Perioperative, Operating Room and Surgical Nursing Commons^™

Dnp Final Report: An Evidence-Based Initiative To Improve Bowel Preparation Quality For Colonoscopy, Jennifer L. Gassett

DNP Final Reports

Good colonic bowel preparation (CBP) is an important component of colonoscopy but is often inadequate. Improving CBP can help increase detection of precancerous polyps, prevent procedures from being canceled or repeated, and decrease medical expenses. A quality improvement project was implemented to increase adequate CBP rates at an ambulatory surgery center specializing in endoscopy. Several factors correlate with suboptimal CBP, but the practice question focused on patient education. The PICOT question guiding evidence synthesis was posed: In adult patients preparing for outpatient colonoscopy, how do revised instructions with visual aids compared to written instructions affect CBP adequacy and patient satisfaction? …

Dnp Final Report: Double Gloving As Part Of The Surgical Site Infection Prevention Bundle For Colorectal Surgeries, Dave P. Calubaquib

DNP Final Reports

Surgical site infection (SSI) is the costliest healthcare-acquired infection that encompasses around three to ten billion dollars annually. The costs do not include the societal challenges and personal losses that patients endure when they have SSI. The evidence-based project revolves around decreasing SSI among colorectal surgical patients with a PICOT question: In patients having colorectal surgery, how does an educational project regarding double gloving for reducing SSIs, compared to no educational project, improve compliance rates for double gloving? The evidence recommends that double-gloving techniques among surgical members (surgeon, surgical assistant, and scrub techs/nurses) during surgery prevent SSI. The project utilized …

Evidence-Based Pain Management With Inclusion Of Music Therapy For Post-Surgical Patients: A Benchmark Study, Ashleigh Rowan

MSN Capstone Projects

Improper pain management in the postsurgical patient can delay proper healing, increase frustration for the patient, and prolong hospital stays (Córcoles-Jiménez et al., 2021). Moderate to severe pain can pose a greater risk for complications such as deep vein thrombosis, pneumonia, and delayed recovery (Kolaczko et al., 2019). Music therapy is an underutilized pain intervention in the PACU environment. Music therapy has been shown to lower pain and anxiety scores in many different clinical settings (Lee et al., 2017). Pain management can radically improve a patient’s outlook and recovery (Luo & Min, 2017). Patients who return to wakefulness and receive …

Massive Transfusion And Shock Index, Kasey House

MSN Capstone Projects

Hemorrhagic shock is one of the leading causes of preventable death in military trauma patients. Literature shows that pre-hospital transfusions of blood products within the combat environment have shown to have a greater likelihood of survival. This has produced a challenge in the pre-hospital setting to have a standardized method of predicting the patient’s need for a massive transfusion. In the last few years, the development of a Massive Transfusion Protocol (MTP) has become the standard to quickly deliver blood products to actively bleeding patients. Every minute waiting to administer blood products increases mortality by 5%.

While initiating an MTP …

Perceptions And Awareness Of Operating Room Staff Regarding Surgical Smoke: Implications For Safety And Health, Karla Flores

MSN Capstone Projects

In the ever-evolving landscape of modern medicine, surgical procedures have become increasingly complex and reliant on energy-based devices, leading to the ubiquitous presence of surgical smoke in ORs. This phenomenon, while a byproduct of technological advancement, poses significant concerns regarding the health and safety of OR personnel, including surgeons, nurses, anesthesiologists, surgical technicians, and ancillary staff. This paper presents a meticulous examination of the multifaceted impacts of surgical smoke, emphasizing the urgency for comprehensive intervention and systemic change.

Robot Revolution: Impacting Adoption Of The Technology, Cece Noland

MSN Capstone Projects

The author examined the value of robotic guidance platforms in spine surgery, and then implemented an improvement project to positively impact internal (Medtronic employee) adoption of the technology. By promoting adoption, robotics will continue to advance the standard of care for spine surgery patients. This paper is to meet fulfillment of requirements for NURS5382 Capstone.

Dnp Final Report: Multimodal Pain Management To Improve Patient Satisfaction In Total Joint Replacement Patients, Dana A. Carns

DNP Final Reports

Pain is a costly result of total joint replacement (TJR) surgery. The effect of pain can extend not only to chronic medical problems for patients but also to the hospital’s bottom line by decreasing patient satisfaction. A systematic literature search was performed, and evidence was appraised that supported the efficacy of a standardized multimodal pain management protocol to decrease pain and improve satisfaction in TJR patients. The evidence-based multimodal pain management protocol was implemented during a one-month period in patients undergoing total knee or total hip replacements. Key outcomes were examined and compared to the body of evidence and to …

Dnp Final Report: Physical Activity In Bariatric Surgery Patients: An Evidence-Based Quality Improvement Project, Amber Buehler

DNP Final Reports

Background: Research evidence supports that increasing physical activity has been shown to reduce weight and prevent weight regain after bariatric surgery. There is currently no specific exercise recommendation or program at the Center for Metabolic and Weight Loss Surgery at Dallas.

Objective: To implement an evidence-based project surrounding physical activity to reduce weight regain in patients 12 months post bariatric surgery.

Methods: The 12-week program will consist of 3 times weekly 1 hour virtual exercise classes led by the Nurse Practitioner and/or Nurse. Patients will be screened for current physical activity via survey using the IPAQ at the beginning and …

Standardizing Surgical Skin Antisepsis, Crystal Vackar

MSN Capstone Projects

Skin antisepsis is one of the most critical factors for preventing postoperative surgical site infections, but with the lack of high-quality research, the choice of which preoperative skin antiseptic is best remains a puzzling problem for clinicians (Chen, Chen, Guo, & Xu, 2020). Minimizing the patient’s risk of a surgical site infection by removing skin contaminants at the surgical site is the goal of surgical skin antisepsis. Therefore, the hospital or organization must choose the right product that is cutting costs, is the most effective, saving surgical time, and has the safest results for the patient. Before prepping the skin, …

Bedside Shift Reporting: A Benchmark Project, Clydea C. Hale

MSN Capstone Projects

Patient care is forever changing to improve satisfaction, safety, and overall treatment. Over the past few years, patients and their families are more invested in their overall care in the hospital and expect to be informed every step of the way. A common complaint from patients or their families is that one nurse or staff did not know the individuals care or treatment plan, there were no shift goals to work toward discharge, and the nurse did not update the patient/family with changes in care. All of these complaints along with the patient satisfaction scores and communication between the treatment …

Deterring Delirium In The Intensive Care Unit, Kimberly Allen

MSN Capstone Projects

There is growing concern about the increase in cases of delirium associated with a critical care hospitalization encounter. Discovery of different types of research that can eliminate or at least minimize occurrences of delirium including early recognition, eye masks and earplug usage, and environmental changes have show promise in reducing the risk of ICU delirium.

Standardizing The Superior Preoperative Skin Antiseptic, Marissa Eckeberger

MSN Capstone Projects

Preoperative skin antisepsis is a critical component in the prevention of surgical site infections. Evidence has shown Chlorhexidine to be more effective than Povidone Iodine as well as any other agent, therefor it should be a standard of care for surgical patients. Patients expect to receive exceptional care and have good quality outcomes. Surgery is a means to resolve patient problems, not to develop new ones. Not having a standardized process in place means that patients are subject to receiving substandard care based on which surgeon they have and the surgeon’s preferences. Surgical nurses may be a part of two …

Influence Of Resilience, Emotional Intelligence, And Teamwork On Registered Nurse Circulator Intent To Leave, Mary Alice Anderson

Nursing Theses and Dissertations

Registered Nurse (RN) circulator attrition is detrimental to the future of the nursing profession. The high average age of perioperative nursing leaders and high intent to leave of younger nurses in the perioperative setting leads to a high vacancy percentage and high expense to retrain and recruit nurses. The purpose of this dissertation was to explore the influence of resilience, emotional intelligence (EI), and teamwork on intent to leave RN circulator positions in full-time nurses who are members of the Association of periOperative Registered Nurses (AORN). Understanding factors that influence RN circulators’ intent to leave is key to developing interventions …

Dnp Final Report: Enhancing Nurses' Knowledge On Opioids To Promote Safe Opioid Use In Post-Operative Patients: An Evidence-Based Practice Project, Amardeep Gill

DNP Final Reports

Pain control remains suboptimal in the United States, while the use and misuse of opioids are growing. Opioid use disorder and opioid misuse are associated with an increased risk of postoperative mortality and morbidity. The Centers for Disease Control and Prevention reported more than 232,000 deaths from a prescription opioid overdose from 1999 to 2018. The economic burden related to prescription opioid misuse in the United States is $78.5 billion a year. According to the literature, lack of knowledge makes patients vulnerable to misuse and nonmedical use of opioids. This lack of patients’ knowledge and over-prescription of opioids are among …

Post Operative Handoff Tool Benchmark Project, Savannah E. Vinson

MSN Capstone Projects

According to a sentinel event statement issued by The Joint Commission in 2017, inadequate hand-off communication is responsible for many adverse-events, including sentinel events in healthcare. A study released in 2016 estimated that communication failures in U.S. hospitals and medical practices were responsible at least in part for 30 percent of all malpractice claims, resulting in 1,744 deaths and $1.7 billion in malpractice costs over five years(The Joint Commission [TJC], 2017). Successful handoff communication has the potential to substantially improve patient safety when leadership displays their commitment to successful handoff, when handoff is standardized and done face-to-face between healthcare providers, …

Dnp Final Report: Practice Change Compliance, Laura Duran

DNP Final Reports

Healthcare professionals in acute care hospital settings at the frontline of patient care affect many aspects of the patient's hospital stay, including infection prevention. The wearing of artificial nails by healthcare professionals in direct patient care is against best practice, although it is often seen. Therefore, the following PICOT question arises: In direct patient care providers who fail to adhere to policy (e.g., artificial nail use per hand hygiene policy) (P), how does a multimodal approach (I) compared to a single approach (education) (C) affect compliance with policy (0) within six months (T)? A systematic review was conducted using CINAHL, …

Standardized Bedside Report During The Transfer Of Care, Lauryn Fanning-Goff

MSN Capstone Projects

Optimization of our communication processes can prevent multiple adverse/sentinel events that will also prevent the organization from potentially being held liable to cover those costs. The use of a standardized form of handoff is supported by literature as a way to ensure critical information is not omitted. Completing the report at bedside allows the patient and family to be involved in care, improve patient safety, and enhance patient satisfaction scores (Baldwin & Spears, 2019). Because of this, the PICOT question is: “In staff nurses on a pediatric surgical unit (P), how would a standardized bedside report during the transfer of …

Huddle And Safety, Jaelynn Hall Bsn, Rn

MSN Capstone Projects

The purposed evidence-based practice (EBP) project focuses on a nursing intervention (team huddles) to increase safety and reduce inpatient fall rates. Negative outcomes to consider from an inpatient fall are harm and injury to the patient along with increased health care cost for the patient as well as hospital facility. Accrued cost associated with an in-patient injury resulting from a fall is not reimbursed according to the Centers for Medicare and Medicaid Services. The additional cost for hospital-acquired falls is estimated to be $6,694 (95% CI: -$1,277 to $14,665) (Agency for Healthcare Research and Quality, 2017). This was only related …

Controlled Donation After Circulatory Death: Benchmark Study, Marilyn R. Strait

MSN Capstone Projects

Abstract

In potential organ donors after circulatory death (P), does the utilization of an evidence-based critical pathway from identification of potential donor to organ donation (I) versus no utilization of an evidence-based critical pathway (C) increase the rate of organ procurement and the satisfaction of donor families with the donation process (O)? A benchmark study was conducted to answer this question, and in short, yes, it does. The utilization of a critical pathway, when individualized to a local population and hospital’s organization increases the organ procurement rate, the donor family satisfaction with the process, and increases staff satisfaction with the …