Perioperative, Operating Room and Surgical Nursing Commons^™

Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens

Doctor of Nursing Practice Scholarly Projects

Postoperative breastfeeding recommendations for lactating mothers by anesthesia providers are inconsistent and often inaccurate. Inappropriate recommendations have led to withholding of breastmilk to the infant, unnecessary disposal of breastmilk, surgical delay, exposure of an infant to high levels of drugs in breastmilk, and early cessation of breastfeeding. The purpose of the scholarly project was to develop a set of evidenced-based practice guideline recommendations and a proposed implementation plan for anesthesia providers to use in support of breastfeeding mothers who recover from surgery. Many studies in the literature indicate that there are inconsistencies in postoperative breastfeeding recommendations by anesthesia providers. When …

Robotic Team High Reliability Organization’S Communication Evaluation Tool, Joanne F. Mercurio

Regis University Student Publications (comprehensive collection)

Multidisciplinary team communication in robotic surgery presents several safety considerations for the intraoperative surgical patient. It is an important consideration since the surgeon and the operating room team are geographically distanced with the surgeon at the console, and the other team members situated at the patient bedside. Scrubbed team members are performing such functions as positioning the robotic arms as well as exchanging instruments, while the remaining interprofessional team members are coordinating multiple patient care activities. It therefore becomes imperative that the recognition of the potential for miscommunication is of paramount importance, and strategies need to be generated that will …

Development Of A Fall Prevention Bundle With Evidence-Based Tools For Hospitalized Adults, Kelly A. Tirone

Master's Projects and Capstones

Problem

One million hospitalized people fall annually in the United States, and up to a third are preventable.

Context

Data from an acute care hospital show one medical-surgical unit reported eight patient falls in 2021, two causing major harm that reached sentinel event criteria.

Interventions

A Clinical Nurse Leader (CNL) leveraged the unique CNL skill set and characteristics of Human-Centered Leadership to engage in horizontal leadership, injury prevention, and team coordination through authentic human connection. The team leveraged documentation for improved fall risk communication. Unavoidable disruptions hindered other planned interventions.

Measures

Outcome measures observe for total fall count and the …

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 …

Using Safety Checklists Outside Of The Operating Room, Annabelle Gerhardt

Doctor of Nursing Practice Scholarly Projects

Abstract

The use of a Time Out checklist for patient safety in non-operating room procedural areas is equally important for positive patient outcomes as in the operating room (OR). In this busy southwestern United States hospital, the procedural teams in the non-operating room areas were reported to not be fully engaged during the performance of the Time Out pre-procedural pause prior to gastroenterological (GI) procedures. This study was conducted to improve compliance with the scripted Time Out checklist and promote full engagement of the GI procedural team during the Time Out thus reducing risks of wrong site surgery. Literature has …

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.

Monitoring Patient Safety In The Recovery Room, Gail Davis

Dissertations

Respiratory depression is a serious complication after surgery. Early detection is a major patient safety concern for recovery room personnel as patients recover from anesthesia and experience pain. The opioids used for pain management may contribute to over-sedation effects and respiratory depression. Vital signs and pulse oximetry are standard postoperative monitoring procedures. End-tidal capnography and arterial blood gases may augment the standard-of-care procedures but may not be effective at detecting early respiratory depression. The purpose of this study was to generate baseline data trending patient safety variables and outcomes for postoperative patients using standard monitoring with standard-of-care plus transcutaneous capnography …

Application Of The Patient Checklist Tool In Anesthesia Handoffs, Theresa Durley

Doctor of Nursing Practice Scholarly Projects

Accurate and essential communication is required during the transfer of patient care from one health care provider to another. Communication errors during the handoff process have been identified as contributing factors in sentinel events. There is a plethora of literature supporting a standardized transfer of care process as well as several accepted handoff communication tools for the various units within a healthcare institution. However, in the anesthesia domain, there is currently only one protocol specifically created for the transfer of patient care between certified registered nurse anesthetists (CRNAs). The PATIENT protocol, created by Dr. Suzanne M. Wright, CRNA, PhD (2013) …

Use Of A Handoff Communication Tool Between Certified Registered Nurse Anesthetists, Anesthesiologists, And Post Anesthesia Care Unit Nurses, Rachel Louise Johnson

Doctoral Projects

Ineffective communication in the post-anesthesia care unit (PACU) is considered to have incidences of increased error, mortality, morbidity, which leads to decrease patient outcomes and quality of care. Therefore, the purpose of this study was to introduce a structured, standardized, and consistent handoff tool to Certified Registered Nurse Anesthetists (CRNA), Anesthesiologists, and Post Anesthesia Care Unit Nurses (PACU) that may result in favorable perception of usage. Without a structured handoff tool, the organization risks the occurrence of increasing errors when the message is not transmitted effectively and efficiently every time. Distractions leave the handoff susceptible to a breakdown during the …

Improve Intra-Operative Nurse-To-Nurse Communication Using A Safety Checklist, Silvinita Tadeo Rowe

Doctoral Projects

Poor and inadequate handoff, or transfer of care of the surgical patient care from the primary to the relief operating room registered nurse circulators, can result in irreversible patient harm, or sentinel events, such as retained foreign items. In this study, Rogers' diffusion of innovation theory was the framework for implementing the handoff safety checklist. Also, Donabedian's structure process and outcome was the model to investigate the feasibility, acceptability, and improvement in the quality of patient handoff communication and improvement of nurse satisfaction over time. Nineteen-statement surveys, conducted at multiple timeframes, were completed by volunteer operating room nurse participants. In …