Perioperative, Operating Room and Surgical Nursing Commons^™

Digital Patient Engagement At A Perioperative Surgical Home Implemented Community Hospital, Srinivasan Sridhar, Amy Mount Hunter, Bernadette Mccrory

Patient Experience Journal

Patients in rural areas typically require more perioperative ‘optimization’ for surgery. The rural healthcare systems often overwhelmed with coordinating perioperative services and deliver less than optimal surgical outcomes. This is due to limited supporting microsystems and ability to effectively engage and track patients over the 120-day perioperative period to limit post-surgical complications. The study assessed longitudinal patient engagement within a newly established Perioperative Surgical Home (PSH) at a rural community hospital serving 10+ surrounding counties to identify barriers and best practices for engagement. A digital patient engagement platform was implemented and used to assess longitudinal patient outcomes and engagement from …

The Practice Environment For Nurse Anesthetists In Tennessee, Taylor Cathey, Jessica Hobbs, Matthew Owen, Alexis Varney, James Alberding, Tausha Alexander

Graduate Publications and Other Selected Works - Doctor of Nursing Practice (DNP)

Potential consequences of anesthesia provider shortages may include a reduction in health care access, poor patient outcomes, and increased costs to government funded agencies. Current leaders in the anesthesia profession need to establish a work environment that is embracing, supportive, and safe so that certified registered nurse anesthetists (CRNA) can remain healthy and productive. The purpose of this Doctor of Nursing Practice (DNP) scholarly project was to provide an overview of the current CRNA practice environment in Tennessee and advocate for policies to promote CRNA retention and enhance patient access to care. The overarching goal included gathering sufficient evidence regarding …

Nonpharmacological Interventions For The Reduction Of Post-Operative Pain After Ambulatory Surgery: A Systematic Review Of Randomised Controlled Trials, Kevin E. Tololiu, Jed Duff, Krisztina Csokasi

Journal of Perioperative Nursing

Aims: To examine the effectiveness of nonpharmacological interventions for the reduction of post-operative pain in patients undergoing ambulatory surgery (also known as day surgery).

Background: Post-surgical pain remains prevalent, especially in day surgery cases. When poorly managed, this acute pain can lead to chronic pain and delayed recovery. Nowadays, several nonpharmacological regimens are available for reducing pain after ambulatory surgery. Further investigation is required to assess the quality of these alternatives.

Design: Systematic review

Methods: An electronic search of PubMed, CINAHL (via EBSCOhost), Embase, and Cochrane library was undertaken to screen and assess the studies of nonpharmacological intervention in reducing …

Health Librarians As Part Of The Perioperative Care Team, Gemma Siemensma

Journal of Perioperative Nursing

Chances are you may never find a librarian in the operating suite, unless as a patient, but they do play a vital role in enabling the work of perioperative nurses. A perioperative nurse’s role can encompass a variety of tasks at the pre-operative, operative and post-operative stage and includes the daily use of information resources to ensure evidence-based practice (EBP) occurs. This article explores the role of health librarians in the perioperative environment and highlights resources and services that are offered to assist perioperative nurses.

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. …

Cesarean Skin-To-Skin Contact: Who Gets The Experience In The Operating Room?, Jessica S. Junk-Wilson

MSU Graduate Theses

For the past decade, skin-to-skin contact immediately after birth has been the general recommendation for all births, as there is evidence that it provides many benefits for mothers and infants. Yet, research has shown that immediate skin-to-skin contact is not the standard practice after most Cesarean births. This study assessed access, incidence, and circumstances surrounding Cesarean skin-to-skin contact (CSSC) in the operating room and examined influencing maternal characteristics of age, education, race, and number of births via a survey of 2327 people. Women who experienced a Cesarean section birth in the past 10 years were recruited through Facebook groups for …

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 …

Improving Nurse Anesthetist Intraoperative Handoff Process By Developing And Implementing An Evidence-Based, Facility-Specific Cognitive Aid, Jason Silva, Myron Arnaud

Journal of Nursing & Interprofessional Leadership in Quality & Safety

Miscommunication or non-transfer of pertinent patient information during intraoperative handoffs between anesthesia providers creates patient safety risks. An evidence-based facility-specific cognitive aid was developed and introduced to nurse anesthetists in an anesthesiology department of a large academic hospital with the aim of improving the intraoperative patient handoff process. The program used a handoff cognitive aid that addressed five pertinent patient information points. A secondary measure was evaluation of provider satisfaction. Twenty-four nurse anesthetists utilized the handoff cognitive aid during handoffs in the course of a 4-week pilot program. Eighty-eight nurse anesthetist handoffs were observed (23 with and 65 without the …

Developing Cultural Competency In Anesthesia Through Student Registered Nurse Anesthetists, Emma To

Doctoral Projects

Certified Registered Nurse Anesthetists (CRNAs) are the main anesthesia providers in over 70% of rural hospitals providing anesthesia. Each year, over 2,000 student registered nurse anesthetists (SRNAs) graduate and continue as licensed CRNAs. This Doctor of Nurse Practice (DNP) project emphasizes the importance of developing culturally competent providers in anesthesia by promoting early outreach in cultural competence education of SRNAs. Cultural competence is described as possessing characteristics of congruent attitudes, awareness, and conduct that provides and enables effective skills in cross-cultural encounters. Encompassing cultural competency education early in the SRNAs profession may provide valuable lifelong cultural skills that will benefit …

Individualizing Care For Pediatric Patients With Autism Spectrum Disorder In Perioperative Services, Erin Scheller

Master's Theses

This research explores solutions for individualizing and improving care for pediatric patients with Autism Spectrum Disorder in the Perioperative Setting of an Outpatient Surgery Center. Specifically, it seeks to determine if providing parent and staff resources on Autism Spectrum Disorder is significantly helpful in increasing confidence in the staff by the parents and the staff themselves. Participants included thirty-five surveyed families who had pediatric patients visiting perioperative services and staff who work on the unit. Methods used include information dissemination with the use of printable and online evidence-based resources, an in-person education event for staff, and a pilot study of …

Human Factors Applied To Perioperative Process Improvement, Joseph R. Keebler, Elizabeth H. Lazzara, Elizabeth Blickensderfer, Thomas D. Looke

Publications

• Human factors/ergonomics (HF/E) is its own scientific discipline that can be applied to understanding performance in perioperative medicine.
• Humans are not perfect decision makers and are affected by a variety of factors that can greatly harm their ability to perform, including attention, bias, stress, and fatigue.
• HF/E has a unique perspective on human error, and HF/E can illustrate how moving away from blame can enhance safety.
• HF/E offers strategies for undertaking a systematic approach to assessment of work processes in perioperative medicine that can be used to increase safety and wellbeing of patients and providers.

Increasing Student Registered Nurse Anesthetists Clinical Self-Efficacy Using Peer Mentoring, Megan Christine Bass

Doctoral Projects

The purpose of this project is to determine if clinical self-efficacy is increased in SRNAs at The University of Southern Mississippi after participation in the peer mentoring program. The project was a one-group pre and posttest design in a sample of SRNAs who received peer mentoring. To evaluate the students’ perceived clinical self-efficacy before and after the peer mentoring educational intervention, the Rowbotham and Schmitz Student Self-Efficacy scale (SSE) (2013) was adapted and administered to second-year SRNAs (N=17). Clinical performance, skill and knowledge development, social interaction with clinical faculty, and coping with clinical stress are the four areas evaluated by …

Multicenter Handoff Collaborative, Philip E. Greilich, Joseph R. Keebler

Publications

Communication and team-based care are at the heart of patient safety. As anesthesia professionals, we witness this at its very best and worst when transferring patients to and from the operating room (see article by Dr. Lorinc on types of transfers in this issue). In response, we have an opportunity to take a leading role in redesigning the most ubiquitous teaming event in hospitals in a manner that promotes team-based behaviors. The impact of unreliable handoffs on communication failures and medical errors is well known. To combat this issue, mandates by The Joint Commission (TJC) in 2006 and the American …

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 …

An Experience Of Practitioners Navigating The Role Of Patient/Caregiver, Susan M. Shaw, Rain Lamdin

Patient Experience Journal

This journey involved one of us having (repeat) intraspinal surgery in a country far from home but of a similar culture and with the same first language. The carer travelled across the world to be present during the hospital stay. We kept a journal during our admission, and following discharge realised there were significant differences between how we had documented our experience and the record presented in the clinical notes. The particular examples we present illustrate the relationships, rules and issues that we navigated. We share our experience in the form of moments from our journal, some of them alongside …

Psychological Distress And Cardiac Disease, Tracey Vitori

Theses and Dissertations--Nursing

The purpose of this dissertation was to evaluate the association of psychological distress with cardiac disease, events, and mortality. Specific aims were to: 1) to evaluate the association between hostility level and recurrence of acute coronary syndrome (ACS) and all-cause mortality in patients with coronary heart disease (CHD); 2) to evaluate the psychometric properties of the Brief Symptom Inventory (BSI) hostility and anxiety subscales in a group of incarcerated participants at high risk of cardiovascular disease; and 3) to evaluate the association of patient and caregiver psychological state with quality of life in both patient and caregiver, and postoperative complications …

Utilization Of A Focus Group To Evaluate The Perceived Stress Levels And Coping Mechanisms Of Student Registered Nurse Anesthetists, Cillora Hicks

Doctoral Projects

Each year, thousands of Student Registered Nurse Anesthetists (SRNAs) matriculate into a nurse anesthesia educational program, confronted with unforeseen challenges and stressors. Although a certain amount of stress is essential to stimulate learning, excessive stress can have dire consequences in delaying a students’ academic and clinical progression. The purpose of this Capstone Project was to explore and describe the perceptions of 12 SRNAs relevant to their stress levels and coping behaviors in the management of academic and personal stress. The clinical research questions guiding the study examined the stress levels and coping behaviors of the SRNAs as measured by the …

La Cesárea Y El Parto Natural: Las Opiniones De Profesionales De La Salud En La Provincia De Buenos Aires / Cesarean Section And Natural Birth: The Opinions Of Health Provinces In The Province Of Buenos Aires, Jacqueline Chipkin

Independent Study Project (ISP) Collection

Introduction: The ways in which women of society give birth have the power to influence maternal-infant health and shape the economy of the healthcare system. Today, the rates of cesarean sections are increasing throughout the world. In Argentina, on average, more than 35% of pregnant women received cesarean sections in 2008, with large differences observed in the rates between the public and private health sectors. The World Health Organization (WHO) has established that healthcare systems should only employ a cesarean section if labor cannot progress safely. According to this standard, the organization estimates that cesarean sections should only be utilized …

Comparison Of Housed And Homeless Patients With An Orthopedic Diagnosis, Susan M. Williams

Electronic Thesis and Dissertation Repository

Studies on homelessness have shown that people who are homeless are admitted to hospital more frequently, for longer periods of time, and at a younger age than people who are housed. Once admitted to hospital, discharge planning is difficult and resource intensive, often leading to discharge back to the streets or a shelter. This puts this population at risk for complications and readmission. Although people who are homeless are prone to orthopedic injuries, there is no research on the outcomes of patients who are homeless with orthopedic injuries. This retrospective, case control study, based on the social determinants of health, …

Hospital Loneliness And The Patient-Physician Relationship: A Preliminary Analysis Of Associations With Recovery In Bone Marrow Transplant Patients, Lindsay E. Balfour

UNF Graduate Theses and Dissertations

The purpose of the present study was to examine general loneliness, hospital loneliness, and the patient-physician relationship in regards to their associations with Bone Marrow Transplant (BMT) recovery outcome variables (days until engraftment and quality of life). Fifteen (66.7% female, 33.3% male; 93.3% white, 6.7% Black/African American; average age 61.73) individuals who had an allogeneic or autologous BMT at The Mayo Clinic of Jacksonville completed the FACT-BMT, UCLA-Loneliness Scale Version 3, the CARE Measure, and provided disease and treatment information at the 6 month posttransplant date (+/- 30 days). Patients recovering from BMT indicated significantly higher scores of hospital loneliness …

Sleeping In Safety: A Study Of Nurse Anesthetists In Ghana, Lauren Kasparian

Inquiry Journal 2011

No abstract provided.

A Comparative Study Of Discomfort Experienced By Surgical Patients On Three Selected Postoperative Days, Lillian Barker Bartlett

Loma Linda University Electronic Theses, Dissertations & Projects

A descriptive survey was conducted to compare the discomfort experienced on three selected postoperative days to determine if there is one day identified by the patient as the most uncomfortable and to assess the symptoms of which he might complain. A checklist of twelve symptoms common to postsurgical patients was administered on the evenings of the second, third and fourth postoperative days by the researcher. Findings indicated that nineteen or 56 per cent of the thirty-four patients interviewed stated that the second day was most uncomfortable, nine or 27 per cent the third and six or 17 per cent the …

Effects Of Music Therapy And Personal Interaction On The Preoperative Patient, Phyllis Jean Nix

Loma Linda University Electronic Theses, Dissertations & Projects

This study was conducted to discover the effects of (1) an interpersonal relationship and (2) an interpersonal relationship and music therapy on preoperative patients in a selected hospital.

The descriptive survey was chosen as the method of study. A checklist and a tape recording of selected music were used as a tool of research. Two groups of preoperative patients were given nursing care by the researcher. Patients in Group One received care with an aim toward developing an interpersonal relationship, while patients in Group Two received the same as Group One with the addition of music therapy.

Findings revealed a …