An underpinning tenet of evidence-based practice is that all routine practices should be open to scrutiny. Questioning practice should not be limited to new, experimental procedures, but should also include examination of 'tried and trusted' techniques. Taking this perspective, the author recently contributed to a systematic review evaluating the use of antiseptics preoperatively.
The role of the preoperative assessment practitioner (POAP) has evolved hugely to allow them to become more autonomous in decision-making, particularly in the design of local protocols and guidelines for preoperative assessment. Good practice guidelines are imperative to ensure that all requirements for the patient have been identified before the day of surgery, which minimises the risk of late cancellations.
The need for patient autonomy, empowerment and choice has become central to health reforms. Confronted with the prospects of such perpetual changes, respect for patient autonomy has to be tempered with paternalistic beneficence. This article discusses the difficulties encountered when applying patient autonomy within the post-anaesthetic care unit (PACU), evaluating ethical, legal and professional issues.
The number of NHS (National Health Service, UK) bodies that work at arm's-length from the Department of Health will be reduced, saving at least pounds sterling 500m in funds and increasing resources that can be channelled directly to front line NHS patient care. John Reid, Health Secretary, has decided that by 2007-08 there will be a 50% reduction in the number of arm's-length bodies and a reduction in posts of 25%.
Dealing with the diverse healthcare needs of people in prison can be a very challenging role for a nurse. This article explores the care management issues which arise when caring for prisoners within a general hospital theatre environment. It is based on the author's experience working as a nurse in the operating theatre and in the prison environment--a 'unique environment that presents unique challenges'.
Compartment syndrome affecting the limbs is a well-documented condition and there are cases where it has become evident following surgery undertaken with the patient in the Lloyd Davies position. This article explores the contributory factors and the devastating effect it can have on the patient, and questions whether we practise evidence-based care when patients are undergoing certain types of surgery. It also discusses factors related to abdominal compartment syndrome, a condition usually affecting the critically ill patient.
This article focuses on the kinds of issues that practice educators in the perioperative setting may face. It looks specifically at current educational programmes for nurses, and has been written in light of key changes to the way such programmes are set up, as a result of recommendations and changes made to the nursing regulatory body.
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