Care of paediatric surgical patients is not limited to paediatric facilities, and all perioperative RNs should have a basic understanding of the specialised care that children require. This knowledge set includes an understanding of the basic terminology used to describe this patient population as well as the developmental stages of paediatric patients. Preoperatively, the nurse should conduct a thorough assessment and evaluation and address the anxieties and questions of the patient and his or her parent or guardian. Intraoperatively, the nurse should be prepared to help manage difficult intubation, laryngospasm during induction and extubation, difficult IV access, positioning, skin care, surgical site preparation and thermoregulation. Postoperative care considerations include addressing airway differences, vital signs, pain assessment and management, fluid management and preparation for discharge. Awareness of the anatomic and physiological differences, developmental stages and surgical needs of children will allow the perioperative RN to provide high-quality, safe care to the paediatric surgical patient.
{"title":"An overview of perioperative care for paediatric patients","authors":"Sarah Derieg","doi":"10.26550/303/23-29","DOIUrl":"https://doi.org/10.26550/303/23-29","url":null,"abstract":"Care of paediatric surgical patients is not limited to paediatric facilities, and all perioperative RNs should have a basic understanding of the specialised care that children require. This knowledge set includes an understanding of the basic terminology used to describe this patient population as well as the developmental stages of paediatric patients. Preoperatively, the nurse should conduct a thorough assessment and evaluation and address the anxieties and questions of the patient and his or her parent or guardian. Intraoperatively, the nurse should be prepared to help manage difficult intubation, laryngospasm during induction and extubation, difficult IV access, positioning, skin care, surgical site preparation and thermoregulation. Postoperative care considerations include addressing airway differences, vital signs, pain assessment and management, fluid management and preparation for discharge. Awareness of the anatomic and physiological differences, developmental stages and surgical needs of children will allow the perioperative RN to provide high-quality, safe care to the paediatric surgical patient.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129320462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Executive Officer's report","authors":"W. Rowland","doi":"10.26550/303/9","DOIUrl":"https://doi.org/10.26550/303/9","url":null,"abstract":"","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128058582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Every year thousands of health care professionals worldwide are exposed to surgical smoke. There is evidence that this smoke consists of toxic gases, pathogens and particulate matter that is a hazard for patients and the perioperative team. Past research indicates that perioperative staff inconsistently comply with smoke evacuation recommendations. The aim of this study was to identify, review and discuss the issues related to surgical plume and its implications for patients and perioperative staff. The findings of this review relate to: surgical smoke content, its risks to the health of the perioperative staff, preventative measures, infection control measures, compliance with smoke evacuation systems, staff knowledge and barriers to implementing smoke evacuation practices. Of particular importance, the literature indicated that strong support from management and the implementation of regular staff education could improve practice for the management of surgical plume in the operating theatre.
{"title":"Surgical plume and its implications: A review of the risk and barriers to a safe work place","authors":"E. Tan, Kylie Russell","doi":"10.26550/2209-1092.1019","DOIUrl":"https://doi.org/10.26550/2209-1092.1019","url":null,"abstract":"Every year thousands of health care professionals worldwide are exposed to surgical smoke. There is evidence that this smoke consists of toxic gases, pathogens and particulate matter that is a hazard for patients and the perioperative team. Past research indicates that perioperative staff inconsistently comply with smoke evacuation recommendations. The aim of this study was to identify, review and discuss the issues related to surgical plume and its implications for patients and perioperative staff. The findings of this review relate to: surgical smoke content, its risks to the health of the perioperative staff, preventative measures, infection control measures, compliance with smoke evacuation systems, staff knowledge and barriers to implementing smoke evacuation practices. Of particular importance, the literature indicated that strong support from management and the implementation of regular staff education could improve practice for the management of surgical plume in the operating theatre.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134257824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The use of antiseptics in theatre is mainstay treatment in reducing cutaneous bioburden and, in turn, preventing surgical site infection and sepsis. Typically, aqueous betadine and chlorhexidine in alcohol are preferred. Aqueous betadine is a broad-spectrum antiseptic with a quick kill rate but is deactivated by organic material on the patient's skin. More effective than aqueous betadine is chlorhexidine gluconate - it is also a broad-spectrum antiseptic but is not deactivated by organic compounds on the patient's skin.
{"title":"A review of suspected intraoperative antiseptic burns: A quality improvement review","authors":"M. Stankiewicz, M. Wyland","doi":"10.26550/2209-1092.1018","DOIUrl":"https://doi.org/10.26550/2209-1092.1018","url":null,"abstract":"The use of antiseptics in theatre is mainstay treatment in reducing cutaneous bioburden and, in turn, preventing surgical site infection and sepsis. Typically, aqueous betadine and chlorhexidine in alcohol are preferred. Aqueous betadine is a broad-spectrum antiseptic with a quick kill rate but is deactivated by organic material on the patient's skin. More effective than aqueous betadine is chlorhexidine gluconate - it is also a broad-spectrum antiseptic but is not deactivated by organic compounds on the patient's skin.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126960243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In the Netherlands, an individual with or without a nursing background can enrol in a nurse anaesthetist or theatre nurse program. Admission to the program requires either a secondary school diploma with a specialisation in physics and health, or a nursing degree. At the end of the study, the Dutch anaesthetic nurse is comparable to a nurse anaesthetist in other countries while theatre nurses are similar in scope of practice to scrub/scout nurses in other European countries. Retention of students is challenging, with an attrition rate of around 24 per cent adding to the cost for hospitals delivering the program1. Identifying ways to improve the efficiency of program delivery through enhanced student retention is a key priority for hospitals delivering this program. In this study, a longitudinal survey design was used to investigate student perceptions of their locus of control, a concept which is linked with motivation, persistence and achievement in study and work. Data was collected from a sample of 100 students over a five-year period in the Netherlands.
{"title":"Locus of control profile in anaesthetic nurse and theatre nurse students: A recruiting guideline?","authors":"V. Meeusen, C. Mangnus, S. Masters","doi":"10.26550/2209-1092.1016","DOIUrl":"https://doi.org/10.26550/2209-1092.1016","url":null,"abstract":"In the Netherlands, an individual with or without a nursing background can enrol in a nurse anaesthetist or theatre nurse program. Admission to the program requires either a secondary school diploma with a specialisation in physics and health, or a nursing degree. At the end of the study, the Dutch anaesthetic nurse is comparable to a nurse anaesthetist in other countries while theatre nurses are similar in scope of practice to scrub/scout nurses in other European countries. Retention of students is challenging, with an attrition rate of around 24 per cent adding to the cost for hospitals delivering the program1. Identifying ways to improve the efficiency of program delivery through enhanced student retention is a key priority for hospitals delivering this program. In this study, a longitudinal survey design was used to investigate student perceptions of their locus of control, a concept which is linked with motivation, persistence and achievement in study and work. Data was collected from a sample of 100 students over a five-year period in the Netherlands.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121464320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At law, adults are presumed to have legal competency to provide consent for or refusal to consent to health care treatments unless they have cognitive impairment. But what of the adolescent who is, at law, a child but who refuses to undergo elective surgical treatment? This paper discusses the issues surrounding the case of Keith, a 14-year-old boy with ulcerative colitis, who refuses consent to undergo an elective ileostomy.
{"title":"'When no means no' - adolescent right to refuse an elective surgical procedure: A case study","authors":"J. Gilbert, B. Gillespie","doi":"10.26550/2209-1092.1014","DOIUrl":"https://doi.org/10.26550/2209-1092.1014","url":null,"abstract":"At law, adults are presumed to have legal competency to provide consent for or refusal to consent to health care treatments unless they have cognitive impairment. But what of the adolescent who is, at law, a child but who refuses to undergo elective surgical treatment? This paper discusses the issues surrounding the case of Keith, a 14-year-old boy with ulcerative colitis, who refuses consent to undergo an elective ileostomy.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124636579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
While the new graduate nurse journey has been well documented, little research exists from the perspective of the experienced nurse, particularly in the perioperative environment. Barriers to graduate nurse support need to be understood, as job satisfaction, nurse wellbeing and quality of patient care can be negatively affected.
{"title":"Exploring experienced nurses' views, attitudes and expectations of graduate nurses in the operating theatre","authors":"Michelle Freeling, S. Parker, K. Breaden","doi":"10.26550/2209-1092.1012","DOIUrl":"https://doi.org/10.26550/2209-1092.1012","url":null,"abstract":"While the new graduate nurse journey has been well documented, little research exists from the perspective of the experienced nurse, particularly in the perioperative environment. Barriers to graduate nurse support need to be understood, as job satisfaction, nurse wellbeing and quality of patient care can be negatively affected.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128065341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
At law, all individuals are presumed to have the legal capacity to provide consent or refusal of treatment unless there are clinical indications of cognitive impairment. Once concerns are raised regarding the ability of an individual to provide valid consent for a surgical procedure, the use of a substitute decision-maker may be necessary. In this paper, we present an analysis of a clinical case study to illustrate the principles of valid consent. As part of the analysis, we discuss the issues relating to obtaining valid consent for an operative surgical procedure from an elderly client with obvious cognitive impairment. We also explore the role of a substitute decision-maker to obtain the requisite valid consent.
{"title":"Surgical consent and the importance of a substitute decision-maker: A case study","authors":"J. Gilbert, B. Gillespie","doi":"10.26550/2209-1092.1011","DOIUrl":"https://doi.org/10.26550/2209-1092.1011","url":null,"abstract":"At law, all individuals are presumed to have the legal capacity to provide consent or refusal of treatment unless there are clinical indications of cognitive impairment. Once concerns are raised regarding the ability of an individual to provide valid consent for a surgical procedure, the use of a substitute decision-maker may be necessary. In this paper, we present an analysis of a clinical case study to illustrate the principles of valid consent. As part of the analysis, we discuss the issues relating to obtaining valid consent for an operative surgical procedure from an elderly client with obvious cognitive impairment. We also explore the role of a substitute decision-maker to obtain the requisite valid consent.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116634456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Kynoch, L. Crowe, A. McArdle, J. Munday, C. J. Cabilan, S. Hines
Perioperative nurses recognise that family members experience increased levels of anxiety during the wait for a relative undergoing a surgical procedure. It is often during this time that little or no meaningful communication occurs between family members and health professionals. It has been suggested that a structured information intervention has the potential to increase communication between families and health care professionals as well as decrease family members' anxiety.
{"title":"Structured communication intervention to reduce anxiety of family members waiting for relatives undergoing surgical procedures","authors":"K. Kynoch, L. Crowe, A. McArdle, J. Munday, C. J. Cabilan, S. Hines","doi":"10.26550/2209-1092.1013","DOIUrl":"https://doi.org/10.26550/2209-1092.1013","url":null,"abstract":"Perioperative nurses recognise that family members experience increased levels of anxiety during the wait for a relative undergoing a surgical procedure. It is often during this time that little or no meaningful communication occurs between family members and health professionals. It has been suggested that a structured information intervention has the potential to increase communication between families and health care professionals as well as decrease family members' anxiety.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115733306","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A personal perspective on separating families before surgery","authors":"C. Steward","doi":"10.26550/2209-1092.1009","DOIUrl":"https://doi.org/10.26550/2209-1092.1009","url":null,"abstract":"Once in a while, something happens to us that makes us question our faith in the caring ethos which is so integral to our role as clinicians.","PeriodicalId":127501,"journal":{"name":"ACORN: the journal of perioperative nursing in Australia","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133161200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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