Perioperative, Operating Room and Surgical Nursing Commons^™

Two-Year Retrospective Evaluation Of Frailty To Optimize Postoperative Spinal Fusion Outcomes In Adults Aged 65 And Older, Sheri Loo

Doctoral Projects

Many older adults over the age of 65 have both spinal stenosis requiring spinal fusion surgery and frailty. As life expectancy has increased, many older individuals will undergo elective spinal fusion surgery to decrease their chronic pain in pursuit of improved quality of life. There is currently an underutilization of frailty screening for risk stratification of postoperative complications. A retrospective chart review over a two-year period from July 2023 to June 2025of adults aged 65 and older who underwent posterior spinal fusion surgery, involving 126 participants, was completed. We assessed the correlation between frailty and postoperative outcomes, discharge disposition, and …

The Influence Of Perioperative Education On Postoperative Digestive Restoration, Christian Cedeno

Doctor of Nursing Practice Scholarly Project

The human body often needs encouragement to return to its natural state of functioning following intraoperative and postoperative drug therapy. Anesthesia can sedate the gastrointestinal tract and frequently requires medical and physical interventions to allow the body to return to full functionality. There are several methods thought to be beneficial in overcoming of this condition, and some have proven their significance more so than other methods. This project seeks to measure the power-of-knowledge methodology via a chart review of individuals specifically educated on what they can expect in the postoperative phase of care compared to those that receive routine education. …

African-American Perceptions On The Importance Of Racially-Concordant Care, John Moya

Nursing | Senior Theses

Racial concordance is defined as a relationship in which a healthcare provider and patient share the same race. Racially concordant care has been, in previous research, associated with improved health outcomes, particularly in minority populations such as African-Americans Despite this, little is known about how African-American patients perceive racial concordance, and how important it is to their care. The focus of this research proposal is to determine the perceptions of African-American patients on racial concordance and racially concordant care, and how important they deem it to be to their care. The literature review delves into racial concordance and its presence …

Implementing Noninvasive Capnography Monitoring To Enhance Early Recognition Of Postoperative Respiratory Decline In High-Risk Patients: A Quality Improvement Project, Trevor A. Messenger

Graduate Theses, Dissertations, and Problem Reports (ETD)

Abstract

Implementing Noninvasive Capnography Monitoring to Enhance Early Recognition of Postoperative Respiratory Decline in High-Risk Patients: A Quality Improvement Initiative

Trevor Messenger

Background: Those suffering from chronic respiratory disease, obstructive sleep apnea (OSA), obesity, and other serious comorbidities are at an increased risk of respiratory decline after receiving general anesthesia. Respiratory decline leads to adverse outcomes, including increased hospital length of stay, intensive care unit (ICU) admissions, morbidity, and mortality.

Purpose: To improve the safety of postoperative patients at risk for OSA, and to reduce adverse events and airway interventions by enhancing the monitoring capabilities of bedside clinicians with waveform …

Racial Concordance Perceptions Of Post-Op African-American Patients, John-Ezekiel Moya

Nursing | Student Research Posters

African-Americans have historically faced significant health disparities, which persist due to implicit racial biases and a lack of cultural competency among non-Black healthcare providers. These disparities often result in poorer health outcomes and diminished patient satisfaction. One potential factor in mitigating these issues is racial concordance, the alignment of racial identity between patients and providers (Jetty et al., 2022). However, only 6.3% of the nursing workforce identifies as Black or African-American (Smiley et al., 2023), limiting opportunities for racially concordant care. While racial concordance may foster trust, communication, and comfort in healthcare settings, research on its importance to African-American Patients—especially …

Improving Quality Of Documentation In Perianesthesia Care Units To Increase Nurse Satisfaction And Patient Safety: A Quality Improvement Project, Anja Novcic

Master's Theses and Capstones

Abstract

Background: Quality documentation in healthcare settings is essential to ensure nurse satisfaction and patient safety. Documentation templates for patient charting should be in a format that follows best practice nursing care and captures all necessary assessments and interventions ordered by providers for patient care. A quality improvement was conducted in a PACU to evaluate the nurse satisfaction with the use of a new and revised documentation template for pain block procedures.

Local Problem: Within the perianesthesia care unit (PACU) of a Same Day Surgery center, a problem was identified regarding the nurse dissatisfaction with the template in place for …

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 …

Best Practice For Post-Operative Surgical Site Infection Prevention, Scott Cavinder

Evidence-Based Practice Project Reports

It is estimated that 300 million surgical procedures take place annually throughout the globe (Gillespie et al., 2021). However, the incidence of surgical site infections (SSI) developing in surgical patients within 30 days of surgery have been estimated to be upwards of 11% (Gillespie et al., 2021). The purpose of this evidence-based practice project was to address the PICOT question: In patients who have undergone cardiothoracic or vascular surgery (P) does implementation of an evidence based post-operative care bundle (I) as compared to current clinical agency practice standards (C) result in a decrease of SSI (O) over a 12-week period …

Perioperative Pain Control: Evaluating Best Practices In Perioperative Pain Measures, Lisa M. Malakowsky

Doctor of Nursing Practice Projects

Background

Postoperative pain is contributing to the nation's opioid epidemic. Pain is an unpleasant sensation felt by the patient. When it is experienced postoperatively, it is a result of the surgical process. Patients up to 80% worldwide state that their pain is not controlled to their satisfaction. When postoperative pain is not treated adequately, it can contribute to chronic pain.

Purpose

Perioperative pain assessment and treatment policy at a rural critical access hospital and compare it to evidence-based guidelines for best practice. The project assessed the patient's pain treatment effectiveness compared to the pain management policy by using the CDC …

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 …

The Association Of Prescription Opioid Exposure And Patient Factors With Prolonged Postoperative Opioid Use In Opioid Naive Patients, Jennifer Lanzillotta

Electronic Theses and Dissertations

Background

Research suggests prolonged postoperative opioid use occurs in 4-13% of opioid naïve patients and is related to factors other than surgical pain. However, it is unclear which patient factors and prescribing practices are associated with prolonged use after surgery among opioid naïve patients.

Objectives

To identify factors associated with prolonged postoperative opioid use (refills 90-180 days after surgery) in opioid naïve patients in two domains: specific patient characteristics (demographics, smoking status, comorbidities, etc.) and exposure through postoperative opioid prescriptions (in oral morphine milligram equivalents [OME]).

Methods

An electronic medical record dataset analysis of inpatient and outpatient opioid naïve adult …

Predicting Arterial Oxygen Desaturation Events Via Patient Journal And Pulse Oximetry Data In Postoperative Ambulatory Surgery Patients, Charles R. Elam Iv

Theses and Dissertations

Associations between patient and procedural factors on the nature and quality of the immediate in-home recovery from anesthesia following ambulatory orthopedic surgery are unknown. Further, there is a paucity of outcomes research quantitatively categorizing in-home

patient recovery and safety following discharge from same-day orthopedic procedures. Tools are available, however, to shed light on outcomes in this population, and integration of such available measures is critical.

Ambulatory orthopedic surgery is a burgeoning specialty, with growth expected over the foreseeable future. The expected increased patient caseload subsequent to implementation of the Affordable Care Act and aging Baby Boom generation suggests greater morbidity …

Adoption Of Perioperative Lidocaine Infusion For The Reduction Of Postoperative Pain, Brandon Scott Figueiredo

Doctoral Projects

Laparoscopic capability provides numerous benefits to patients requiring abdominal surgical procedures. However, the use of these techniques has presented the anesthesia provider with a unique set of challenges in terms of perioperative management and postoperative pain reduction. No standardized method has existed to reduce postoperative pain and improve recovery following these procedures. There were three primary goals of this project. The first goal was to conduct a meta-analysis of randomized controlled trials to determine the benefit of the use of intravenous lidocaine infusions to reduce postoperative pain in laparoscopic abdominal surgery. Twelve articles were included in the meta-analysis that pertained …

Postoperative Pain Management, Taylor H. Schuler

Senior Honors Projects, 2010-2019

This literature review examined two pharmacological forms of postoperative pain

management and one nonpharmacological intervention to help reduce pain (See

Appendix A). Sources were gathered from the nursing research databases of

Cumulative Index to Nursing & Allied Health Literature (CINAHL) and PubMed.

Articles and studies between 2004 and 2015 were analyzed to write the review. The

focus was to look at postoperative patients and determine if epidural or patient

controlled analgesia (PCA) provided the same satisfaction for individuals who

underwent surgery. In addition, music therapy was researched to explore the effects

of listening to a pleasurable sound and how it …

The Effect Of Telephone Follow-Up On Pain Experienced By Patients After Knee Replacement Surgery, Laurie J. Jones

Evidence-Based Practice Project Reports

Hospital length of stays are decreasing throughout the U.S. in an effort to contain healthcare costs, but these measures can be detrimental to patients. Those who get knee replacement surgery are finding their length of stay reduced from an average of 3 to 4 days to 24 to 48 hours, which can affect pain control and interfere with rehabilitation and recovery. This affects many people, as more than 632,000 knee replacements occur each year (American Academy of Orthopedic Surgeons, 2008). The purpose of this evidence-based project was to evaluate the effect of telephone follow-up on pain experienced by knee replacement …