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nurse anesthesia and leadership

Kyle T Leggott, Matthew Martin, David Sklar, Deborah Helitzer, Randy Rosett, Cameron Crandall, Firoz Vagh, Deana Mercer
INTRODUCTION: To provide insight into how an innovation in healthcare is implemented and diffused, we studied the transition from routine use of general anesthesia to peripheral nerve blocks (PNBs) for ambulatory orthopedic extremity surgery. Rogers' diffusion of innovations (DOI) theory was used as our theoretical framework. We identified themes that would be helpful for others attempting to diffuse innovations into healthcare settings. MATERIAL AND METHODS: A mixed quantitative and qualitative methodology was used...
September 2016: Healthcare
Amy S Wasterlain, Andrew A Tran, Chad Tang, David R Campbell, Hillary J Braun, Yasmeen A Scuderi, Gaetano J Scuderi
INTRODUCTION: Cost containment and surgical inef - ficiencies are major concerns for hospitals in this era of declining resources. The primary aim of this investigation was to understand subjective perceptions of perioperative spine surgical quality across three practice settings and to identify potential factors contributing to these perceptions. Subsequently, we objectively evaluated factors that influence the duration of time in which the patient is in the operating room (OR) prior to the surgical incision and assessed the influence of fluoroscopy technician expertise on radiation dose and imaging efficiency...
July 2015: Bulletin of the Hospital for Joint Diseases
Alan David Kaye, Joseph L McDowell, James H Diaz, Jay A Buras, Amy E Young, Richard D Urman
BACKGROUND: Traditionally, the operating room (OR) in an academic medical center has faced numerous challenges to effective clinical productivity, including additional missions of teaching and research. Level 1 trauma poses more challenges related to the need for additional specialized personnel in anesthesia, surgery, and nursing. The present investigation explores lessons learned in efficiency, teamwork, and data evaluation at a level 1 academic teaching facility. METHODS: The months of July 2012, July 2013, and July 2014 were selected for this study...
March 2015: Journal of Medical Practice Management: MPM
Monica R McLemore, Amy Levi, E Angel James
OBJECTIVE(S): The purpose of this thematic analysis is to describe recruitment, retention and career development strategies for expert nurses in abortion care provision. STUDY DESIGN: Thematic analysis influenced by grounded theory methods were used to analyze interviews, which examined cognitive, emotional, and behavioral processes associated with how nurses make decisions about participation in abortion care provision. The purposive sample consisted of 16 nurses, who were interviewed between November 2012 and August 2013, who work (or have worked) with women seeking abortions in abortion clinics, emergency departments, labor and delivery units and post anesthesia care units...
June 2015: Contraception
A Irwin, A E Weidmann
BACKGROUND: Non-technical skills refer to the social and cognitive factors that may influence efficient and safe job performance. Non-technical skills are an important element of patient safety in a variety of health care disciplines, including surgery, anesthesia and nursing. However, the use of non-technical skills in pharmacy practice has not yet been fully assessed. OBJECTIVE: To examine attitudes toward, and use of, non-technical skills by pharmacy personnel...
September 2015: Research in Social & Administrative Pharmacy: RSAP
Grace A Nicksa, Cristan Anderson, Richard Fidler, Lygia Stewart
IMPORTANCE: The Accreditation Council for Graduate Medical Education core competencies stress nontechnical skills that can be difficult to evaluate and teach to surgical residents. During emergencies, surgeons work in interprofessional teams and are required to perform certain procedures. To obtain proficiency in these skills, residents must be trained. OBJECTIVE: To educate surgical residents in leadership, teamwork, effective communication, and infrequently performed emergency surgical procedures with the use of interprofessional simulations...
March 1, 2015: JAMA Surgery
Shawn Bryant Collins, Duane Covrig, Isadore Newman
Some fear that the added demands of the Affordable Care Act may worsen already high attrition rates among nurses. One potential solution is that graduate nursing programs must do a better job of selecting and retaining those who can persist in training to gain the clinical and leadership skills necessary to fill these new roles. Some believe emotional intelligence (EI) may help with the selection and retention of graduate nursing students. This study examined EI in 216 nurse anesthesia (NA) students. Q-factor analysis was used to create EI profiles of first-semester, 1-year, and last-semester NA students...
September 2014: Journal of Nursing Education
Blair A Wormer, Vedra A Augenstein, Christin L Carpenter, Patrick V Burton, William T Yokeley, Ajita S Prabhu, Beth Harris, Sujatha Norton, David A Klima, Amy E Lincourt, B Todd Heniford
Generating over four billion pounds of waste each year, the healthcare system in the United States is the second largest contributor of trash with one-third produced by operating rooms. Our objective is to assess improvement in waste reduction and recycling after implementation of a Green Operating Room Committee (GORC) at our institution. A surgeon and nurse-initiated GORC was formed with members from corporate leadership, nursing, anesthesia, and OR staff. Initiatives for recycling opportunities, reduction of energy and water use as well as solid waste were implemented and the results were recorded...
July 2013: American Surgeon
Michaela Kolbe, Michael J Burtscher, Johannes Wacker, Bastian Grande, Renata Nohynkova, Tanja Manser, Donat R Spahn, Gudela Grote
BACKGROUND: Our goal in this study was to test the relationship between speaking up--i.e., questioning, correcting, or clarifying a current procedure--and technical team performance in anesthesia. Hypothesis 1: team members' higher levels of speaking up are related to higher levels of technical team performance. Hypothesis 2: team members will react to speaking up by either clarifying their procedure or initiating a procedural change. Hypothesis 3: higher levels of speaking up during an earlier phase of teamwork will be related to higher levels of speaking up during a later phase...
November 2012: Anesthesia and Analgesia
E Sander Connolly, Alejandro A Rabinstein, J Ricardo Carhuapoma, Colin P Derdeyn, Jacques Dion, Randall T Higashida, Brian L Hoh, Catherine J Kirkness, Andrew M Naidech, Christopher S Ogilvy, Aman B Patel, B Gregory Thompson, Paul Vespa
PURPOSE: The aim of this guideline is to present current and comprehensive recommendations for the diagnosis and treatment of aneurysmal subarachnoid hemorrhage (aSAH). METHODS: A formal literature search of MEDLINE (November 1, 2006, through May 1, 2010) was performed. Data were synthesized with the use of evidence tables. Writing group members met by teleconference to discuss data-derived recommendations. The American Heart Association Stroke Council's Levels of Evidence grading algorithm was used to grade each recommendation...
June 2012: Stroke; a Journal of Cerebral Circulation
Lynne R Ferrari, Anne Micheli, Christopher Whiteley, Raoul Chazaro, David Zurakowski
BACKGROUND:   The staffed hours of operation in any surgical facility are a valuable institutional resource. The realistic target for the utilization of this resource is dependent on many factors including scheduling, efficiency, and culture of the facility. There is no previously reported measure for the actual utilization of staffed regular operating room (OR) hours in an academic pediatric institution. The leadership of the perioperative services at Children's Hospital Boston (CHB) sought to define the utilization of surgical suite staffed block time hours at that institution and in addition determine whether changes in workflow could increase the measured utilization...
July 2012: Paediatric Anaesthesia
Philip B Gorelick, Angelo Scuteri, Sandra E Black, Charles Decarli, Steven M Greenberg, Costantino Iadecola, Lenore J Launer, Stephane Laurent, Oscar L Lopez, David Nyenhuis, Ronald C Petersen, Julie A Schneider, Christophe Tzourio, Donna K Arnett, David A Bennett, Helena C Chui, Randall T Higashida, Ruth Lindquist, Peter M Nilsson, Gustavo C Roman, Frank W Sellke, Sudha Seshadri
BACKGROUND AND PURPOSE: This scientific statement provides an overview of the evidence on vascular contributions to cognitive impairment and dementia. Vascular contributions to cognitive impairment and dementia of later life are common. Definitions of vascular cognitive impairment (VCI), neuropathology, basic science and pathophysiological aspects, role of neuroimaging and vascular and other associated risk factors, and potential opportunities for prevention and treatment are reviewed...
September 2011: Stroke; a Journal of Cerebral Circulation
Linda Lakdawala
Obstructive sleep apnea (OSA) is a common condition that increases the risk of complications for patients undergoing sedation and/or general anesthesia. The purpose of this quality improvement project was to promote evidence-based practice for nurses to screen patients with OSA in the perioperative setting. A step-by-step team process was implemented using the Iowa Model of Evidence-Based Practice in a shared leadership environment at an acute care facility to educate staff and evaluate the practice change...
February 2011: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Shireen Ahmad
Office-based anesthesia (OBA) is a unique and challenging venue, and, although the clinical outcomes have not been evaluated extensively, existing data indicate a need for increased regulation and additional education. Outcomes in OBA can be improved by education not only of anesthesiologists but also of surgeons, proceduralists, and nursing staff. Legislators must be educated so that appropriate regulations are instituted governing the practice of office-based surgery and the lay public must be educated to make wise, informed decisions about choice of surgery location...
June 2010: Anesthesiology Clinics
Barbara Künzle, Enikö Zala-Mezö, Johannes Wacker, Michaela Kolbe, Donat R Spahn, Gudela Grote
BACKGROUND: Leadership plays a crucial role in teams working in complex environments, and research has shown that shared leadership where all team members perform leadership functions is an effective strategy. The authors aimed to describe shared leadership patterns during anaesthesia induction and show how they are linked to team performance. METHODS: 12 anaesthesia teams consisting of one resident and one nurse during a simulated anaesthesia induction including a non-routine event (asystole) were videotaped, and two kinds of leadership behaviour (content-oriented and structuring) were coded...
December 2010: Quality & Safety in Health Care
Judy Smetzer, Christine Baker, Frank D Byrne, Michael R Cohen
BACKGROUND: In July 2006, a 16-year-old patient came to the hospital to deliver her baby. During the process of her care, an infusion intended exclusively for the epidural route was connected to the patient's peripheral intravenous line and infused by pump. The patient experienced cardiovascular collapse. A cesarean section resulted in the delivery of a healthy infant, but the medical team was unable to resuscitate the mother. The media attention surrounding the error accelerated through the national provider and safety community when the nurse was charged with a criminal offense...
April 2010: Joint Commission Journal on Quality and Patient Safety
Kay Daniels, Steven Lipman, Kimberly Harney, Julie Arafeh, Maurice Druzin
BACKGROUND: Obstetric crises are unexpected and random. Traditionally, medical training for these acute events has included lectures combined with arbitrary clinical experiences. This educational paradigm has inherent limitations. During actual crises insufficient time exists for discussion and analysis of patient care. Our objective was to create a simulation program to fill this experiential gap. METHODS: Ten L&D teams participated in high fidelity simulation training...
2008: Simulation in Healthcare: Journal of the Society for Simulation in Healthcare
Martin J Heslin, Barbara E Doster, Sandra L Daily, Michael R Waldrum, Arthur M Boudreaux, A Blair Smith, Glenn Peters, Debbie B Ragan, Scott Buchalter, Kirby I Bland, Loring W Rue
BACKGROUND: Enhanced productivity and efficiency in the operating room must be balanced with patient safety and staff satisfaction. In December 2004, transition to an expanded replacement hospital resulted in mandatory overtime, unpredictable work hours, and poor morale among operating room (OR) staff. A staff-retention crisis resulted, which threatened the viability of the OR and the institution. We report the changes implemented to efficiently deliver safe patient care in a supportive environment for surgeons and OR staff...
May 2008: Journal of the American College of Surgeons
Rozina Merali, Beverley A Orser, Alexandra Leeksma, Shirley Lingard, Susan Belo, Sylvia Hyland
A medication safety project for operating rooms (ORs) was initiated under the leadership of the Departments of Anesthesia and Nursing with a representative from the Canadian Anesthesiologists' Society and the Institute for Safe Medication Practices Canada. The aims of the collaborative project were twofold: (1) to identify areas of exposure to risk and make recommendations to enhance medication safety within the hospital and (2) to inform the development of a medication safety checklist specific to the OR setting...
2008: Healthcare Quarterly
Susan N Kamerling, Linda Cunningham Lawler, Marie Lynch, Alan Jay Schwartz
Although parental visitation in the PACU is the standard of care in a few institutions, it is surprisingly not a standard of care at most. Parental presence in the PACU at The Children's Hospital of Philadelphia (CHOP) was historically inconsistent and limited. It was recognized that consistent and relatively unlimited parental presence in the PACU was needed to better meet the CHOP commitment to provide family-centered care. Under the leadership of the Family Services Coordinators and the Perioperative Family-Centered Care Committee, staff worked to promote parental visitation in the PACU...
February 2008: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
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