Nursing Commons^™

Surgical Plume And Its Implications: A Review Of The Risk And Barriers To A Safe Work Place, Eunice Tan, Kylie P. Russell

Journal of Perioperative Nursing

Every year thousands of health care professionals worldwide are exposed to surgical smoke. There is evidence that this smoke consists of toxic gases, pathogens and particulate matter that is a hazard for patients and the perioperative team. Past research indicates that perioperative staff inconsistently comply with smoke evacuation recommendations. The aim of this study was to identify, review and discuss the issues related to surgical plume and its implications for patients and perioperative staff. The findings of this review relate to: surgical smoke content, its risks to the health of the perioperative staff, preventative measures, infection control measures, compliance with …

A Review Of Suspected Intraoperative Antiseptic Burns: A Quality Improvement Review, Monica Stankiewicz, Michele Wyland

Journal of Perioperative Nursing

No abstract provided.

Knowledge And Perceptions Of The Nmsa Role In Australia: A Perioperative Staff Survey, Toni Hains, Catherine Turner, Haakan Strand

Journal of Perioperative Nursing

In Australia, the role of the Non-Medical Surgical Assistant (NMSA) lacks recognition and professional regulation. This paper reports the findings of a recent survey of Australian perioperative staff [n=116] to determine their knowledge and perceptions of the NMSA role. The survey findings confirm that the role is not well established across the Australian health care system. Of concern is that perioperative staff are required to fill the role of surgical assistant on an impromptu basis. NMSAs with no post-graduate qualifications are perceived by perioperative staff to be less equipped in mentoring, leadership, theatre efficiency, safety and procedural knowledge. There was …

Locus Of Control Profile In Anaesthetic Nurse And Theatre Nurse Students: A Recruiting Guideline?, Vera Meeusen, Carla Mangnus, Samantha Masters

Journal of Perioperative Nursing

In the Netherlands, an individual with or without a nursing background can enrol in a nurse anaesthetist or theatre nurse program. Admission to the program requires either a secondary school diploma with a specialisation in physics and health, or a nursing degree. At the end of the study, the Dutch anaesthetic nurse is comparable to a nurse anaesthetist in other countries while theatre nurses are similar in scope of practice to scrub/scout nurses in other European countries. Retention of students is challenging, with an attrition rate of around 24 per cent adding to the cost for hospitals delivering the program1. …

Interdepartmental Rounding, Peggy Anderson, Carrie Strick, R3 Med-Surg Unit, Haley Pelletier, Suneela Nayak, Stephen Tyzik, Ruth Hanselman, Maine Medical Center Operational Excellence

Maine Medical Center

STRATEGIES FOR IMPROVING COMMUNICATION BETWEEN DOCTORS AND NURSES IN AN ACUTE CARE HOSPITAL

Effective interdisciplinary communication is imperative for safe patient care in an acute care hospital environment.

A surgical unit used their HCAHPs scores to assess how often patients perceived there was good communication between different doctors and nurses during their hospital stays. The data demonstrated that this occurred 22% less often than the national average.

As a result of a root cause analysis, a number of countermeasures were initiated with the goal of achieving scores greater than the national average. Post KPI inception in the second quarter of …

A Selected International Appraisal Of The Role Of The Non-Medical Surgical Assistant, Toni Hains, Haakan Strand, Catherine Turner

Journal of Perioperative Nursing

No abstract provided.

‘When No Means No’ – Adolescent Right To Refuse An Elective Surgical Procedure: A Case Study, Julia Gilbert, Brigid M. Gillespie

Journal of Perioperative Nursing

At law, adults are presumed to have legal competency to provide consent for or refusal to consent to health care treatments unless they have cognitive impairment. But what of the adolescent who is, at law, a child but who refuses to undergo elective surgical treatment? This paper discusses the issues surrounding the case of Keith, a 14-year-old boy with ulcerative colitis, who refuses consent to undergo an elective ileostomy.

Decreasing Cost In The Gi Endoscopy Suite By Utilizing Best Sedation Practices, Casey Brianne Mancini

Doctoral Projects

Colorectal cancer is a leading cause of cancer death in the United States (Mandel, Tanner, Lichtenstein, Metz, Katzka, Ginsberg, & Kochman, 2008; Siegel, DeSantis, & Jemal, 2014). Because this lethal disease claims lives of many people every year, more patients are undergoing screening colonoscopies, which have greatly aided in decreasing the number of colorectal cancer deaths (Siegel et al., 2014). The most common form of sedation for colonoscopies is moderate sedation with a benzodiazepine and an opioid (Cohen, Hightower, Wood, Miller, & Aisenberg, 2004; Lera dos Santos, et. al., 2013). However, sedation by anesthesia providers using propofol is becoming more …

Effects Of A Comprehensive Bariatric Program Implementation On 30-Day Readmission And 30-Day Er/Infusion Clinic Visit Rates Due To Dehydration, Azra Kukic, Dnp, Rn, Cbn, Acm

Doctor of Nursing Practice Projects

Background: Program accreditation requires adherence to MBSAQIP standards to assist patient in making needed changes to his/her diet and lifestyle. However, literature provides conflicting information regarding the value of a comprehensive bariatric program accreditation and its effects on 30-day readmission and 30-day ER/infusion clinic visit due to dehydration development.

Objectives: To examine the effects of implementing a comprehensive bariatric surgical program on 30-day readmission rates, and 30-day emergency room (ER) and infusion clinic visit rates due to dehydration for bariatric surgical patients.

Methods: Our study was a retrospective separate sample pre-post intervention chart review. The data were collected before and …

A Retrospective Analysis Of Surgeon Estimated Time And Actual Operative Time To Develop An Efficient Operating Room Scheduling System, Pearly T. Brown, Dnp, Rn, Cnor

Doctor of Nursing Practice Projects

Problem: Surgical departments account for sizable budgets in hospitals. To ensure efficiency, optimal processes need to be maintained. The current practice for posting a surgical case is using surgeon estimated times (SETs), which only includes the reporting points of component 2 (C2) “incision” to “dressing.”

Objective: To analyze if there was a significant difference in minutes between actual operative times (AOT) and SET in patients undergoing outpatient general laparoscopic and inpatient orthopedic total joint surgery.

Methods: The facility is a level one trauma teaching center, with 371 beds, and a yearly surgical volume of 17,000 cases. This retrospective …

Exploring Experienced Nurses’ Views, Attitudes And Expectations Of Graduate Nurses In The Operating Theatre, Michelle Freeling, Steve Parker, Katrina Breaden

Journal of Perioperative Nursing

No abstract provided.

Surgical Consent And The Importance Of A Substitute Decision-Maker: A Case Study, Julia Gilbert, Brigid M. Gillespie

Journal of Perioperative Nursing

At law, all individuals are presumed to have the legal capacity to provide consent or refusal of treatment unless there are clinical indications of cognitive impairment. Once concerns are raised regarding the ability of an individual to provide valid consent for a surgical procedure, the use of a substitute decision-maker may be necessary. In this paper, we present an analysis of a clinical case study to illustrate the principles of valid consent. As part of the analysis, we discuss the issues relating to obtaining valid consent for an operative surgical procedure from an elderly client with obvious cognitive impairment. We …

Structured Communication Intervention To Reduce Anxiety Of Family Members Waiting For Relatives Undergoing Surgical Procedures, Kathryn Kynoch, Linda Crowe, Annie Mcardle, Judy Munday, Cj Cabilan, Sonia Hines

Journal of Perioperative Nursing

Perioperative nurses recognise that family members experience increased levels of anxiety during the wait for a relative undergoing a surgical procedure. It is often during this time that little or no meaningful communication occurs between family members and health professionals. It has been suggested that a structured information intervention has the potential to increase communication between families and health care professionals as well as decrease family members’ anxiety.

The aim of this study was to establish the effect of a structured communication program on anxiety of family members’ awaiting relatives undergoing surgical procedures. A quasi-experimental design was used with a …

Factors Influencing Preference For Surgical Choice Among Women With Early Stage Breast Cancer, Susan G. Yackzan

Theses and Dissertations--Nursing

Breast cancer is the most common cancer among women in the United States with over 60% of cases diagnosed as early stage disease. For those women without prohibiting clinical or cosmetic concerns, a choice between breast-conserving surgery and mastectomy can be made. Either choice confers equivalent survival. The decision-making process also involves consideration of recurrence risk as well as management of the unaffected, contralateral breast for both future surveillance and risk reduction. In recent years, increasing rates of mastectomy with contralateral prophylactic mastectomy have been reported among women with unilateral, early stage breast cancer. If eligible for a choice among …

Evaluation Of An Enhanced Recovery After Surgery (Eras) Pathway In Two Hospitals, Jennifer A. Janes

DNP Projects

OBJECTIVE: The purpose of this study is to evaluate the Enhanced Recovery After Surgery (ERAS) pathway utilized at two Norton Healthcare facilities for colorectal and gynecological surgeries. The specific aim is to examine the impact on patient outcomes, clinical effectiveness, and costs.

METHODS: This was a multi-center, pre-post implementation retrospective study of the impact of ERAS pathways on colorectal surgery patients at Norton Audubon Hospital (NAH) and gynecological surgery patients at Norton Women’s and Children's Hospital (NWCH). The sample included 399 patients including patients from both hospitals, pre- and post-ERAS.

RESULTS: The ERAS pathway lead to a significant reduction in …

Pediatric Emergence Delirium In The Postoperative Setting, Jennifer Miranda Snell

Walden Dissertations and Doctoral Studies

Emergence delirium (ED), also known as emergence agitation, is a postoperative condition characterized by aberrant cognitive and psychomotor behaviors following general anesthesia. The incidence of ED is 3 to 8 times higher in children 5 years of age or less. There is no standard of nursing practice for managing ED symptoms in the pediatric surgical population. The purpose of this quality improvement project was to address a gap in knowledge needed to inform clinical decision-making when managing ED in the postoperative setting. Using an educational presentation for post anesthesia care unit (PACU) nurses, this project introduced the use of non-pharmacological …