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Perioperative, Operating Room and Surgical Nursing Commons

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Breastfeeding After Maternal Anesthesia: A Guideline Development, Megan Berens 2023 Otterbein University

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 ...


Development And Implementation Of An Evidence-Based Practice Guideline Regarding Cricoid Pressure, William Carson II 2023 Otterbein University

Development And Implementation Of An Evidence-Based Practice Guideline Regarding Cricoid Pressure, William Carson Ii

Doctor of Nursing Practice Scholarly Projects

Cricoid pressure (CP) has been a standard of practice since the 1960s. The purpose is to reduce aspiration of gastric content into the lungs in high-risk patients undergoing induction of general anesthesia. Aspiration has been identified as the most common cause of airway-related mortality for patients undergoing general anesthesia. The cause of airway-related mortality can be correlated to the application of CP. Incorrect application of CP may lead to adverse clinical events and outcomes. It has been demonstrated that when administering CP in a simulation-based environment, providers are applying pressure to the incorrect anatomical location and/or applying the incorrect ...


Factors Impacting Organ Transplant Outcomes, Katelyn Grubich 2022 Dominican University of California

Factors Impacting Organ Transplant Outcomes, Katelyn Grubich

Nursing | Senior Theses

Organ transplants are crucial to the survival of those on the receiving end. With medicine advancing, so has transplantation. Health care providers are becoming more aware of the strategies necessary to prolong the transplanted organ and how to obtain better outcomes. Heart, lungs, kidney, liver, pancreas, and some where more than one organ are involved, are the types of organ transplants performed.

Providing patients information will allow them to be a part of their treatment and can help to ease their anxiety knowing what is being performed and what can be expected. Health care providers must ensure that patients and ...


An Evidence-Based Teaching Plan To Increase Awareness Of Certified Registered Nurse Anesthetists To Patient Safety Threats Due To Provider Fatigue And To Offer Effective Strategies To Mitigate Fatigue, Tieneasha Hines, Lisa Alexander 2022 La Salle University

An Evidence-Based Teaching Plan To Increase Awareness Of Certified Registered Nurse Anesthetists To Patient Safety Threats Due To Provider Fatigue And To Offer Effective Strategies To Mitigate Fatigue, Tieneasha Hines, Lisa Alexander

DNP Scholarly Projects

The mental, physical, and emotional effects of stress and fatigue pose significant patient safety risks resulting from impaired concentration, coordination, and overall productivity in certified registered nurse anesthetists. Fatigue is commonly experienced by nurse anesthetists. Fatigue is an occupational hazard that affects not only nurse anesthetists but also patients, colleagues, and other healthcare stakeholders. Certified registered nurse anesthetists are most affected by fatigue due to the prolonged duration of extensive patient monitoring during surgical and complex medical procedures. Due to their central role in ensuring patient safety and comfort during surgery and other procedures requiring anesthesia, certified registered nurse anesthetists ...


Educational Modules On Pediatric Cardiac Care For Host Nurse Training During Surgical Mission Trips: A Quality Improvement Project, Maria Arlene Gapac Lemin 2022 La Salle University

Educational Modules On Pediatric Cardiac Care For Host Nurse Training During Surgical Mission Trips: A Quality Improvement Project, Maria Arlene Gapac Lemin

DNP Scholarly Projects

Numerous health care organizations conduct international surgical mission trips to treat pediatric patients with congenital cardiac disorders in countries unable to provide complex surgical interventions locally without support. This doctoral student’s experience on numerous mission trips provided the opportunity to evaluate the expertise of circulating and scrub nurses in host countries. Based on this assessment, a knowledge and skill gap was identified and suggested that an educational intervention might benefit host nurses. The purpose of this doctoral project was to develop evidence- and theoretically-based educational modules for local nurses to improve perioperative nursing practice in meeting the needs of ...


Utilization Of A Block Excellence Specialty Team Is B.E.S.T, Lauren E. Pittman 2022 University of San Francisco

Utilization Of A Block Excellence Specialty Team Is B.E.S.T, Lauren E. Pittman

Master's Projects and Capstones

Perioperative registered nurses and anesthesiologists that rely on a process for placing regional anesthesia (R.A.) blocks on the correct side for surgical patients consistently provide high-quality, safe care. Infrequently anesthesiologists place the wrong side peripheral nerve blocks (P.N.B.). Due to the sensitive nature of sentinel events, the frequency of its occurrence at this quality improvement (Q.I.) project site is unavailable. Therefore, a report by Harris et al. (2021) was referenced for the incidence of wrong side blocks (W.S.B.), which were recorded in worldwide, national, and multihospital health care system cohorts as 3.63/10 ...


Caring For The Caregiver During Covid-19 Suspended Visitation, Melissa D. Rouse, Lorie K. Shoemaker, Priscilla Kyle, Chris Tenold, Whitney Anthony, Jordan White 2022 Northeast Georgia Health System

Caring For The Caregiver During Covid-19 Suspended Visitation, Melissa D. Rouse, Lorie K. Shoemaker, Priscilla Kyle, Chris Tenold, Whitney Anthony, Jordan White

Patient Experience Journal

During the 4th surge of COVID-19, August to November 2021, visitation was suspended in a hospital system in North Georgia. The Compassionate Connections Call Center (CCCC) was created to alleviate staff stress and to manage calls and communication. The goal of the initiative was to reduce interruptions to patient care caused by the increased number of calls to the clinical units by patients, families, loved ones and personal caregivers. The CCCC managed all incoming calls and communicated with the patient’s primary nurse through a coordinated process which limited interruptions. By caring for the caregiver, the aim was to improve ...


Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller 2022 East Tennessee State University

Cognitive Preference And Skill Acquisition: The Relationship Between Student Nurse Anesthetists And Certified Registered Nurse Anesthetists Thinking Styles, Thomas Diller

Electronic Theses and Dissertations

Decision-making in healthcare is a complex and, at times, uncertain process. In the United States Certified Registered Nurse Anesthetists (CRNA) administer the majority of anesthesia. Nurse Anesthetists must draw on their educational background, clinical experience, and cognitive processes to make sound clinical judgments. To avoid errors understanding the relationship between cognitive preference and skill acquisition is critical. This study was designed to describe the cognitive preferences of Student Nurse Anesthetists (SRNAs) and CRNAs in the United States. The 2 cognitive preferences explored are rational (analytical) and experiential (intuitive) decision-making.

The researcher used a quantitative, cross-sectional, descriptive correlational design. The researcher ...


Reducing Falls Related To Toileting, Brian Locastro 2022 University of St. Augustine for Health Sciences

Reducing Falls Related To Toileting, Brian Locastro

Student Scholarly Projects

Practice Problem: The practice problem for the medical-surgical unit is a high rate of falls associated with toileting activities, despite universal fall precautions for all patients. The current fall rate is an average rate of 4 falls per 1,000 patient days.

PICOT: The PICOT question that guided this project was: Among adult patients in the inpatient medical-surgical unit (P), what is the effect of adding a toileting care plan (I) to the current practice of universal fall precautions (C) to reduce the severity and incidence of falls (O) within an 8-week period (T)?

Evidence: Nine high-quality articles supported a ...


Acorn Papua New Guinea Angau Memorial Hospital Redevelopment Clinical Support Program (Part 1), Carollyn Williams, Ruth Melville, Elinor Radke, Sonia Griffiths 2022 Barwon Health

Acorn Papua New Guinea Angau Memorial Hospital Redevelopment Clinical Support Program (Part 1), Carollyn Williams, Ruth Melville, Elinor Radke, Sonia Griffiths

Journal of Perioperative Nursing

This article is the first in a series that will describe ACORN’s role in the redevelopment of the ANGAU Memorial Hospital in Lae, Papua New Guinea.


Nurse-Led Intervention: Implementing Early Mobilization Of Patients In The Intensive Care Unit, Lou A. Hill 2022 University of St. Augustine for Health Sciences

Nurse-Led Intervention: Implementing Early Mobilization Of Patients In The Intensive Care Unit, Lou A. Hill

Student Scholarly Projects

Practice Problem: Immobility of patients in the hospital intensive care unit can cause longer stays in the intensive care unit and the hospital. Evidence-based early mobilization of patients helps to reduce length of stay (LOS) and avoid many detrimental sequelae, leading to short and long-term debilitation.

PICOT: The PICOT question that guided this project was: In the adult medical and surgical intensive care units (P), how does implementation of a nurse-driven protocol for early mobility (I), affect the LOS in the intensive care units and the LOS in the hospital (O), as opposed to not using a protocol for early ...


Integrated Simulations To Build Teamwork, Safety Culture And Efficient Clinical Services: A Case Study, Melanie J. Ferguson Miss, Cassandra Sampson, Jed Duff, Theresa Green Professor 2022 Surgical Treatment and Rehabilitation Service (STARS)

Integrated Simulations To Build Teamwork, Safety Culture And Efficient Clinical Services: A Case Study, Melanie J. Ferguson Miss, Cassandra Sampson, Jed Duff, Theresa Green Professor

Journal of Perioperative Nursing

Background: Simulation methodology and frameworks were used to build teamwork and a safety culture, and to establish efficient clinical services within the procedure centre of a newly constructed, stand-alone, fully digital greenfield hospital. Rapid ramp up of surgical services required significant recruitment, and onboarding necessitated training of nursing and other perioperative support staff.

Methods: A two-day, immersive integrated simulation activity was carried out with the interprofessional onboarding staff participating in their usual roles. During the simulation, staff had the opportunity to apply newly acquired skills and knowledge to all stages of a patient’s clinical journey through the procedure centre ...


Exploring Risk, Antecedents And Human Costs Of Living With A Retained Surgical Item: A Narrative Synthesis Of Australian Case Law 1981–2018, Sonya Osborne, Tina Cockburn, Juliet Davis 2022 University of Southern Queensland

Exploring Risk, Antecedents And Human Costs Of Living With A Retained Surgical Item: A Narrative Synthesis Of Australian Case Law 1981–2018, Sonya Osborne, Tina Cockburn, Juliet Davis

Journal of Perioperative Nursing

Objective(s): This study aimed to critically examine the circumstances contributing to, and the human costs arising from, the retention of surgical items through the lens of Australian case law.

Design, setting and participants: We reviewed Australian cases from 1981 to 2018 to establish a pattern of antecedents and identify long-term patient impacts (human costs) of retained surgical items. We used a modified fourstep process to conduct a systematic review of legal doctrine, combined with a narrative synthesis approach to bring the information together for understanding. We searched LexisNexis, AustLII, Coroner Court websites, Australian Health Practitioner Regulation Agency Tribunal Decisions ...


The Effect Of An Enhanced Recovery After Surgery Protocol On Opioid Consumption, Pain And Length Of Stay Among Patients Undergoing Prostatectomy And Nephrectomy, Lindsay Anne Bowles, Whitney Heet, Jerieka Waterbeck, Lori Chastain, Martha Monroe, Claire C. Davies 2022 Baptist Health Lexington

The Effect Of An Enhanced Recovery After Surgery Protocol On Opioid Consumption, Pain And Length Of Stay Among Patients Undergoing Prostatectomy And Nephrectomy, Lindsay Anne Bowles, Whitney Heet, Jerieka Waterbeck, Lori Chastain, Martha Monroe, Claire C. Davies

Journal of Perioperative Nursing

Objective: To examine the effect of the Baptist Health Lexington Urology ERAS Protocol (BHLEX-UEP) on opioid consumption, pain and length of stay among patients undergoing prostatectomy and nephrectomy.

Methods: A quasi-experiment (N=303) was conducted in a 434-bed Magnet® re-designated community hospital in the south-eastern United States of America (USA). Data on all adult patients who underwent prostatectomy or nephrectomy surgery were retrieved over a 19-month period. Group differences related to morphine equivalents consumed, mean pain score on the day of surgery, and length of stay were examined between patients who experienced the traditional recovery protocol (n=133) and those ...


The Creation Of An Evidence-Based Educational Intervention For Preceptor Development Of The Novice Certified Registered Nurse Anesthetist, Kathleen Yoka, Nathalie Anderson 2022 La Salle University

The Creation Of An Evidence-Based Educational Intervention For Preceptor Development Of The Novice Certified Registered Nurse Anesthetist, Kathleen Yoka, Nathalie Anderson

DNP Scholarly Projects

Novice certified registered nurse anesthetists (CRNA) are responsible for precepting student registered nurse anesthetists (SRNA) while simultaneously caring for patients in the operating room (OR). SRNAs rely on CRNAs for the majority of clinical training by preceptorship. Well-defined best precepting practices do not exist. The ability to teach others is a learned skill, and the lack of such skill can lead to undue stress for both the novice CRNA and the SRNA. This may lead to reduced job satisfaction of the CRNA and diminished educational experience of the SRNA. The primary purpose of this Doctor of Nursing Practice (DNP) project ...


What Does Integrated Care Look Like In A Perioperative Service?, Jed Duff 2022 Queensland University of Technology

What Does Integrated Care Look Like In A Perioperative Service?, Jed Duff

Journal of Perioperative Nursing

The traditional approach to planning care based on surgical procedures rather than patient needs is no longer fit for purpose. The typical surgical patient has grown increasingly more complex over the past decade due to a combination of clinical and social factors. If this complexity is poorly managed, it can result in substantial and avoidable increases in length of hospital stay, post-operative complications, hospital readmissions, delayed recovery and reduced quality of life.


Excessive Noise In The Operating Room: Can It Be Improved?, Judith Ellen Bodin 2022 Austin Health

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 ...


Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher 2022 University of San Diego

Enriching The Perioperative Enhanced Recovery After Surgery (Eras) Program For Patients Undergoing Whipple Procedure For Pancreatic Cancer, Natalie E. Fisher

Doctor of Nursing Practice Final Manuscripts

Pancreatic cancer remains one of the most complex and lethal diseases worldwide with surgical resection as a major treatment choice. Although surgery may be one of the only options for advanced pancreatic cancer, it is not without a lengthy hospital stay, a long list of possible postoperative complications, and an increased risk for readmission after discharge. Enhanced recovery after surgery (ERAS) programs have been implemented for years in other surgical services for cancer care. These programs have now been extended and researched to include patients undergoing surgery for pancreatic cancer. These programs are designed to assist patients and their families ...


Understanding The Use Of Tympanic Thermometry In The Post Anaesthesia Care Unit: A Discussion Paper, James Halford, Paula Foran 2022 University of Tasmania, Australia

Understanding The Use Of Tympanic Thermometry In The Post Anaesthesia Care Unit: A Discussion Paper, James Halford, Paula Foran

Journal of Perioperative Nursing

Inadvertent perioperative hypothermia (IPH) is an uncomfortable, dangerous and costly but preventable complication of surgery. For perioperative nurses to treat this condition, they must first have an accurate means of detecting it. In making clinical decisions based on patients’ temperature, an important vital sign, nurses must understand how different thermometers work and be competent in their use. It is vital that patients have accurate core body temperature recorded when admitted to the Post Anaesthesia Care Unit (PACU). Infrared tympanic thermometers are a non-invasive tool regularly used by PACU nurses and provide a quick and easily obtained measurement that is a ...


Uncertainty In Post-Anaesthesia Nursing Clinical Reasoning: An Integrative Review In The Light Of The Model Of Uncertainty In Complex Health Care Settings, Lara Daniela Matos Cunha, Márcia Pestana-Santos, Lurdes Lomba, Margarida Reis Santos 2022 Instituto Ciências Biomédicas de Abel Salazar, Centro Hospitalar e Universitário de Coimbra

Uncertainty In Post-Anaesthesia Nursing Clinical Reasoning: An Integrative Review In The Light Of The Model Of Uncertainty In Complex Health Care Settings, Lara Daniela Matos Cunha, Márcia Pestana-Santos, Lurdes Lomba, Margarida Reis Santos

Journal of Perioperative Nursing

Problem identification: Post-anaesthesia nursing plays an important role in the early detection and treatment of clinical deterioration after surgery and/or anaesthesia. Concomitantly, the effectiveness of post-operative care is highly dependent on the accurate analysis, synthesis of patient data and quality of diagnostic decisions through clinical reasoning. Given the dynamic processes required to come to a diagnosis, uncertainty is common in clinical reasoning and expected during practice. Nevertheless, uncertainty may permeate the foundations of clinical reasoning, which can jeopardise diagnostic accuracy and consequently the quality and safety of health care.

Literature search: The objectives of this review are to identify ...


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