Aorn Journal最新文献

The article describes major milestones in acknowledgment of pathophysiological relationship between heart and kidneys since Ancient Egypt till our time and history of term "cardiorenal syndrome" (CRS). First references about kidney and heart functions could be dated to 13 BC when Hippocrates mentioned them. In the XIV century Gentile da Foligno proposed a hypothesis about functional interconnection between heart and kidneys. In the XVIII century Richard Bright described the link between myocardial hypertrophy and kidneys diseases. Frederic Justin Collet was the first one who used the term "cardiorenal" in his article in 1903. In Russia, I.I. Stolnikov conducted his experiments about myocardial hypertrophy and kidneys ischemia in 1880. Famous Russian internist, E.M. Tareev, devoted several paragraphs to cardiorenal interactions in his fundamental manuals "Anemia in Bright's disease" (1929) and "Hypertension" (1948). The research on this topic was continued by Tareev's followers: N.A. Mukhin, V.S. Moiseev, more recent successors - Zh.D. Kobalava, S.V. Moiseev, V.V. Fomin, S.V. Villevalde and others. Their contribution resulted in development of first Russian clinical guidelines on cardio and nephroprotection in CRS in 2014. In 2008 consensus of Acute Disease Quality Initiative summarized current experience on CRS. Today, research on controversial classification questions, biomarkers and other aspects of CRS continues.

Personnel are a critical resource in health care. Ensuring that enough staff members are available to provide necessary care for patients is of utmost importance. Leaders can use labor productivity measures to compare their department to other like departments and set a benchmark to ensure that staff members are performing at their fullest potential. Productivity measures provide data to help leaders better understand how well processes, personnel, and technology are performing the required work of the department. Benchmarking the sterile processing department for labor productivity is one of the measures that leaders can use to ensure that staff members understand expectations and the role that they play in providing quality care and improving patient outcomes. Benchmarking provides the sterile processing leader with the ability to measure performance; look for opportunities to improve performance; and ensure that staff members are working safely and efficiently, especially during staffing shortages.

Respiratory protection against surgical smoke from liver tissue Key words: surgical N95 respirator, surgical smoke, liver tissue, fine and ultrafine particles, particulate matter concentrations. Local exhaust ventilation and surgical smoke safety Key words: local exhaust ventilation (LEV), surgical smoke evacuation, medical-surgical suction, hierarchy of controls, engineering control. Location of endoscopy storage cabinets Key words: endoscope; sterile storage; contamination; environmental conditions; heating, ventilation, and air-conditioning (HVAC) design parameters. Sterility of ultrasound transmission gel Key words: sterile gel, nonsterile gel, multidose container, ultrasound, outbreaks.

The use of performance qualification (PQ) tests for ultrasonic cleaners leads to improvements in the quality of processing lumened surgical instruments. Evidence and national standards assert the need for health care facilities to implement a quality management system related to device reprocessing and testing the adequacy of mechanical cleaning processes. Testing includes showing that ultrasonic cleaners have properly functioning cavitation, soil removal, and lumen perfusion capabilities. This article summarizes survey responses from an audit of sterile processing personnel regarding ultrasonic cleaning units in health care facilities. The article also provides guidance to facilities regarding assessing installation, operational, and PQ related to ultrasonic cleaning equipment. Implementing PQ testing of ultrasonic cleaners in sterile processing units leads to a decreased risk of soiled instrumentation in the OR, which can reduce the risk of patient infection and adverse events.

Effective hand hygiene is an important part of infection prevention, especially in perioperative areas. The revised AORN "Guideline for hand hygiene" provides perioperative personnel with evidence-based practice recommendations for hand hygiene. This article presents an overview of the guideline and discusses specific recommendations for maintaining appropriate fingernail and hand condition; wearing or removing hand and wrist jewelry; performing general hand hygiene; performing surgical hand antisepsis with a traditional hand scrub or surgical hand rub; selecting sinks, faucets, and drains to avoid hand contamination; and implementing quality activities to enhance hand hygiene compliance. It also includes a scenario illustrating how nurses can use the guideline to mitigate hand dermatitis associated with surgical hand antisepsis. Perioperative nurses should review the revised guideline in its entirety and apply the recommendations as applicable for their practice.