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Results for “Association of Operating Room Nurses”

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PubMed2002

Anesthetic and perfusion issues in contemporary pediatric cardiac surgery.

As the fields of pediatric cardiology and cardiac surgery advance in complexity and in accountability for clinical and economic outcomes, several issues traditionally associated with the operating room are becoming important to physicians, nurses, and respiratory therapists who take care of children after cardiac surgery. The article discusses the concepts of "fast track" cardiac surgery, regional anesthetic techniques, coagulopathies and bleeding after cardiopulmonary bypass, intraoperative ultrafiltration, and mechanical circulatory assist devices.

Anesthesia↗
PubMed1991

What if the health-care worker is the one infected with HIV or HBV?

1. The recent limited number of reports of HBV transmission from HCWs to patients may reflect the adoption of universal precautions and increased use of HBV vaccine. 2. Since nurses rarely perform the types of exposure-prone procedures described by the CDC, a nurse would not likely be associated with transmission of HIV to a patient, and HBV transmission most likely would not occur. 3. Agencies employing HCWs who perform exposure-prone procedures should establish expert review panels.

American Nurses' Association↗
PubMed1996

Ethical issues: a survey of perioperative nurses.

A convenience sample of 499 perioperative nurses was surveyed to determine what they perceive to be the most pressing ethical issues. Staffing patterns, informed consent, allocation of resources, and occupational risk were ranked as most important. Also surveyed were subjects' knowledge and application of the American Nurses Association (ANA) Code for Nurses with Interpretive Statements--Explications for Perioperative Nursing (ANA Code in AORN: Standards and Recommended Practices. Denver, CO, 1994.

Attitude of Health Personnel↗
PubMed2001

Cost considerations in the use of anaesthetic drugs.

Anaesthetic drugs typically comprise approximately 5% or less of a hospital pharmacy budget, yet they are a common target for cost reduction measures. In particular, there is considerable pressure to use less costly products where alternatives exist and to limit the introduction of expensive new items. In considering strategies to reduce a departmental drug budget, or in defending against restrictions imposed from outside, it is important to consider all of the costs associated with anaesthetic drug delivery. These costs comprise not only the expense of the anaesthetic drugs themselves, but also fixed and variable costs associated with their delivery and related to their effects. Elimination of drug waste will always be beneficial, since it has no direct effect on the patient yet clearly reduces cost. Waste is by no means confined to anaesthetic drugs, however. Using less expensive drugs may appear an attractive option and can reduce costs, provided that patient outcome is in no way affected. Rarely is this the case. Once patient care is modified, through changes in recovery times or complication rates, determining the true cost of the intervention becomes essential; there may be increases in indirect costs which dwarf the apparent savings. Sometimes indirect costs will rise by a lesser amount than savings in direct costs, such that there is still an overall benefit but less than that originally anticipated. Exactly how indirect effects result in indirect costs is highly variable. The requirement for additional drugs or supplies to treat an adverse event, such as emesis, will always have an associated cost. Delayed recovery or prolonged hospital stay will waste operating room time or increase the amount of time that a patient requires nursing care, but whether this carries an associated cost depends on what the staff would otherwise have been doing. Depending on the employment method, staff may have been sent home early (with less pay) or employed at identical cost but with less to do. Many studies which purport to consider all costs either ignore such issues, or make invalid assumptions. These issues are complex, but anyone involved with decisions concerning anaesthetic costs should be familiar with the underlying principles and be able to make a rational assessment of the likely indirect costs in their own institution.

Anesthesia↗
PubMed1997

Pain and pain management in newborn infants: a survey of physicians and nurses.

BACKGROUND: Despite an increased awareness among clinicians regarding pain and pain management for infants undergoing surgery, pain associated with procedures performed outside the operating room may not be adequately managed. PURPOSE: To examine the beliefs and self-described behavior of physicians and nurses regarding the management of procedural pain in newborn infants. METHODS: A survey was distributed to 467 clinicians (nurses and physicians) working in 11 level II and 4 level III nurseries in a large metropolitan area. Respondents were asked to rate the painfulness of 12 common bedside nursery procedures and how often pharmacologic and nonpharmacologic (comfort) measures are currently used and should be used for those procedures. Demographic data were also collected. RESULTS: Surveys were completed by 374 clinicians (80% response rate). Physicians and nurses believe infants feel as much pain as adults and that 9 of the 12 listed procedures are moderately to very painful. Neither pharmacologic nor comfort measures are believed to be used frequently, even for the most painful procedures. Physicians and nurses believe both pharmacologic and comfort measures should be used more frequently, but nurses believe comfort measures should be used more frequently than do physicians. Beliefs about infant pain and procedural pain were related to pain management preferences. Physicians' but not nurses' ratings were associated with significant personal pain. CONCLUSIONS: Despite their beliefs that infants experience significant procedure-related pain, clinicians believe pain management for infants remains below optimal levels. Barriers to more consistent and effective pain management need to be identified and surmounted.

Attitude of Health Personnel↗