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Results for “Association of Operating Room Nurses”

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At least 289 records · Page 16Linked to original sources

PubMed2001

Dedicated minimally invasive surgery suites increase operating room efficiency.

BACKGROUND: The rapid adoption of laparoscopic surgery since the late 1980s added tremendous complexity into the operating room (OR) environment. For each case, a plethora of additional equipment-including monitors, video equipment, wiring, tubing, and cords-had to be set up, prolonging OR turnover time and decreasing OR efficiency. In 1993, the concept of designated minimally invasive surgery (MIS) suites was introduced. MIS suites integrated monitors and video equipment into the OR on ceiling-mounted columns and moved the controls to a centralized nursing station. The overall effect of this innovation on OR efficiency has not been measured. METHODS: Five RNs with varying degrees of MIS experience were instructed on video setup and put-away criteria and then timed while performing a set of standardized tasks. Each set of tasks was performed twice using a standardized surgery model. Differences in setup and put-away times between MIS suites and standard ORs were tested using the t-test for paired comparisons. RESULTS: The mean +/- standard deviation (SD) video setup times were 27.9 +/- 5.3 sec (MIS) and 254.3 +/- 54.0 sec (standard); the put-away times were 19.8 +/- 2.7 sec (MIS) and 222.3 +/- 26.0 sec (standard). The mean difference +/- standard error (SE) in both the setup (226.4 +/- 16.9 sec, p = 0.0001) and put-away times (202.5 +/- 8.6, p = 0.0001) were large and statistically significant. CONCLUSION: Using a simulation model, we have demonstrated that the use of a MIS suite reduces video setup and put-away time significantly, with the potential for significant associated cost savings. This provides just one justification for the high cost of building such "ORs of the future."

Cost-Benefit Analysis↗

PubMedDate not supplied

Monitoring monitors.

A centralized, remote alarm system was implemented to alert nursing personnel when patient monitors located in isolation rooms go into alarm. The design includes a method of confirming the ON/OFF status of individual monitors to avoid operator error. This system utilizes low-cost individual patient monitors and includes interface devices, an alarm panel, and indicator panels. The design logic is based on the need for nursing personnel to also be alerted in the event of any abnormality associated with the patient monitors, the alarm panel itself, or with the interconnections. The system will also accommodate infusion pumps, respirators, or any other devices equipped with a remote alarm (nurse call) output.

Equipment Failure↗

PubMedDate not supplied

[Backache from exertion in health personnel of the Istituti Ortopedici Rizzoli in Bologna. A case-control study of the injury phenomenon in the 10-year period of 1987-1996].

Low-back (lumbosacral) injuries are known as one of more important occupational health problems in health care workers, because of high prevalence and impact of socioeconomic costs. To investigate the risk of low-back pain in hospital workers into the Istituti Ortopedici Rizzoli in Bologna (Italy), a retrospective study was carried out. The adapted study design was the matched (1:1 for age) case-control, enlisting the first injuries occurred in the hospital staff like cases, and personnel in force, matched for age and year of happened case, like controls. Information about diagnoses and occupational data was obtained from the current informative systems. Comparison with a control group suggests the validity of the work-relatedness of low-back pain in nursing and health aides (OR: 21.67; LC: 4.69-196.56), in nurses (OR: 20.21; LC: 4.81-177.95), in therapists (OR: 16.36; LC: 2.80-163.54) and in X-ray technicians (OR: 13.64; LC: 2.25-138.99). The risk of occupational injury is not homogeneously allocated into the hospital, and significatively prevails in the orthopaedic wards, in the plaster-rooms, in the operating blocks and in the sterilization plants. Specific manual handling were associated with an increased risk of back pain, while some non occupational factors like cigarette smoking, previous trauma leading to hospital admission, and number of children in female, were resulted weakly associated.

Adult↗

PubMed1987

Microbial contamination associated with routine aseptic practice.

We have studied the rate of fortuitous contamination associated with routine aseptic technique under operational conditions. Stainless steel strips, as simulators of surgical instruments, were contained in sterilized surgical packs and assayed by nursing personnel during surgical and other invasive procedures at three different hospitals. The rates of contamination observed for the 36 investigators ranged from 0% to 11.3%, with an overall rate of 2.7%. Assays conducted in a clean room environment, under conditions approaching industrial sterility standards, showed a contamination rate of 0.16%. We concluded that aseptic practices, as routinely performed without any noticeable breaks or transgressions, do not guarantee sterility. The concept of surgical sterility implies low level, but measurable, microbial contamination.

Antisepsis↗

PubMed2002

Profit opportunities still exist....in the operating room.

This piece is the first in a new series focused on improving profitability in the OR. Subsequent articles will present case studies, tools and best practices to help healthcare organizations improve resource management and increase profitability. The healthcare industry is at a financial impasse. While costs have increased, reimbursement has decreased. And just when the aging baby boomers are at the cusp of needing more care, the current nursing population is retiring, with too few new nurses to fill their shoes. Furthermore, healthcare organizations are experiencing the phenomenon of "profitless growth," a situation in which beds are full and resources appear to be fully utilized, yet profits are stagnant. Where can organizations focus to help close these gaps? The OR remains the single biggest opportunity. This project is a collaboration between McKesson Information Solutions and HFMA. The series will uncover hidden profit opportunities in the OR by focusing on three key areas: streamlining workflow, improving resource standardization and utilization, and integrating information and decision-making.

Financial Management, Hospital↗

PubMed1992

Sister-chromatid exchanges in operating room personnel.

Sister-chromatid exchange (SCE) analysis was carried out in 67 operating room personnel (anaesthetists M.D.; anaesthesia nurses and anaesthesia unit technicians) exposed to waste anaesthetic gases such as halothane, nitrous oxide and isoflurane and in 50 healthy unexposed controls. The SCE frequencies were increased significantly in operating room personnel as compared to controls. A significant increase in SCEs was found in non-smoking operating room personnel as compared to non-smoking controls. This study supports the existence of an association between occupational exposure to mutagens and an increase in SCEs in lymphocytes.

Adult↗

PubMed1994

Asepsis: a prophylactic technique.

The incorporation of aseptic technique into surgical practice can reduce the risk of nosocomial infections associated with surgery. The four principles of asepsis are: know what is sterile, know what is not sterile, keep these concepts separate, and remedy contamination immediately. This article details aseptic technique for operating room (OR) practice. As we progress with technology, it seems there is a desire to change these time-honored practices to fit the new world of surgical specialization. OR nurses must be proficient in critically reviewing studies and rationale before making changes in these practices.

Asepsis↗

PubMed1994

Comprehensive surgical radiation oncology.

Surgical radiation oncology uses surgical procedures to deliver or assist in the delivery of radiation to a tumor or tumor bed after resection. Intraoperative radiation therapy (IORT) bypasses radiosensitive skin and superficial structures and allows radiation to be delivered directly to the surgically exposed tumor. Removable brachytherapy places radioactive material inside or close to a tumor through hollow catheters positioned inside the tumor. Permanent brachytherapy inserts encapsulated radioactive seeds through needles attached to a mechanical gun directly into the tumor during surgery. This article discusses radiation precautions associated with each type of therapy and describes the nursing care needed by patients undergoing liver transplant radiation therapy.

Bile Duct Neoplasms↗

PubMed1986

Perioperative nursing diagnoses. What, why, and how.

Nursing diagnoses are important to perioperative nursing practice because they promote quality care and the growth of nursing as a profession. The development of nursing diagnoses is still in its infancy, and some perioperative patient problems cannot be delineated by the current list. For nursing diagnoses to be clinically useful to practicing nurses, they must be derived from data collected, compiled, and analyzed by practicing nurses. The North American Nursing Diagnosis Association has prepared guidelines for submitting diagnoses. A copy can be obtained by writing to NANDA, St Louis University School of Nursing, 3525 Caroline St, St Louis, MO 64104.

Adult↗

PubMed1997

Unlicensed assistive personnel in the perioperative setting.

The present climate in health care, including a tendency toward more managed care and capitation systems, has caused hospital administrators and perioperative managers to reexamine traditional work systems and their associated costs. Some decisions around work redesign may be financially driven or based on the decreased availability of qualified professionals in the job market. The use of an increased number of unlicensed assistive personnel (UAP) in hospital settings has become a common redesign strategy to address both issues. In the perioperative setting, some traditional roles are well established for UAP. Today, changes associated with downsizing, cost containment, and increasing technology have opened up new opportunities to explore ways to integrate UAP roles into the perioperative setting.

Clinical Competence↗

PubMed2002

An outbreak of Serratia marcescens bacteremia after general anesthesia.

OBJECTIVE: To investigate an outbreak of Serratia marcescens bacteremia among patients after general anesthesia. DESIGN: A case-control study. SETTING: A 304-bed, pediatric teaching hospital. PATIENTS: Twenty-three pediatric patients who developed S. marcescens bacteremia within 2 weeks after general anesthesia between June 15 and September 22, 1999, were compared with 46 age-matched control-patients who had undergone procedures on the same clinical services of the hospital during the same period. RESULTS: Cases were distributed over a wide range of surgical services and were not correlated with exposure to any of the surgical, anesthesia, or nursing staff. Case-patients were significantly more likely than control-patients to have received cefazolin (odds ratio [OR], 11.1; 90% confidence interval [CI90], 1.9 to 24.3) or to have had perioperative placement of a central vascular catheter (OR, 4.2; CI90, 1.2 to 18.8). The timing of the procedures of patients who subsequently developed S. marcescens bacteremia was significantly associated with the shifts of one or more of five operating room technicians (OR, 2.9 to 6.8) who were responsible for preparing intravenous fluids used both to reconstitute perioperatively administered antibiotics and to prime central vascular catheter assemblies. CONCLUSIONS: Our findings are consistent with a pattern of intermittent contamination due to periodic breaches in sterile technique, rather than a point-source of contamination. The unique challenges that such a procedural breakdown presents to an epidemiologic investigation are discussed. This outbreak stresses the importance of providing comprehensive training in antisepsis when multifunctional personnel are incorporated into an operating room work environment.

Adolescent↗

PubMed1997

Epidemiology of sharp object injuries in a children's hospital.

BACKGROUND: Limited data exist on the frequency, circumstances and management of sharp object injuries (SOIs) in pediatric facilities. METHOD: SOIs reported at a large children's hospital during a 2-year period were reviewed. RESULTS: One hundred thirteen SOIs were reported for an average of 6 injuries per 100 employees per year. The greatest number of injuries occurred among nurses (46%) and physicians (23%), but phlebotomists experienced the highest rate (25.5 injuries per 100 full time equivalent employees per year). Most common locations were the patient room (27%), operating room (25%) and intensive care units (17%). Needles accounted for 71% of injuries and procedural devices accounted for 22%. Forty-eight percent of injuries occurred during use of the item, 42% after use or during disposal and 7% after disposal. Twenty percent were associated with loose sharps and 15% with inadvertent patient movement. Only 2 injuries were associated with recapping. Eighty-eight percent of the objects were contaminated with blood or body fluid. Of 88 known source patients 1 tested positive for hepatitis B surface antigen, 2 for hepatitis C virus and none for HIV. One hundred four employees sought treatment: 36 received tetanus vaccine; 14 received hepatitis B vaccine; 9 received hepatitis B immunoglobulin; and 12 received zidovudine. No employee subsequently tested positive for HIV, hepatitis B virus, or hepatitis C virus. CONCLUSIONS: SOIs represent a frequent occurrence among pediatric health care workers. Minimizing the use of sharps, appropriately restraining patients during procedures and promptly disposing of sharp items after use might decrease the frequency of SOIs.

Health Personnel↗

PubMed1989

Free-standing birth centers in California. Program and medical outcome.

During 1985, 25 free-standing birth centers (FSBCs) were operating in California. All had a written or verbal backup agreement with a hospital that averaged six minutes away from the center. Seventy-four percent of the deliveries in these centers were attended by obstetricians, 6% by certified nurse-midwives, less than 1% by family physicians and 19% by a team of physicians and midwives. Between 1979 and 1985, over 10,000 women were admitted in labor in California FSBCs. Medical outcome data were collected for 1984 and 1985. The medical outcome for births in these centers demonstrates that FSBCs, while existing under the aegis of an "alternative" philosophy, are associated with a low cesarean section rate, low neonatal mortality and no neonatal mortality.

California↗

PubMedDate not supplied

Management of retained placenta using intraumbilical oxytocin injection.

Manual removal of the placenta carries significant risk of hemorrhage and infection plus the risks associated with general anesthesia, if used. Transporting the patient from home or birthing center to hospital or from birthing room to delivery room or operating room is also disruptive to the patient and the initial parent-infant attachment process. The injection of oxytocin into the umbilical vein is a safe procedure that can cause placental separation and delivery, thus preventing the need for manual removal for some women. This technique can be useful in a nurse-midwifery practice in the management of a retained placenta or prolonged third stage of labor. The following review of current research and example of a protocol used in a nurse-midwifery service will provide guidance for incorporating this procedure into practice. As with any new technique, the need to continue to collect and publish outcome data is important.

Clinical Protocols↗

PubMed1995

Congenital idiopathic clubfoot deformities.

Clubfoot is a birth defect that is marked primarily by a deformed talus (ie, ankle) and calcaneous (ie, heel) that give the foot a characteristic "club-like" appearance. In congenital idiopathic clubfoot (ie, talipes equinovarus), the infant's foot points downward (ie, equinus) and turns inward (ie, varus), while the forefoot curls toward the heel (ie, adduction). This congenital disorder has an incidence of 1 in 400 live births, with boys affected twice as often as girls. Unilateral clubfoot is somewhat more common than bilateral clubfoot and may occur as an isolated defect or in association with other disorders (eg, chromosomal aberrations, cerebral palsy, spina bifida, arthrogryposis). Infantile clubfoot deformity is painless and is correctable with early diagnosis and prompt treatment.

Clubfoot↗

PubMed1992

Award for Excellence in Perioperative Nursing--AORN's ultimate prize.

Excellence should be part of our daily practice. Through sharing of knowledge, ideas, and information, private excellence is transformed into public excellence and deserves recognition. AORN recognizes that many individuals have and do make a difference in their individual practice settings as well as by their national influence. The importance of recognizing members for their contributions to perioperative nursing is evidenced by the addition of the two new awards and the many other individual awards given by the Association. The importance of peer recognition and participation in the selection process for the awards cannot be underestimated. The Award for Excellence Committee encourages your continued involvement in the nomination process. Excellence is not just for a chosen few! It is something each of us is capable of doing each day. What we need to do now is to recognize it in ourselves and others and to accord those who display this quality the recognition they deserve.

Awards and Prizes↗

PubMed1999

Prevalence of leg wound complications after coronary artery bypass grafting: determination of risk factors.

BACKGROUND: The reported prevalence of leg wound complications after coronary artery bypass grafting is 2% to 24%. Decreased length of hospital stay for patients who have this surgical procedure poses new care requirements in both acute care and community settings. OBJECTIVE: To determine the prevalence of postoperative leg wound complications in patients undergoing coronary artery bypass grafting and the risk factors associated with these complications. METHOD: In this prospective, observational study, 547 consecutive patients who had coronary artery bypass grafting alone or in combination with other cardiac surgical procedures were examined for evidence of leg wound complications each day after surgery during hospitalization. After discharge, problems were detected by home care nurses. RESULTS: The prevalence of leg wound complications was 6.8%. Factors significant by multiple logistic regression included preoperative hospitalization, use of an Ace elastic bandage in the operating room, the length of time the leg incision remained open in the operating room, and administration of nicardipine intravenously in the intensive care unit. Odds ratios were calculated for each variable. Premorbid factors such as diabetes or peripheral vascular disease were not predictive of complications. On average, most problems occurred on postoperative day 10, when many patients were at home. CONCLUSIONS: The results highlight the need to detect complications early, in both the hospital and the community settings. The determination of factors related to poor outcomes may assist clinicians in improving healthcare delivery.

Aged↗

PubMed2005

Rethinking theatre in modern operating rooms.

Metaphor is a means through which a widely accepted meaning of a word is used in a different context to add understanding that would otherwise be difficult to conceive. Through etymological and metaphorical associations, we contend that aspects of "theatre" are still relevant in the modern operating rooms and that the use of dramaturgical metaphors can add another layer of understanding about the social reality in this setting. We begin by exploring the historical roots and derivation of the word theatre as it applied to anatomical dissection and surgery. Briefly, we touch on the work of Erving Goffman and examine how his work has been used by others to explore aspects of operating room nursing. Then, drawing on data from a postmodern ethnographic study that has been used to examine communication in operating room nursing, four dramaturgical metaphors are used to illustrate the argument. They are drama, the script and learning the lines, the show must go on, and changing between back stage and front stage. To conclude, the small amount of previously published literature on this topic is compared and contrasted, and the relevance of using dramaturgical metaphors to understand modern operating rooms is discussed. Being able to distinguish between the inherent drama in operating room work and the dramatic realisation of individuals who work within, can help operating room nurses to think differently about, and perhaps re-evaluate their social situation and how they function within it.

Anthropology, Cultural↗