Aorn Journal最新文献

Perioperative anxiety is common in surgical patients and linked to poor outcomes. This multicenter randomized controlled trial assessed the effect of the use of a warm weighted blanket on presurgical anxiety and pain, as well as postsurgical restlessness, nausea, and vomiting. Levels of anxiety and pain were measured in adult patients using a 100-point visual analog scale before elective surgery. Patients received either a warm weighted blanket (n = 74) or a traditional sheet or nonweighted blanket (n = 74). Patients in the intervention group had significantly lower preoperative anxiety scores (mean [SD] = 26.28 [25.75]) compared to the control group (mean [SD] = 38.73 [30.55], P = .008). However, the intervention had no significant effect on presurgical pain or postsurgical nausea, vomiting, or restlessness. These results suggest that weighted blankets reduce preoperative anxiety in adult patients.

The electromagnetic spectrum includes ultraviolet (UV) light, which has a wavelength of 100 to 400 nanometers (nm), and visible light, which has a wavelength of 400 to 760 nm.² “The UV spectrum from 200 nm to 400 nm, as well as visible light up to a wavelength of 405 nm, are considered to be germicidal,” said Arthur Kreitenberg, MD, clinical professor and orthopedic surgeon, University of California Irvine, and cofounder and chief technology officer, Dimer LLC, Los Angeles, California. The germicidal light most commonly used for disinfection is UVC, which has wavelengths of 220 to 280 nm.^{3, 4} Ultraviolet light can inactivate microorganisms by degrading their genetic material and reducing their ability to reproduce.³ Visible light works by targeting intracellular porphyrins that absorb the light and produce reactive oxygen species that kill bacteria.⁵

According to Kreitenberg, when used for disinfection in health care settings, germicidal light only works “line of sight” and does not reflect off equipment, walls, or ceilings or penetrate clear glass. “Its efficacy drops off extremely quickly with distance from the light to the target surface,” he said. “It has limited ability to penetrate a biofilm, so routine mechanical cleaning remains a mainstay.” AORN indicates that room decontamination systems can be assessed for use as an adjunct to manual cleaning protocols to help decrease contamination on surfaces in the OR that could lead to transmission and patient infection.⁶ “Reducing surface bioburden should reduce surgical site infection risk; however, the problem is that multiple studies show that EVS [Environmental Services] crews miss about 50% of potentially contaminated surfaces,” Kreitenberg noted.

This year has flown by, and it is bittersweet that I must write my final President's Message column. Being the 61st AORN President is the professional honor of a lifetime, and I am excited to reflect on my year as I prepare to pass the torch. Attending meetings and conferences, representing our 45,000 members, and advocating for the perioperative nursing specialty entails great responsibility and accountability, but I wouldn't change the experience for anything.

Many years ago, before I was on the AORN Board, the AORN President at the time told me something I have never forgotten. She had given me my first committee assignment, so during the AORN Global Surgical Conference & Expo that marked the end of her Presidential term, I introduced myself to her. We chatted briefly, and then she said, “We expect great things from you.” I was honored, humbled, and terrified, wondering if I could ever live up to that. I hope when my term ends that she and each one of our members believes that I have done great things.

Serving on the Board for the past eight years has been a privilege. I was shocked when I was first elected to the Board in 2016. I was relatively new to AORN, but the membership put its faith in me. Each time that I was placed on the ballot, I held firm to who I was and why being a perioperative nurse was so important. I promised to listen intently to the information presented to the Board and vote in the best interest of our membership.

As I stepped into the role of AORN President one year ago, I took great pride and responsibility in leading our team of 12 Board members. No one is truly ready to assume the Presidential role, and the imposter syndrome is real! But I discovered what the AORN voters knew: I could lead with integrity and a meaningful, strategic vision. Your Board has made challenging decisions, knowing that we have positioned our association for continued growth and success.

Climate change^{1, 2} and climate justice²—which addresses the social, racial, environmental, multispecies, and economic aspects of the climate crisis³—and their relationship with health are urgent issues that require nurses’ attention.^{1, 2, 4} The American Nurses Association,² the International Council of Nurses,⁵ the World Health Organization,⁶ the American Society of Anesthesiologists,⁷ and AORN¹ believe that the health of the environment is interconnected with the health of patients, and that nurses^{1, 2, 4, 5, 7} and health care leaders⁶ should be informed about the ways that they can make a positive contribution to sustainable health care.

In 1987, the United Nations’ World Commission on Environment and Development declared that “[h]umanity has the ability to make development sustainable – to ensure that it meets the needs of the present without compromising the ability of future generations to meet their own needs.”^8(p24) Measures to conserve natural resources, decrease waste, and reduce hazardous material exposure and emissions are important aspects of environmentally responsible practices that may result in a sustainable health care system.¹ Perioperative practices can have a profound effect on the environment;^{1, 9} for example, perioperative areas consume approximately five times more energy per square foot than any other area of a health care facility and produce more than 30% of the waste of an entire facility.¹⁰ Personnel should strive for environmental responsibility and support sustainability^{1, 9} through a variety of initiatives, such as clinical plastics recycling and medical waste reduction.^{10, 11}

An interdisciplinary approach to creating a comprehensive program that includes a variety of environmentally responsible actions in the perioperative setting likely can have the greatest effect.^{1, 10} This article summarizes the actions that perioperative RNs can implement to contribute to a sustainable world through environmental responsibility in the OR.