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Perioperative nursing

Anita Mohandas, Chris Summa, W Bradley Worthington, Jason Lerner, Kevin T Foley, Robert J Bohinski, Gregory B Lanford, Carol Holden, Richard N W Wohns
STUDY DESIGN: Delphi Panel expert panel consensus and narrative literature review OBJECTIVE.: To obtain expert consensus on best practices for patient selection and perioperative decision making for outpatient anterior cervical surgery (anterior cervical disc fusion (ACDF) and cervical total disc replacement (CTDR)). SUMMARY OF BACKGROUND DATA: Spine surgery in ambulatory settings is becoming a preferred option for both patients and providers. The transition from traditional inpatient environments has been enabled by innovation in anesthesia protocols and surgical technique, as well as favorable economics...
October 6, 2016: Spine
Brid O' Brien, Margaret M Graham, Sile Mary Kelly
AIM: To explore nurses' use of the World Health Organization safety checklist in the perioperative setting. BACKGROUND: Promoting quality and safety in health care has received worldwide attention. The World Health Organization surgical safety checklist (2009) is promoted for reducing postoperative morbidity and mortality. The checklist has been introduced in Irish perioperative settings. METHOD(S): A descriptive, qualitative approach was utilised...
October 18, 2016: Journal of Nursing Management
Angela Jones, Megan-Jane Johnstone
BACKGROUND: Failure to identify and respond to clinical deterioration is an important measure of patient safety, hospital performance and quality of care. Although studies have identified the role of patient, system and human factors in failure to rescue events, the role of 'inattentional blindness' as a possible contributing factor has been overlooked. OBJECTIVES: To explore the nature and possible patient safety implications of inattentional blindness in critical care, emergency and perioperative nursing contexts...
October 5, 2016: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Ann Malley, Gary J Young
AIMS: To explore the issues and challenges of care transitions in the preoperative environment. BACKGROUND: Ineffective transitions play a role in a majority of serious medical errors. There is a paucity of research related to the preoperative arena and the multiple inherent transitions in care that occur there. DESIGN: Qualitative descriptive design was used. METHODS: Semi-structured interviews were conducted in a 975 bed academic medical center...
October 5, 2016: Journal of Clinical Nursing
Matthew E Gitelis, Adelaide Kaczynski, Torin Shear, Mark Deshur, Mohammad Beig, Meredith Sefa, Jonathan Silverstein, Michael Ujiki
BACKGROUND: In 2009, NorthShore University HealthSystem adapted the World Health Organization Surgical Safety Checklist (SSC) at each of its 4 hospitals. Despite evidence that SSC reduces intraoperative mistakes and increase patient safety, compliance was found to be low with the paper form. In November 2013, NorthShore integrated the SSC into the electronic health record (EHR). The aim was to increase communication between operating room (OR) personnel and to encourage best practices during the natural workflow of surgeons, anesthesiologists, and nurses...
August 16, 2016: American Journal of Surgery
Debra Dunn
Body modification, also known as body art, has been a common cultural practice for thousands of years and includes body piercings, transdermal and subdermal implants, tattoos, scarification, body stretching and sculpting, dental grills, and nail art. Perioperative nurses must learn more about body art to provide nonjudgmental, nonprejudicial care and to ensure patient safety when they prepare patients for surgery. A welcoming environment engages patients and fosters communication so that patients are more likely to share hidden body art...
October 2016: AORN Journal
Bonnie L Westra, Jessica J Peterson
Big data are large volumes of digital data that can be collected from disparate sources and are challenging to analyze. These data are often described with the five "Vs": volume, velocity, variety, veracity, and value. Perioperative nurses contribute to big data through documentation in the electronic health record during routine surgical care, and these data have implications for clinical decision making, administrative decisions, quality improvement, and big data science. This article explores methods to improve the quality of perioperative nursing data and provides examples of how these data can be combined with broader nursing data for quality improvement...
October 2016: AORN Journal
Thomas E Schulte, Ellen K Roberts, Kristina Birch, Steven J Lisco
STUDY OBJECTIVE: The purpose of this study was to assess the workflow interruptions on an anesthesiology clinical director (CD). By assessing the interruptions on the CD, we hypothesize that these frequent interruptions would prohibit the CD from medical direction of residents or certified nurse anesthetists in operating rooms. DESIGN: Cellular phone data were obtained from Verizon Wireless statements over 10 months, August 2012 through May 2013. These data were from a single cellular phone carried by the anesthesia CD and subsequent overnight anesthesiologist 24 hours a day...
November 2016: Journal of Clinical Anesthesia
Yin Li
Enhanced recovery after surgery (ERAS) is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition and psychology. It aims to minimize surgical stress and maintain physiological function in perioperative care, thereby expediting recovery. ERAS theory has been clinically applied for nearly 20 years and it is firstly used in colorectal surgery, then widely used in other surgical fields. However, ERAS is not used commonly in esophagectomy because of its surgical complexity and high morbidity of postoperative complications, which limits the application of ERAS in the field of esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Ann-Sofie Sundqvist, Marie Holmefur, Ulrica Nilsson, Agneta Anderzén-Carlsson
PURPOSE: The purpose of this review was to identify the characteristics and consequences of perioperative patient advocacy. DESIGN: An integrative review method was employed. METHODS: A database search to identify peer-reviewed articles that focused on perioperative patient advocacy was conducted in PubMed and CINAHL, followed by a manual search for additional articles. Studies were selected if they reported original empirical research findings with regard to perioperative patient advocacy...
October 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Honey Calebrant, Marie Sandh, Inger Jansson
PURPOSE: To determine the factors that affect how nurse anesthetists in a county in Sweden decide how to manage perioperative fluid status. DESIGN: A cross-sectional qualitative study was conducted at two surgical wards in a county hospital. METHODS: Sixteen nurse anesthetists were interviewed to explore how nurse anesthetists assess patients' intraoperative fluid requirements and the subsequent measures adopted. FINDING: Three categories emerged through content analysis: clinical criteria and the thought process that drives decision making, interdependence in decision making, and uncertainty in decision making...
October 2016: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
T Saller, V V Dossow, K Hofmann-Kiefer
BACKGROUND: Delirium is a common complication in critical care. The syndrome is often underestimated due to its potentially no less dangerous course as a hypoactive delirium. Therefore, current guidelines ask for a structured, regular and routine screening in all intensive care units. If delirium is diagnosed, symptomatic therapy should be initiated promptly. OBJECTIVES: The aim of the current study was to evaluate recent German anesthetists' strategies regarding delirium care compared to the German guidelines for sedation and delirium in intensive care...
October 2016: Der Anaesthesist
Kyle Merandy
Patients with bladder (urothelial) cancer undergoing urinary diversion (UD) experience physical changes that require important adjustments in their daily lives. This integrative review aims to identify factors that influence adult adaptation to life after cystectomy with the creation of a UD. A review of primary research articles published between 1990 and 2014 was conducted using the PubMed and CINAHL Plus electronic databases. Results of the studies were summarized into 5 categories: (1) individual and family factors, (2) technical aspects related to the individual's ability to care for his or her UD, (3) perioperative nursing care, (4) educational needs, and (5) symptom experience...
September 2016: Journal of Wound, Ostomy, and Continence Nursing
Gillian Strudwick, Nicholas R Hardiker
BACKGROUND: In the era of evidenced based healthcare, nursing is required to demonstrate that care provided by nurses is associated with optimal patient outcomes, and a high degree of quality and safety. The use of standardized nursing terminologies and classification systems are a way that nursing documentation can be leveraged to generate evidence related to nursing practice. Several widely-reported nursing specific terminologies and classifications systems currently exist including the Clinical Care Classification System, International Classification for Nursing Practice(®), Nursing Intervention Classification, Nursing Outcome Classification, Omaha System, Perioperative Nursing Data Set and NANDA International...
October 2016: International Journal of Medical Informatics
Carmina Wanden-Berghe, Javier Sanz-Valero, Antonio Arroyo-Sebastián, Kamila Cheikh-Moussa, Pedro Moya-Forcen
UNLABELLED: Introducción: Preoperative nutritional status (NS) has consequences on postoperative (POSTOP) recovery. Our aim was to systematically review the nutritional interventions (NI) in Fast-Track protocols for colorectal cancer surgery and assess morbidity-mortality and patient´s recovery. METHOD: Systematic review of scientific literature after consulting bibliographic databases: Medline, The Cochrane Library, Scopus, Embase, Web of Science, Institute for Scientific Information, Latin American and Caribbean Health Sciences Literature, The Cumulative Index to Nursing and Allied Health Literature...
2016: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
Jaclyn Bradley Palmer, Deforia Lane, Diane Mayo
Collaboration between perioperative nurses and music therapists can be beneficial in providing a safe, cost-effective means of managing patients' anxiety and pain and reducing the need for pharmacologic intervention in the perioperative setting. The use of a board-certified music therapist may help to improve patient outcomes, ease nurse workload, and serve as an adjunct therapeutic modality that is enjoyable for both patients and staff members. We conducted a two-year, randomized controlled trial to determine how to best implement a music therapy program, navigate its challenges, and collaborate with nurse colleagues to bring its benefits to surgical patients...
September 2016: AORN Journal
Luke D Rothermel, Jeremy M Lipman
BACKGROUND: To determine the characteristics associated with improved accuracy or reliability of estimating operative blood loss. METHODS: Operating room personnel at a tertiary care hospital evaluated 3 operative simulations and provided estimations of blood loss. The simulations utilized precise, known volumes of porcine blood and saline on tapes, sponges, and in suction containers. Low volume (50 mL), mid volume (300 mL), and high volume (900 mL) blood loss scenarios were used in this simulation...
October 2016: Surgery
Chunyuan Qiu, Maxime Cannesson, Atef Morkos, Vu T Nguyen, Diana LaPlace, Narendra S Trivedi, Armond Khachatourians, Joseph Rinehart, Zeev N Kain
BACKGROUND: In this article, we report on the implementation and impact of a Perioperative Surgical Home (PSH) model for the total knee arthroplasty at an integrated delivery system (Kaiser Permanente). METHODS: A multidisciplinary committee developed and implemented a series of PSH protocols that included the entire continuum of care from the decision for surgery until 30 days after surgery. Five hundred forty-six subjects were included in the preimplementation phase (Fast Track [T-fast]), and 518 patients were included in the postimplementation phase (PSH)...
September 2016: Anesthesia and Analgesia
Steven L Bokshan, Alex L Han, J Mason DePasse, Adam E M Eltorai, Stephen E Marcaccio, Mark A Palumbo, Alan H Daniels
Sarcopenia is the loss of muscle mass associated with aging and advanced disease. This study retrospectively examined patients older than 55 years (N=46) who underwent thoracolumbar spine surgery between 2003 and 2015. Each patient's comorbidity burden was determined using the Charlson Comorbidity Index, and the Mirza Surgical Invasiveness Index was used to measure procedural complexity. Sarcopenia was diagnosed by measuring the total cross-sectional area of the psoas muscle at the L4 vertebrae using perioperative computed tomography scans...
August 18, 2016: Orthopedics
Shaunak S Adkar, Ryan S Turley, Ehsan Benrashid, Sandhya Lagoo, Cynthia K Shortell, Leila Mureebe
OBJECTIVE: The initiation of bundled payment for care improvement (BPCI) by Centers for Medicare & Medicaid Services (CMS) has led to increased financial and performance accountability. As the majority of vascular surgery patients are elderly and reimbursed via CMS, improving their outcomes will be critical for durable financial stability. As a first step in forming a multi-disciplinary pathway for the elderly vascular patient, we sought to identify modifiable perioperative variables in geriatric patients undergoing lower extremity arterial bypass (LEB)...
August 12, 2016: Annals of Vascular Surgery
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