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PubMedDate not supplied

Fluid replacement therapy and perioperative management.

Fluid management is a vital component of the perioperative management of every patient. The operating room nurse should be familiar with the dynamics of body fluids and its clinical significance. Having an understanding of fluid therapy and the individual patient's needs will enhance and assist in building the teamwork approach of care with the anesthetist.

Blood Loss, Surgical↗
PubMed2001

Scattered radiation during fixation of hip fractures. Is distance alone enough protection?

We measured the scattered radiation received by theatre staff, using high-sensitivity electronic personal dosimeters, during fixation of extracapsular fractures of the neck of the femur by dynamic hip screw. The dose received was correlated with that received by the patient, and the distance from the source of radiation. A scintillation detector and a water-filled model were used to define a map of the dose rate of scattered radiation in a standard operating theatre during surgery. Beyond two metres from the source of radiation, the scattered dose received was consistently low, while within the operating distance that received by staff was significant for both lateral and posteroanterior (PA) projections. The routine use of lead aprons outside the 2 m zone may be unnecessary. Within that zone it is recommended that lead aprons be worn and that thyroid shields are available for the surgeon and nursing assistants.

Anesthesiology↗
PubMed1995

Individual assessment of visual perception by surgeons observing the same laparoscopic organs with various imaging systems.

Laparoscopic surgery necessitates that operations be performed via a television screen; therefore, image quality is crucial in determining the final outcome. Electronic imaging systems are constantly undergoing revisions and incorporating new ideas. Recently, we have been confronted with a variety of systems, and we, as operators, have no idea what the differences are between the old and the newer systems. As clinicians, we have no electronic yardstick available to compare the options presented or to check the specifications. This study examines critical aspects of image perception. General surgeons, gynecologists, operating-room nurses, as well as allied health personnel all experienced in laparoscopic surgery participated as test subjects. A blinded study was performed in which various camera systems (single chip, three-chip, digitized and nondigitized) were displayed in random fashion. Porcine abdominal areas were displayed using the various imaging units. Participants graded image perception based on the following characteristics: sharpness, color, contrast, and depth of field. The audience were blinded to the types, brand, and number of cameras utilized. A significant preference was shown for digitized systems (P < 0.0001). Also, digitized single-chip cameras scored higher than three-chip cameras (P < 0.05). We propose thorough testing by surgeons and nursing personnel before deciding what type of equipment to purchase.

Allied Health Personnel↗
PubMed1996

Standardization of orthopedic hip and knee implants.

The standardization of orthopedic hip and knee implants was a collaborative endeavor by material management, orthopedic surgeons, and operating room nursing staff. The key concept was to eliminate paying list price for hip and knee implants and to standardize to one vendor and establish the hospital as the premier center for total joint replacement.

Cost Savings↗
PubMed1995

Sailing with the winds of change.

The theme for the 1994 Operating Room Nurse Week in the United States was, "We cannot change the wind, but we can adjust the sails." For the sailor, the wind is a powerful force. It must be constantly monitored and the sails adjusted to keep the vessel on course. Occasionally, if conditions are severe, the course may have to be altered.

Female↗
PubMed2000

Perioperative materials manager, inventory specialist, supply coordinator ... a rose by any other name.

Perioperative materials management is a developing field that is best suited to those with operating room nursing experience. A broad knowledge base garnered from experience in the surgical environment, and an ability to interact with physicians, nurses, administrators, and other ancillary personnel, seem to require a multidimensional character that most perioperative nurses possess.

Humans↗
PubMed1994

Laparoscopic inguinal herniorrhaphy.

Recent advances in laparoscopic techniques present a promising approach to the surgical treatment of inguinal hernias. Higher success rates, better cosmetic results, less pain, and shorter postoperative recovery periods have precipitated an increased consumer demand for laparoscopic rather than traditional herniorrhaphy. The transabdominal, preperitoneal laparoscopic procedure presents a promising approach to successful inguinal hernia repair. Perioperative nurses should be aware of the direct correlation between laparoscopic success rates and surgical team members' training and experience. Adequate preparation and current knowledge promote optimal patient outcomes.

Contraindications↗
PubMed1983

Coming on board and staying.

The outcome of a successful orientation is expected to be a fully functioning nurse who provides safe and effective care with minimum supervision and support. Deviation from this outcome focuses disappointment on either the nurse (who may be seen as inadequate or slow) or the orienter (who may be seen as not having done a good job of preparing the nurse). The work share the new employee does not carry must be carried by someone else, putting additional stress on a department that is often short-staffed and expecting the new person to lighten the load. The cost of failure is great to both the hospital and the individual. We believe hospitals can build interpersonal relations into their orientation programs. Even if strategies aren't used throughout the hospital, the operating room can implement them. Tne newcomer who feels capable but remains socially excluded is a likely candidate for turnover.

Inservice Training↗
PubMed1994

Intraoperative nursing activities performed by surgical technologists.

In this study of delegated intraoperative nursing activities performed by surgical technologists (STs) in low-risk and high-risk surgical procedures, 343 OR directors, perioperative nurses, and STs from rural, community, and medical center hospitals reported that STs frequently perform activities related to surgical counts, the sterile field, and equipment and supplies. Surgical technologists do not frequently perform tasks related to patient transportation, teaching, medication administration, OR environment, patient monitoring, and patients' rights. The investigator used nine competency statements of intraoperative nursing as a framework for the research instrument. Data analysis determined that the levels of risk in patient situations affects how frequently STs perform transportation, teaching, sterile field, OR environment, and patients' rights activities.

Clinical Competence↗
PubMed1992

Ethylene oxide. The importance of aeration.

Residual EO on instruments and supplies can cause serious patient injuries. It is imperative that these items be adequately aerated before they are used. Removing instruments prematurely from an aerator is, indeed, "a blatant disregard for patient safety." The perioperative nurse has the responsibility and accountability for patient protection. Preventive measures and alternatives to using improperly aerated instruments have been described. If these measures do not resolve the problem, the surgery must be postponed until adequately aerated instruments are available.

Air↗
PubMed2004

The hazards of diathermy plume. Part 1. The literature search.

Laser and electrocautery devices used during surgery produce smoky emissions that may contain vapours and particulate aerosols, which can have a chemical and biological impact on those exposed. A group of theatre staff and specialist nurses at Rotherham District General Hospital got together to draw up a risk assessment into the possible occupational exposure of theatre staff, with a view to eliminating or controlling these hazards as far as possible.

Air Pollutants, Occupational↗