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Results for “Association of Operating Room Nurses”

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PubMed2001

An integrative review of pressure relief in surgical patients.

Effective patient positioning has been an important issue throughout the history of the nursing profession. Pressure ulcers result from prolonged pressure, which causes skin, tissue, or muscle damage. Surgical patients present a unique challenge in preventing pressure ulcers because they are immobile and unable to perceive the discomfort of prolonged pressure. The purpose of this integrative review is to examine risk factors associated with pressure ulcer development in surgical patients and to examine pressure-relieving support surfaces to determine if they significantly reduce intraoperative tissue pressure and result in a lower incidence of postoperative pressure ulcers. Most of the research focuses on long-term care units, with little attention given to the acute care setting. Although the pathophysiology and etiology of pressure ulcers are well documented by years of research, the OR as an etiologic factor is largely undefined.

Bedding and Linens↗

PubMed1987

Postoperative complications: factors of significance to anaesthetic practice.

In an attempt to define what factors are important to the development of postanaesthetic complications, the data from a nine-year prospective study of anaesthetic practice in a large tertiary care institution were evaluated. A model of anaesthetic morbidity dependent upon factors of patient illness, surgical practice, anaesthetic technique and physician experience, and duration of anaesthesia was developed. Postoperative anaesthetic morbidity was defined as any anaesthetic-related complication which, in the opinion of the follow-up nurse, was associated with prolonged hospitalization or documented compromise of the patient. Using a multiple logistic regression, ASA physical status was a risk factor for postoperative complications (odds ratio = 1.95) but the number of preoperative conditions and age were not. The type of surgical procedure, classified by site or by degree of trauma, did not influence postanaesthetic complication rates. The duration of anaesthetic exposure was an important determinant of risk (odds ratio = 2.53), with complications increasing with the length of anaesthetic time. As to factors under control of the anaesthetist those patients experiencing operating room complications (odds ratio = 3.36) or those receiving pure spinal (odds ratio = 5.53) or narcotic techniques (odds ratio = 2.14) had higher risks of postoperative complications. Finally, it would appear that the greater the experience of the anaesthetist the less the risk of postoperative problems (odds ratio = 0.52).

Anesthesia↗

PubMed1996

[Occupational exposure in the operating room by isoflurane when using the laryngeal mask].

Success of intraocular surgery depends in part on low intraocular pressure, sufficient muscle relaxation during the operative period, and avoidance of coughing during emergence from anaesthesia. Isoflurane (ISO) guarantees deep anaesthesia and Laryngeal Mask Airway (LM) makes emergence smoother than when using conventional endotracheal intubation. Occupational exposure to isoflurane appears unavoidable near the potential main source of leakage, the "patient's mouth". Due to the short distance between the patient's mouth and the working area, the risk of exposure for the surgeon could be high. Traces of anesthetic gases may cause various negative effects on the health of the personnel. Higher abortion rates are reported on in recent literature. The aim of this study was to quantify trace amounts of ISO and then to compare these values with international threshold limits. In this study, trace concentrations of ISO were measured directly by means of a high sensitive photoacoustic infrared spectrometry analyser. Measurements were done continuously every 120 seconds at the working places of the surgeon, anaesthetist and the assisting nurse. One possible leakage source, the patient's mouth, was also analysed. 10 cataract operations under general anaesthesia were included in the study. All the measured values were low, the majority under 2 ppm isoflurane. The national threshold values (10 ppm) were not exceeded. We conclude that the use of the LMA in ventilated patients is not associated with high concentrations of isoflurane in the working environment of the operating theatre personnel during eye surgery. Trace concentrations of isoflurane using the LMA are comparable with those using ET under these working conditions. Under other working conditions, higher concentrations may be expected should therefore be controlled.

Air Pollutants, Occupational↗

PubMed2000

The current scope and future direction of perioperative nursing practice in Victoria, Australia.

The current scope and future direction of perioperative nursing practice in Victoria, Australia Unlike some overseas countries, perioperative nursing roles in Australia are largely undeveloped, and very little research has explored the opinions of perioperative nurses regarding the development of their specialty. This study was undertaken to identify the current scope, possible future directions, and the barriers to developing perioperative nursing practice in the state of Victoria (Australia). The study design was descriptive and utilized survey methodology. An instrument was constructed by the researcher for the specific purposes of the study, and comprised three stages of development: questionnaire development; validation by a panel of experts; and a pilot study. The questionnaire was sent randomly to selected perioperative nurses (n=224) and a response rate of 79% (n=176) was obtained. Data were analysed using the Statistical Package for the Social Sciences (SPSS). Descriptive statistics were used to summarize data, and independent sample t-tests, one-way ANOVA and Wilcoxon signed rank tests were used to test differences between groups. For the purpose of data reduction factor analysis was undertaken. The findings of the study indicated that the perioperative nursing model in its espoused form is not being practised, but a large majority of participants believe that perioperative nursing practice should not be restricted to the intraoperative phase of the perioperative model. Expanded rather than extended activities and functions were perceived as more important for development of the specialty, and perceived barriers to advanced perioperative nursing practice centred predominantly on the current application of the perioperative model. Recommendations include refinement of the perioperative nursing model to reflect changes in the delivery of healthcare, addressing issues of cost associated with further education, and undertaking interpretive research to provide more detailed information on the possible future direction for perioperative nursing.

Adult↗

PubMed2004

Management of a CJD case. Part 2. The patient with CJD in the operating theatre.

Along with details as to how CJD-associated instrumentation should now be handled, following a recent updating of DoH advice, this article contains comprehensive guidelines which can be followed in the event of a procedure involving a CJD patient. All the practicalities associated with managing a CJD case are dealt with step by step, from collection of the patient from the ward, through terminal cleaning of the theatre, to discharge of the patient from Recovery.

Creutzfeldt-Jakob Syndrome↗

PubMed2005

The economic impact of early enteral feeding in gastrointestinal surgery: a prospective survey of 51 consecutive patients.

Early postoperative oral feeding has been demonstrated to be safe and not increase postoperative morbidity. There are conflicting reports about its effect on postoperative length of stay. Some patients will fail attempts at early postoperative feeding and may be relegated to a longer postoperative course. Few studies to date have attempted to identify cost savings associated with early oral support, and those identified address nasoenteric support only. Fifty-one consecutive patients were randomized into either a traditional postoperative feeding group or an early postoperative feeding group after their gastrointestinal surgery. Length of hospital stay, hospital costs (excluding operating room costs), morbidity, and time to tolerance of a diet were compared. There was a tendency toward increased nasogastric tube use in the early feeding arm, but the morbidity rates were similar. Length of hospital stay and costs were similar in both arms. Early postoperative enteral support does not reduce hospital stay, nursing workload, or costs. It may come at a cost of higher nasogastric tube use, however, without an increase in postoperative morbidity.

Adult↗

PubMed2004

[Surgery for children and adolescents. Post-operative phase].

The authors explain the third and last phase in the surgical process, the post-operative phase. The authors propose a standardized model of nursing care for children and adolescents. The third and last phase in the surgical process commences at the moment the child arrives in the recovery room and lasts until he/she is released from the hospital. This phase includes the treatment applied in the recovery room and later in a hospital ward or in the child's home. The authors use the Gordon Functional Health Patterns. Special emphasis is given to the perception-management health pattern, the nutritional-metabolic pattern, the elimination pattern, the exercise-activity pattern, and the cognitive-perception pattern. Of special importance is the vigilance during the first post-operative hours, as well as the child's parenteral nutrition or total parenteral nutrition, TPN, and the evaluation of pain according to the age of the child. The authors select the NANDA (North American Nursing Diagnosis Association) Nursing Diagnoses which appear most frequently in this post-operative phase.

Adolescent↗

PubMed1995

Nurses' educational preparation and attitudes toward cost containment.

This study examined attitudes toward cost-effectiveness among nurses who were stratified according to their highest educational nursing preparation (ie, diploma, associate degree, bachelor's degree). A convenience sample of 65 staff nurses from OR and intensive care settings participated. Descriptive statistics and one-way and two-way analyses of variance were used to analyze the data. Mean scores on the Blaney/Hobson Nursing Attitude Scale for the associate degree nurse (ADN), diploma, and bachelor of science in nursing (BSN) groups were 69.90, 76.65, and 81.27, respectively. The diploma- and BSN-prepared staff nurses had significantly more favorable attitudes toward cost-containment issues in nursing practice than did the ADN group (p = .05).

Adult↗

PubMed1990

Health effects associated with exposure to anaesthetic gases in Ontario hospital personnel.

In a retrospective study (by questionnaire) of 8032 personnel exposed to anaesthetic gases in operating and recovery rooms in Ontario hospitals, and 2525 non-exposed hospital staff, the response was 78.8% for the exposed and 87.2% for the unexposed personnel during the period 1981-5. Logistic regression analysis, with age and smoking standardised, showed that women in the exposed group had significantly increased frequencies of spontaneous abortion and their children had significantly more congenital abnormalities (p less than 0.05). No chronic disease was significantly associated with the exposed group. These findings, together with similar ones from other studies, suggest that it is prudent to minimise exposure to waste anaesthetic gases.

Abortion, Habitual↗

PubMed2006

Daisy Ayris Lecture. Looking back, looking forward.

This was the second time that Mary Spinks, a former Chairman of NATN, has given the Daisy Ayris Lecture. This unprecedented move indicates the Association's respect for Mary's influence and commitment to patient care in her current role as Director of the Florence Nightingale Foundation. Her address, given below in full, covers key themes of education, reasoning and communication.

Forecasting↗

PubMed2002

Recruiting students to your theatres.

This article is based on a paper presented at the National Association of Theatre Nurses Congress and Exhibition in October 2001. In it, Judith Tanner asks why it is so difficult to recruit students to theatres, identifies some reasons given by students for not going into theatres, as well as their reasons forgoing into theatres, and gives advice on how perioperative departments can become more student-friendly.

Career Choice↗

PubMed2002

Perioperative considerations in major orthopedic trauma: pelvic and long bone fractures.

Although pelvic fractures constitute a small percentage of total orthopedic injuries, they are associated with highest mortality rate. Pelvic fractures, along with long bone fractures, frequently are the result of significant blunt trauma often encountered in high-speed motor vehicle accidents. However, other types of trauma can cause these devastating injuries. Early recognition and a high index of suspicion are necessary to ensure that effective and aggressive resuscitation is instituted immediately. Expeditious assessment in the emergency department and care of the patient with pelvic and long bone fractures will greatly enhance the ongoing resuscitation in the operating room. Potentially life-threatening associated injuries in these patients make resuscitation even more challenging. Therefore, a basic knowledge of the mechanisms of injury, early treatment in the emergency department, and the factors that affect intraoperative management will help optimize the outcome for patients with these injuries. This course describes the perioperative concerns and the evaluation and treatment of a patient with a pelvic or a long bone fracture.

Bone and Bones↗

PubMed1996

What is the future of the OR director?

So, if there are still some nurses out there who want to get into administration, here's some good advice: "Pick your mentors, get a master's degree early in your career, get involved in your professional association and the sooner you commit, the better." There are still a lot of opportunities for OR managers, and the better ones will flourish in tomorrow's OR. The efficient and forward-looking OR managers will always do well and the well-managed ORs will survive!

Career Mobility↗

PubMed1998

Electrosurgical safety.

Technological advances in safety and the performance of electrosurgical units (ESUs) have made the ESU the most common piece of electrical equipment in the OR. The constant presence of the ESU in the OR increases the potential for patient injury that is associated with the use of any piece of electrical equipment. To prevent injuries related to the use of an ESU, the perioperative nurse must understand the types of current used, types of ESUs available, and potential complications and have a working knowledge of safe practices for using this equipment in the perioperative setting.

Electricity↗

PubMed2000

Laryngoscope handles: a potential for infection.

Laryngoscope handles do not usually come in direct contact with the patient's mucous membranes. Consequently, routine disinfection of laryngoscope handles is not currently standard practice unless gross contamination is clearly evident. Recent reports indicate that apparently clean handles may be contaminated with blood or body fluids. No report examined microbes on handles. The present article describes the incidence and types of microbes on laryngoscope handles after their use in the operating rooms of a 502-bed medical center in northwestern Pennsylvania. Twenty laryngoscope handles were cultured on Mueller Hinton 5% sheep blood agar plates. The plates were incubated at 37 degrees C for 48 hours and examined for growth. The identification, incidence, and susceptibility patterns of organisms were determined. Microorganisms were present on all 20 laryngoscope handles. Nine different types were isolated; some strains were resistant to multiple antibiotics. Organisms were categorized as contaminants or opportunistic pathogens. The presence of opportunistic pathogens places anesthesia providers and patients at risk of nosocomial infections. Based on the recommendations of the 1997 American Association of Nurse Anesthetists' Infection Control Guide and the results of the present study, institutional guidelines should be established for the use of disposable laryngoscope covers, high-level (destroying all microorganisms with the exception of high numbers of bacterial spores) disinfection, or sterilization of laryngoscope equipment between each patient use.

Cross Infection↗

PubMedDate not supplied

The surgeon's garb.

A comprehensive evaluation of all factors associated with the surgeon's garb worn with and without laminar air flow revealed that in a conventional operating room, all personnel should wear an impermeable one-piece suit with foot attachments, any type of head cover, and, if they are going to be near the operative site or instrument table, a disposable mask. Scrub personnel should wear some type of a disposable gown to reduce the amount of surface contamination. The best way to reduce the environmental and surface contamination would be for all personnel to wear some type of a hooded exhaust equipment, but this is impractical both for circulating nurses and for anesthesiologists. Despite the reduction obtained from all the above controls, the reduction in the amount of bacterial contamination would not be as great as that obtained with laminar air flow, 93% (p < 0.005). Laminar air flow produced the greatest single reduction in environmental and surface contamination and variables such as time, people and attire did not influence the overall counts. The attire recommended for the conventional operating room can be used in laminar air flow with an expectation of overall reduction in contamination.

Antisepsis↗

PubMed2000

Applying the health care industry representative statement to your setting. Association of periOperative Registered Nurses.

AORN values the role our industry partners play in the care of our patients. Table 3 is an example of a policy on the health care representative in the OR. This article is meant to assist perioperative nurses in writing policies that enhance the role of the health care industry representative in the OR, promote collegial relationships with an important player on the team, and preserve patient safety and privacy.

Humans↗

PubMed1991

Glaucoma. Classifications, treatment options, patient care.

Advances in pharmacology, cell biology, and laser and fiberoptic technology are providing many opportunities in glaucoma research. As researchers increasingly understand the physiology of the eye, they develop new therapies. A wide variety of new drugs including dopaminergics, calcium channel blockers, and prostaglandins are under investigation for glaucoma treatment. The THC:YAG laser is being developed to perform thermal sclerotomy and may eliminate much of the risk associated with standard filtering surgery. Biologic, anatomic, and biochemical studies of the trabecular meshwork are leading to greater understanding of aqueous humor formation, aqueous humor outflow in the normal eye, and aqueous humor flow resistance in the glaucomatous eye--knowledge that eventually could provide preventive measures or eliminate glaucoma entirely.

Drug Therapy↗