanna Briggs Institute (JBI), Scopus, CINAHL, and PubMed databases to address the PICOT question above and determine the impact of patient education tools on health literacy and patient engagement. The literature recommended improving patient education for better …

Behavioral And Enhanced Perinatal Intervention (B-Epic): A Randomized Trial Targeting Tobacco Use Among Opioid Dependent Pregnant Women, Amanda Fallin-Bennett, Michelle R. Lofwall, Teresa M. Waters, Paul Nuzzo, Janine Barnett, Letitia Ducas, Andrea Mccubbin, Niraj R. Chavan, Lisa Blair, Kristin Ashford

Nursing Faculty Publications

Background

Opioid use during pregnancy is a significant public health issue. The standard of care for treating opioid use disorder during pregnancy includes medications for opioid disorder (MOUD). However, tobacco use often goes unaddressed among pregnant women on MOUD. In 2018, our team received a National Institute on Drug Abuse (NIDA) funded R34 to conduct a three year-randomized trial to test the feasibility of a novel tobacco intervention for pregnant women receiving MOUD.

Aims

The aims of this study are: (1) to determine the impact of the B-EPIC intervention on maternal tobacco use and stage of change; (2) to determine …

Alumna Profile: Empowering Women In Science

Scientia

Nursing school alumna Linda Degutis is interviewed about her career and her work with the CDC and other government programs aimed to reduce violence and improve women's and veterans' health care.

Patient Participation Strategies: The Nursing Bedside Handover, Irene Decelie

Patient Experience Journal

Patient participation is an important goal in today’s health care and considered necessary to achieve safe and quality patient care. The purpose of this paper is to discuss the historical and theoretical background surrounding the concept of patient participation in health care and specifically to examine patient participation strategies which have been reported to be of influence when employed during the nurse to nurse and patient to nurse activities encompassed in the bedside handover. The bedside handover is the nursing activity of transferring primary nursing responsibility of care from one nurse to another. Encouraging patients to participate during this process …

Empowering Nurses Of Minority In The Face Of Incivility And Bullying: Through The Lens Of Phenomenology, Corrine Floyd

Dissertations

Abstract

Up to 85% of nurses have reported exposure to incivility in the workplace (Hunt & Marini, 2012). The often-subtle nature of incivility toward nurses in a minority population may partially explain why it remains a problem. Healthcare organizations realize the need for civility to counter the high turnover rate, staff shortages, and low job satisfaction reported by nurses, but lack understanding of how nurses of a minority population perceive incivility and bullying. This study aimed to answer the research question how do nurses with minority representation experience incivility and bullying versus empowerment in the workplace? A descriptive phenomenological design …

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).

What Is The Scope Of Practice Of The Nurse Practitioner As A Surgical Assistant In Australia?, Toni G. Hains, Catherine L. Smith

Journal of Perioperative Nursing

Discussion around the scope of practice of all nurse practitioners (NPs) in Australia was a component of the recent review of NPs’ eligibility to have broader access to the Medical Benefits Schedule (MBS). This review process has been prolonged and, while the MBS review officially concluded on the 30 June 2020, no information regarding decisions about expanded NP access to the MBS for patient rebates had been disclosed at the time of publication. It is anticipated that the MBS review will contribute little change to NP access to the MBS.

The MBS is the primary funding process for private-sector medical …

Will Robots Make Good Perioperative Nurses?, Jed Duff

Journal of Perioperative Nursing

New technology is always being introduced into health care and nursing as a profession has had to adapt. Technological advances have changed the practice of nursing from the introduction of the stethoscope to the electronic health record, and now robots and artificial intelligence (AI). With technological advancements occurring at an ever-increasing rate, more and more perioperative tasks will be delegated to robots and AI. The main question for perioperative nurses is, how can we remain relevant in the high-tech operating room of the future?

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 …

Nursing Leadership During Covid-19: Enhancing Patient, Family And Workforce Experience, Anne Aquilia, Karen Grimley, Barbara Jacobs, Maryellen Kosturko, Jerry Mansfield, Charlotte Mathers, Peggie Parniawski, Laura Wood, Victoria Niederhauser

Patient Experience Journal

The global COVID-19 pandemic has challenged nurse leaders in ways that one could not imagine six months ago. Along with ongoing priorities of providing high quality, cost-effective and safe care, nurse leaders are also committed to creating environments that support excellence in patient and family experience. This article will provide exemplars of how nurse leaders used decisive decision-making, adapted to novel situations and issues, ensured reliable and safe delivery of care and engaged patients, families and their workforce to create excellent experiences of care during the pandemic. Throughout this crisis, nurse leaders have learned how to grapple with quick and …

A Daily Measure Of Job Satisfaction In The Operating Room: Investigating Its Value And Viability, Miriam S. James-Scotter, Lixin Jiang, Cameron Walker, Stephen Jacobs

Journal of Perioperative Nursing

Objectives: This study aims to explore the value, validity and viability of implementing a daily job satisfaction tool in the operating room setting (OR).

Sample and setting: A daily one-minute survey was developed and trialled with 269 OR staff members (123 nurses) over a three-week period within one New Zealand hospital.

Method: A feedback and validation survey was then administered to staff one week following the trial.

Results: The trial resulted in 569 tool submissions. A daily average of 71% of participants (69% nurses) reported feeling ‘pretty good’ or ‘great’ about their jobs, with ‘relationships and communication with colleagues’ …

Pandemics: A Covid-19 Perspective, Lyn Bowen

Journal of Perioperative Nursing

The world is currently gripped by a pandemic, a term that is on everyone’s lips. However, six months ago, many would have found it difficult to define the terms pandemic, epidemic and outbreak, or explain the difference.

The emergence of a novel coronavirus, commonly referred to as COVID-19, has significantly changed our awareness. It has heightened our anxiety, like a primordial fear, leaving us feeling vulnerable, similar to how past generations reacted to pandemics.

The Imperative To Build Research Capacity And Promote Evidence-Based Practice In Australian Perioperative Nurses, Jed Duff

Journal of Perioperative Nursing

Evidence-based practice is considered the gold standard of care, and as such it is now an expectation of our patients, regulatory agencies and health care funders. Unfortunately, much of what we do in perioperative nursing continues to be based on tradition and history rather than robust clinical evidence. Even when evidence is available to use, it is often not fully applied in practice. If we want to maintain our standing as a leading nursing specialty, then we need to address this issue by engaging with research and growing our evidence base. To do this, we need to conduct and disseminate …

Perioperative Nurses’ Engagement With The Surgical Safety Checklist: A Focused Ethnography, Julie A. Rogers, Paul Mcleish, Jan Alderman

Journal of Perioperative Nursing

Purpose

To gain greater insight into how nurses engage with the multidisciplinary team during the surgical safety checklist process.

Participants and setting

Participants were a purposeful sample of eight operating room nurses. The study was conducted in the operating room department of a major tertiary teaching hospital in South Australia.

Methods

Phase 1 employed participant observations while phase 2 employed semi-structured interviews.

Findings

Participants supported the use of the surgical safety checklist and valued its role to enhance patient safety. Multidisciplinary team culture played a significant role in how the checklist was conducted and heavily influenced the level of nurse …

Ecg For All Patients In The Pacu: Some Say, Why? I Say, Why Not?, Paula Foran

Journal of Perioperative Nursing

Currently in many Australian hospitals, electrocardiogram (ECG) leads are removed after the operative process and, despite the machines being freely available in the Post Anaesthesia Care Unit (PACU), they are not connected to all patients.

There are many evidence-based reasons why an ECG would be advantageous for perioperative patient safety, including the detection of often asymptomatic conditions such as myocardial injury after non-cardiac surgery (MINS) and new-onset atrial fibrillation, which has been shown to increase the risk of stroke. Advantages may also be seen in saving precious minutes in a cardiac arrest, and the ability for nurses to constantly observe …

Who’S Under The Mask? Colour-Differentiated Identification Labels For Perioperative Staff, Diana Bentley

Journal of Perioperative Nursing

Staff identification in the perioperative environment is difficult when all staff, students and visitors wear the same attire. All attire needs to be laundered to national standards for infection control governance and consequently attire cannot be individualised. In emergency situations it is also difficult to identify the roles of all staff with standard methods of identification.

The aim of the ‘Colour-differentiated identification labels’ project was to improve identification of all staff and visitors in the perioperative environment with the intended result being improved communication and safety among staff, patients and visitors. The project began in February 2018 with project leads …

Covid-19 And Perioperative Nursing – Inside The Nsw State Emergency Operation Centre, Sarah-Jane Waller

Journal of Perioperative Nursing

This article is a guest editorial describing how it was to work inside the NSW State Emergency Operation Centre, the COVID-19 response coordinating hub for the Australian state of New South Wales, in the early days of the pandemic.

The Effect Of The Timing Of A Hospice Referral And The Perceived Quality Of Care By The Family, Caitlin Tran

Nursing | Senior Theses

Hospice care is a specialized type of palliative care for patients with a time-limiting illness. Despite its benefits, hospice remains underutilized. A key reason behind the underutilization are untimely referrals, often made during the last weeks or days of the patient’s life. The purpose of this paper is to investigate the existing barriers towards hospice that play into late referrals and its effect on patient/family satisfaction. This information will be examined to propose a pilot research study for further exploration.

Implementing Inter-Professional Patient-Family Centered Plan Of Care Meetings On An Inpatient Hospital Unit, Nicolas Hernandez, Alice Fornari, Sage Rose, Leanne Tortez

Patient Experience Journal

Inpatient plan of care meetings support efforts to encourage collaborative practice and patient-family centered care and result in an effective strategy to enhance communication and patient satisfaction. Clinical team members participated in patient/family centered plan of care meetings at a community hospital in a selected inpatient unit with full time hospitalist physicians. Quantitative data were gathered pre/post implementation from the external Hospital Consumer Assessment of Health Care Providers (HCAHPS) survey. HCAHPS data were collected independently, specifically for questions related to communication between patients, family members/guardians and the medical team and also the effects of care transition. There was a slow …

The ‘Human Factor’… Worth Considering?, Geoff Hay

Journal of Perioperative Nursing

On any given day, be it in our professional or personal lives, our predominant thought processes are geared towards outcomes. How often, though, do we allow ourselves time to pause and reflect on the human factors involved in our decision making? This article examines lessons we can learn from human factors training and systems used in aviation and how they can be applied in the perioperative environment.

Climate And Health, Amanda Adrian

Journal of Perioperative Nursing

While being responsible for a relatively high proportion of CO₂ emissions, the health professions also have a professional responsibility to take action to respond to the health threats that climate change is generating.This feature article examines our responsibilities as health professional leaders in mitigating the enormous risk posed by climate change and some of the possibilities for action at both local and national level.

The Future Of Nurse Education In Australia And Implications For Perioperative Nursing, Jed Duff

Journal of Perioperative Nursing

A national review into nurse education in Australia examined the current educational preparation of Australian nurses to ensure the profession is adequately equipped to meet the future needs of the nation’s evolving health system. This editorial outlines and reviews some of the key recommendations from the report and their potential implications for perioperative nursing and nursing education.

Factor V Leiden And Superior Mesenteric Artery Occlusion: A Case Study, Cristina Atayde

Journal of Perioperative Nursing

Factor V Leiden (FVL) is an inherited condition that prolongs the clotting process; this subsequently places individuals at a higher risk of developing a thromboembolism. This case study will discuss a 41-year-old female who developed a superior mesenteric artery occlusion with subsequent small bowel ischaemia on a background of FVL. The discussion will illustrate the rarity of an arterial occlusion, the risk factors that are associated with an ischaemic small bowel, the implications of inheriting FVL and some of the associated social aspects of an ileostomy.

Malignant Hyperthermia In A Regional Facility: A Case Study, Catherine Kleidon

Journal of Perioperative Nursing

Malignant hyperthermia (MH) is a rare hypermetabolic state that may be triggered by both anaesthesia and non-anaesthesia triggers. The main anaesthesia triggers for MH are the depolarising muscle relaxant suxamethonium and volatile anaesthetic gases. MH presents in several ways with not all clinical symptoms being required to make a diagnosis. Safe and efficient patient management of MH requires knowledge and understanding of this inherited disorder. The perioperative team need to be aware of the tasks that are required to manage this emergency. This case study will discuss a suspected episode of MH presenting in a patient late on Christmas Eve …

Changing Workplace Culture: What Would It Take To Speak Up?, Sandra Millis

Journal of Perioperative Nursing

Bullying in the health care environment historically has been tolerated and, in many cases, expected. The Health and Safety at Work Act 2015 has provided the necessary legislation to stimulate a move toward addressing the bullying culture within New Zealand hospitals. This article takes a reflective look at how speaking up about bullying, although difficult, is important in order to change workplace culture.

Cost-Effectiveness Of A Mobile Health-Supported Lifestyle Intervention For Pregnant Women With An Elevated Body Mass Index, Elizabeth O'Sullivan, Salwa Rokicki, Maria Kennelly, Kate Ainscough, Fionnuala M. Mcauliffe

Articles

Objective To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.

Methods We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost‐effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG …