Discussion around the scope of practice of all nurse practitioners (NPs) in Australia was a component of the recent review of NPs’ eligibility to have broader access to the Medical Benefits Schedule (MBS). This review process has been prolonged and, while the MBS review officially concluded on the 30 June 2020, no information regarding decisions about expanded NP access to the MBS for patient rebates had been disclosed at the time of publication. It is anticipated that the MBS review will contribute little change to NP access to the MBS. The MBS is the primary funding process for private-sector medical services in Australia and is a barrier to the scope of practice of Australian NPs. Specifically, in the perioperative setting the lack of access to the ‘assistance at operations’ MBS item numbers limits the NP’s scope of practice as it leaves the private sector surgical patient out-of-pocket when an NP provides surgical assisting services. This discussion paper considers the international non-medical surgical assistant experience and relates this to the Australian context exploring the complexities associated with the term advanced practice nursing, regulation of the NP compared to other clinicians, and the matters of funding and protectionism in the perioperative space.
{"title":"What is the scope of practice of the Nurse Practitioner as a surgical assistant in Australia?","authors":"Toni Hains, Catherine Smith","doi":"10.26550/2209-1092.1090","DOIUrl":"https://doi.org/10.26550/2209-1092.1090","url":null,"abstract":"Discussion around the scope of practice of all nurse practitioners (NPs) in Australia was a component of the recent review of NPs’ eligibility to have broader access to the Medical Benefits Schedule (MBS). This review process has been prolonged and, while the MBS review officially concluded on the 30 June 2020, no information regarding decisions about expanded NP access to the MBS for patient rebates had been disclosed at the time of publication. It is anticipated that the MBS review will contribute little change to NP access to the MBS. The MBS is the primary funding process for private-sector medical services in Australia and is a barrier to the scope of practice of Australian NPs. Specifically, in the perioperative setting the lack of access to the ‘assistance at operations’ MBS item numbers limits the NP’s scope of practice as it leaves the private sector surgical patient out-of-pocket when an NP provides surgical assisting services. This discussion paper considers the international non-medical surgical assistant experience and relates this to the Australian context exploring the complexities associated with the term advanced practice nursing, regulation of the NP compared to other clinicians, and the matters of funding and protectionism in the perioperative space.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43484789","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}
Problem identification: In the operating room (OR), distractions and interruptions are frequent, impacting patient safety, coordination and efficiency and causing errors and patient harm. The OR team is impacted while attempting to perform critical work. This review explores the impact of distractions and interruptions in the OR on patient safety and the OR team. Literature search: Inclusion and exclusion criteria were determined. Six databases were searched with the search criteria for inclusion being in English, peer-reviewed and published between 2014 and 2019. In total 296 papers were identified. Data evaluation synthesis: Duplicates were removed, and 195 papers were screened using inclusion and exclusion criteria. Fourteen studies were included in the review: 12 were quantitative reviews and two were mixedmethod reviews. Methodological quality was assessed using the mixed methods appraisal tool (MMAT), with scores between 60 and 90 per cent. A thematic analysis revealed observational study themes of types, frequency and severity of distractions and interruptions, and impacts upon mental workload, patient safety and the OR team. Simulation study themes included types of distractions and interruptions, and impact on mental workload, clinical decision-making, surgical performance and nurses. Implications for practice or research: The heterogeneity of the literature and paucity of recent nursing and anaesthetic studies highlights that further research is necessary. Nurses can educate and develop policies and interventions to reduce distractions, enhancing patient safety and decreasing the negative impact upon their colleagues and teams.
{"title":"The impact of distractions and interruptions in the operating room on patient safety and the operating room team: An integrative review","authors":"S. Mackenzie, P. Foran","doi":"10.26550/2209-1092.1098","DOIUrl":"https://doi.org/10.26550/2209-1092.1098","url":null,"abstract":"Problem identification: In the operating room (OR), distractions and interruptions are frequent, impacting patient safety, coordination and efficiency and causing errors and patient harm. The OR team is impacted while attempting to perform critical work. This review explores the impact of distractions and interruptions in the OR on patient safety and the OR team. Literature search: Inclusion and exclusion criteria were determined. Six databases were searched with the search criteria for inclusion being in English, peer-reviewed and published between 2014 and 2019. In total 296 papers were identified. Data evaluation synthesis: Duplicates were removed, and 195 papers were screened using inclusion and exclusion criteria. Fourteen studies were included in the review: 12 were quantitative reviews and two were mixedmethod reviews. Methodological quality was assessed using the mixed methods appraisal tool (MMAT), with scores between 60 and 90 per cent. A thematic analysis revealed observational study themes of types, frequency and severity of distractions and interruptions, and impacts upon mental workload, patient safety and the OR team. Simulation study themes included types of distractions and interruptions, and impact on mental workload, clinical decision-making, surgical performance and nurses. Implications for practice or research: The heterogeneity of the literature and paucity of recent nursing and anaesthetic studies highlights that further research is necessary. Nurses can educate and develop policies and interventions to reduce distractions, enhancing patient safety and decreasing the negative impact upon their colleagues and teams.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43423379","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}
New technology is always being introduced into health care and nursing as a profession has had to adapt. Technological advances have changed the practice of nursing from the introduction of the stethoscope to the electronic health record, and now robots and artificial intelligence (AI). With technological advancements occurring at an ever-increasing rate, more and more perioperative tasks will be delegated to robots and AI. The main question for perioperative nurses is, how can we remain relevant in the high-tech operating room of the future?.
{"title":"Will robots make good perioperative nurses?","authors":"J. Duff","doi":"10.26550/2209-1092.1096","DOIUrl":"https://doi.org/10.26550/2209-1092.1096","url":null,"abstract":"New technology is always being introduced into health care and nursing as a profession has had to adapt. Technological advances have changed the practice of nursing from the introduction of the stethoscope to the electronic health record, and now robots and artificial intelligence (AI). With technological advancements occurring at an ever-increasing rate, more and more perioperative tasks will be delegated to robots and AI. The main question for perioperative nurses is, how can we remain relevant in the high-tech operating room of the future?.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48910559","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}
Miriam James-Scotter, Lixin Jiang, CA Walker, S. Jacobs
Objectives: This study aims to explore the value, validity and viability of implementing a daily job satisfaction tool in the operating room (OR) setting. Sample and setting: A daily one-minute survey was developed and trialled with 269 OR staff members (123 nurses) over a three-week period in one New Zealand hospital. Method: A feedback and validation survey was then administered to staff one week following the trial. Results: The trial resulted in 569 tool submissions. A daily average of 71 per cent of participants (69% nurses) reported feeling ‘pretty good’ or ‘great’ about their jobs, with ‘relationships and communication with colleagues’ most influential for both a positive and negative day at work. Findings also supported the validity of the tool and highlighted strengths and areas for improvement. Conclusion: The results of the study provide initial support for the value and feasibility of implementing a daily job satisfaction measurement tool in the OR setting. A daily satisfaction measure has the potential to be a powerful tool for perioperative nursing managers at all levels enabling active measurement and management of nurse job satisfaction from an interprofessional perspective.
{"title":"A daily measure of job satisfaction in the operating room: investigating its value and viability","authors":"Miriam James-Scotter, Lixin Jiang, CA Walker, S. Jacobs","doi":"10.26550/2209-1092.1082","DOIUrl":"https://doi.org/10.26550/2209-1092.1082","url":null,"abstract":"Objectives: This study aims to explore the value, validity and viability of implementing a daily job satisfaction tool in the operating room (OR) setting. Sample and setting: A daily one-minute survey was developed and trialled with 269 OR staff members (123 nurses) over a three-week period in one New Zealand hospital. Method: A feedback and validation survey was then administered to staff one week following the trial. Results: The trial resulted in 569 tool submissions. A daily average of 71 per cent of participants (69% nurses) reported feeling ‘pretty good’ or ‘great’ about their jobs, with ‘relationships and communication with colleagues’ most influential for both a positive and negative day at work. Findings also supported the validity of the tool and highlighted strengths and areas for improvement. Conclusion: The results of the study provide initial support for the value and feasibility of implementing a daily job satisfaction measurement tool in the OR setting. A daily satisfaction measure has the potential to be a powerful tool for perioperative nursing managers at all levels enabling active measurement and management of nurse job satisfaction from an interprofessional perspective.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47584019","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}
[ ]though, how do we define the terms pandemic, epidemic, outbreak and cluster? [ ]the microorganism has to be pathogenic, that is, be able to infect and cause disease in humans [ ]it needs to be able to easily spread between humans6, like COVID-19, which is spread by large droplets, fomite and aerosol transmission from airways and through contaminate surfaces as contact transmission8
{"title":"Pandemics: A COVID-19 perspective","authors":"L. Bowen","doi":"10.26550/2209-1092.1092","DOIUrl":"https://doi.org/10.26550/2209-1092.1092","url":null,"abstract":"[ ]though, how do we define the terms pandemic, epidemic, outbreak and cluster? [ ]the microorganism has to be pathogenic, that is, be able to infect and cause disease in humans [ ]it needs to be able to easily spread between humans6, like COVID-19, which is spread by large droplets, fomite and aerosol transmission from airways and through contaminate surfaces as contact transmission8","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41382946","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}
Purpose: To gain greater insight into how nurses engage with the multidisciplinary team during the surgical safety checklist process. Participants and setting: Participants were a purposeful sample of eight operating room nurses. The study was conducted in the operating room department of a major tertiary teaching hospital in South Australia. Methods: Phase 1 employed participant observations while phase 2 employed semi-structured interviews. Findings: Participants supported the use of the surgical safety checklist and valued its role to enhance patient safety. Multidisciplinary team culture played a significant role in how the checklist was conducted and heavily influenced the level of nurse participation in the process. Observations indicated poor compliance with the nursing review section of the checklist. Conclusions: Multidisciplinary team engagement is important for effective communication during the process of utilising the surgical safety checklist to promote safe outcomes for patients. Nurses are more likely to actively participate in the checklist process if they feel their role is valued by other team members. The nurse-specific area of the checklist is an area for improvement as this tends to be overlooked and considered less important than other checklist items. Modifications in timing the checklist and nurse training may be beneficial to address non-compliance with the nurse area of the checklist.
{"title":"Perioperative nurses’ engagement with the surgical safety checklist: A focused ethnography","authors":"Julie A Rogers Mrs, Paul Mr, Jan Alderman Mrs","doi":"10.26550/2209-1092.1066","DOIUrl":"https://doi.org/10.26550/2209-1092.1066","url":null,"abstract":"Purpose: To gain greater insight into how nurses engage with the multidisciplinary team during the surgical safety checklist process. Participants and setting: Participants were a purposeful sample of eight operating room nurses. The study was conducted in the operating room department of a major tertiary teaching hospital in South Australia. Methods: Phase 1 employed participant observations while phase 2 employed semi-structured interviews. Findings: Participants supported the use of the surgical safety checklist and valued its role to enhance patient safety. Multidisciplinary team culture played a significant role in how the checklist was conducted and heavily influenced the level of nurse participation in the process. Observations indicated poor compliance with the nursing review section of the checklist. Conclusions: Multidisciplinary team engagement is important for effective communication during the process of utilising the surgical safety checklist to promote safe outcomes for patients. Nurses are more likely to actively participate in the checklist process if they feel their role is valued by other team members. The nurse-specific area of the checklist is an area for improvement as this tends to be overlooked and considered less important than other checklist items. Modifications in timing the checklist and nurse training may be beneficial to address non-compliance with the nurse area of the checklist.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45624814","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}
Staff identification in the perioperative environment is difficult when all staff, students and visitors wear the same attire. All attire needs to be laundered to national standards for infection control governance and consequently attire cannot be individualised. In emergency situations it is also difficult to identify the roles of all staff with standard methods of identification. The aim of the ‘Colour-differentiated identification labels’ project was to improve identification of all staff and visitors in the perioperative environment with the intended result being improved communication and safety among staff, patients and visitors. The project began in February 2018 with project leads Diana Bentley and Wendy Howard in the anaesthetics department of the perioperative service in a New South Wales (NSW) public hospital. Disposable identification (ID) labels were initially trialled with the anaesthetic staff for three months. ID labels were designed and printed to give a more uniform appearance. The trial period proved highly successful so the project expanded to include the whole perioperative service at the hospital. Disposable ID labels were subsequently developed that included staff members’ roles, and teams were differentiated by specific colours.
{"title":"Who’s under the mask? Colour-differentiated identification labels for perioperative staff","authors":"D. Bentley","doi":"10.26550/2209-1092.1088","DOIUrl":"https://doi.org/10.26550/2209-1092.1088","url":null,"abstract":"Staff identification in the perioperative environment is difficult when all staff, students and visitors wear the same attire. All attire needs to be laundered to national standards for infection control governance and consequently attire cannot be individualised. In emergency situations it is also difficult to identify the roles of all staff with standard methods of identification. The aim of the ‘Colour-differentiated identification labels’ project was to improve identification of all staff and visitors in the perioperative environment with the intended result being improved communication and safety among staff, patients and visitors. The project began in February 2018 with project leads Diana Bentley and Wendy Howard in the anaesthetics department of the perioperative service in a New South Wales (NSW) public hospital. Disposable identification (ID) labels were initially trialled with the anaesthetic staff for three months. ID labels were designed and printed to give a more uniform appearance. The trial period proved highly successful so the project expanded to include the whole perioperative service at the hospital. Disposable ID labels were subsequently developed that included staff members’ roles, and teams were differentiated by specific colours.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43277424","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}
Evidence-based practice is considered the gold standard of care, and as such it is now an expectation of our patients, regulatory agencies and health care funders. Unfortunately, much of what we do in perioperative nursing continues to be based on tradition and history rather than robust clinical evidence. Even when evidence is available to use, it is often not fully applied in practice. If we want to maintain our standing as a leading nursing specialty, then we need to address this issue by engaging with research and growing our evidence base. To do this, we need to conduct and disseminate rigorous primary research, clinically relevant systematic reviews and evidence-based practice projects.
{"title":"The imperative to build research capacity and promote evidence-based practice in Australian perioperative nurses","authors":"J. Duff","doi":"10.26550/2209-1092.1086","DOIUrl":"https://doi.org/10.26550/2209-1092.1086","url":null,"abstract":"Evidence-based practice is considered the gold standard of care, and as such it is now an expectation of our patients, regulatory agencies and health care funders. Unfortunately, much of what we do in perioperative nursing continues to be based on tradition and history rather than robust clinical evidence. Even when evidence is available to use, it is often not fully applied in practice. If we want to maintain our standing as a leading nursing specialty, then we need to address this issue by engaging with research and growing our evidence base. To do this, we need to conduct and disseminate rigorous primary research, clinically relevant systematic reviews and evidence-based practice projects.","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48968828","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}
Sansanee Ruttanamontree, Usavadee Asdornwised, Kessiri Wongkongkam, S. Chuthapisith
{"title":"The effectiveness of a telehealth program on the anxiety levels among women with core needle biopsy for suspected breast cancer","authors":"Sansanee Ruttanamontree, Usavadee Asdornwised, Kessiri Wongkongkam, S. Chuthapisith","doi":"10.26550/2209-1092.1071","DOIUrl":"https://doi.org/10.26550/2209-1092.1071","url":null,"abstract":"","PeriodicalId":37332,"journal":{"name":"Journal of Perioperative Nursing","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42888967","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}