Application Of Perioperative Standards Of Nursing Practice

* Personnel Issues: One of the key barriers to effective interaction for the pre-op nurses is that they are not getting any information from the registrar or the surgeon related to the patients unique circumstances. There is not a communication process in place for the pre-op nurse to actively communicate with the surgeon or his office regarding a patient’s care during their day of surgery. An additional factor in this situation was the pre-op nurse documented the mother’s contact information in her notepad, but not on the

Second, the nurse commences assessment with an evaluation of patient’s airway, breathing, and circulation for any signs of inadequate oxygenation and ventilation. One of the patients’ temperature was 102 F and the physician recommended pain medication (dilaudid) and it was administered instantly. The nurse gets vital signs and compare the result with intraoperative care. The nurse chart vital signs every 5 mins for the next 15mins, every 15mins for the next hour depending on the recovery state of the patient. I also noticed that for diabetic patients, the nurse checks for blood glucose and also compare result with intraoperative care unit result. Third, the nurse assess pain although the patients receive pain medication before surgery. Fourth, the nurse assess surgical site (dressings and drainage). Fifth, the nurse assess neurologic (level of consciousness, orientation, sensory & motor status, pupil size and reaction. Finally, the nurse assess gastrointestinal (nausea, vomiting, intake of

In preparation of a review from the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Nightingale Community Hospital will focus on improving its communication process in the operating room. The purpose of communication in the healthcare setting is to disseminate information in such a way as to create shared understanding about the patient and about what needs to be done for a positive outcome. (synergia.com) A patient is at his most vulnerable state during procedures that require sedation or anesthesia. The patient is releasing his decision making ability and safety into the control and care of the healthcare team. Therefore, effective communication on behalf of the patient is

In 1999, expert surgical nurse authors at the Association of periOperative Registered Nurses (AORN) developed a comprehensive curriculum to assist in the education and transition of nurses entering perioperative clinical specialty for the first time (Beyea, 2002). In 2007, Periop 101: A Core Curriculum (AORN, n.d.) was created which moved the instructor-based program into an online format of modules designed to assist with mastering core perioperative competencies. The program provides instruction with videos, assigned readings, and quizzes at the end of each module. The learning focuses on patient safety and the program is best utilized when combined with preceptorships and skills labs.

This essay discusses and reflects upon patient care in the post anaesthetic care unit (PACU) and is linked to my experiences on placement. It discusses how my approach to patient care has been challenged and analyses how evidence based practice can create a change in the way patients are cared for. It reviews the processes of managing the perioperative environment and evaluates the implications for practice when applying a change in healthcare. Wicker and O’Neill (2010) state that “The lack of immediate medical support in the recovery room means that practitioners work in a more autonomous role than any other area of the operating department” (p.379). By reflecting upon my experiences I am able to link practical and theoretical aspects of the operating department practitioner (ODP) job role. This will provide me with a greater understanding of professional practice and it will develop my personal knowledge and self-awareness (Forrest, 2008). Using a model of reflection is important as it provides a framework that can be systematically followed and acts as a guide through the process of reflection. For this essay I have chosen to use the Gibbs’ Reflective Cycle (1988) as it provides a methodical guide to reflection using a series of ordered questions that each lead to the next stage of the cycle (Forrest, 2008).

The role of the nurse anesthetist gradually developed as the demand increased for individuals who were highly and meticulously trained in anesthesia administration in an era where knowledge of germs, antisepsis and surgical interventions was emerging. During the 1800s, medical students were often responsible in the administration of anesthesia under the direct supervision of surgeons but the increased mortality rates in intraoperative patients suggested the need to reevaluate who would provide anesthesia. As a result of negative patient outcomes, surgeons turned to nurses, who served to be an adequate and reliable replacement. This trend proved to be catalytic in the movement of the nurse anesthetist.

Certified Registered Nurse Anesthetists (CRNAs) can be employed under two practice models. Each one of these models, Anesthesia Care Team (ACT) and CRNA-only, affords their own level of autonomy to the CRNA practitioner. The CRNA is supervised to some degree in all practice models; however, this does not reflect the level of competency or safety of CRNAs. The stringent supervision does not imply that academic standards of CRNAs are beneath that of any other practitioner. The requirement of supervision for anesthesia care provided by CRNAs is rooted in financial reimbursement. Cost effectiveness is the driving force behind why some institutions elect one model over the other (Hogan, Seifert, Moore, & Simonson, 2010). Each model yields it

VASNHS Surgical Specialty Outpatient department has a designated pre-operative management unit that oversees the patients undergoing surgery. The predicaments stem from various guidelines or protocol originating from numerous surgeons and clinics. At present, the pre-operative nurses abide simple pre-op instructions (NPO protocol, medications, what to bring, during the surgery, transportation, cancellation instructions) for the entire Surgical Specialty Outpatient department. Surgical procedures are being canceled due to lack of communications and cancelations of patients prior to surgery date.

Nurse Salo’s performance in this area of providing programmatic leadership has been exemplary. He is consistently sought out as a resource and leader, by members of the interdisciplinary team, regarding ethical dilemmas, particularly issues surrounding surgical patients and their unique needs. He uses the ANA Code of Ethics, AORN standards and practice, and VHA Directives to guide his professional practice. He is a role model for patient advocacy and shares his perioperative knowledge and expertise beyond the medical center by being a resource and educating various professional/ medical vendors on surgical patient care and other health care issues. Specific exemplary sample of his contributions:

The newly qualified nurse is in an especially good position to provide excellent patient care. Having only recently left education and training, the most up-to-date evidence regarding best practice should be fresh in the newly qualified nurse’s mind. However, what knowledge the newly qualified nurse possesses in theory, they lack in experience.

Over the past seven years as a clinical nurse on the McKeen Pavilion (the medical-surgical amenities unit at New York Presbyterian/Columbia Medical Center), I have committed to excelling in a clinical bedside capacity, as well as a member of the NYP community. This combination has allowed me to be a true advocate for my patients, their families, and my colleagues. The unit has afforded me a tremendous amount of hands on nursing experience, as

Does the compliance with a sedation protocol improve after nurses receive a sedation competency over a three month period? The available data supported the hypothesis that nursing education and competency can lead to consistent best practices and positive outcomes for patients. The answers to this research question can help develop interventions that support best practices for patients who are mechanically ventilated and receiving intravenous sedation.

For this reflection of advanced perioperative practice I will be using a case study approach, I will also be using the Gibbs’ reflective cycle. (1988). Gibbs’ reflective cycle (1988) is a model of reflection that I feel allows me to achieve the depth of reflection that is required, I also feel that this model helps me to break the scenario that I have chose to reflect on into manageable sections. This model includes 6 stages of reflection which include description, feelings, evaluation, analysis ,conclusion, action plan.

Nurses are the ones who provide for their patients by giving them the emotional and physical support they need while helping their patient reach their goals of becoming healthier. Perioperative Nursing, a nursing specialty that is associated with patients who are in surgeries, works primarily with the surgical team, which includes the surgeons, nurse anesthetists, anesthesiologists, and surgical assistants and technologists. Perioperative nurses, also called surgical nurses or operating room nurses, are there for patients and their families before, during and after surgery. The high intensity environment can create stress and can also cause communication conflicts between the surgical team. Perioperative nursing deals with various amounts of stress based on the work environment and affects burnout, turnover rates, and difficulties in communication with their surgical team.

In relation to maintaining the safety of a patient whilst in the Anaesthetic Room, Patient Monitoring is a fundamental practice within the role of an Operating Department Practitioner (ODP) as instructed by the Health and Care Professions Council (HCPC, 2012). Interestingly, the word ‘monitor’ comes from Latin, and it means “to warn” (Pillai, 2007). As suggested by the derivation however; a ‘monitor’ can only ‘warn’ and it is therefore up to the ODP to make conscientious observations of the patient with help of clinically interpreted information from