Perioperative, Operating Room and Surgical Nursing Commons^™

Lateral Decubitus And Prone Positioning: An Objective Structured Clinical Evaluation, David Hesley-Hernandez, James Bailey

Doctoral Projects

Improper positioning of patients in the lateral decubitus or prone positions can lead to significant complications, including but not limited to: airway and invasive line loss, physiologic derangements, soft tissue injury, and peripheral nerve injuries (PNI) (Barash et al., 2017; Butterworth et al., 2018). Chui et al.’s (2018) analysis found that PNIs accounted for 12% of anesthesia malpractice since 1990, making PNIs costly. PNIs effects are not limited to cost and result in increased lengths of stay, increased pain levels, and decreased quality of life (Wojtkiewicz et al., 2015). The massive effect poor positioning can have requires that the anesthesia …

The Effects Of Hospital Policy And Procedure On Cauti Occurrence, Kevin Kaga, Michaela Morrison, Daniel John

Symposium of Student Scholars

Abstract

Background: Clients that require indwelling catheterization often get bacterial infection causing catheter-associated urinary tract infections. These infections lead to longer hospital admissions and poorer outcomes for clients.

Objectives: To assess the effectiveness of the use of suggested hygiene methods from hospital policy/guidelines in preventing catheter-associated urinary tract infections.

Methods: Using the Kennesaw State Library search system, 10 articles were found to support that the use of consistent evidence based practices can prevent urinary tract infection occurrence.

Results: Our articles identified appropriate and inappropriate indications for catheterization and effective hygiene techniques used by nurses in the prevention of CAUTIs. These …

Nursing Students’ Perceptions Of Using Branching Simulation: A Qualitative Descriptive Study, Mohammad Rababa, Dania Bani-Hamad, Shatha Al-Sabbah

The Qualitative Report

Previous intervention studies have shown that branching simulation (BS) unfolds the complex multidimensional aspects of challenging health problems. The present study aimed to examine graduate nursing students’ perceptions of using BS in professional training. This study used a qualitative descriptive design with semi-structured interviews with a sample of 20 graduate nursing students. Four main themes emerged from the results: (a) BS as a support to students’ professional training, (b) BS leads to changes in clinical practice, (c) whether BS is a stressful learning experience, and (d) BS versus traditional lecturing. The participating students perceived BS as a valid learning tool …

Leading With Emotional Intelligence In Perioperative Nursing: An Integrative Review, Elise Rhodes, Paula Foran

Journal of Perioperative Nursing

Background: Emotional intelligence has increasingly become synonymous with effective leaders within successful organisations. The perioperative environment is a complex setting within an organisation that requires nurse leaders to possess self-awareness that allows them to understand and control their emotions while using this insight to benefit others. Perioperative nurse leaders can use their emotional intelligence to manage conflict, negotiate between multidisciplinary team members, motivate staff to provide high level safe patient care and promote a positive work culture that can increase staff retention.

Review methods: A literature search of databases of CINAHL, Pubmed, Medline and Scopus was conducted to extract qualitative, …

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 …

Improving The Perioperative Experience Of Patients And Families In A Pediatric Setting, Anjanette Pong

Student Scholarly Projects

Practice Problem: The experience of surgery for pediatric patients and their families can be dependent on multiple factors including adequate preparation, English language proficiency and realistic expectations. Anxiety can contribute to a negative experience that may result in poor outcomes and a damaging reflection of the healthcare team and organization.

PICOT: The PICOT question that guided this project was: In preoperative pediatric patients and their families, how do therapeutic communication style and the provision of information about the perioperative experience affect their healthcare experience over eight weeks?

Evidence: A multi-modal approach to providing tailored preoperative education for the child and …

Uncovering The Benefits Of Naturalistic Blue-Depleted Lighting In Hospitals: A Qualitative Study, Sam P. Cotton

Symposium of Student Scholars

With exponential technological advances, hospitals are tasked with prioritizing which expensive innovations truly impact as many patients as possible to give them the greatest chance of recovering and discharge them earlier. It is no surprise that most of the attention is focussed on pharmaceutical drugs and a variety of different equipment and machinery, but hospital facilities should look into simpler additions that can aid every patient admitted. The use of naturalistic blue-wavelength lighting is something that can benefit each patient’s recovery immensely. Multiple studies have proven positive effects that blue-depleted lighting compared to standard indoor fluorescent lighting has lowered stress …

Strategies To Prevent Inadvertent Retained Surgical Items: An Integrative Review, Amanda J. Snape, Jed Duff, Oya Gumuskaya, Kerry Inder, Alison Hutton

Journal of Perioperative Nursing

Background: The surgical count process is currently the recommended strategy for preventing unintentionally retained surgical items (RSIs) in Australia. Despite this, RSIs still occur and remain an internationally recognised issue and sentinel event associated with morbidity and mortality. There are numerous new and emerging strategies to prevent inadvertent RSIs, apart from the surgical count, and many involve the use of technology. These strategies are not currently specified in Standards for Perioperative Nursing in Australia (the ACORN Standards).

Aim: To provide an integrative synthesis of the literature to identify current and emerging strategies for preventing RSIs during surgical procedures.

Design: An …

It’S Time For The Perioperative Community To Recommit To The Who Surgical Safety Checklist, Jed Duff

Journal of Perioperative Nursing

For over a decade, the World Health Organization (WHO) Surgical Safety Checklist has been recognised as an essential perioperative safety tool. The first landmark multi-national study demonstrated a remarkable 47 per cent reduction in mortality and a 36 per cent reduction in surgical complications, which was confirmed in subsequent studies. Although effective in a research environment, the checklist has been challenging to implement. Today, hospitals worldwide still struggle to use the checklist as designed and maintain enthusiasm for its sustained use. Is it time for the perioperative health care community to revisit the checklist and recommit to safer surgery?

Mothers’ Satisfaction With Distraction As A Postoperative Pain Management Intervention For Their Child: An Interventional Study, Edlin Glane Mathias, Mamatha Shivananda Pai, Vijay Kumar, Vasudeva Guddattu, Ann-Cathrine Bramhagen

Journal of Perioperative Nursing

Aim: This study aimed to investigate mothers’ levels of satisfaction with distraction as a post-operative pain management intervention for their child.

Background: Although the number of studies on paediatric pain management has increased over time, research into non-pharmacological post-operative pain management remains inadequate, indicating that more research is required.

Design: A posttest-only control group design was adopted to measure mothers’ levels of satisfaction with distraction as a non-pharmacological post-operative pain management intervention for their child.

Methods: The study included 160 mothers and their children undergoing elective surgery in a paediatric surgical unit. Mothers and children were randomly allocated to intervention …

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 …

Objective Structured Clinical Evaluation For Volume Control And Pressure Control Ventilator Modes, Brian Bailey, Anthony Newsom

Doctoral Projects

The purpose of this doctoral project was to create a tool to teach student registered nurse anesthetists (SRNAs) in The University of Sothern Mississippi’s (USM’s) anesthesia program about pressure control and volume control ventilator modes, and how to use them. To accomplish this goal an Objective Structured Clinical Examination (OSCE) was developed. The framework used for creating this OSCE was Kolb's Theory. Kolb's Theory uses a four-stage learning cycle in which the learner encounters a new experience, reflects on the observations of said new experience, conceptualizes or modifies a concept based on this experience, and then applies their idea to …

One Step Forward Or Two Steps Back?, Toni G. Hains

Journal of Perioperative Nursing

The Surgical Assistant Working Group (SAWG) draft report has been released, which proposes to allow nurses in the surgical assistant role to access a patient rebate from the Medicare Benefits Schedule (MBS). This will address some of the issues affecting access to surgery in Australia. While an initial read of the report has buoyed the spirits of those closely involved, it is with circumspection that we venture forward.

Measuring Surgical Patient Engagement: A Scoping Review, Rebecca Law, Dawn Wong Lit Wan, Sonja Cleary, Wanda Stelmach, Krinal Mori, Zhen Zheng

Journal of Perioperative Nursing

Background

Patient engagement is a patient’s capacity and willingness to participate and collaborate in their own health care. This scoping review aimed to identify tools used to measure engagement among surgical patients, the levels of engagement and the association between engagement and surgical outcomes. We hypothesise that highly engaged patients are more likely to achieve better surgical outcomes.

Review methods

MEDLINE/PubMed, CINAHL, SCOPUS and Embase were searched for studies that assessed adult perioperative patients for engagement. Analysis from charting the data identified the measurement tools, levels of capacity to engage and relationships between engagement and surgical outcomes.

Results

Twelve studies …

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 their …

Occupational Violence Against Staff In The Perioperative Environment, Jed Duff

Journal of Perioperative Nursing

Occupational violence is a common problem in many workplaces, including health service organisations. In the perioperative environment, we are acutely aware of the problem of lateral violence, such as bullying, harassment and incivility. But as a specialty we rarely acknowledge violence perpetrated against us by patients, relatives or visitors. Anecdotally, this violence has been steadily increasing over the past decade and peaked during the current COVID-19 pandemic. Perioperative nurse leaders must be aware of the risks and implement appropriate mitigation strategies.

Prevention Of Post-Operative Nausea And Vomiting With Honey As A Pre-Operative Oral Carbohydrate: A Randomised Controlled Pilot Trial, Oya Gumuskaya, Ikbal Cavdar Prof., Cigdem Akyol Beyoglu

Journal of Perioperative Nursing

Background

Post-operative nausea and vomiting (PONV) is the secondmost common post-operative complication. Prolonged pre-operative fasting is common in Australia despite guidelines recommending reduced fasting to improve patient outcomes, such as PONV. Commercially prepared preoperative oral carbohydrate (OC) drinks may be used to reduce fasting time. In this study commercial products were replaced with honey, an inexpensive and common food item.

Design

Partially blinded, four parallel arms randomised controlled noninferiority trial compared pre-operative OC loading with overnight fasting.

Methods

Adult elective laparoscopic cholecystectomy and thyroidectomy patients having two or more risk factors for PONV were allocated into intervention and control groups …

Improving Perioperative Communication: Can Labelled Theatre Caps Play A Role?, Maree Yates, Paula Foran

Journal of Perioperative Nursing

Studies have shown that approximately one third of operating room communications fail. This has a negative impact on patient safety, with half of all adverse events being attributed to communication failures. However, human factors have the capacity to protect patients. Aviation’s human factors strategies provide guidance for staff and are beneficial in the operating room. Currently, no intervention is universally applied to improve operating room communication and team performance. Closed loop communication, though poorly utilised, has been demonstrated to counteract communication errors, therefore protecting patient safety. In 2018, calls were made to take advantage of theatre caps to display staff …

Teaching Time: Postoperative Urinary Catheter Care In The Preoperative Setting Before Surgery, Lynn Utecht

Master's Projects and Capstones

Abstract

Problem: Patients who have same day surgery often have little or no recall of the postoperative home care instructions when delivered in the aftercare area. The number of instructions that are required for home care, combined with medications given for pain and nausea as well as anesthesia, can make recall of these instructions difficult. The purpose of this quality improvement project was to provide the postoperative instructions for post prostatectomy patients discharged with an indwelling urinary catheter in the pre-operative area before the patient underwent surgery to decrease the length of time the patient spent in the recovery unit. …

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 3.63/10,000, 1.6/10,000, and 1.28/10,000 respectively. The PreOp/PACU nursing staff …