Kathryn Kozhimala, Jennifer Crowley-Barnett, Mary Dobbie, Barbara Delmore, Jasmine Chau, Joan Flood
Hospital-acquired pressure injuries create a tremendous cost to health care organizations and negatively affect quality and patient safety. Surgical patients are at an increased risk for skin injury, particularly a pressure injury, because of a lack of sensation and immobility during a procedure. An interprofessional team at our facility identified factors that place surgical patients at risk for skin injury. We developed a risk assessment protocol in March 2021 using the Six Sigma DMAIC (define, measure, analyze, improve, and control) method. After data review and analysis, we identified age of 65 years or older, existence of a skin condition, and procedural duration greater than four hours as significant predictors for postoperative skin injury. Our findings reinforce the benefit of using an appropriate risk assessment protocol that alerts the perioperative team members to at-risk patients.
{"title":"Perioperative Risk Assessment for Skin Injury.","authors":"Kathryn Kozhimala, Jennifer Crowley-Barnett, Mary Dobbie, Barbara Delmore, Jasmine Chau, Joan Flood","doi":"10.1002/aorn.13985","DOIUrl":"https://doi.org/10.1002/aorn.13985","url":null,"abstract":"<p><p>Hospital-acquired pressure injuries create a tremendous cost to health care organizations and negatively affect quality and patient safety. Surgical patients are at an increased risk for skin injury, particularly a pressure injury, because of a lack of sensation and immobility during a procedure. An interprofessional team at our facility identified factors that place surgical patients at risk for skin injury. We developed a risk assessment protocol in March 2021 using the Six Sigma DMAIC (define, measure, analyze, improve, and control) method. After data review and analysis, we identified age of 65 years or older, existence of a skin condition, and procedural duration greater than four hours as significant predictors for postoperative skin injury. Our findings reinforce the benefit of using an appropriate risk assessment protocol that alerts the perioperative team members to at-risk patients.</p>","PeriodicalId":54317,"journal":{"name":"Aorn Journal","volume":"118 3","pages":"149-156"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10071700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Health Care Worker Exposure to Blood and Other Body Fluids.","authors":"","doi":"10.1002/aorn.13996","DOIUrl":"https://doi.org/10.1002/aorn.13996","url":null,"abstract":"","PeriodicalId":54317,"journal":{"name":"Aorn Journal","volume":"118 3","pages":"P10"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10121543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
During the patient surge associated with the onset of the COVID-19 pandemic in the spring of 2020, perioperative and ambulatory RNs at an acute-care specialty orthopedic hospital were redeployed to medical-surgical inpatient nursing units to care for patients with the disease. The purpose of this phenomenological study was to describe perioperative and ambulatory RNs' experiences during the redeployment. We used purposeful sampling to obtain representatives who worked routinely in perioperative (including postanesthesia care) and ambulatory settings before redeployment. Data saturation was reached after eight in-depth interviews that yielded rich descriptions of the nurses' experiences. Most participants indicated that the fundamental structure of the experience involved being "thrown into a war without weapons" and needing to find ways to fight. The results of this study provide a unique contribution to nursing literature and may assist nurses and leaders in the future.
{"title":"The Lived Experience of Ambulatory and Perioperative RNs Displaced During the COVID-19 Pandemic: A Phenomenological Study.","authors":"Jennifer Withall, Patricia M Lavin, Ellen Rich","doi":"10.1002/aorn.13984","DOIUrl":"https://doi.org/10.1002/aorn.13984","url":null,"abstract":"<p><p>During the patient surge associated with the onset of the COVID-19 pandemic in the spring of 2020, perioperative and ambulatory RNs at an acute-care specialty orthopedic hospital were redeployed to medical-surgical inpatient nursing units to care for patients with the disease. The purpose of this phenomenological study was to describe perioperative and ambulatory RNs' experiences during the redeployment. We used purposeful sampling to obtain representatives who worked routinely in perioperative (including postanesthesia care) and ambulatory settings before redeployment. Data saturation was reached after eight in-depth interviews that yielded rich descriptions of the nurses' experiences. Most participants indicated that the fundamental structure of the experience involved being \"thrown into a war without weapons\" and needing to find ways to fight. The results of this study provide a unique contribution to nursing literature and may assist nurses and leaders in the future.</p>","PeriodicalId":54317,"journal":{"name":"Aorn Journal","volume":"118 3","pages":"e1-e10"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10071701","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Flexible endoscopes allow surgeons and proceduralists to view patients' internal organs through small incisions or natural orifices. These devices may be difficult to clean and dry adequately, and the formation of biofilm can further complicate effective cleaning. The updated AORN "Guideline for processing flexible endoscopes" provides perioperative personnel with evidence-based best practice recommendations on a variety of concepts associated with this topic. This article provides an overview of the guideline and discusses recommendations for point-of-use treatment, transport, cleaning (including verification and drying), and storage of flexible endoscopes. It also includes a scenario that illustrates the importance of adequately drying and storing flexible endoscopes. When processing flexible endoscopes, personnel should adhere to the endoscope and processing equipment manufacturers' instructions for use. Perioperative nurses should review the guideline in its entirety and implement recommendations in practice settings where flexible endoscopes are used.
{"title":"Guidelines in Practice: Processing Flexible Endoscopes.","authors":"Jennifer Speth","doi":"10.1002/aorn.13982","DOIUrl":"https://doi.org/10.1002/aorn.13982","url":null,"abstract":"<p><p>Flexible endoscopes allow surgeons and proceduralists to view patients' internal organs through small incisions or natural orifices. These devices may be difficult to clean and dry adequately, and the formation of biofilm can further complicate effective cleaning. The updated AORN \"Guideline for processing flexible endoscopes\" provides perioperative personnel with evidence-based best practice recommendations on a variety of concepts associated with this topic. This article provides an overview of the guideline and discusses recommendations for point-of-use treatment, transport, cleaning (including verification and drying), and storage of flexible endoscopes. It also includes a scenario that illustrates the importance of adequately drying and storing flexible endoscopes. When processing flexible endoscopes, personnel should adhere to the endoscope and processing equipment manufacturers' instructions for use. Perioperative nurses should review the guideline in its entirety and implement recommendations in practice settings where flexible endoscopes are used.</p>","PeriodicalId":54317,"journal":{"name":"Aorn Journal","volume":"118 3","pages":"169-178"},"PeriodicalIF":0.9,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10071702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}