Aorn Journal最新文献

Enhanced recovery after surgery (ERAS) programs have become a transformative approach in perioperative care, aiming to optimize patient preparation and improve outcomes. The recently developed AORN "Guideline for the implementation of enhanced recovery after surgery" provides perioperative nurses and other clinicians with implementation interventions for patients undergoing operative or other invasive procedures in any setting. This guideline also includes implementation guidance for many patient-specific populations. This article provides an overview of the guideline and discusses recommendations for ERAS program planning and implementation, the prehabilitation phase/surgical optimization, the preoperative phase, the intraoperative phase, the postoperative phase, and patient-specific considerations. It also includes a scenario describing the challenges related to implementing new ERAS protocols. Perioperative nurses should review the guideline in its entirety and apply the recommendations when implementing an ERAS program.

Although the use of robotic-assisted surgery (RAS) is increasing worldwide, qualitative research on the patient experience with RAS is lacking. To understand patients' perioperative experiences, the authors conducted semi-structured interviews with five elective surgical patients from two regional hospitals. The interviews were structured to explore patient experiences that may reflect the implementation of enhanced recovery after surgery protocols. The transcribed interviews were analyzed, coded, and interpreted within a hermeneutic framework. Findings revealed three themes: perceptions of RAS as a surgical modality, preoperative preparation was soothing, and health care professionals influence the patient experience. The authors noted that although the participants reported limited knowledge of RAS, they generally felt positive about its use. The competence and demeanor of health care professionals may influence patients' experiences and perceptions of outcomes, and positive clinical outcomes may overcome negative perioperative experiences.

Inadvertent perioperative hypothermia occurs before, during, or after surgery when the patient's core body temperature is unexpectedly less than 36 °C (96.8 °F). Perioperative nurses at an ambulatory surgery center performed a quality improvement project involving prewarming with a forced-air warming device. The nurses reviewed 40 patient records for temperatures without prewarming and collected temperature data for 40 prewarmed patients. The nurses compared patient temperatures preoperatively, 30 minutes and one hour after anesthesia induction, and upon arrival in the postanesthesia care unit. The results for both groups at 30 minutes after induction were similar; however, at one hour after anesthesia induction, 38% of patients in the preimplementation group and 53% of patients in the postimplementation group were normothermic. Patients in both groups were normothermic upon arrival in the postanesthesia care unit. Education of staff members, patients, and patients' family members was key to the successful implementation of prewarming at the facility.

The purpose of this study was to evaluate the content, reliability, and quality of YouTube videos on surgical hand scrubbing. Two hundred videos in English were identified and screened according to the inclusion criteria. The evaluation of the sample of 72 videos was guided by content, reliability, and quality tools. Videos with at least one source in the description had significantly greater reliability scores than those without (t = 3.871, P < .001). There were no significant differences between the content scores and the general traits of the videos (eg, advertisements, subtitles). Analysis of the relationship between the content and quality scores with the video traits showed a weak positive correlation between quality scores and video length (r = 0.233, P = .049). Viewers should consider content, reliability, and quality rather than popularity when seeking educational video content on hand scrubbing.

Proper sterilization of instruments and medical devices is important in ensuring patient safety and preventing surgical site infections. Adhering to the manufacturer's written instructions for use of an item, its packaging, and the sterilizer is essential to ensure instruments and medical devices are properly sterilized. Quality assurance measures should be used to evaluate and monitor sterilization processes and increase patient safety. The recently updated AORN "Guideline for sterilization" provides perioperative nurses with guidance for processing, transporting, and storing reusable medical devices for use in perioperative and procedural settings. This article provides an overview of the guideline and discusses recommendations for selection of a processing method, transport and storage of sterile items, steam sterilization, and quality. It also includes a scenario describing specific concerns related to quality assurance and steam sterilizer maintenance. Perioperative nurses should review the guideline in its entirety and apply the recommendations when processing reusable medical devices.

Perioperative nurse turnover adds to workforce instability and affects patient safety and the well-being of nurses. Nurse turnover is influenced by an interplay of individual nurse characteristics, workplace interpersonal relationships, and organizational culture. The purpose of our study was to describe nurse turnover intention and explore the predictive influence of workplace sense of belonging and structural empowerment in a nationwide sample of perioperative nurses. Participants (N = 468) completed an online demographic questionnaire and three validated self-survey instruments. Approximately 40% of participants reported some degree of turnover intent. AORN membership (unstandardized beta [B] = -3.85, P < .05), structural empowerment (B = -0.80, P < .05), and workplace sense of belonging (B = -0.51, P < .001) were independent predictors of lower turnover intent scores. The findings provide valuable insights for designing interventions to promote supportive workplace relationships and create work environments where nurses feel empowered.

The United States is facing a critical nursing shortage, with an expected need for an additional 1 million nurses by 2030. The COVID-19 pandemic exacerbated this issue, causing significant stress and burnout among nurses, leading to high turnover rates. Perioperative nursing is challenged with recruitment and retention because of the steep learning curve and limited undergraduate training opportunities. A community teaching hospital implemented a Perioperative Clinical Advancement Program to address these challenges. The program includes components such as The Art of OR Nursing, The Science of OR Nursing, The Essence of OR Teamwork, and A Unique OR Initiative. This new ladder led to improved job satisfaction, reduced turnover rates, and enhanced professional development opportunities for nurses. The pilot program's success highlights the importance of tailored retention strategies and systematic interventions to support and retain perioperative nurses, ultimately contributing to better patient care and organizational stability.